Does calcium score in great pelvic vessels predict colorectal anastomotic leakage? A prospective study of one hundred anastomoses.

BACKGROUND: Anastomotic leakage is one of the most severe surgical complications following surgery. This prospective study was designed to investigate an association between the calcification in the descending aorta and its major branches using a calcium-scoring software and colorectal anastomotic leakage.

METHODS: From January 2012 to March 2013, one hundred patients underwent surgeries involving colorectal anastomosis procedures. Calcium score in descending aorta and great pelvic vessels was measured using the Syngo-CT 2006G-W software. A questionnaire was completed containing demographic and underlying risk factors suspicious to be associated with anastomotic leakage, in addition to surgical characteristics data.

RESULTS: 55 males and 45 females entered the study with the mean age of 63.70±7.17 years. The average duration time of surgery was 149.30±20.24 minutes. The type of surgery was elective for 90 patients and emergency for 10 others. The mean calcium score was higher in greater arteries as in abdominal aorta and common iliac arteries in comparison to the other pelvic vessels. Comparing two groups of patients with and without anastomotic leakage, the calcium score was higher in descending aorta and all great pelvic vessels of patients with colorectal anastomotic leakage (P<0.001). One patient (1%) died due to postoperative anastomotic leakage two weeks after the surgery.

CONCLUSIONS: Atherosclerotic calcification in the descending aorta and its major branches can be considered as a risk factor in the development of colorectal anastomotic leakage. (Acta gastroenterol. belg., 2016, 79, 415-420).