Post Right Hemicolectomy Anastomotic Leak, the Rate, and the Related Risk Factors: A Descriptive Study Saed Fahad Al-Shoufeen, Suhaib Mohammad Al-Mistarehi, Hashem Mustafa Qawasmeh, Waleed Monawer Al-Shoubaki, Moath Hasan Hayajneh Published: July 18, 2024 | 22 23 DOI: 10.36347/sasjs.2024.v10i07.026 Pages: 865-868 Downloads Abstract Backgrounds: Colon cancer is usually treated by colon resection and bowel anastomosis. Right hemicolectomy is the main stay treatment of right sided colon cancer. Because the anastomotic leak (AL) post right hemicolectomy carries a significant morbidity and mortality, we evaluated the rate of this complication and the related risk factors. Methodology: (653) patients who underwent right hemicolectomy in our general surgery department at Jordanian Royal Medical Services between July 2017 and February 2023 enrolled in this retrospective descriptive study. The follow-up period was from two weeks to 45 days. Results: Of 653 patients who had a right hemicolectomy (42.7% male, ages from 24-71 years), emergency surgery 176 (27%). 248 (38.0%) had laparoscopic resection (5% conversion rate) and 405 (62%) underwent open surgery. 119 (18.22%) of all patients got a hand-sewn anastomosis, whereas 534 (81.77%) received stapled ones. 12 (1.83%) patients got a protective ileostomy and were excluded from other calculations, so the final number of patients was 641. The overall leakage rate was 2.2% (n=14) with a postoperative mortality of 16 (2.5%) (4 of 16 patients with leakage, P=0.007). The occurrence of an AL after laparoscopic technique was in 5 patients (0.78%), open approach in 7 (1.1%), and after revisional surgeries was in two cases (0.3%), (P=0.064, 0.051. 0.015, respectively). AL was in 6 cases (0.9%) after hand-sewn and in 8 cases (1.24%) after staple ones (P=0.077, 0.069, respectively). In emergency cases the AL was in 9 cases (1.4%) while in elective ones was in 5 cases (0.78%) (P=0.034, 0.004, respectively). Conclusion: Good assessment of risk factors of this anastomotic leak may lead to a decrease in the rate of this leak especially in acute condition and therefore the morbidity rate, mortality rate, and improve the quality of health care which will be more cost effective.
Authors: Al-Shoufeen Saed Fahad , Al-Mistarehi Suhaib Mohammad , Qawasmeh Hashem Mustafa , Al-Shoubaki Waleed Monawer , Hayajneh Moath Hasan 
Published: July 2024

Backgrounds: Colon cancer is usually treated by colon resection and bowel anastomosis. Right hemicolectomy is the main stay treatment of right sided colon cancer. Because the anastomotic leak (AL) post right hemicolectomy carries a significant morbidity and mortality, we evaluated the rate of this complication and the related risk factors. Methodology: (653) patients who underwent right hemicolectomy in our general surgery department at Jordanian Royal Medical Services between July 2017 and February 2023 enrolled in this retrospective descriptive study. The follow-up period was from two weeks to 45 days. Results: Of 653 patients who had a right hemicolectomy (42.7% male, ages from 24-71 years), emergency surgery 176 (27%). 248 (38.0%) had laparoscopic resection (5% conversion rate) and 405 (62%) underwent open surgery. 119 (18.22%) of all patients got a hand-sewn anastomosis, whereas 534 (81.77%) received stapled ones. 12 (1.83%) patients got a protective ileostomy and were excluded from other calculations, so the final number of patients was 641. The overall leakage rate was 2.2% (n=14) with a postoperative mortality of 16 (2.5%) (4 of 16 patients with leakage, P=0.007). The occurrence of an AL after laparoscopic technique was in 5 patients (0.78%), open approach in 7 (1.1%), and after revisional surgeries was in two cases (0.3%), (P=0.064, 0.051. 0.015, respectively). AL was in 6 cases (0.9%) after hand-sewn and in 8 cases (1.24%) after staple ones (P=0.077, 0.069, respectively). In emergency cases the AL was in 9 cases (1.4%) while in elective ones was in 5 cases (0.78%) (P=0.034, 0.004, respectively). Conclusion: Good assessment of risk factors of this anastomotic leak may lead to a decrease in the rate of this leak especially in acute condition and therefore the morbidity rate, mortality rate, and improve the quality of health care which will be more cost effective.