Background: The incidence of anastomotic leakage still remains a great problem in rectal surgery. The aim Of this study was to evaluate the riskfactors of anastomotic leakage and to develope a scoringsystem for a risk assessment of developing an anastomotic leakage after low anterior resection. Methods: In the time period between 1995 and 2003, 423 patients with a carcinoma of the rectum were scheduled for low anterior resection in our departement. Within these population 12% developed an anastomotic leakage. Of these we reviewed the histopatholocic tumor marker and all data referring to surgical technique. A random sample consisting of 123 patients (33%) were taken to asses and analyse the clinical picture of the patient, the laboratory values and the amount of bloodtransfusion within the first 14 postoperative days. Results: The peak when anastomtic leakage occurred clinically was the sixth day (11%) after surgery, following by day 7 and 11 (each 9%). In our multivariate analysis we were able to show that the need for bloodtransfusion, a leukocytosis on day 3, an elevated bilirubin and a temperature above 38 degree Celsius were independent risk factors in the incidence of anastomtic leakage. By using the coefficient of regression we gave the first two parameters 2 points and the last two parameters were given 3 points. The resulting receiver operating characteristic curve showed a sensitivity of 64% and a specifity of 83% in occurence of anastomtic leakage. Conclusion: In clinical practice the above mentioned parameters are routinely assessed and with low cost this scoring system is an effective tool in recognizing patients with a higher risk in developing an anastomotic leakage.     «

Background: The incidence of anastomotic leakage still remains a great problem in rectal surgery. The aim Of this study was to evaluate the riskfactors of anastomotic leakage and to develope a scoringsystem for a risk assessment of developing an anastomotic leakage after low anterior resection. Methods: In the time period between 1995 and 2003, 423 patients with a carcinoma of the rectum were scheduled for low anterior resection in our departement. Within these population 12% developed an anasto...     »