1. Coordinators : dr. Lucian Mocan, dr. Cornel Iancu Assessment of risk factors for anastomotic leak occurrence after resection of colorectal cancer Author: Teodora Irina Adam Coauthors: Alexandru Achim, Dragoș Aconstantinesei, Vlad Bura, Patricia Furda

2. Radical tumor resection – curative procedure in colorectal cancer Anastomotic leaks (AL) are widely considered the Achilles heel of colorectal surgery UK SISG: a “leak of luminal contents from a surgical join between two hollow viscera” Background Bruce J, Krukowski ZH, Al-Khairy G, Park KG. Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg 2001;88:1157–1168.

3. Incidence of AL varies between institutions depending on the definition chosen Certain factors are known to increase the likelihood of an AL Background Bruce J, Krukowski ZH, Al-Khairy G, Park KG. Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg 2001;88:1157–1168.

4. Identify risk factors for AL Assess the correlation between the observed risk factors and AL Objectives

5. Retrospective study 310 patients (01.01.2013 – 31.03.2014) Data collection: Standard form Methods

6. - Observed parameters

7. Methods preOPintraOPpostOP AnemiaSuture methodTiming of oral nutrition and mobilization HypoproteinemiaAnastomosis technique Topography of neoplastic lesions Intraoperative events - Observed parameters - Data analysis

8. Results PreOP parameters

9. Results Anemia Hypoproteinemia Topography of neoplastic lesion Anastomotic Leak Chi- Square

10. Results Chi-Squared H 1 0: “There is no significance between anemia and AL occurence” H 2 0: “There is no significance between hypoproteinemia and AL occurence” H 3 0: “There is no significance between topography of neoplastic lesions and AL occurence”

11. Results Chi-Squared 2-1 = 1 degree of freedom

12. Results Anemia Hypoproteinemia Anastomotic Leak Topography Anastomotic Leak X 2 > 3,84 X 2 (-3,84;3,84)

13. Results Chi-Squared Reject: H 1 0: “There is no significance between anemia and AL occurence” H 2 0: “There is no significance between hypoproteinemia and AL occurece” Accept: H 3 0: “There is no significance between topography of neoplastic lesions and AL”

14. Results Chi-Squared “There is significance between anemia and AL” “There is significance between hypoproteinemia and AL”

15. Results IntraOP

16. Results Chi-Squared H 1 0: “There is no significance between the employed suture method and AL occurrence” H 2 0: “There is no significance between the employed anastomosis technique and AL occurrence”

17. Results Suture method Anastomosis technique Anastomotic Leak Chi- Square Suture method Anastomosis technique Anastomotic Leak X 2 (-3,84;3,84)

18. Results Chi-Squared Accept H 1 0: “There is no significance between the employed suture method and AL occurrence” H 2 0: “There is no significance between the employed anastomosis technique and AL occurrence”

19. Results PostOP 24 - 48 h 2,58 %

20. Conclusions Anemia Hypoproteinemia Risk factors for AL Delayed postoperative oral nutrition and patient mobilization

21. Discussions More patients included in the study Single surgeon experience ? Prospective study Further investigation

22. Thank you !