DR P. TARUN VARMA ,DR P.B. TARUN TEJA,DR SIVARAJAN N
DOI: https://doi.org/Background: Gastrointestinal (GI) resection and anastomosis are common surgical procedures, but postoperative complications—particularly anastomotic leaks—remain a major cause of morbidity and mortality. Multiple systemic and local factors such as nutritional status, comorbidities, and surgical technique influence outcomes. Identifying predictors of complications is critical to optimize perioperative care and improve survival.
Objectives: To assess the morbidity pattern following gastrointestinal resections and anastomoses and to evaluate systemic and local factors associated with adverse outcomes.
Methods:A prospective observational study was conducted on 120 patients undergoing GI resection and anastomosis at a tertiary care hospital between January 2022 and January 2023. Data were collected on demographics, nutritional parameters (serum albumin, hemoglobin), comorbidities, type of surgery (elective/emergency), and anastomotic technique (hand-sewn/stapled). Postoperative outcomes including anastomotic leak, wound infection, sepsis, ICU admission, hospital stay, and mortality were recorded. Statistical analysis was performed using SPSS, with p < 0.05 considered significant.
Results: The mean age was 52.4 years, with a male predominance (65%). Elective surgeries accounted for 60% of cases. Hand-sewn anastomosis was performed in 75%, and stapled in 25%. Overall, anastomotic leaks occurred in 15.8%, wound infection in 20.3%, septic complications in 12.5%, and mortality in 5.8%—mostly associated with leaks. Hypoalbuminemia (<3.0 g/dL) showed a significant association with leaks (p = 0.003), while emergency surgeries were linked with higher leak and mortality rates (p = 0.02). Diabetes mellitus was associated with increased wound infections (p = 0.01). Poor bowel preparation and intraoperative peritoneal contamination significantly worsened outcomes.
Conclusion: Anastomotic complications remain a substantial challenge in GI surgery, with hypoalbuminemia and emergency surgery emerging as major risk factors. Optimizing preoperative nutrition, careful patient selection, meticulous surgical technique, and vigilant postoperative monitoring are essential to reduce morbidity and mortality. Standardized perioperative protocols may improve outcomes, particularly in high-risk patients.
