Abstract:

Background: Worldwide, intra-abdominal surgical interventions carry high risk of complications and mortality. There is also progressive increase in the number of abdominal surgeries that as being performed in various hospitals in Mwanza. This study aimed at giving evidence on prevalence and factors associated with anastomotic leakage among patients undergoing bowel resection and anastomosis at Bugando Medical Centre (BMC) and Sekou Toure Regional Referral Hospital (SRRH)

Methodology: A hospital based cross sectional analytical study with a follow-up component, was carried out at Bugando Medical Centre (BMC) and Sekou Toure Regional Referral Hospital (SRRH)

Results: Eight out of 144 patients (5.6%) developed anastomotic leakage. The common indication for surgery was sigmoid volvulus, the common performed anastomosis was ileo-ileo to end, and double layer continuous anastomotic suture was the common method of anastomosis anemia (0.012), presence of premorbid illness (p=0.003), American Association for Anesthesia (ASA) greater than II (p=0.001), intraoperative contamination/sepsis (p<0.001), low ranked operator (p=0.046), prolonged duration of operation (0.001), and delayed passage of stool and flatus (p=0.001) were found to be variables associated with anastomotic leakage among study participants.

Conclusion: Anastomotic leakage in our setting occurs is approximately 5.6% of patients operated. Several factors such as high American Society for Anesthesiologist above III, premorbid condition such as uncontrolled diabetes mellitus, intraoperative contamination/sepsis, low ranked operator, prolonged duration of operations above 3 hours and prolonged ileus were among factors that the present study found to be associated with high risk of anastomotic leakage. These factors therefore, should be carefully taken into account when planning for patients for surgical interventions, so as to reduce the potential subsequent anastomotic leakage.