Risk Factors for Intestinal Anastomotic Leakage After Hemicolectomy: A Single-Center Retrospective Study

ORIGINAL ARTICLE
E. A. Toneev, D. D. Prokhorov, M. A. Iglina, S. R. Ziganshina, D. R. Pyatikop, D.V. Golovko, Z. Yu. Yunkina

 

For citation: Toneev EA, Prokhorov DD, Iglina MA, Ziganshina SR, Pyatikop DR, Golovko DV, Yunkina ZYu. Risk Factors for Intestinal Anastomotic Leakage After Hemicolectomy: A Single-Center Retrospective Study. International Journal of Biomedicine. 2026;16(3):364-371. doi:10.21103/Article16(3)_OA6

Originally published September 5, 2026

Abstract: 

Background: Colorectal anastomotic leakage is currently an acute problem in the surgical treatment of colorectal cancer. This study aims to identify early predictors of intestinal anastomotic leakage after hemicolectomy.

Methods and Results: The study, conducted at Ulyanovsk Regional Clinical Oncology Dispensary from 2019 to 2024, included a retrospective analysis of 583 patients who underwent elective hemicolectomy and sigmoid colon resection. Patients with fatal outcomes due to comorbid pathology and emergency operations were excluded. Complications were assessed according to the Clavien-Dindo classification, and tumors were staged using the TNM classification. Statistical analysis included methods for comparing quantitative and categorical data, assessing odds, and constructing a predictive model using logistic regression and ROC analysis.

Colorectal anastomotic leakage (CAL) occurred in 48 patients (8.24%). Compared with patients without CAL, patients with CAL had lower serum albumin concentrations preoperatively and on postoperative days 1 and 5, higher neutrophil counts on postoperative days 1 and 5, a lower lymphocyte count on postoperative day 1, and higher neutrophil-to-lymphocyte ratio (NLR) values on postoperative days 1 and 5. In the multivariable model, preoperative colostomy, multiorgan resection, preoperative albumin, albumin on postoperative days 1 and 5, neutrophils on postoperative day 5, and operation time remained statistically significant. The model showed an area under the ROC curve of 0.940.

Conclusion: Lower perioperative albumin and a more pronounced postoperative inflammatory response, together with preoperative colostomy, multiorgan resection, and operative duration, were associated with CAL and may support early risk stratification after hemicolectomy.

Keywords: 
intestinal anastomosis • resection • colorectal anastomotic leakage
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Received May 6, 2026.
Accepted July 25, 2026.
© 2026 The Author(s). International Journal of Biomedicine is published by IMRDC. This is an open access article under the CC BY-NC-ND 4.0 license.