Scripties UMCG - Rijksuniversiteit Groningen
English | Nederlands

Inaccuracy of the Colon Leakage Score in left and right-sided colorectal surgery

(2018) Vorst, N.E. van der

Background: Anastomotic leakage (AL) is a severe and frequent complication after colorectal
surgery. The Colon leakage score (CLS) is developed to assess the risk of developing AL
based on pre-and intra-operative factors, for patients with left-sided colonic and rectal
anastomosis. The aim of this study is to verify the utility of this score and explore if the CLS
is also applicable for right sided colonic anastomosis.
Patients and methods: Patients were included from an existing prospective cohort. Hundredseventy-
eight patients were included in the group with rectal and left-sided anastomosis and
153 patients were included in the right-sided group. In each group the CLS between patients
with and without AL were compared. The predictive value and area under the receiver
operating curve (AUC) were calculated. Additional logistic regression analysis was
Results: There were only significant differences in mean CLS for patients with left-sided (Pvalue
= 0.015) and right-sided anastomosis (P-value = 0.041). However, the AUCs and odds
ratios in both cases were low (left-sided, AUC = 0.653 (CI 0.477 – 0.828); odds ratio = 1.295
(CI 1.040 – 1.614; p=0,021)) (right-sided, AUC = 0.672 (CI 0.518 – 0.827); odds ratio = 1.
195 (CI 1.003 – 1.423)).
Conclusions: The CLS did not hold up as a good predictor for the occurrence of AL for
patients who either received a rectal, left-sided or right-sided colonic anastomosis in the
present study. To create a more comprehensive and accurate score, large cohort multiple
regression analysis should be considered in the future.

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