Mean Arterial Pressure changes as a risk factor for anastomotic leakage in colorectal cancer surgery

Abstract

Introduction: Surgery in CRC cases is very susceptible to various complications, one of which is an anastomotic leak. Splanchnic organs are vulnerable to the adverse effects of hypotension due to the decreased perfusion effect, which causes reduced tissue oxygen (O2) distribution and can cause intestinal/ colon damage. This study aimed to determine the relationship between Mean Arterial Pressure (MAP) during surgery and the incidence of anastomosis leak in CRC patients.

Methods: Observational analytical study with a retrospective cohort design. Namely, by conducting a search and assessment to know the number of occurrences of anastomosis leak found during the treatment period in patients who have experienced the MAP (< 65 mmHg), only once or more during the resection activity of CRC patients. Test statistics using the Wilcoxon and Chi-Square test. All collected data is processed and analyzed using the Statistical Package for the Social Sciences (SPSS) version 24 with a significant test result statistic if the P-value is < 0.05.

Result: In the < 65 mmHg MAP groups, 55.1% of patients with positive results experienced anastomosis leakage (AL), and 44,9% of patients without AL. Meanwhile, in the group with MAP ≥ 65 mmHg, 17.5% of patients suffered AL post anastomosis resection.

Conclusion: There is a relationship between MAP changes before and during surgery and anastomotic leak.