Non-specific risk factors for predicting intestinal anastomotic leakage following right/left hemicolectomy and sigmoidectomy: development and internal validation of a model

Objective. Тhis study aimed to identify early predictors of intestinal anastomotic leakage following hemicolectomies. Material and Methods. We conducted a retrospective analysis of 583 patients who underwent elective hemicolectomies and sigmoid resections at the Ulyanovsk Regional Oncology Center from 2019 to 2024. Patients with fatal outcomes from comorbid conditions or emergency surgeries were excluded. Complications were assessed using the Clavien-Dindo classification, while tumors were evaluated using the ТNM classification. Statistical analysis involved methods for comparing quantitative and categorical data, assessing odds ratios, and developing a predictive model using logistic regression and ROC analysis. Results. Statistically significant risk factors for intestinal anastomotic leakage were: colostomy before surgery (p<0.001); multiorgan resections (p<0.001); albumin levels before surgery (p=0.001) albumin levels on day 1 after surgery (p<0.001); albumin levels on day 5 after surgery (p=0.032), neutrophil counts on day 5 after surgery (p=0.012), and operation time (p=0.048). Conclusion. In our study, the incidence of intestinal anastomotic leakage was 48 (8.24%). Multivariate analysis identified the following statistically significant factors for developing anastomotic leakage: cancer stage, Т-spread of the primary tumor, presence of metastases, operation time, length of hospital stay, preoperative colostomy, multiorgan resection, Clavien–Dindo complications, blood loss volume, type of surgery, albumin levels before surgery, albumin levels on day 1 and day 5 after surgery, neutrophil counts on day 1 and day 5 after surgery, lymphocyte counts on day 1 after surgery, and the neutrophil-to-lymphocyte ratio on day 1 and day 5 after surgery.