Background: Anastomotic leakage (AL) is the most feared complication of colorectal surgery. Atherosclerosis is suggested to have a detrimental effect on anastomotic healing. This study aimed to analyze the calcium score, a measure for atherosclerosis, as a risk factor for AL. Study design: The calcium scores of colorectal patients operated on in 2 Dutch university medical centers were determined using a computed tomography scan and calcium scoring software. The aorta, common iliac arteries, internal and external iliac arteries were studied. Additionally, patient- and operation-related factors were scored. Results: A total of 122 patients were included. In patients with AL, calcium scores were significantly higher in the left common iliac artery (561.4 vs 156.0, P =.028), right common iliac artery (542.0 vs 144.4, P =.041), both common iliac arteries together (1,103.3 vs 301.9, P =.046), and the left internal iliac artery (716.3 vs 35.3, P =.044). Conclusions: Patients with higher calcium scores in the iliacal arteries have an increased leakage risk.

Anastomotic leakage, Atherosclerosis, CT-scan, Calcium score, Colorectal surgery,
The American Journal of Surgery
Erasmus MC: University Medical Center Rotterdam

Komen, N.A.P, Klitsie, P.J, Dijk, J-W, Slieker, J.C, Hermans, J.J, Havenga, K, … Lange, J.F. (2011). Calcium score: A new risk factor for colorectal anastomotic leakage. The American Journal of Surgery, 201(6), 759–765. doi:10.1016/j.amjsurg.2010.01.033