Is a minor clinical anastomotic leak clinically significant after resection of XXXX ?

@entity1 @entity14 @entity86 @entity260
BACKGROUND: There are few reports comparing the variety and frequency of @entity260 between @entity1 with a major clinical leak requiring emergency abdominal reoperation and those with a minor leak diagnosed from clinical signs and managed expectantly without reoperation. This study examined the association between severity of leakage and 18 other @entity260 , @entity86 , and length of postoperative hospital stay. STUDY DESIGN: Data were drawn from a comprehensive, prospective hospital registry of 1,507 @entity14 resections involving an anastomosis from January 1995 to December 2006. Differences were evaluated by two-tailed Fisher's exact test, Student's t-test, or Mann-Whitney U test. RESULTS: Leaks occurred in 54 @entity1 (3.6%; 95% CI, 2.7% to 4.7%), comprising 21 major (1.4%; 95% CI, 0.9% to 2.1%) and 33 minor leaks (2.2%; 95% CI, 1.5% to 3.2%). @entity1 with a leak were significantly (p < 0.01) more likely than those without to have 11 of 18 other surgical and medical complications considered, although with few differences in complication rates between those with major and minor leaks. As compared with @entity1 without leak, those with a leak (major or minor) had several of these complications rather than just one (p < 0.001) and greatly prolonged hospital stay (p < 0.001). Postoperative mortality was higher after major leaks than after minor leaks (4 of 21 and 0 of 33, respectively, p = 0.019). CONCLUSIONS: A minor leak is not trivial. Apart from the fact that major clinical leakage necessitates urgent reoperation, there were few other differences between major and minor clinical leaks in the frequency of other complications.
