Hemoglobin level and albumin as a predictive factors for anastomotic leakage following after hemicolectomy: A prospective study for colon cancer

Anastomotic leaks after colon surgery are associated with increased morbidity and mortality, the incidence and mortality rate reaches 6%-22% of total cases. Multiple risk factors for anastomotic leak have been identified for better prevention and an earlier diagnosis anastomosis leakage complication. Haemoglobin is related to perfusion and oxygenation of the anastomotic margins, and albumin is the protein with an essential factor for anastomotic healing. This study examined the relationship between albumin and haemoglobin levels with anastomotic leakage after hemicolectomy in colon cancer patients. A cohort study of all the colon cancer patients after hemicolectomy at Soetomo General Hospitals, Surabaya Indonesia between January 2018 and December 2022. A total of 31 out of 85 patients who developed anastmotic leak were analyzed. Albumin serum and haemoglobin level were analysed by univariate analysis and stepwise multiple logistic regression analysis. A comparison was made between the patients’ intergroups according to the kind of operation. In this study, 31 patien (36.5%) anastomotic leaks were confirmed. The result showed that the preoperative variables significantly associated with anastomotic leakage included hypoalbumin p-value 0.01 OR: 2.3 (ROC curve analysis albumin level ≤ 2.7 g/dl with cut off value sensitivity of 66.7% a sensitivity 74.2%) and anemia p-value 0.007 and OR 3.4 (ROC curve serum haemoglobin level ≤ 10.3 g/dl with cut-off value sensitivity of 63.0% a sensitivity 61.3%) remained significant in the logistic regression model. The preoperative serum albumin level and haemoglobin levels are independent risk factors for anastomotic leakage in colon cancer patients after hemicolectomy.