Anastomotic Leakage in Colorectal Cancer Surgery in Syria

NCT07092631 | Completed

• 1 other identifier: IRB number 1497/436
• Study Type: observational
• Target: 119
• Locations: 1 country
• Sites: 1

Brief Summary

Anastomotic leakage is a serious complication of colorectal cancer surgery, particularly in resource-limited and conflict-affected settings. This retrospective cohort study conducted at Damascus Hospital, Syria, evaluated patient and procedure related risk factors for anastomotic leakage following elective sigmoid colon and rectal resections. An initial cohort (January 2016-March 2024) identified modifiable risk factors that informed updates to institutional preoperative and perioperative guidelines. A follow-up cohort (April 2024-October 2025) was subsequently analyzed to assess outcomes after guideline implementation. The study demonstrates that targeted optimization, especially correction of hypoalbuminemia and improved perioperative management was associated with reduced anastomotic leakage and postoperative mortality, highlighting the value of context-specific, evidence-based guideline changes in low-resource surgical settings.

Conditions

Anastomotic Leakage in Colon Surgery; Anastomotic Leak Rectum; Anastomotic Leak Large Intestine

Keywords

general surgery; Syria; leakage; colorectal cancer; rectum; guidelines implementation.

Outcome Measures

Primary Outcomes (1)

• Correlation between preoperative serum albumin level and incidence of anastomotic leakage following colorectal cancer surgery

  Preoperative serum albumin concentration measured in g/dL using routine hospital laboratory biochemical analysis will be correlated with the incidence of anastomotic leakage. Anastomotic leakage will be assessed as a binary outcome (yes/no) based on clinical findings, radiological imaging (contrast-enhanced CT), and/or intraoperative confirmation within the postoperative follow-up period.

  Within 30 days post-surgery

Study Arms (2)

The First Cohort

Pre-guideline cohort - patients treated before the implementation of the updated hospital guidelines (January 2016 - March 2024).

The follow-up cohort

Post-guideline cohort - patients treated after the implementation of the updated guidelines (April 2024 - October 2025).

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

from the General Surgery Department of Damascus hospital, Damascus, Syria.

You may qualify if:

• Patients who underwent colorectal cancer surgery for tumor-related indications.

You may not qualify if:

• Emergency cases
• Non-tumor related colorectal surgeries

Sponsors & Collaborators

• Elie Bitar: lead
• Damascus Hospital: collaborator
• Syrian Private University: collaborator

Study Sites (1)

Syrian Private University

Damascus, Syria

Location

MeSH Terms

Conditions

Colorectal Neoplasms

Condition Hierarchy (Ancestors)

Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Elie Wadie Bitar MD, Faculty of Medicine, Syrian Private University, Damascus, Syria.

Study Record Dates

• First Submitted: July 22, 2025
• First Posted: July 30, 2025
• Study Start: January 4, 2016
• Primary Completion: October 8, 2025
• Study Completion: October 20, 2025
• Last Updated: January 6, 2026

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will not share

Locations

SY (1)