Analytical Study of Risk Factors for Anastomotic Leakage Following Colorectal Surgery in Southwest Nigerian Teaching Hospitals

Anastomotic leakage is one of the most feared complications of colorectal surgery, carrying significant mortality, prolonged hospital stay, and high reoperation rates. Despite its clinical importance, patient-level and technical risk factors for anastomotic leakage in Nigerian colorectal surgery practice are poorly characterised. This study analytically examines the risk factors for anastomotic leakage following elective and emergency colorectal procedures at three South West Nigerian teaching hospitals over a five-year period. A retrospective cohort design is applied to 350 colorectal surgical cases with primary anastomosis, comparing patients who developed anastomotic leakage against those who did not. Independent variables include patient age, body mass index, diabetes mellitus, serum albumin, ASA grade, operative indication, anastomosis technique, use of defunctioning stoma, and surgeon experience level. Anastomotic leakage is defined by radiological or clinical evidence of extraluminal contrast or faecal peritonitis within 30 days. Binary logistic regression in SPSS identifies independent predictors. Available colorectal surgery literature from South West Nigeria identifies low serum albumin, emergency operative indication, and absence of defunctioning stoma as the most consistent independent predictors of leakage in comparable settings. The Clavien-Dindo classification grades leakage severity. Findings will inform the development of a risk-stratification protocol for prophylactic defunctioning stoma selection in South West teaching hospitals. Keywords: anastomotic leakage, colorectal surgery, risk factors, South West Nigeria, surgical outcomes.