Background: Anastomosis of the bowel is a frequently conducted procedure in gastrointestinal surgery, with anastomotic leakage being one of the most severe postoperative complications. This study assessed the factors affecting outcomes after bowel anastomosis, focusing specifically on anastomotic leakage and postoperative morbidity.

Materials and Methods: This analytical observational study was carried out in the Department of General Surgery at a tertiary care teaching hospital over a period of 18 months. The study included 49 patients who underwent bowel anastomosis. Data collected encompassed demographic details, clinical characteristics, comorbidities, operative variables, serum albumin levels, postoperative complications, duration of hospital stay, and mortality rates. Categorical variables were subjected to analysis using the Chi-square test or Fisher’s exact test, as appropriate. A p-value of less than 0.05 was deemed statistically significant.

Results: The mean age of the patients was 50.16 ± 17.46 years, and 28 (57.14%) were males. The mean BMI was 25.88 ± 4.11 kg/m², mean hemoglobin was 11.92 ± 1.84 g/dL, and mean serum albumin was 3.66 ± 0.68 g/dL. Hypoalbuminemia was present in 18 (36.73%) patients. Emergency surgery was performed in 26 (53.06%) patients. Surgical site infection and anastomotic leak were observed in 7 (14.29%) patients each. The mean hospital stay was 9.89 ± 3.13 days, and mortality occurred in 3 (6.12%) patients. Age group, sex, and serum albumin status were not significantly associated with anastomotic leak; however, leak was proportionally more frequent among males, patients above 60 years, and those with hypoalbuminemia.

Conclusion: Anastomotic leak occurred in a clinically significant proportion of patients undergoing bowel anastomosis. Although the evaluated factors did not show statistically significant associations, higher leak proportions among elderly patients, males, and hypoalbuminemic patients indicate the importance of preoperative optimization, nutritional assessment, meticulous surgical technique, and close postoperative monitoring to improve surgical outcomes.