Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
2015 European Society of Coloproctology Collaborating Group.
The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit.
Colorectal Dis. 2018; 20(11): 1028-1040.
Doi: 10.1111/codi.14308
Web of Science
PubMed
FullText
FullText_MUG
- Study Group Mitglieder der Med Uni Graz:
- Mikalauskas Saulius
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- Abstract:
- AIM: There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure. METHOD: Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side-to-side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak. RESULTS: One thousand three hundred and forty-seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54-1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52-1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46-4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04-2.64, P = 0.04). CONCLUSION: This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high-risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration.
- Find related publications in this database (using NLM MeSH Indexing)
- Adolescent - administration & dosage
- Adult - administration & dosage
- Aged - administration & dosage
- Aged, 80 and over - administration & dosage
- Anastomosis, Surgical - adverse effects, methods
- Anastomotic Leak - etiology
- Colectomy - adverse effects, methods
- Colon - surgery
- Colorectal Neoplasms - surgery
- Colorectal Surgery - statistics & numerical data
- Female - administration & dosage
- General Surgery - statistics & numerical data
- Humans - administration & dosage
- Male - administration & dosage
- Medical Audit - administration & dosage
- Middle Aged - administration & dosage
- Prospective Studies - administration & dosage
- Surgical Stapling - adverse effects, methods
- Treatment Failure - administration & dosage
- Young Adult - administration & dosage
- Find related publications in this database (Keywords)
- Bowel anastomosis
- stapler
- oversewn
- surgical technique
- anastomotic leak
- colorectal cancer
- Crohn's disease
- epidemiology
- international
- surgery