uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit
Queen Elizabeth Hosp, Birmingham, W Midlands, England..
Hampshire Hosp NHS Trust, Basingstoke, Hants, England..
Sandwell Gen Hosp, West Bromwich, England..
Leicester Gen Hosp, Leicester, Leics, England..
Show others and affiliations
2017 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 19, no 8, e296-e311 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn).

Method: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable.

Results: This study included 3208 patients, of whom 78.4% (n = 2515) underwent surgery for malignancy and 11.7% (n = 375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8% (n = 3041) of patients, which was handsewn in 38.9% (n = 1183) and stapled in 61.1% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5% handsewn vs 12.9% stapled) and to undergo open surgery (54.7% handsewn vs 36.6% stapled). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95% CI: 1.04-1.95; P = 0.03).

Conclusion: Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe.

Place, publisher, year, edition, pages
WILEY , 2017. Vol. 19, no 8, e296-e311 p.
Keyword [en]
Anastomotic leak, colorectal cancer, Crohn's disease, epidemiology, international
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-334324DOI: 10.1111/codi.13646ISI: 000406961000003OAI: oai:DiVA.org:uu-334324DiVA: diva2:1159249
Available from: 2017-11-22 Created: 2017-11-22 Last updated: 2017-11-22Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Authority records BETA

Folkesson, JoakimSköldberg, Filip

Search in DiVA

By author/editor
Folkesson, JoakimSköldberg, Filip
By organisation
Upper Abdominal Surgery
In the same journal
Colorectal Disease
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 11 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf