Introduction: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. Methods: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (> 16 years) who underwent emergency (unplanned, within 24 h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5). Results: From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83–2.79, P = 0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43–11.02, P = 0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur. Conclusions: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications.

Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit / L. Sanchez-Guillen, D. Nepogodiev, E. Sivrikoz, T. van Elst, A. Minaya, F. Pata, J. Glasbey, T. Pinkney, A. Bhangu, A. El-Hussuna, N. Buchs, C. Buskens, S. Chaudri, M. Frasson, G. Gallo, D. Morton, I. Negoi, B. Singh, O. Zmora, R. Perry, L. Magill, D. Altomare, W. Bemelman, S. Brown, Q. Denost, C. Knowles, S. Laurberg, J. Lefevre, G. Moeslein, T. Pinkney, C. Vaizey, S. Bilali, V. Bilali, M. Salomon, M. Cillo, D. Estefania, J. Patron Uriburu, H. Ruiz, P. Farina, F. Carballo, S. Guckenheimer, D. Proud, R. Brouwer, A. Bui, B. Nguyen, P. Smart, A. Warwick, J. Theodore, F. Herbst, T. Birsan, B. Dauser, S. Ghaffari, N. Hartig, A. Stift, S. Argeny, L. Unger, R. Strouhal, A. Heuberger, A. Varabei, N. Lahodzich, A. Makhmudov, L. Selniahina, T. Feryn, T. Leupe, L. Maes, E. Reynvoet, K. Van Langenhove, M. Nachtergaele, B. Monami, D. Francart, C. Jehaes, S. Markiewicz, J. Weerts, K. Van Belle, B. Bomans, V. Cavenaile, Y. Nijs, M. Vertruyen, P. Pletinckx, D. Claeys, B. Defoort, F. Muysoms, S. Van Cleven, C. Lange, K. Vindevoghel, A. Wolthuis, M. Todorovic, S. Dabic, B. Kenjic, S. Lovric, J. Vidovic, S. Delibegovic, Z. Mehmedovic, A. Christiano, B. Lombardi, M. Marchiori, V. Tercioti, D. Dardanov, P. Petkov, L. Simonova, A. Yonkov, E. Zhivkov, S. Maslyankov, V. Pavlov, M. Sokolov, G. Todorov, V. Stoyanov, I. Batashki, N. Iarumov, I. Lozev, B. Moshev, M. Slavchev, B. Atanasov, N. Belev, P. Krstev, R. Penkov, G. Santak, J. Cosic, A. Previsic, L. Vukusic, G. Zukanovic, M. Zelic, D. Krsul, V. Lekic Vitlov, D. Mendrila, J. Orhalmi, T. Dusek, O. Maly, J. Paral, O. Sotona, M. Skrovina, V. Bencurik, M. Machackova, Z. Kala, M. Farkasova, T. Grolich, V. Prochazka, J. Hoch, P. Kocian, L. Martinek, F. Antos, V. Pruchova, A. Ceccotti, T. Madsboll, D. Straarup, A. Uth Ovesen, P. Christensen, P. Bondeven, P. Edling, H. Elfeki, V. Alexandrovich Gameza, S. Michelsen Bach, I. Zheltiakova, P.M. Krarup, A. Krogh, H.-. Rolff, J. Lykke, A.F. Juvik, H.H.K. Loven, M. Marckman, J.T.F. Osterkamp, A.H. Madsen, J. Worsoe, A. Ugianskis, M.D. Kjaer, B. Youn Cho Lee, A. Khalid, M.H. Kristensen, M. El Sorogy, A. Elgeidie, M. Elhemaly, A. Elnakeeb, M. Elrefai, M. Shalaby, S. Emile, W. Omar, A. Sakr, W. Thabet, S. Awny, I. Metwally, B. Refky, N. Shams, M. Zuhdy, A. Lepisto, I. Keranen, A. Kivela, T. Lehtonen, P. Siironen, T. Rautio, M. Ahonen-Siirtola, K. Klintrup, K. Paarnio, H. Takala, M. Hyoty, E. Haukijarvi, S.-. Kotaluoto, K. Lehto, T. Tomminen, H. Huhtinen, A. Carpelan, J. Karvonen, A. Rantala, P. Varpe, E. Cotte, Y. Francois, O. Glehen, G. Passot, A. D'Alessandro, E. Chouillard, J.C. Etienne, E. Ghilles, B. Vinson-Bonnet, A. Germain, A. Ayav, L. Bresler, R. Chevalier, R. Didailler, E. Rullier, E. Tiret, N. Chafai, J. Lefevre, Y. Parc, I. Sielezneff, D. Mege, Z. Lakkis, M. Barussaud, C. Krones, B. Bock, R. Webler, J. Baral, T. Lang, S. Munch, F. Pullig, M. Schon, S. Hinz, T. Becker, T. Moller, F. Richter, C. Schafmayer, J. Hardt, P. Kienle, F. Crescenti, M. Ahmad, Y. Soleiman, I. Papaconstantinou, A. Gklavas, K. Nastos, T. Theodosopoulos, A. Vezakis, K. Stamou, A. Saridaki, E. Xynos, S. Paraskakis, N. Zervakis, G. Skroubis, T. Amanatidis, S. Germanos, I. Maroulis, G. Papadopoulos, N. Dimitriou, A. Alexandrou, E. Felekouras, J. Griniatsos, I. Karavokyros, A. Papadopoulos, C. Chouliaras, P. Ioannidis, D. Katsounis, E. Kefalou, I. Katsoulis, D. Balalis, D. Manatakis, G. Tzovaras, I. Baloyiannis, I. Mamaloudis, G. Lazar, S. Abraham, A. Paszt, Z. Simonka, A. Zarand, Z. Baranyai, G. Ferreira, L. Harsanyi, P. Onody, B. Banky, A. Burany, M. Lakatos, J. Marton, A. Solymosi, I. Besznyak, A. Bursics, G. Papp, G. Saftics, I. Svastics, E. Valsdottir, J. Atladottir, T. Jonsson, P. Moller, H. Sigurdsson, S.K. Gupta, N. Kaul, S. Mohan, G. Sharma, R. Wani, N. Chowdri, M. Khan, A. Mehraj, F. Parray, A. Coveney, J. Burke, J. Deasy, S. El-Masry, D. Mcnamara, R. Cahill, E. Faul, J. Mulsow, C. Shields, M.E. Kelly, G. Bass, S.T. Martin, R. O'Connell, E. Ryan, T. Connelly, G. Ahmad, W. Bukhari, F. Cooke, R. Gold Deutch, N. Haim, R. Lavy, A. Moscovici, N. Shussman, R. Gefen, G. Marom, A. Pikarsky, D. Weiss, S. Avital, N. Hermann, B. Raguan, M. Slavin, I. White, N. Wasserberg, H. Arieli, N. Gurevich, M.R. Freund, S. Dorot, G. Halfteck, P. Reissman, E. Yair, Y. Eden, R. Pery, H. Tulchinsky, A. Weizman, F. Agresta, R. Curinga, E. Finotti, G. Savino, L.A. Verza, C.R. Asteria, L. Boccia, A. Pascariello, N. Tamini, A. Bugatti, L. Gianotti, M. Totis, L. Vincenti, V. Andriola, I. Giannini, E. Travaglio, R. Balestri, P. Buccianti, N. Roffi, E. Rossi, L. Urbani, A. Mellano, A. Cinquegrana, A. Lauretta, C. Belluco, M. Mistrangelo, M.E. Allaix, S. Arolfo, M. Morino, V. Testa, P. Delrio, U. Pace, D. Rega, D. Scala, Z. Donald, G. Clerico, S. Cornaglia, A. Realis Luc, M. Trompetto, G. Ugolini, N. Antonacci, S. Fabbri, I. Montroni, D. Zattoni, C. D'Urbano, A. Cornelli, M. Viti, M. Inama, M. Bacchion, A. Casaril, H. Impellizzeri, G. Moretto, A. Spinelli, M. Carvello, G. David, F. Di Candido, M. Sacchi, A. Frontali, V. Ceriani, M. Molteni, R. Rosati, F. Aleotti, U. Elmore, M. Lemma, A. Vignali, S. Scabini, G. Casoni Pattacini, A. Luzzi, E. Romairone, F. Marino, D. Lorusso, F. Pezzolla, F. Colombo, C. Baldi, D. Foschi, G. Sampietro, L. Sorrentino, S. Di Saverio, A. Birindelli, E. Segalini, D. Spacca, G.M. Romano, A. Belli, F. Bianco, S. De franciscis, A. Falato, A. Muratore, P. Marsanic, S. Grimaldi, N. Castaldo, M.G. Ciolli, P. Picarella, R. Porfidia, G. Tugnoli, A. Bondurri, D. Cavallo, A. Maffioli, A. Pertusati, F. Pulighe, F. Balestra, C. De Nisco, M. Podda, E. Opocher, M. Longhi, N.M. Mariani, N. Maroni, A. Pisani Ceretti, R. Galleano, P. Aonzo, G. Curletti, L. Reggiani, M. Marconi, L. Del Prete, M. Oldani, R. Pappalardo, S. Zaccone l, M. Scatizzi, M. Baraghini, S. Cantafio, F. Feroci, I. Giani, R. Tutino, G. Cocorullo, G. Gulotta, L. Licari, G. Salamone, P. Sileri, F. Saraceno, F. La Torre, P. Chirletti, D. Coletta, G. De Toma, A. Mingoli, M. Papandrea, E. De Luca, R. Sacco, G. Sammarco, G. Vescio, V. Tonini, S. Bianchini, M. Cervellera, S. Vaccari, N. Cracco, G. Barugola, E. Bertocchi, R. Rossini, G. Ruffo, A. Sartori, N. Clemente, M. De Luca, A. De Luca, G. Scaffidi, L. Lorenzon, G. Balducci, T. Bocchetti, M. Ferri, P. Mercantini, P. Jackson, S. Bauce, A. Benevento, C. Bottini, P.R. Crapa, M. Rubbini, G. Anania, P. Carcoforo, G. Cavallesco, C. Feo, T. Yamamoto, A. Sivins, G. Ancans, S. Gerkis, R. Lunis, A. Pcolkins, D. Venskutonis, S. Bradulskis, E. Dainius, A. Subocius, J. Vencius, P. Zeromskas, V. Eismiontas, V. Nutautiene, D. Simcikas, A. Tamosiunas, S. Svagzdys, T. Latkauskas, P. Lizdenis, Z. Saladzinskas, A. Tamelis, A. Dulskas, J. Kuliavas, N.E. Samalavicius, T. Poskus, V. Jotautas, S. Mikalauskas, E. Poskus, K. Strupas, A. Zakaria, N.N. Lah, M. Wong, Z. Zain, Z. Zakaria, L. Mazlan, Z.A. Mohd Azman, I. Sagap, J. Psaila, P. Andrejevic, C. Cini, S. Ellul, K. Pace, M. Ahallat, M. Hamid, A. Hrora, M.A. Majbar, M. Raiss, E. Westerduin, W. Bemelman, P. Tanis, P.C. van der Sluis, P.H. Davids, A. Pronk, A.H.W. Schiphorst, N. Smakman, D. Zimmerman, T. Koeter, J. Stijns, Y.-. van Loon, M. Vermaas, E. de Graaf, P. Doornebosch, P. van Hagen, O. van Ruler, B. Toorenvliet, J. Nonner, I. van den Berg, L. van Steensel, W. Vles, J. Melenhorst, R. Orsini, R. Visschers, C. Hoff, R. Blom, H. Marsman, I. Mulder, H. Cense, S. de Castro, A. Demirkiran, M. Hunfeld, A. van Geloven, J. de Groof, E. Hendriks, M. Leeuwenburg, N. van Oorschot, F. Wit, C. Rupert, P. Veldman, M. Keijzers, J. Konsten, F. Den Boer, M. Corver, E.-. Boerma, L. Koolen, M. Martens, K. Van Wijck, D. Ignjatovic, R. Breuer, B. Gurpreet, T. Oresland, T. Tetens Moe, A. Nesbakken, I. Flateh Backe, T.-. Wik, K. Radiya, T. Dehli, P. Gjessing, S. Norderval, K. Woll, M. Anwer, M.S. Qureshi, A.U. Qureshi, M. Billah, M.Y. Jawad, A. Raza, N. Urooj, X. Wang, L. Li, D. Jajtner, B. Gasinski, W. Kabiesz, P. Walega, M. Romaniszyn, M. Zawadzki, R. Czarnecki, Z. Obuszko, M. Rzaca, M. Sitarska, P. Silva, A. Duarte, D. Goncalves, M. Morais, N. Rama, J. Nobre, I. Sales, J. Costa Pereira, S. Costa, C. Costa Pereira, C. Insua, I. Romero, N. Figueiredo, J. Cunha, H. Domingos, P. Vieira, M. Cunha, M. Americano, E. Amorim, J. Rachadell, J. Carvas, I. Armas, P. Fernandes, C. Pires, R. Reis, R. Martins, M. Dos Santos, P. Henriques, O. Oliveira, M. Duarte, L. Ferreira, J. Miranda, N. Vilela, J. Corte Real, S. Carlos, M. Frois Borges, P. Moniz Pereira, J. Simoes, P. Silva-vaz, V. Bettencourt, A. Gouveia, H. Perez, R. Rainho, V. Bintintan, C. Ciuce, G. Dindelegan, R. Scurtu, R. Seicean, D. Cristian, T. Burcos, F. Grama, D.M. Mandi, G. Richiteanu, A. Miron, V. Calu, O. Enciu, M. Nadragea, R. Parvuletu, S.S. Mogoanta, A. Crafciuc, S. Paitici, M. Beuran, C. Ciubotaru, A. Prodan, M. Vartic, V. Tomulescu, C. Copaescu, D. Popov, A. Sednev, A. Klimenko, A. Semenov, S. Vasilyev, A. Pozdnyakov, D. Cherdancev, D. Mahotin, A. Nesytykh, V. Samsonyuk, I. Pravosudov, D. Ivlev, A. Karachun, K. Lebedev, D. Samsonov, R. Aiupov, D. Feoktistov, M. Garipov, S. Nail, N. Tarasov, A. Yanishev, A. Abelevich, A. Kokobelyan, M. Lebedeva, R. Luzan, A. Rasulov, H. Dzhumabaev, Z. Mamedli, A. Bedzhanyan, A. Khazov, M. Khanevich, G. Khrykov, S. Katorkin, P. Andreev, A. Chernov, O. Davidova, A. Zhuravlev, S. Achkasov, D. Shakhmatov, Y. Shelygin, O. Sushkov, A. Vardanyan, A. Ilkanich, N. Barbashinov, V. Darvin, S. Onishchenko, Y. Voronin, Z. Krivokapic, G. Barisic, I. Dimitrijevic, V. Markovic, A. Sekulic, G. Stanojevic, B. Brankovic, M. Nestorovic, V. Pecic, D. Petrovic, I. Kostic, A. Aleksic, D. Dabic, B. Maric, V. Perunicic, Z. Radovanovic, M. Djuric, D. Lukic, D. Radovanovic, V. Cuk, J. Juloski, M. Kenic, I. Krdzic, J.C. Ngu, Y.Y. Ng, N. Teo, J. Korcek, A. Lazorisak, M. Rems, S. Ramovs Trampus, A. Tomazic, J. Grosek, J. Kosir, G. Norcic, V. Vigorita, N. Caceres, E. Casal, A. Ruano, I. Trostchansky, T. Golda, A. Galvez Saldana, E. Kreisler Moreno, J. Lopez Dominguez, M. Vila Tura, F. Labarga, P. Galvez, V. Maderuelo, C. Suero, J. Bargallo, L. Cayetano, S. Lamas, M.C. Silva, J.C. Bernal-Sprekelsen, R. Gomez, S. Jareno, A. Rios, D. Vercher, J.-. Garcia-Gonzalez, J. Cervera-Aldama, J. Ramos-Prada, M. Santamaria-Olabarrieta, N. Borda, J.M. Enrriquez-Navascues, Y. Saralegui, A. Calero-Lillo, S. Aznar-Puig, M.A. Lopez-Lara, S. Munoz-Collado, J. Valverde-Sintas, P. Menendez, C. Leon, N. Truan, R. Baldonedo, D. Martinez, J. Otero, L. Solar, V. Turrado-Rodriguez, F. de Lacy Oliver, A.M. Lacy Fortuny, B. Martin Perez, A.M. Otero Pineiro, J. Paredes, F. Fernandez, M.J. Ladra, A. Paulos, D. Prieto, J.P. Beltran de Heredia, F. Blanco Antona, B. de Andres Asenjo, C. Ferreras Garcia, A. Romero de Diego, E. Cordoba Diaz de Laspra, E. Echazarreta Gallego, M. Elia Guedea, D. Escola, S. Martinez, V. Primo Romaguera, R. Parreno, L. Pastor, E. Rosell, R. Lozoya Trujillo, R. Alos Company, M.D. Ruiz Carmona, A. Solana Bueno, S. Salvans Ruiz, S. Alonso Goncalves, M. Jimenez-Toscano, M. Pascual Damieta, M. Pera Roman, E.M. Pellicer-Franco, J.A. Garcia-Marin, M. Mengual-Ballester, V. Soria-Aledo, G. Valero-Navarro, M. Vicente-Ruiz, C. Garcia-Zamora, A. Gonzalez-Gil, M.J. Montoya-Tabares, M. Paredes-Quiles, J. Die Trill, P. Abadia, I. Moreno, J.D. Pina, D. Ramos Rubio, J. Escartin, J.L. Blas, J. Fernando, R. Ferrer, J. Garcia Egea, I. Pros, W. Martinez, J. Rius, M. Socias, D. Sabia, J. Castellvi Valls, V. Gonzalez Santin, S. Mompart Garcia, L. Viso Pons, D. Julia, A. Codina-Cazador, R. Farres, N. Gomez, P. Planellas, M. Cuadrado, I. Camps, M. Rufas, J. Escoll, A. Ferminan, P. Muriel, E. Sierra, C. Alvarez-Laso, P. Lora, H. Padin, J. Garcia-Septiem, C. Bustamante, V. Jimenez, J. Jimenez-Miramon, J.L. Ramos, A.B. Gallardo, P. Benito, L. Colao, P. Galindo, C. Garcia, A. Forero-Torres, A. Alonso Poza, B. Dieguez Fernandez, C. Gilsanz Martin, M. Hernandez Garcia, J.A. Rojo Lopez, J.M. Gil Lopez, M. Gonzalez Zunzarren, J. Martinez Alegre, J.P. Zorrilla Matilla, A. Navarro-Sanchez, F.J. Alcala Serrano, J. Lopez-Fernandez, D. Montesdeoca Cabrera, M. Alvarez-Gallego, J. Guevara, I. Pascual Miguelanez, I. Rubio-Perez, M. Gomez Ruiz, J. Alonso Martin, C. Cagigas Fernandez, J. Castillo Diego, J.A. Pando, C. Maristany, A. Munoz-Duyos, A. Rada-Palomino, H. Vargas-Pierola, E. Pena Ros, J.A. Benavides Buleje, J.M. Munoz Camarena, P.A. Parra Banos, M. Ramirez Faraco, J.J. Arenal, M.A. Citores, J.L. Marcos, J. Sanchez, C. Tinoco, L.J. Garcia Florez, R.D. Arias Pacheco, G. Minguez Ruiz, N. Rodriguez Corral, A. Rodriguez Infante, M.J. Carrillo Lopez, M.M. Carrasco Prats, A. Lage Laredo, A. Martinez Manzano, P. Rodriguez Garcia, J.J. Segura-Sampedro, N. Alonso-Hernandez, M. Fernandez Isart, M. Gamundi Cuesta, A. Ochogavia Segui, N. Ibanez, J. Abrisqueta, J. Lujan, R. Gomez Perez, E. Corrales Valero, C. Monje Salazar, E. Sanchiz Cardenas, R. Soler Humanes, R.M. Jimenez-Rodriguez, F. De la Portilla, J.M. Diaz Pavon, A.M. Garcia Cabrera, M.L. Reyes Diaz, E. Espin, F. Marinello, M. Marti, J.L. Sanchez, F. Vallribera, F.J. Orts Mico, M. Ortin Navarro, M. Perez Climent, C. Serra Diaz, M. Millan, A. Caro, J. Escuder, B. Espina, F. Feliu, A. Climent Aira, A. Estevez Diz, M.T. Moreno Asencio, A. Varela Mato, R. Vazquez Bouzan, A.M. Minaya-Bravo, M.M. Diez-Alonso, R. Villeta-Plaza, H. Guadalajara, D. Alias, D. Garcia Olmo, C. Pastor, I. Valverde, A. Sanchez Romero, A. Gardea, M. Gil Santos, T. Nimmersgern, P. Serrano Paz, M. Romero-Simo, T. Blasco-Segura, I. Caravaca-Garcia, D. Costa-Navarro, A. Zarco-Pleguezuelos, B. Flor-Lorente, A. Garcia-Granero, E. Garcia-Granero, B. Arencibia, J. Alonso, G. Febles, E.M. Nogues, C. Roque, J. Segelman, J. Nygren, G. Nestler, M. Abraham-Nordling, M. Egenvall, P. Myrelid, B. Jung, P. Loftas, M.-. Lydrup, N. Azahr, P. Buchwald, P. Mangell, I. Syk, M. Nikberg, J. Carlander, A. Chabok, K. Smedh, C. Tiselius, S. Haapaniemi, A. Benckert, M. Adamina, C. Freil-Lanter, C. Gingert, P. Muller, J. Schafli, L. Regusci, M. Brenna, F. Fasolini, H. Misteli, P. Kirchhoff, D. Oertli, D. Hahnloser, D. Clerc, M. Hubner, F. Ris, M. Chevallay, P. Morel, B. Schiltz, J.Y. Wang, W.-. Su, C.-. Huang, C.-. Ma, H.-. Tsai, G.S. Ozbalci, B.B. Ozkan, U. Karabacak, D. Bugra, F. Agalar, H. Baloglu, I. Basoglu, N. Okkabaz, E. Binboga, A. Biricik, A. Celik, E. Yavuz, A.E. Canda, C. Agalar, M. Fuzun, S. Sokmen, C. Terzi, A. Isik, B. Karip, A.C. Bilgili, S. Leventoglu, B. Aytac, A. Yildiz, O. Yuksel, H. Sinan, O. Hancerliogullari, S. Kaymak, O. Kozak, M.T. Ozer, I.S. Sarici, O. Akca, M.U. Kalayci, Y. Kara, O. Agcaoglu, E. Balik, O. Bayram, U. Sungurtekin, U. Ozgen, S. Demirbas, E. Ozturk, O. Isik, T. Yilmazlar, E. Colak, S. Karagul, V. Kinas, N. Fearnhead, I. Lord, P. Stewart, M. Zammit, S. Arnold, N. Battersby, J. Broadhurst, A. Mehta, F. Seretis, J. Shabbir, C. Jones, J. Kynaston, D. Vimalachandran, E. Blower, C. Mcfaul, D. Mcwhirter, J. Pilkington, T. Wilson, M. Chowdhary, B. Stubbs, M. Abdalkoddus, C. Lai, N. Thavanesan, C. Yao, T. Agarwal, S. Dindyal, R.M.C. Hill, S. Reade, A. Slesser, H. Paterson, A. Balfour, M. Boland, A. Geraghty, J. O'Kelly, P. Patel, S. Tezas, S. Yahia, V. Jadhav, K. Marimuthu, A. Narayanan, B. Piramanayagam, N. Bradley, F. Buchanan, K. Paul, J. Singh, K. Thomson, S. Korsgen, M. Bedford, K. Lee, K. Leong, D. Mcarthur, S. Malik, I. Mohamed, P. Cunha, A. Pilavas, A. Reddy, S. Ahmed, A. Ahmed, J. Voll, V. Velchuru, R. Lal, B. Mirshekar-Syahkal, M. Kassai, M. Aleem, S. Keogh-Bootland, P. Sarmah, R. Keegan, A. Kelkar, P. Sen, M. Oliveira-Cunha, S. Chaudhri, R. Fares, B. Singh, W.M. Thomas, M.I. Aslam, K. Boyle, D. Hemingway, A. Miller, M. Norwood, S. Gurjar, M. Al-Saeedi, L. Anandan, A. Sudlow, N. Zampitis, K. Malik, M. Bogdan, C. Smart, M.R. Iqbal, S. Bailey, D. Lawes, G. Omar, R. Tamhane, M. Evans, S. Ather, J. Lim, H. Nageswaran, G. Taylor, L. Hunt, J. Nicholls, I. Shaikh, F. Muscara, J. O'Brien, E. Photi, A. Stearns, D. Meylemans, C. Cunningham, R. Hompes, A. Tennakoon, N. Kumarasinghe, M. Rao, I. Upanishad, S. Smolarek, E. Platt, B. Rossi, J.C. Tham, J. Khan, N. Ahmad, Z. Shweejawee, S. Stefan, N. Smart, I. Daniels, T. Gregoir, L. Longstaff, F. Mcdermott, M. Varcada, I. Drami, T. Gala, E. Moggia, K. Ratnatunga, R. Harries, J. Hayes, G. Williams, T. Raymond, C. Bronder, E. Davies, P. Hawkin, O. Ryska, K. Ayral, A. Beveridge, A. Bhowmik, M. Gill, R. Simpson, A. Schofield, K. Mcardle, M. Parmar, M. Williamson, H. Burton, E. Courtney, C. Grant, A. Saracino, K. Newton, J. Epstein, G. Branagan, M. Bignell, M. Symankewicz, S. Zaman, R. Mankotia, Z. Siddiqui, A. Torrance, D. Artioukh, M. Eggleston, K. Gokul, D. Selwyn, J. Warusavitarne, P. Chandrasinghe, J. Grainger, C.A. Leo, G. Harris, B. Levy, A. Skull, M. Thaha, S. Ahmed, A. Garg, H. Patel, A. Ramsanahie, M. Mondragon-Pritchard, K. Cuinas Leon, A. Shukla, H. Brewer, J. Fitzgerald, H. Kho, J. Torkington, S. Tate, J. Wheat, J. Knight, J. Richardson, A. Tzivanakis, M. Gregori, M.A. Ashraf, M. Atif, J. Santos, N. Saffaf, L. Canning, N. Chandratreya, M. Bowen, B. Graham, Y. Hamad, M. Kaubrys, Z.U. Chaudhry, C. Bhan, H. Mukhtar, A. Oshowo, J. Wilson, N. Gouvas, D. Nicol, S. Pandey, M. Zilvetti, A. Sharma, T. Fatayer, S. Mothe, M. Rahman, N. Curtis, A. Allison, R. Dalton, N. Francis, J. Ockrim, G. Psaras, H. Dudarovaska, T. Marharint, E. Mostovoy, S. Voloshin, O. Kolesnik, D. Makhmudov, Y. Altinel, A. Iqbal, L. Cunningham, K. Go, S. Tan. - In: COLORECTAL DISEASE. - ISSN 1462-8910. - 20(2018), pp. 47-57.

Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit

F. Colombo;D. Foschi;A. Bondurri;A. Maffioli;E. Opocher;N.M. Mariani;
2018

Abstract

Introduction: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. Methods: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (> 16 years) who underwent emergency (unplanned, within 24 h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5). Results: From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83–2.79, P = 0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43–11.02, P = 0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur. Conclusions: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications.
anastomotic leak; colon cancer; emergency surgery; gastrointestinal surgery; rectal cancer; Surgery; surgical complications; surgical outcomes
Settore MED/18 - Chirurgia Generale
2018
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/667130
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