Anastomotic leak after manual circular stapled left-sided bowel surgery: analysis of technology-, disease-, and patient-related factors

Null, N.; Tong, C.; Jamous, N.; Schmitz, N.; Szwarcensztein, K.; Morton, D.; Pinkney, T.; El-Hussuna, A.; Battersby, N.; Bhangu, A.; Blackwell, S.; Buchs, N.; Chaudhri, S.; Dardanov, D.; Dulskas, A.; El-Hussuna, A.; Frasson, M.; Gallo, G.; Glasbey, J.; Keatley, J.; Kelly, M.; Knowles, C.; Ye, L.; Mccourt, V.; Minaya-Bravo, A.; Neary, P.; Negoi, I.; Nepogodiev, D.; Pata, F.; Pellino, G.; Poskus, T.; Sanchez-Guillen, L.; Singh, B.; Sivrikoz, E.; Van Ramshorst, G.; Zmora, O.; Pinkney, T.; Perry, R.; Magill, E.; Keatley, J.; Tong, C.; Ahmed, S.; Abdalkoddus, M.; Abelevich, A.; Abraham, S.; Abraham-Nordling, M.; Achkasov, S.; Adamina, M.; Agalar, C.; Agalar, F.; Agarwal, T.; Agcaoglu, O.; Agresta, F.; Ahmad, G.; Ainkov, A.; Aiupov, R.; Aledo, V.; Aleksic, A.; Aleotti, F.; Alias, D.; Allison, A.; Alonso, A.; Alonso, S.; Alós, R.; Altinel, Y.; Alvarez-Gallego, M.; Amorim, E.; Anania, G.; Andreev, P.; Andrejevic, P.; Andriola, V.; Antonacci, N.; Antos, F.; Anwer, M.; Aonzo, P.; Arenal, J.; Arencibia, B.; Argeny, S.; Arnold, S.; Arolfo, S.; Artioukh, D.; Ashraf, M.; Aslam, M.; Asteria, C.; Atif, M.; Avital, S.; Bacchion, M.; Bach, S.; Balestri, R.; Balfour, A.; Balik, E.; Baloyiannis, I.; Banipal, G.; Baral, J.; Barišić, B.; Bartella, I.; Barugola, G.; Bass, G.; Bedford, M.; Bedzhanyan, A.; Belli, A.; Beltrán De Heredia, J.; Bemelman, W.; Benčurik, V.; Benevento, A.; Bergkvist, D.; Bernal-Sprekelsen, J.; Besznyák, I.; Bettencourt, V.; Beveridge, A.; Bhan, C.; Bilali, S.; Bilali, V.; Binboga, E.; Bintintan, V.; Birindelli, A.; Birsan, T.; Blanco-Antona, F.; Blom, R.; Boerma, E.; Bogdan, M.; Boland, M.; Bondeven, P.; Bondurri, A.; Broadhurst, J.; Brown, S.; Buccianti, P.; Buchs, N.; Buchwald, P.; Bugra, D.; Bursics, A.; Burton, H.; Buskens, C.; Bustamante Recuenco, C.; Cagigas-Fernandez, C.; Calero-Lillo, A.; Calu, V.; Camps, I.; Canda, A.; Canning, L.; Cantafio, S.; Carpelan, A.; Carrillo Lopez, M.; Carvas, J.; Carvello, M.; Castellvi, J.; Castillo, J.; Castillo-Diego, J.; Cavenaile, V.; Cayetano Paniagua, L.; Ceccotti, A.; Cervera-Aldama, J.; Chabok, A.; Chandrasinghe, P.; Chandratreya, N.; Chaudhri, S.; Chaudhry, Z.; Chirletti, P.; Chi-Yong Ngu, J.; Chouliaras, C.; Chowdhary, M.; Chowdri, N.; Christiano, A.; Christiansen, P.; Citores, M.; Ciubotaru, C.; Ciuce, C.; Clemente, N.; Clerc, D.; Codina-Cazador, A.; Colak, E.; Colao García, L.; Coletta, D.; Colombo, F.; Connelly, T.; Cornaglia, S.; Corte Real, J.; Costa Pereira, J.; Costa, S.; Cotte, E.; Courtney, E.; Coveney, A.; Crapa, P.; Cristian, D.; Cuadrado, M.; Cuinas, K.; Cuk, M.; Cuk, V.; Cunha, M.; Curinga, R.; Curtis, N.; Dainius, E.; D'Alessandro, A.; Dalton, R.; Daniels, I.; Dardanov, D.; Dauser, B.; Davydova, O.; De Andrés-Asenjo, B.; De Graaf, E.; De La Portilla, F.; De Lacy, F.; De Laspra, E.; Defoort, B.; Dehli, T.; Del Prete, L.; Delrio, P.; Demirbas, S.; Demirkiran, A.; Den Boer, F.; Di Saverio, S.; Diego, A.; Dieguez, B.; Diez-Alonso, M.; Dimitrijevic, I.; Dimitrios, B.; Dimitriou, N.; Dindelegan, G.; Dindyal, S.; Domingos, H.; Doornebosch, P.; Dorot, S.; Draga, M.; Drami, I.; Dulskas, A.; Dzulkarnaen Zakaria, A.; Echazarreta-Gallego, E.; Edden, Y.; Egenvall, M.; Eismontas, V.; El Nakeeb, A.; El Sorogy, M.; Elfike, H.; Elgeidie, A.; El-Hussuna, A.; Elía Guedea, M.; Ellul, S.; El-Masry, S.; Elmore, U.; Emile, S.; Enciu, O.; Enriquez-Navascues, J.; Epstein, J.; Escolà Ripoll, D.; Espina, B.; Espin-Basany, E.; Estévez Diz, A.; Evans, M.; Farina, P.; Fatayer, N.; Feliu, F.; Feo, C.; Feo, C.; Fernando, J.; Feroci, F.; Ferreira, L.; Feryn, T.; Flor-Lorente, B.; Forero-Torres, A.; Francis, N.; Frasson, M.; Freund, M.; Fróis Borges, M.; Frontali, A.; Gallardo, A.; Galleano, R.; Gallo, G.; Garcia, D.; García Flórez, L.; García Marín, J.; García Septiem, J.; Garcia-Cabrera, A.; García-González, J.; Garcia-Granero, E.; Garipov, M.; Gefen, R.; Gennadiy, P.; Gerkis, S.; Germain, A.; Germanos, S.; Gianotti, L.; Gil Santos, M.; Gingert, C.; Glehen, O.; Golda, T.; Gómez Ruiz, M.; Gonçalves, D.; González, J.; Grainger, J.; Grama, F.; Grant, C.; Griniatsos, J.; Grolich, T.; Grosek, J.; Guevara-Martínez, J.; Gulcu, B.; Gupta, S.; Gurjar, S.; Haapaniemi, S.; Hamad, Y.; Hamid, M.; Hardt, J.; Harries, R.; Harris, G.; Harsanyi, L.; Hayes, J.; Hendriks, E.; Herbst, F.; Hermann, N.; Heuberger, A.; Hompes, R.; Hrora, A.; Hübner, M.; Huhtinen, H.; Hunt, L.; Hyöty, M.; Ibañez, N.; Ignjatovic, D.; Ilkanich, A.; Inama, M.; Infantino, M.; Iqbal, M.; Isik, A.; Isik, O.; Ismaiel, M.; Ivanovich, S.; Jadhav, V.; Jajtner, D.; Jiménez Carneros, V.; Jimenez-Rodriguez, R.; Jotautas, V.; Jukka, K.; Juloski, J.; Jung, B.; Kara, Y.; Karabacak, U.; Karachun, A.; Karagul, S.; Kassai, M.; Katorkin Sergei, E.; Katsaounis, D.; Katsoulis, I.; Kelly, M.; Kenjić, B.; Keogh-Bootland, S.; Khasan, D.; Khazov, A.; Kho, S.; Khrykov, G.; Kivelä, A.; Kjaer, M.; Knight, J.; Kocián, P.; Koëter, T.; Konsten, J.; Korček, J.; Korkolis, D.; Korsgen, S.; Kostić, I.; Krarup, P.; Krastev, P.; Krdzic, I.; Kreisler Moreno, E.; Krivokapic, Z.; Krones, C.; Kršul, D.; Kumar Kaul, N.; La Torre, F.; Lahodzich, N.; Lai, C.; Laina, J.; Lakkis, Z.; Lamas, S.; Lange, C.; Lauretta, A.; Lee, K.; Lefèvre, J.; Lehtonen, T.; Leo, C.; Leong, K.; Lepistö, A.; Licari, L.; Lizdenis, P.; Loftås, P.; Longhi, M.; Lopez-Dominguez, J.; López-Fernández, J.; Lovén, H.; Lozoya Trujillo, R.; Lunin, R.; Luzzi, A.; Lydrup, M.; Lykke, J.; Maderuelo-Garcia, V.; Madsboell, T.; Madsen, A.; Maffioli, A.; Majbar, M.; Makhmudov, A.; Makhmudov, D.; Malik, K.; Malik, S.; Mamedli, Z.; Manatakis, D.; Mankotia, R.; Maria, J.; Mariani, N.; Marimuthu, K.; Marinello, F.; Marino, F.; Marom, G.; Maroni, N.; Maroulis, I.; Marsanic, P.; Marsman, H.; Martí-Gallostra, M.; Martin, S.; Martinez Alegre, J.; Martinez Manzano, A.; Martins, R.; Maslyankov, S.; Mcardle, K.; Mcarthur, D.; Mcfaul, C.; Mcwhirter, D.; Mege, D.; Mehraj, A.; Metwally, M.; Metwally, I.; Millan, M.; Miller, A.; Minaya-Bravo, A.; Mingoli, A.; Minguez Ruiz, G.; Minusa, C.; Mirshekar-Syahkal, B.; Mistrangelo, M.; Mogoanta, S.; Mohamed, I.; Möller, P.; Möller, T.; Molteni, M.; Mompart, S.; Monami, B.; Mondragon-Pritchard, M.; Moniz-Pereira, P.; Montesdeoca Cabrera, D.; Morais, M.; Moran, B.; Moretto, G.; Morino, M.; Moscovici, A.; Muench, S.; Mukhtar, H.; Muller, P.; Muñoz-Duyos, A.; Muratore, A.; Muriel, P.; Myrelid, P.; Nachtergaele, M.; Nadav, H.; Nastos, K.; Navarro-Sánchez, A.; Negoi, I.; Nesbakken, A.; Nestler, G.; Nicholls, J.; Nicol, D.; Nikberg, M.; Nobre, J.; Nonner, J.; Norčič, G.; Norderval, S.; Norwood, M.; Nygren, J.; O'Brien, J.; O'Connell, P.; O'Kelly, J.; Okkabaz, N.; Oliveira-Cunha, M.; Omar, G.; Onody, P.; Opocher, E.; Orhalmi, J.; Orts-Micó, F.; Ozbalci, G.; Ozgen, U.; Ozkan, B.; Ozturk, E.; Pace, K.; Padín, M.; Pandey, S.; Pando, J.; Papaconstantinou, I.; Papadopoulos, A.; Papadopoulos, G.; Papp, G.; Paraskakis, S.; Parc, Y.; Parra Baños, P.; Parray, F.; Parvuletu, R.; Pascariello, A.; Pascual Migueláñez, I.; Pata, F.; Patel, H.; Patel, P.; Paterson, H.; Patrón Uriburu, J.; Pattacini, G.; Pavlov, V.; Pcolkins, A.; Pellicer-Franco, E.; Peña Ros, E.; Pérez, H.; Petkov, P.; Picarella, P.; Pikarsky, A.; Pisani Ceretti, A.; Platt, E.; Pletinckx, P.; Podda, M.; Popov, D.; Poskus, E.; Poskus, T.; Prats, M.; Pravosudov, I.; Primo-Romaguera, V.; Prochazka, V.; Pros Ribas, I.; Proud, D.; Psaila, J.; Pullig, F.; Qureshi Jinnah, M.; Rachadell Montero, J.; Radovanovic, D.; Radovanovic, Z.; Rahman, M.; Rainho, R.; Rama, N.; Ramos, D.; Ramsanahie, A.; Rantala, A.; Rasulov, A.; Rautio, T.; Raymond, T.; Raza, A.; Reddy, A.; Refky, B.; Regusci, L.; Reissman, P.; Rems, M.; Reyes-Diaz, M.; Riccardo, R.; Richiteanu, G.; Richter, F.; Rios, A.; Ris, F.; Rodriguez, F.; Rodriguez Garcia, P.; Rojo Lopez, J.; Romaniszyn, M.; Romano, G.; Romero, A.; Romero-Simó, M.; Roshan Lal, A.; Rossi, B.; Ruano Poblador, A.; Rubbini, M.; Rubio-Perez, I.; Ruiz, H.; Rullier, E.; Ryska, O.; Sabia, D.; Sacchi, M.; Saffaf, N.; Sakr, A.; Saladzinskas, Z.; Sales, I.; Salomon, M.; Salvans, S.; Samalavicius, N.; Sammarco, G.; Sampietro, G.; Samsonov, D.; Sanchez-Garcia, J.; Sánchez-Guillén, L.; Sanchiz, E.; Šantak, G.; Santos Torres, J.; Saraceno, F.; Sarici, I.; Sarmah, P.; Savino, G.; Scabini, S.; Schafmayer, C.; Schiltz, B.; Schofield, A.; Scurtu, R.; Segalini, E.; Segelman, J.; Segura Sampedro, J.; Seicean, R.; Sekulic, A.; Selwyn, D.; Serrano Paz, P.; Shabbir, J.; Shaikh, I.; Shalaby, M.; Sharma, A.; Shukla, A.; Shussman, N.; Siddiqui, Z.; Siironen, P.; Sileri, P.; Silva-Vaz, P.; Simoes, J.; Sinan, H.; Singh, B.; Sivins, A.; Skroubis, G.; Skrovina, M.; Skull, A.; Slavchev, M.; Slavin, M.; Slesser, A.; Smart, C.; Smart, N.; Smedh, K.; Smolarek, S.; Sokolov, M.; Sotona, O.; Spacca, D.; Spinelli, A.; Stanojevic, G.; Stearns, A.; Stefan, S.; Stift, A.; Stijns, J.; Stoyanov, V.; Straarup, D.; Strouhal, R.; Stubbs, B.; Suero Rodríguez, C.; Sungurtekin, U.; Svagzdys, S.; Svastics, I.; Syk, I.; Tabares, M.; Tamelis, A.; Tamhane, R.; Tamini, N.; Tamosiunas, A.; Tan, S.; Tanis, P.; Tate, S.; Tercioti Junior, V.; Terzi, C.; Testa, V.; Thaha, M.; Tham, J.; Thavanesan, N.; Theodore, J.; Tinoco, C.; Todorovic, M.; Tomazic, A.; Tomulescu, V.; Tonini, V.; Toorenvliet, B.; Torkington, J.; Torrance, A.; Toscano, M.; Tóth, I.; Trampus, S.; Travaglio, E.; Trostchanky, I.; Truan, N.; Tulchinsky, H.; Turrado-Rodriguez, V.; Tutino, R.; Tzivanakis, A.; Tzovaras, G.; Unger, L.; Vaccari, S.; Vaizey, C.; Valero-Navarro, G.; Valverde Nuñez, I.; Van Belle, K.; Van Belle, K.; Van Den Berg, I.; Van Geloven, A.; Van Loon, Y.; Van Steensel, L.; Varcada, M.; Vardanyan, A.; Varpe, P.; Velchuru, V.; Vencius, J.; Venskutonis, D.; Vermaas, M.; Vertruyen, M.; Vicente-Ruiz, M.; Vignali, A.; Vigorita, V.; Vila Tura, M.; Vimalachandran, D.; Vincenti, L.; Viso, L.; Visschers, R.; Voronin, Y.; Walega, P.; Wan Zainira, W.; Wang, J.; Wang, X.; Wani, R.; Warusavitarne, J.; Warwick, A.; Wasserberg, N.; Weiss, D.; Westerduin, E.; Wheat, J.; White, I.; Williams, G.; Williams, G.; Wilson, T.; Wilson, J.; Winter, D.; Wolthuis, A.; Wong, M.; Worsøe, J.; Xynos, E.; Yahia, S.; Yamamoto, T.; Yanishev, A.; Zaidi, Z.; Zairul Azwan, M.; Zaman, S.; Zaránd, A.; Zarco, A.; Zawadzki, M.; Zelic, M.; Žeromskas, P.; Zilvetti, M.; Zmora, O.

doi:10.1093/bjsopen/zrae089

Background: Anastomotic leak rates after colorectal surgery remain high. In most left-sided colon and rectal resection surgeries, a circular stapler is utilized to create the primary bowel anastomosis. However, it remains unclear whether a relationship between circular stapler technology and anastomotic leak in left-sided colorectal surgery exists.Methods: A post-hoc analysis was conducted using a prospectively collected data set of patients from the 2017 European Society of Coloproctology snapshot audit who underwent elective left-sided resection (left hemicolectomy, sigmoid colectomy, or rectal resection) with a manual circular stapled anastomosis. Rates of anastomotic leak and unplanned intensive care unit stay in association with manual circular stapling were assessed. Patient-, disease-, geographical-, and surgeon-related factors as well as stapler brand were explored using multivariable regression models to identify predictors of adverse outcomes.Results: Across 3305 procedures, 8.0% of patients had an anastomotic leak and 2.1% had an unplanned intensive care unit stay. Independent predictors of anastomotic leak were male sex, minimal-access surgery converted to open surgery, and anastomosis height C11 (lower third rectum) (all P < 0.050). Independent predictors of unplanned intensive care unit stay were minimal-access surgery converted to open surgery and American Society of Anesthesiologists grade IV (all P < 0.050). Stapler device brand was not a predictor of anastomotic leak or unplanned intensive care unit stay in multivariable regression analysis. There were no differences in rates of anastomotic leak and unplanned intensive care unit stay according to stapler head diameter, geographical region, or surgeon experience.Conclusion: In patients undergoing left-sided bowel anastomosis, choice of manual circular stapler, in terms of manufacturer or head diameter, is not associated with rates of anastomotic leak and unplanned intensive care unit stay.

Anastomotic leak after manual circular stapled left-sided bowel surgery: analysis of technology-, disease-, and patient-related factors / N. Null, C. Tong, N. Jamous, N. Schmitz, K. Szwarcensztein, D. Morton, T. Pinkney, A. El-Hussuna, N. Battersby, A. Bhangu, S. Blackwell, N. Buchs, S. Chaudhri, D. Dardanov, A. Dulskas, A. El-Hussuna, M. Frasson, G. Gallo, J. Glasbey, J. Keatley, M. Kelly, C. Knowles, Y. Li, V. Mccourt, A. Minaya-Bravo, P. Neary, I. Negoi, D. Nepogodiev, F. Pata, G. Pellino, T. Poskus, L. Sanchez-Guillen, B. Singh, E. Sivrikoz, G. van Ramshorst, O. Zmora, T. Pinkney, R. Perry, E. Magill, J. Keatley, C. Tong, S. Ahmed, M. Abdalkoddus, A. Abelevich, S. Abraham, M. Abraham-Nordling, S. Achkasov, M. Adamina, C. Agalar, F. Agalar, T. Agarwal, O. Agcaoglu, F. Agresta, G. Ahmad, A. Ainkov, R. Aiupov, V. Aledo, A. Aleksic, F. Aleotti, D. Alias, A. Allison, A. Alonso, S. Alonso, R. Alós, Y. Altinel, M. Alvarez-Gallego, E. Amorim, G. Anania, P. Andreev, P. Andrejevic, V. Andriola, N. Antonacci, F. Antos, M. Anwer, P. Aonzo, J. Arenal, B. Arencibia, S. Argeny, S. Arnold, S. Arolfo, D. Artioukh, M. Ashraf, M. Aslam, C. Asteria, M. Atif, S. Avital, M. Bacchion, S. Bach, R. Balestri, A. Balfour, E. Balik, I. Baloyiannis, G. Banipal, J. Baral, B. Barišić, I. Bartella, G. Barugola, G. Bass, M. Bedford, A. Bedzhanyan, A. Belli, J. Beltrán de Heredia, W. Bemelman, V. Benčurik, A. Benevento, D. Bergkvist, J. Bernal-Sprekelsen, I. Besznyák, V. Bettencourt, A. Beveridge, C. Bhan, S. Bilali, V. Bilali, E. Binboga, V. Bintintan, A. Birindelli, T. Birsan, F. Blanco-Antona, R. Blom, E. Boerma, M. Bogdan, M. Boland, P. Bondeven, A. Bondurri, J. Broadhurst, S. Brown, P. Buccianti, N. Buchs, P. Buchwald, D. Bugra, A. Bursics, H. Burton, C. Buskens, C. Bustamante Recuenco, C. Cagigas-Fernandez, A. Calero-Lillo, V. Calu, I. Camps, A. Canda, L. Canning, S. Cantafio, A. Carpelan, M. Carrillo Lopez, J. Carvas, M. Carvello, J. Castellvi, J. Castillo, J. Castillo-Diego, V. Cavenaile, L. Cayetano Paniagua, A. Ceccotti, J. Cervera-Aldama, A. Chabok, P. Chandrasinghe, N. Chandratreya, S. Chaudhri, Z. Chaudhry, P. Chirletti, J. Chi-Yong Ngu, C. Chouliaras, M. Chowdhary, N. Chowdri, A. Christiano, P. Christiansen, M. Citores, C. Ciubotaru, C. Ciuce, N. Clemente, D. Clerc, A. Codina-Cazador, E. Colak, L. Colao García, D. Coletta, F. Colombo, T. Connelly, S. Cornaglia, J. Corte Real, J. Costa Pereira, S. Costa, E. Cotte, E. Courtney, A. Coveney, P. Crapa, D. Cristian, M. Cuadrado, K. Cuinas, M. Cuk, V. Cuk, M. Cunha, R. Curinga, N. Curtis, E. Dainius, A. D'Alessandro, R. Dalton, I. Daniels, D. Dardanov, B. Dauser, O. Davydova, B. De Andrés-Asenjo, E. de Graaf, F. De la Portilla, F. de Lacy, E. De Laspra, B. Defoort, T. Dehli, L. Del Prete, P. Delrio, S. Demirbas, A. Demirkiran, F. Den Boer, S. Di Saverio, A. Diego, B. Dieguez, M. Diez-Alonso, I. Dimitrijevic, B. Dimitrios, N. Dimitriou, G. Dindelegan, S. Dindyal, H. Domingos, P. Doornebosch, S. Dorot, M. Draga, I. Drami, A. Dulskas, A. Dzulkarnaen Zakaria, E. Echazarreta-Gallego, Y. Edden, M. Egenvall, V. Eismontas, A. El Nakeeb, M. El Sorogy, H. Elfike, A. Elgeidie, A. El-Hussuna, M. Elía Guedea, S. Ellul, S. El-Masry, U. Elmore, S. Emile, O. Enciu, J. Enriquez-Navascues, J. Epstein, D. Escolà Ripoll, B. Espina, E. Espin-Basany, A. Estévez Diz, M. Evans, P. Farina, N. Fatayer, F. Feliu, C. Feo, C. Feo, J. Fernando, F. Feroci, L. Ferreira, T. Feryn, B. Flor-Lorente, A. Forero-Torres, N. Francis, M. Frasson, M. Freund, M. Fróis Borges, A. Frontali, A. Gallardo, R. Galleano, G. Gallo, D. Garcia, L. García Flórez, J. García Marín, J. García Septiem, A. Garcia-Cabrera, J. García-González, E. Garcia-Granero, M. Garipov, R. Gefen, P. Gennadiy, S. Gerkis, A. Germain, S. Germanos, L. Gianotti, M. Gil Santos, C. Gingert, O. Glehen, T. Golda, M. Gómez Ruiz, D. Gonçalves, J. González, J. Grainger, F. Grama, C. Grant, J. Griniatsos, T. Grolich, J. Grosek, J. Guevara-Martínez, B. Gulcu, S. Gupta, S. Gurjar, S. Haapaniemi, Y. Hamad, M. Hamid, J. Hardt, R. Harries, G. Harris, L. Harsanyi, J. Hayes, E. Hendriks, F. Herbst, N. Hermann, A. Heuberger, R. Hompes, A. Hrora, M. Hübner, H. Huhtinen, L. Hunt, M. Hyöty, N. Ibañez, D. Ignjatovic, A. Ilkanich, M. Inama, M. Infantino, M. Iqbal, A. Isik, O. Isik, M. Ismaiel, S. Ivanovich, V. Jadhav, D. Jajtner, V. Jiménez Carneros, R. Jimenez-Rodriguez, V. Jotautas, K. Jukka, J. Juloski, B. Jung, Y. Kara, U. Karabacak, A. Karachun, S. Karagul, M. Kassai, E. Katorkin Sergei, D. Katsaounis, I. Katsoulis, M. Kelly, B. Kenjić, S. Keogh-Bootland, D. Khasan, A. Khazov, S. Kho, G. Khrykov, A. Kivelä, M. Kjaer, J. Knight, P. Kocián, T. Koëter, J. Konsten, J. Korček, D. Korkolis, S. Korsgen, I. Kostić, P. Krarup, P. Krastev, I. Krdzic, E. Kreisler Moreno, Z. Krivokapic, C. Krones, D. Kršul, N. Kumar Kaul, F. La Torre, N. Lahodzich, C. Lai, J. Laina, Z. Lakkis, S. Lamas, C. Lange, A. Lauretta, K. Lee, J. Lefèvre, T. Lehtonen, C. Leo, K. Leong, A. Lepistö, L. Licari, P. Lizdenis, P. Loftås, M. Longhi, J. Lopez-Dominguez, J. López-Fernández, H. Lovén, R. Lozoya Trujillo, R. Lunin, A. Luzzi, M. Lydrup, J. Lykke, V. Maderuelo-Garcia, T. Madsboell, A. Madsen, A. Maffioli, M. Majbar, A. Makhmudov, D. Makhmudov, K. Malik, S. Malik, Z. Mamedli, D. Manatakis, R. Mankotia, J. Maria, N. Mariani, K. Marimuthu, F. Marinello, F. Marino, G. Marom, N. Maroni, I. Maroulis, P. Marsanic, H. Marsman, M. Martí-Gallostra, S. Martin, J. Martinez Alegre, A. Martinez Manzano, R. Martins, S. Maslyankov, K. Mcardle, D. Mcarthur, C. Mcfaul, D. Mcwhirter, D. Mege, A. Mehraj, M. Metwally, I. Metwally, M. Millan, A. Miller, A. Minaya-Bravo, A. Mingoli, G. Minguez Ruiz, C. Minusa, B. Mirshekar-Syahkal, M. Mistrangelo, S. Mogoanta, I. Mohamed, P. Möller, T. Möller, M. Molteni, S. Mompart, B. Monami, M. Mondragon-Pritchard, P. Moniz-Pereira, D. Montesdeoca Cabrera, M. Morais, B. Moran, G. Moretto, M. Morino, A. Moscovici, S. Muench, H. Mukhtar, P. Muller, A. Muñoz-Duyos, A. Muratore, P. Muriel, P. Myrelid, M. Nachtergaele, H. Nadav, K. Nastos, A. Navarro-Sánchez, I. Negoi, A. Nesbakken, G. Nestler, J. Nicholls, D. Nicol, M. Nikberg, J. Nobre, J. Nonner, G. Norčič, S. Norderval, M. Norwood, J. Nygren, J. O'Brien, P. O'Connell, J. O'Kelly, N. Okkabaz, M. Oliveira-Cunha, G. Omar, P. Onody, E. Opocher, J. Orhalmi, F. Orts-Micó, G. Ozbalci, U. Ozgen, B. Ozkan, E. Ozturk, K. Pace, M. Padín, S. Pandey, J. Pando, I. Papaconstantinou, A. Papadopoulos, G. Papadopoulos, G. Papp, S. Paraskakis, Y. Parc, P. Parra Baños, F. Parray, R. Parvuletu, A. Pascariello, I. Pascual Migueláñez, F. Pata, H. Patel, P. Patel, H. Paterson, J. Patrón Uriburu, G. Pattacini, V. Pavlov, A. Pcolkins, E. Pellicer-Franco, E. Peña Ros, H. Pérez, P. Petkov, P. Picarella, A. Pikarsky, A. Pisani Ceretti, E. Platt, P. Pletinckx, M. Podda, D. Popov, E. Poskus, T. Poskus, M. Prats, I. Pravosudov, V. Primo-Romaguera, V. Prochazka, I. Pros Ribas, D. Proud, J. Psaila, F. Pullig, M. Qureshi Jinnah, J. Rachadell Montero, D. Radovanovic, Z. Radovanovic, M. Rahman, R. Rainho, N. Rama, D. Ramos, A. Ramsanahie, A. Rantala, A. Rasulov, T. Rautio, T. Raymond, A. Raza, A. Reddy, B. Refky, L. Regusci, P. Reissman, M. Rems, M. Reyes-Diaz, R. Riccardo, G. Richiteanu, F. Richter, A. Rios, F. Ris, F. Rodriguez, P. Rodriguez Garcia, J. Rojo Lopez, M. Romaniszyn, G. Romano, A. Romero, M. Romero-Simó, A. Roshan Lal, B. Rossi, A. Ruano Poblador, M. Rubbini, I. Rubio-Perez, H. Ruiz, E. Rullier, O. Ryska, D. Sabia, M. Sacchi, N. Saffaf, A. Sakr, Z. Saladzinskas, I. Sales, M. Salomon, S. Salvans, N. Samalavicius, G. Sammarco, G. Sampietro, D. Samsonov, J. Sanchez-Garcia, L. Sánchez-Guillén, E. Sanchiz, G. Šantak, J. Santos Torres, F. Saraceno, I. Sarici, P. Sarmah, G. Savino, S. Scabini, C. Schafmayer, B. Schiltz, A. Schofield, R. Scurtu, E. Segalini, J. Segelman, J. Segura Sampedro, R. Seicean, A. Sekulic, D. Selwyn, P. Serrano Paz, J. Shabbir, I. Shaikh, M. Shalaby, A. Sharma, A. Shukla, N. Shussman, Z. Siddiqui, P. Siironen, P. Sileri, P. Silva-Vaz, J. Simoes, H. Sinan, B. Singh, A. Sivins, G. Skroubis, M. Skrovina, A. Skull, M. Slavchev, M. Slavin, A. Slesser, C. Smart, N. Smart, K. Smedh, S. Smolarek, M. Sokolov, O. Sotona, D. Spacca, A. Spinelli, G. Stanojevic, A. Stearns, S. Stefan, A. Stift, J. Stijns, V. Stoyanov, D. Straarup, R. Strouhal, B. Stubbs, C. Suero Rodríguez, U. Sungurtekin, S. Svagzdys, I. Svastics, I. Syk, M. Tabares, A. Tamelis, R. Tamhane, N. Tamini, A. Tamosiunas, S. Tan, P. Tanis, S. Tate, V. Tercioti Junior, C. Terzi, V. Testa, M. Thaha, J. Tham, N. Thavanesan, J. Theodore, C. Tinoco, M. Todorovic, A. Tomazic, V. Tomulescu, V. Tonini, B. Toorenvliet, J. Torkington, A. Torrance, M. Toscano, I. Tóth, S. Trampus, E. Travaglio, I. Trostchanky, N. Truan, H. Tulchinsky, V. Turrado-Rodriguez, R. Tutino, A. Tzivanakis, G. Tzovaras, L. Unger, S. Vaccari, C. Vaizey, G. Valero-Navarro, I. Valverde Nuñez, K. Van Belle, K. Van Belle, I. van den Berg, A. van Geloven, Y. Van Loon, L. van Steensel, M. Varcada, A. Vardanyan, P. Varpe, V. Velchuru, J. Vencius, D. Venskutonis, M. Vermaas, M. Vertruyen, M. Vicente-Ruiz, A. Vignali, V. Vigorita, M. Vila Tura, D. Vimalachandran, L. Vincenti, L. Viso, R. Visschers, Y. Voronin, P. Walega, W. Wan Zainira, J. Wang, X. Wang, R. Wani, J. Warusavitarne, A. Warwick, N. Wasserberg, D. Weiss, E. Westerduin, J. Wheat, I. White, G. Williams, G. Williams, T. Wilson, J. Wilson, D. Winter, A. Wolthuis, M. Wong, J. Worsøe, E. Xynos, S. Yahia, T. Yamamoto, A. Yanishev, Z. Zaidi, M. Zairul Azwan, S. Zaman, A. Zaránd, A. Zarco, M. Zawadzki, M. Zelic, P. Žeromskas, M. Zilvetti, O. Zmora. - In: BJS OPEN. - ISSN 2474-9842. - 8:5(2024), pp. zrae089.1-zrae089.8. [10.1093/bjsopen/zrae089]

Anastomotic leak after manual circular stapled left-sided bowel surgery: analysis of technology-, disease-, and patient-related factors

null, null;Tong, C;Jamous, N;Schmitz, N-D;Szwarcensztein, K;Morton, DG;Pinkney, TD;El-Hussuna, A;Battersby, N;Bhangu, A;Blackwell, S;Buchs, N;Chaudhri, S;Dardanov, D;Dulskas, A;El-Hussuna, A;Frasson, M;Gallo, G;Glasbey, J;Keatley, J;Kelly, M;Knowles, C;Li, YE;McCourt, V;Minaya-Bravo, A;Neary, P;Negoi, I;Nepogodiev, D;Pata, F;Pellino, G;Poskus, T;Sanchez-Guillen, L;Singh, B;Sivrikoz, E;van Ramshorst, G;Zmora, O;Pinkney, TD;Perry, R;Magill, EL;Keatley, J;Tong, C;Ahmed, SE;Abdalkoddus, M;Abelevich, A;Abraham, S;Abraham-Nordling, M;Achkasov, SI;Adamina, M;Agalar, C;Agalar, F;Agarwal, T;Agcaoglu, O;Agresta, F;Ahmad, G;Ainkov, A;Aiupov, R;Aledo, VS;Aleksic, A;Aleotti, F;Alias, D;Allison, AS;Alonso, A;Alonso, S;Alós, R;Altinel, Y;Alvarez-Gallego, M;Amorim, E;Anania, G;Andreev, PS;Andrejevic, P;Andriola, V;Antonacci, N;Antos, F;Anwer, M;Aonzo, P;Arenal, JJ;Arencibia, B;Argeny, S;Arnold, SJ;Arolfo, S;Artioukh, DY;Ashraf, MA;Aslam, MI;Asteria, CR;Atif, M;Avital, S;Bacchion, M;Bach, SM;Balestri, R;Balfour, A;Balik, E;Baloyiannis, I;Banipal, GS;Baral, JEM;Barišić, B;Bartella, I;Barugola, G;Bass, GA;Bedford, MR;Bedzhanyan, A;Belli, A;Beltrán de Heredia, J;Bemelman, WA;Benčurik, V;Benevento, A;Bergkvist, DJ;Bernal-Sprekelsen, JC;Besznyák, I;Bettencourt, V;Beveridge, AJ;Bhan, C;Bilali, S;Bilali, V;Binboga, E;Bintintan, V;Birindelli, A;Birsan, T;Blanco-Antona, F;Blom, RLGM;Boerma, EG;Bogdan, M;Boland, MZ;Bondeven, P;Bondurri, A;Broadhurst, J;Brown, SA;Buccianti, P;Buchs, NC;Buchwald, P;Bugra, D;Bursics, A;Burton, HLE;Buskens, CJ;Bustamante Recuenco, C;Cagigas-Fernandez, C;Calero-Lillo, A;Calu, V;Camps, I;Canda, AE;Canning, L;Cantafio, S;Carpelan, A;Carrillo Lopez, MJ;Carvas, JM;Carvello, M;Castellvi, J;Castillo, J;Castillo-Diego, J;Cavenaile, V;Cayetano Paniagua, L;Ceccotti, AA;Cervera-Aldama, J;Chabok, A;Chandrasinghe, PC;Chandratreya, N;Chaudhri, SS;Chaudhry, ZU;Chirletti, P;Chi-Yong Ngu, J;Chouliaras, C;Chowdhary, M;Chowdri, NA;Christiano, AB;Christiansen, P;Citores, MA;Ciubotaru, C;Ciuce, C;Clemente, N;Clerc, D;Codina-Cazador, A;Colak, E;Colao García, L;Coletta, D;Colombo, F;Connelly, TM;Cornaglia, S;Corte Real, J;Costa Pereira, J;Costa, S;Cotte, E;Courtney, ED;Coveney, AP;Crapa, P;Cristian, DA;Cuadrado, M;Cuinas, K;Cuk, MV;Cuk, VV;Cunha, MF;Curinga, R;Curtis, N;Dainius, E;d'Alessandro, A;Dalton, RSJ;Daniels, IR;Dardanov, D;Dauser, B;Davydova, O;De Andrés-Asenjo, B;de Graaf, EJR;De la Portilla, F;de Lacy, FB;De Laspra, ECD;Defoort, B;Dehli, T;Del Prete, L;Delrio, P;Demirbas, S;Demirkiran, A;Den Boer, FC;Di Saverio, S;Diego, A;Dieguez, B;Diez-Alonso, M;Dimitrijevic, I;Dimitrios, B;Dimitriou, N;Dindelegan, G;Dindyal, S;Domingos, H;Doornebosch, PG;Dorot, S;Draga, M;Drami, I;Dulskas, A;Dzulkarnaen Zakaria, A;Echazarreta-Gallego, E;Edden, Y;Egenvall, M;Eismontas, V;El Nakeeb, A;El Sorogy, M;Elfike, H;Elgeidie, A;El-Hussuna, A;Elía Guedea, M;Ellul, S;El-Masry, S;Elmore, U;Emile, SH;Enciu, O;Enriquez-Navascues, JM;Epstein, JC;Escolà Ripoll, D;Espina, B;Espin-Basany, E;Estévez Diz, AM;Evans, MD;Farina, PA;Fatayer, null;Feliu, F;Feo, C;Feo, CV;Fernando, J;Feroci, F;Ferreira, L;Feryn, T;Flor-Lorente, B;Forero-Torres, A;Francis, N;Frasson, M;Freund, MR;Fróis Borges, M;Frontali, A;Gallardo, AB;Galleano, R;Gallo, G;Garcia, D;García Flórez, LJ;García Marín, JA;García Septiem, J;Garcia-Cabrera, AM;García-González, JM;Garcia-Granero, E;Garipov, M;Gefen, R;Gennadiy, P;Gerkis, S;Germain, A;Germanos, S;Gianotti, L;Gil Santos, M;Gingert, C;Glehen, O;Golda, T;Gómez Ruiz, M;Gonçalves, D;González, JS;Grainger, J;Grama, F;Grant, C;Griniatsos, J;Grolich, T;Grosek, J;Guevara-Martínez, J;Gulcu, B;Gupta, SK;Gurjar, SV;Haapaniemi, S;Hamad, Y;Hamid, M;Hardt, J;Harries, RL;Harris, GJC;Harsanyi, L;Hayes, J;Hendriks, ER;Herbst, F;Hermann, N;Heuberger, A;Hompes, R;Hrora, A;Hübner, M;Huhtinen, H;Hunt, L;Hyöty, M;Ibañez, N;Ignjatovic, D;Ilkanich, A;Inama, M;Infantino, MS;Iqbal, MR;Isik, A;Isik, O;Ismaiel, M;Ivanovich, SO;Jadhav, V;Jajtner, D;Jiménez Carneros, V;Jimenez-Rodriguez, RM;Jotautas, V;Jukka, K;Juloski, J;Jung, B;Kara, Y;Karabacak, U;Karachun, A;Karagul, S;Kassai, M;Katorkin Sergei, E;Katsaounis, D;Katsoulis, IE;Kelly, ME;Kenjić, B;Keogh-Bootland, S;Khasan, D;Khazov, A;Kho, SH;Khrykov, GN;Kivelä, AJ;Kjaer, MD;Knight, JS;Kocián, P;Koëter, T;Konsten, JLM;Korček, J;Korkolis, D;Korsgen, S;Kostić, IS;Krarup, PM;Krastev, P;Krdzic, I;Kreisler Moreno, E;Krivokapic, Z;Krones, CJ;Kršul, D;Kumar Kaul, N;La Torre, F;Lahodzich, N;Lai, CW;Laina, JLB;Lakkis, Z;Lamas, S;Lange, CP;Lauretta, A;Lee, KA;Lefèvre, J;Lehtonen, T;Leo, CA;Leong, KJ;Lepistö, A;Licari, L;Lizdenis, P;Loftås, P;Longhi, M;Lopez-Dominguez, J;López-Fernández, J;Lovén, H;Lozoya Trujillo, R;Lunin, R;Luzzi, AP;Lydrup, ML;Lykke, J;Maderuelo-Garcia, VM;Madsboell, T;Madsen, AH;A. Maffioli^{Membro del Collaboration Group};Majbar, MA;Makhmudov, A;Makhmudov, D;Malik, KI;Malik, SS;Mamedli, ZZ;Manatakis, DK;Mankotia, R;Maria, J;Mariani, NM;Marimuthu, K;Marinello, F;Marino, F;Marom, G;Maroni, N;Maroulis, I;Marsanic, P;Marsman, HA;Martí-Gallostra, M;Martin, ST;Martinez Alegre, J;Martinez Manzano, A;Martins, R;Maslyankov, S;McArdle, K;McArthur, DR;McFaul, C;McWhirter, D;Mege, D;Mehraj, A;Metwally, MZ;Metwally, IH;Millan, M;Miller, AS;Minaya-Bravo, A;Mingoli, A;Minguez Ruiz, G;Minusa, C;Mirshekar-Syahkal, B;Mistrangelo, M;Mogoanta, SS;Mohamed, I;Möller, PH;Möller, T;Molteni, M;Mompart, S;Monami, B;Mondragon-Pritchard, M;Moniz-Pereira, Pedro;Montesdeoca Cabrera, D;Morais, M;Moran, BJ;Moretto, G;Morino, M;Moscovici, A;Muench, S;Mukhtar, H;Muller, P;Muñoz-Duyos, A;Muratore, A;Muriel, P;Myrelid, P;Nachtergaele, M;Nadav, H;Nastos, K;Navarro-Sánchez, A;Negoi, I;Nesbakken, A;Nestler, G;Nicholls, J;Nicol, D;Nikberg, M;Nobre, JMS;Nonner, J;Norčič, G;Norderval, S;Norwood, MGA;Nygren, J;O'Brien, JW;O'Connell, PR;O'Kelly, J;Okkabaz, N;Oliveira-Cunha, M;Omar, GEEI;Onody, P;Opocher, E;Orhalmi, J;Orts-Micó, FJ;Ozbalci, GS;Ozgen, U;Ozkan, BB;Ozturk, E;Pace, K;Padín, MH;Pandey, SB;Pando, JA;Papaconstantinou, I;Papadopoulos, A;Papadopoulos, G;Papp, G;Paraskakis, S;Parc, Y;Parra Baños, P;Parray, FQ;Parvuletu, R;Pascariello, A;Pascual Migueláñez, I;Pata, F;Patel, H;Patel, PK;Paterson, HM;Patrón Uriburu, JC;Pattacini, GC;Pavlov, V;Pcolkins, A;Pellicer-Franco, EM;Peña Ros, E;Pérez, HD;Petkov, P;Picarella, P;Pikarsky, AJ;Pisani Ceretti, A;Platt, E;Pletinckx, P;Podda, M;Popov, D;Poskus, E;Poskus, T;Prats, MC;Pravosudov, I;Primo-Romaguera, V;Prochazka, V;Pros Ribas, I;Proud, D;Psaila, J;Pullig, F;Qureshi Jinnah, MS;Rachadell Montero, J;Radovanovic, D;Radovanovic, Z;Rahman, MM;Rainho, R;Rama, N;Ramos, D;Ramsanahie, A;Rantala, A;Rasulov, A;Rautio, T;Raymond, T;Raza, A;Reddy, A;Refky, B;Regusci, L;Reissman, P;Rems, M;Reyes-Diaz, ML;Riccardo, R;Richiteanu, G;Richter, F;Rios, A;Ris, F;Rodriguez, FL;Rodriguez Garcia, P;Rojo Lopez, JA;Romaniszyn, M;Romano, GM;Romero, AS;Romero-Simó, M;Roshan Lal, A;Rossi, B;Ruano Poblador, A;Rubbini, M;Rubio-Perez, I;Ruiz, H;Rullier, E;Ryska, O;Sabia, D;Sacchi, M;Saffaf, N;Sakr, A;Saladzinskas, Z;Sales, I;Salomon, M;Salvans, S;Samalavicius, NE;Sammarco, G;Sampietro, GM;Samsonov, D;Sanchez-Garcia, JL;Sánchez-Guillén, L;Sanchiz, E;Šantak, G;Santos Torres, J;Saraceno, F;Sarici, IS;Sarmah, PB;Savino, G;Scabini, S;Schafmayer, C;Schiltz, B;Schofield, A;Scurtu, R;Segalini, E;Segelman, J;Segura Sampedro, JJ;Seicean, R;Sekulic, A;Selwyn, D;Serrano Paz, P;Shabbir, J;Shaikh, IA;Shalaby, M;Sharma, A;Shukla, A;Shussman, N;Siddiqui, ZA;Siironen, P;Sileri, P;Silva-Vaz, P;Simoes, JF;Sinan, H;Singh, B;Sivins, A;Skroubis, G;Skrovina, M;Skull, AJ;Slavchev, M;Slavin, M;Slesser, AAP;Smart, CJ;Smart, NJ;Smedh, K;Smolarek, S;Sokolov, M;Sotona, O;Spacca, D;Spinelli, A;Stanojevic, G;Stearns, A;Stefan, S;Stift, A;Stijns, J;Stoyanov, V;Straarup, D;Strouhal, R;Stubbs, BM;Suero Rodríguez, C;Sungurtekin, U;Svagzdys, S;Svastics, I;Syk, I;Tabares, MJM;Tamelis, A;Tamhane, RG;Tamini, N;Tamosiunas, A;Tan, SA;Tanis, PJ;Tate, SJ;Tercioti Junior, V;Terzi, C;Testa, V;Thaha, MA;Tham, JC;Thavanesan, N;Theodore, JE;Tinoco, C;Todorovic, M;Tomazic, A;Tomulescu, V;Tonini, V;Toorenvliet, BR;Torkington, J;Torrance, A;Toscano, MJ;Tóth, I;Trampus, S;Travaglio, E;Trostchanky, I;Truan, N;Tulchinsky, H;Turrado-Rodriguez, V;Tutino, R;Tzivanakis, A;Tzovaras, GA;Unger, LW;Vaccari, S;Vaizey, CJ;Valero-Navarro, G;Valverde Nuñez, I;Van Belle, K;Van Belle, K;van den Berg, I;van Geloven, AAW;Van Loon, YT;van Steensel, L;Varcada, M;Vardanyan, AV;Varpe, P;Velchuru, VR;Vencius, J;Venskutonis, D;Vermaas, M;Vertruyen, M;Vicente-Ruiz, M;Vignali, A;Vigorita, V;Vila Tura, M;Vimalachandran, D;Vincenti, L;Viso, L;Visschers, RGJ;Voronin, YS;Walega, P;Wan Zainira, WZ;Wang, JH;Wang, X;Wani, R;Warusavitarne, J;Warwick, A;Wasserberg, N;Weiss, DJ;Westerduin, E;Wheat, JR;White, I;Williams, G;Williams, GL;Wilson, TR;Wilson, JM;Winter, D;Wolthuis, AM;Wong, MPK;Worsøe, J;Xynos, E;Yahia, S;Yamamoto, T;Yanishev, A;Zaidi, Z;Zairul Azwan, MA;Zaman, S;Zaránd, A;Zarco, A;Zawadzki, M;Zelic, M;Žeromskas, P;Zilvetti, M;Zmora, O

2024

Abstract

Background: Anastomotic leak rates after colorectal surgery remain high. In most left-sided colon and rectal resection surgeries, a circular stapler is utilized to create the primary bowel anastomosis. However, it remains unclear whether a relationship between circular stapler technology and anastomotic leak in left-sided colorectal surgery exists.Methods: A post-hoc analysis was conducted using a prospectively collected data set of patients from the 2017 European Society of Coloproctology snapshot audit who underwent elective left-sided resection (left hemicolectomy, sigmoid colectomy, or rectal resection) with a manual circular stapled anastomosis. Rates of anastomotic leak and unplanned intensive care unit stay in association with manual circular stapling were assessed. Patient-, disease-, geographical-, and surgeon-related factors as well as stapler brand were explored using multivariable regression models to identify predictors of adverse outcomes.Results: Across 3305 procedures, 8.0% of patients had an anastomotic leak and 2.1% had an unplanned intensive care unit stay. Independent predictors of anastomotic leak were male sex, minimal-access surgery converted to open surgery, and anastomosis height C11 (lower third rectum) (all P < 0.050). Independent predictors of unplanned intensive care unit stay were minimal-access surgery converted to open surgery and American Society of Anesthesiologists grade IV (all P < 0.050). Stapler device brand was not a predictor of anastomotic leak or unplanned intensive care unit stay in multivariable regression analysis. There were no differences in rates of anastomotic leak and unplanned intensive care unit stay according to stapler head diameter, geographical region, or surgeon experience.Conclusion: In patients undergoing left-sided bowel anastomosis, choice of manual circular stapler, in terms of manufacturer or head diameter, is not associated with rates of anastomotic leak and unplanned intensive care unit stay.

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				Settore MEDS-06/A - Chirurgia generale
			
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				2024
			
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				BJS OPEN
			
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				https://dx.doi.org/10.1093/bjsopen/zrae089
			
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