BACKGROUND: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified 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) 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) cases. Patients undergoing handsewn anastomosis were more likely to be emergency admissions (20.5% handsewn versus 12.9% stapled) and to undergo open surgery (54.7% versus 36.6%). 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 odds ratio 1.43, 95% confidence interval 1.04-1.95, p=0.03). DISCUSSION: 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.
Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection : an international snapshot audit / N. Battersby, A. Bhangu, S. Chaudhri, A. El hussuna, M. Frasson, D. Nepogodiev, B. Singh, S. Vennix, O. Zmora, D. Altomare, W. Bemelman, P. Christensen, A. D'Hoore, S. Laurberg, D. Morton, M. Rubbini, C. Vaizey, L. Magill, R. Perry, N. Sheward, N. Ives, S. Mehta, M. Cillo, D. Estefania, J. Patron Uriburu, H. Ruiz, M. Salomon, A. Makhmudov, L. Selnyahina, A. Varabei, Y. Vizhynis, D. Claeys, B. Defoort, F. Muysoms, P. Pletinckx, V. Vergucht, I. Debergh, T. Feryn, H. Reusens, M. Nachtergaele, D. Francart, C. Jehaes, S. Markiewicz, B. Monami, J. Weerts, W. Bouckaert, B. Houben, J. Knol, G. Sergeant, G. Vangertruyden, L. Haeck, C. Lange, C. Sommeling, K. Vindevoghel, S. Castro, H. De Bruyn, H. De Bruyn, H. De Bruyn, M. Huyghe, E. De Wolf, D. Reynders, A. D'Hoore, A. Wolthuis, S. Delibegovic, A. Christiani, M. Marchiori, C.R. De Moraes, V. Tercioti, E. Arabadjieva, D. Bulanov, D. Dardanov, V. Stoyanov, A. Yonkov, K. Angelov, S. Maslyankov, M. Sokolov, G. Todorov, S. Toshev, Y. Georgiev, A. Karashmalakov, G. Zafirov, X. Wang, D. Condic, D. Kraljik, H. Mrkovic, V. Pavkovic, K. Raguž, V. Bencurik, E. Holášková, M. Skrovina, M. Farkašová, T. Grolich, Z. Kala, F. Antos, V. Pruchova, O. Sotona, M. Chobola, T. Dusek, A. Ferko, J. Örhalmi, J. Hoch, P. Kocian, L. Martinek, I. Bernstein, K. Gotschalck Sunesen, J. Leunbach, O. Thorlacius ussing, A. Uth Oveson, P. Christensen, S. Dahl Chirstensen, V. Gamez, M. Oeting, U. Schou Loeve, A. Ugianskis, M. Jessen, P. Krarup, K. Linde, Q. Mirza, J. Overgaard Stovring, L. Erritzøe, H. Loft Jakobsen, J. Lykke, E. Palmgren Colov, A. Husted Madsen, T. Linde Friis, J. Amstrup Funder, R. Dich, S. Kjaer, S. Rasmussen, N. Schlesinger, M. Dilling Kjaer, N. Qvist, A. Khalid, G. Ali, A. El hussuna, S. Hadi, L. Rosell Walker, A. Kivelã¤, T. Lehtonen, A. Lepistö, T. Scheinin, P. Siironen, J. Kössi, P. Kuusanmäki, T. Tomminen, A. Turunen, T. Rautio, M. Vierimaa, H. Huhtinen, J. Karvonen, M. Lavonius, A. Rantala, P. Varpe, E. Cotte, Y. Francois, O. Glehen, V. Kepenekian, G. Passot, L. Maggiori, G. Manceau, Y. Panis, M. Gout, E. Rullier, N. Chafai, J.H. Lefevre, Y. Parc, E. Tiret, C. Couette, E. Duchalais, A. Agha, M. Hornberger, A. Hungbauer, I. Iesalnieks, I. Weindl, F. Crescenti, M. Keller, N. Kolodziejski, R. Scherer, D. Sterzing, B. Bock, G. Boehm, M. El Magd, C. Krones, M. Niewiera, J. Buhr, S. Cordesmeyer, M. Hoffmann, K. Krückemeier, T. Vogel, M. Schön, J. Baral, T. Lukoschek, S. Münch, F. Pullig, K. Horisberger, P. Kienle, J. Magdeburg, S. Post, K. Batzalexis, S. Germanos, C. Agalianos, C. Dervenis, N. Gouvas, P. Kanavidis, A. Kottikias, I.E. Katsoulis, D. Korkolis, G. Plataniotis, G. Sakorafas, I. Akrida, M. Argentou, C. Kollatos, C. Lampropoulos, S. Tsochatzis, I. Besznyák, A. Bursics, T. Egyed, G. Papp, I. Svastics, J. Atladottir, P. Möller, H. Sigurdsson, T. Stefánsson, E. Valsdottir, E. Andrews, N. Foley, D. Hechtl, M. Majeed, M. Mccourt, A. Hanly, J. Hyland, S. Martin, P.R. O'Connell, D. Winter, T. Connelly, W. Joyce, P. Wrafter, R. Berkovitz, S. Avital, I. Haj Yahia, N. Hermann, B. Shpitz, I. White, Y. Lishtzinsky, A. Tsherniak, N. Wasserberg, N. Horesh, U. Keler, R. Pery, R. Shapiro, O. Zmora, H. Tulchinsky, B. Badran, K. Dayan, A. Iskhakov, J. Lecaros, N. Nabih, I. Angrima, R. Bardini, E. Pizzolato, M. Tonello, F. Arces, R. Balestri, C. Ceccarelli, V. Prosperi, E. Rossi, I. Giannini, L. Vincenti, D.F. Altomare, F. Di Candido, M. Di Iena, A. Guglielmi, O. Caputi iambrenghi, P. Marsanic, A. Mellano, A. Muratore, M. Annecchiarico, L. Bencini, S. Amore Bonapasta, A. Coratti, F. Guerra, C.R. Asteria, L. Boccia, L. Gerard, A. Pascariello, G. Manca, F. Marino, A. Casaril, M. Inama, G. Moretto, C. Bacchelli, M. Carvello, N.M. Mariani, M. Montorsi, A. Spinelli, E. Romairone, S. Scabini, A. Belli, F. Bianco, S. De Franciscis, G. Maria Romano, P. Delrio, U. Pace, D. Rega, C. Sassaroli, D. Scala, R. De Luca, E. Ruggieri, C. Elbetti, A. Garzi, L. Romoli, M. Scatizzi, A. Vannucchi, G. Curletti, V. Durante, R. Galleano, F. Mariani, L. Reggiani, R. Bellomo, A. Infantino, L. Franceschilli, P. Sileri, I. Clementi, D. Coletta, F. La Torre, A. Mingoli, F. Velluti, A. Di Giacomo, A. Fiorot, M. Massani, L. Padoan, C. Ruffolo, S. Caruso, F. Franceschini, R. Laessig, I. Monaci, M. Rontini, P. De Nardi, U. Elmore, M. Lemma, R. Rosati, A. Tamburini, M. De Luca, A. Sartori, A. Benevento, C. Bottini, C.C. Ferrari, F. Pata, G. Tessera, G. Pellino, F. Selvaggi, A. Lanzani, F. Romano, G. Sgroi, F. Steccanella, L. Turati, T. Yamamoto, G. Ancans, S. Gerkis, M. Leja, A. Pcolkins, A. Sivins, T. Latkauskas, P. Lizdenis, Z. Saladžinskas, S. Švagždys, A. Tamelis, A. Razbadauskas, M. Sokolovas, A. Dulskas, N. Samalavicius, V. Jotautas, S. Mikalauskas, E. Poskus, T. Poskus, K. Strupas, C. Camenzuli, C. Cini, A. Predrag, J. Psaila, N. Spiteri, W. Bemelman, C. Buskens, J. Gooszen, P. Tanis, E. Belgers, P. Davids, E. Furnee, E. Postma, A. Pronk, N. Smakman, S. Clermonts, D. Zimmerman, J. Omloo, E. Wassenaar, M. Bruijninckx, P. Doornebosch, G. Tetteroo, M. Vermaas, G. Iordens, S. Knops, B. Toorenvliet, E. Boerma, P. Coene, M. Raber, J. Melenhorst, M. Gerhards, M. Arron, A. Bremers, F. Ferenschild, S. Yauw, H. Cense, A. Demirkiran, M. Hunfeld, I. Mulder, J. Nonner, H. Swank, M. Bolmers, J. Briel, V. Klemann, J. Konsten, B. Leenders, T. Schok, W. Bleeker, A. Gidwani, R. Lawther, P. Loughlin, B. Skelly, R. Spence, M. Brun, M. Helgeland, D. Ignjatovic, T. Øresland, P. Yousefi, I. Flåten Backe, O. Helmer Sjo, A. Nesbakken, M. Tandberg eriksen, A. Cais, J. Hallvard Trã¦land, R. Herikstad, H. Kã¸rner, N. Lauvland, D. Jajtner, W. Kabiesz, M. Rak, L. Gmerek, K. Horbacka, N. Horst, P. Krokowicz, A. Kwiatkowski, K. Pasnik, P. Karcz, M. Romaniszyn, T. Rusek, P. Walega, R. Czarencki, Z. Obuszko, M. Sitarska, W. Wojciech, M. Zawadzki, S. Amado, P. Clara, A. Couceiro, R. Malaquias, N. Rama, A. Almeida, E. Barbosa, E. Cernadas, A. Duarte, P. Silva, S. Costa, C. Martinez Insua, J. Pereira, C. Pereira, M. Sacchetti, B. Carvalho Pinto, P. Jorge Vieira Sousa, R. Marques, A. Oliveira, R. Cardoso, S. Carlos, J. Corte real, P. Moniz Pereira, R. Souto, C. Carneiro, R. Marinho, V. Nunes, R. Rocha, M. Sousa, F. Fonseca, J. Leite, F. Melo, J. Pimentel, L. Ventura, C. Vila Nova, C. Copäƒescu, V. Bintintan, C. Ciuce, G. Dindelegan, R. Scurtu, R. Seicean, N. Domansky, A. Karachun, A. Moiseenko, Y. Pelipas, A. Petrov, I. Pravosudov, R. Aiupov, Y. Akmalov, A. Parfenov, N. Suleymanov, N. Tarasov, H. Jumabaev, Z. Mamedli, A. Rasulov, I. Aliev, I. Chernikovskiy, V. Kochnev, K. Komyak, I. Pravosudov, A. Smirnov, S. Achkasov, K. Bolikhov, Y. Shelygin, O. Sushkov, A. Zapolskiy, M. Gvozdenovic, D. Jovanovic, Z. Lausevic, D. Cvetkoviä‡, M. Maraviä‡, B. Milovanovic, N. Stojakovic, I. Tripkoviä‡, D. Mihajlovic, M. Nestorovic, V. Pecic, D. Petrovic, G. Stanojevic, G. Barisic, I. Dimitrijevic, Z. Krivokapic, V. Markovic, M. Popovic, A. Aleksic, D. Dabic, I. Kostic, A. Milojkovic, V. Perunicic, D. Lukic, T. Petrovic, D. Radovanovic, Z. Radovanovic, V.M. Cuk, V.V. Cuk, M. Kenic, B. Kovacevic, I. Krdzic, J. Korcek, M. Rems, J. Toplak, J. Escarrã¢, M. Gil Barrionuevo, T. Golda, E. Kreisler Moreno, C. Zerpa Martin, C. à lvarez Laso, P. Cumplido, H. Padin, J. Baixauli Fons, J. Hernã¡ndez lizoain, P. Martinez ortega, M. Molina Fernàndez, C. Sànnchez justicia, J. Antonio Gracia Solanas, E.C.D. De Laspra, E. Echazarreta gallego, M. Elia Guedea, J. Ramirez, J. Arredondo Chaves, P. Diez Gonzã¡lez, T. Elosua, J. Sahagan, A. Turienzo Frade, J. à lvarez Conde, E. Castrillo, R. Diaz Maag, V. Maderuelo, L. Saldarriaga, I. Aldrey Cao, X. Fernàndez Varela, S. Nàyàez Fernã¡ndez, A. Par Calvo, S. Villar à lvarez, I. Blesa Sierra, A. Duarte, R. Lozano, M. Màrquez, O. Porcel, P. Menendez, M. Fernã¡ndez Hevia, L. Flores Sigã¼enza, M. Jimenez Toscano, A. Lacy Fortuny, J. Ordoãnez Trujillo, A. Espi, S. Garcia Botello, J. Martãn Arãvalo, D. Moro valdezate, V. Pla martã, F. Blanco antona, J. Abrisqueta, N. Ibanez Canovas, J. Lujan Mompean, D. Escolã¡ Ripoll, S. Martinez Gonzalez, J. Parodi, A. Fernàndez Lòpez, M. Ramos Fernã¡ndez, J. Castellvi Valls, L.O. De Zarate, R. Ribas, D. Sabia, L. Viso, S. Alonso Gonã§alves, M. José Gil Egea, M. Pascual Damieta, M. Pera, S. Salvans Ruiz, J. Bernal, F. Landete, G. Ais, J. Etreros, J. Aguilã³ Lucia, A. Boscã¡, S. Deusa, J. Garcãa Del Caã±o, V. Viciano, J. Garcìa Armengol, J. Roig, J. Blas, J. Escartin, J. Fatãs, J. Fernando, R. Ferrer, R. Arias Pacheco, L. Garcìa Flérez, M. Moreno Gijan, J. Otero Dãez, L. Solar Garcia, F. Aguilar Teixido, C. Balaguer Ojo, J. Bargallo Berzosa, S. Lamas Moure, J. Enrique Sierra, A. Fermiàn, F. Herrerias, M. Rufas, J. Viãnas, A. Codina cazador, R. Farres, N. Gòmez, D. Juliã , P. Planellas, J. Lòpez, A. Luna, C. Maristany, A. Munoz Duyos, N. Purtolas, M. Alcantara Moral, X. Serra aracil, P. Concheiro Coello, D. Gòmez, C. Carton, A. Miguel, F. Reoyo Pascual, X. Valero Cerrato, R. Zambrano Munoz, J. Cervera aldama, J. Garcìa Gonzàlez, J. Ramos prada, M. Santamarãa olabarrieta, A. Urigaen echeverrãa, R. Coves Alcover, J. Espinosa Soria, E. Fernandez Rodriguez, J. Hernandis Villalba, V. Maturana Ibanez, F. De La Torre Gonzalez, D. Huerga, E. Pérez Viejo, A. Rivera, E. Ruiz Ucar, J. Garcia septiem, V. Jiménez, J. Jiménez Miraman, J. Ramons Rodriquez, V. Rodriguez Alvarez, A. Garcea, L. Ponchietti, N. Borda, J. Enriquez navascues, Y. Saralegui, G. Febles Molina, E. Nogues, A. Rodrìguez Méndez, C. Roque Castellano, Y. Sosa Quesada, M. Alvarez gallego, I. Pascual, I. Rubio perez, B. Diaz San Andrés, F. Tone villanueva, J. Alonso, C. Cagigas, J. Castillo, M. Gòmez, J. Martãn parra, M. Mengual Ballester, E. Pellicer Franco, V. Soria Aledo, G. Valero Navarro, E. Caballero Rodrãguez, P.G. De Chaves, G. Hernandez, A. Perez Alvarez, A. Soto Sanchez, F. Cesar Becerra Garcia, J. Guillermo Alonso Roque, F. Lòpez Rodrãguez Arias, S.R. Del Valle Ruiz, G.S. De La Villa, A. Compana, A. Garcãa Marãn, C. Nofuentes, F. Orts Mica, V. Pérez Auladell, M. Carrasco, C. Duque Perez, S. Gãlvez Pastor, I. Navarro Garcia, A. Sanchez Perez, D. Enjuto, F. Manuel Bujalance, N. Marcelin, M. Pérez, R. Serrano Garcìa, A. Cabrera, F. De La Portilla, J. Diaz Pavon, R. Jimenez Rodriguez, J. Vazquez Monchul, J. Daza Gonzãlez, R. Gomez Pérez, J. Rivera Castellano, J.R. De La Rua, J. Errasti Alustiza, L. Fernandez, J. Romeo Ramirez, J. Sardon Ramos, B. Cermeã±o Toral, D. Alias, D. Garcia olmo, H. Guadalajara, M. Herreros, P. Pacheco, P. Lima, J. Martinez Alegre, I. Ortega, A. Picardo Nieto Antonio, A. Caro, J. Escuder, F. Feliu, M. Millan, A. Frangi Caregnato, R. Lozoya Trujillo, R. Rodriguez Carrillo, M. Ruiz Carmona, N. Alonso, D. Ambrona Zafra, B.J. Amilka Ayala Candia, C. Pineo Flores, J. Alcazar Montero, M. Angoso Clavijo, J. Garcia, J. Sanchez Tocino, C. Gomez Alcazar, D. Costa navarro, J. Ferri Romero, M. Rey Riveiro, M. Romero, B. Arencibia, P. Esclapez, M. Frasson, E. Garcìa Granero, P. Granero, F.J. Medina Fernandez, A.B. Gallardo Herrera, C. Diaz Lopez, E. Navarro Rodriguez, E. Torres Tordera, J. Arenal, M. Citores, J. Marcos, J. Sã¡nchez, C. Tinoco, E. Espin, A. Garcia Granero, L. Jimenez Gomez, J. Sanchez Garcia, F. Vallribera, J. Folkesson, F. Sköldberg, K. Bergman, E. Borgström, J. Frey, A. Silfverberg, M. Söderholm, J. Nygren, J. Segelman, D. Gustafsson, A. Lagerqvist, A. Papp, M. Pelczar, M. Abraham nordling, M. Ahlberg, A. Sjovall, J. Tengstrom, K. Hagman, A. Chabok, E. Ezra, M. Nikberg, K. Smedh, C. Tiselius, N. Al naimi, M. Dao Duc, J. Meyer, M. Mormont, F. Ris, G. Prevost, P. Villiger, H. Hoffmann, C. Kettelhack, P. Kirchhoff, D. Oertli, B. Weixler, B. Aytac, S. Leventoglu, B. Mentes, O. Yuksel, S. Demirbas, B. Busra Ozkan, G. Selçuk Özbalci, U. Sungurtekin, B. Gülcü, E. Ozturk, T. Yilmazlar, C. Challand, N. Fearnhead, R. Hubbard, S. Kumar, J. Arthur, C. Barben, P. Skaife, S. Slawik, M. Williams, M. Zammit, J. Barker, I. Sarantitis, C. Slawinski, R. Clifford, N. Eardley, M. Johnson, C. Mcfaul, D. Vimalachandran, S. Allan, A. Bell, E. Oates, V. Shanmugam, A. Brigic, M. Halls, P. Pucher, B. Stubbs, T. Agarwal, A. Chopada, S. Mallappa, M. Pathmarajah, C. Sugden, C. Brown, E. Macdonald, A. Mckay, J. Richards, A. Robertson, M. Kaushal, P. Patel, S. Tezas, N. Touqan, S. Ayaani, K. Marimuthu, B. Piramanayagam, M. Vourvachis, N. Iqbal, S. Korsgen, C. Seretis, U. Shariff, S. Arnold, N. Battersby, H. Chan, E. Clark, R. Fernandes, B. Moran, A. Bajwa, D. Mcarthur, K. Cao, P. Cunha, H. Pardoe, A. Quddus, K. Theodoropoulou, C. Bolln, G. Denys, M. Gillespie, N. Manimaran, J. Reidy, A.I. Malik, A. Malik, J. Pitt, K. Aryal, A. El hadi, R. Lal, A. Pal, V. Velchuru, S. Chaudhri, M. Oliveira Cunha, B. Singh, M. Thomas, S. Bains, K. Boyle, A. Miller, M. Norwood, J. Yeung, L. Goian, S. Gurjar, W. Saghir, N. Sengupta, E. Stewart parker, S. Bailey, T. Khalil, D. Lawes, S. Nikolaou, G. Omar, R. Church, B. Muthiah, W. Garrett, P. Marsh, N. Obeid, S. Chandler, P. Coyne, M. Evans, L. Hunt, J. Lim, Z. Oliphant, E. Papworth, H. Weaver, K. Cuiñas Leon, G. Williams, J. Hernon, S. Kapur, R. Moosvi, I. Shaikh, L. Swafe, M. Aslam, J. Evans, U. Ihedioha, P. Kang, J. Merchant, R. Hompes, R. Middleton, A. Broomfield, D. Crutten wood, J. Foster, G. Nash, M. Akhtar, M. Boshnaq, S. Eldesouky, S. Mangam, M. Rabie, J. Ahmed, J. Khan, N. Ming Goh, A. Shamali, S. Stefan, D. Nepogodiev, C. Thompson, A. Amin, J. Docherty, M. Lim, K. Walker, A. Watson, M. Hossack, N. Mackenzie, M. Paraoan, N. Alam, I. Daniels, S. Narang, S. Pathak, N. Smart, A. Al qaddo, R. Codd, O. Rutka, G. Williams, C. Bronder, I. Crighton, E. Davies, T. Raymond, L. Bookless, B. Griffiths, S. Plusa, G. Carlson, R. Harrison, N. Lees, C. Mason, J. Quayle, G. Branagan, J. Broadhurst, H. Chave, S. Sleight, F. Awad, A. Bhangu, N. Cruickshank, H. Joy, C. Boereboom, P. Daliya, A. Dhillon, N. Watson, R. Watson, D. Artioukh, K. Gokul, M. Javed, R. Kong, J. Sutton, O. Faiz, I. Jenkins, C.A. Leo, S.F. Samaranayake, J. Warusavitarne, S. Arya, C. Bhan, H. Mukhtar, A. Oshowo, J. Wilson, S. Duff, T. Fatayer, J. Mbuvi, A. Sharma, J. Cornish, L. Davies, R. Harries, C. Morris, J. Torkington, J. Knight, C. Lai, O. Shihab, A. Tzivanakis, A. Hussain, D. Luke, R. Padwick, A. Torrance, A. Tsiamis, P. Dawson, A. Balfour, R. Brady, J. Mander, H. Paterson, N. Chandratreya, H. Chu, J. Cutting, S. Vernon, C. Wai Ho, S. Andreani, H. Patel, J. Yan Qi Tan, A. Iqbal, A. Khan, K. Perrin, A. Raza, S. Tan. - In: COLORECTAL DISEASE. - ISSN 1462-8910. - 19:8(2017), pp. 296-311. [10.1111/codi.13646]
Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection : an international snapshot audit
N.M. Mariani;
2017
Abstract
BACKGROUND: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified 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) 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) cases. Patients undergoing handsewn anastomosis were more likely to be emergency admissions (20.5% handsewn versus 12.9% stapled) and to undergo open surgery (54.7% versus 36.6%). 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 odds ratio 1.43, 95% confidence interval 1.04-1.95, p=0.03). DISCUSSION: 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.File | Dimensione | Formato | |
---|---|---|---|
2017 - ESCP 2015 - Colorectal_Disease 2017.pdf
accesso riservato
Tipologia:
Post-print, accepted manuscript ecc. (versione accettata dall'editore)
Dimensione
453.07 kB
Formato
Adobe PDF
|
453.07 kB | Adobe PDF | Visualizza/Apri Richiedi una copia |
2017-Colorectal_Disease.pdf
accesso riservato
Tipologia:
Publisher's version/PDF
Dimensione
470.62 kB
Formato
Adobe PDF
|
470.62 kB | Adobe PDF | Visualizza/Apri Richiedi una copia |
Pubblicazioni consigliate
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.