The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit

C Glasbey, J.; Nepogodiev, D.; Battersby, N.; Bhangu, A.; El-Hussuna, A.; Frasson, M.; Singh, B.; Vennix, S.; Zmora, O.; Pinkney, T.; Chaudhri, S.; Bemelman, W.; Christensen, P.; D'Hoore, A.; Laurberg, S.; Morton, D.; Pinkney, T.; Rubbini, M.; Vaizey, C.; Mehta, S.; Ives, N.; Magill, L.; Perry, R.; Sheward, N.; Cillo, M.; Estefania, D.; J Patron Uriburu,; Ruiz, H.; Salomon, M.; Makhmudov, A.; Selnyahina, L.; Varabei, A.; Vizhynis, Y.; Claeys, D.; Defoort, B.; Muysoms, F.; Pletinckx, P.; Vergucht, V.; Debergh, I.; Feryn, T.; Reusens, H.; Nachtergaele, M.; Francart, D.; Jehaes, C.; Markiewicz, S.; Monami, B.; Weerts, J.; Bouckaert, W.; Houben, B.; Knol, J.; Sergeant, G.; Vangertruyden, G.; Haeck, L.; Lange, C.; Sommeling, C.; Vindevoghel, K.; Castro, S.; H De Bruyn,; Huyghe, M.; E De Wolf,; Reynders, D.; D'Hoore, A.; A de Buck van Overstraeten,; Wolthuis, A.; Delibegovic, S.; Christiani, A.; M Marchiori Jr,; C Rocha de Moraes,; V Tercioti Jr,; Arabadjieva, E.; Bulanov, D.; Dardanov, D.; Stoyanov, V.; Yonkov, A.; Angelov, K.; Maslyankov, S.; Sokolov, M.; Todorov, G.; Toshev, S.; Georgiev, Y.; Karashmalakov, A.; Zafirov, G.; Wang, X.; Condic, D.; Kraljik, D.; Mrkovic, H.; Pavkovic, V.; Raguž, K.; Bencurik, V.; Holášková, E.; Skrovina, M.; Farkašová, M.; Grolich, T.; Kala, Z.; Antos, F.; Pruchova, V.; Sotona, O.; Chobola, M.; Dusek, T.; Ferko, A.; Örhalmi, J.; Hoch, J.; Kocian, P.; Martinek, L.; Bernstein, I.; K Gotschalck Sunesen,; Leunbach, J.; Thorlacius-Ussing, O.; A Uth Oveson,; Christensen, P.; S Dahl Chirstensen,; Gamez, V.; Oeting, M.; U Schou Loeve,; Ugianskis, A.; Jessen, M.; Krarup, P.; Linde, K.; Mirza, Q.; J Overgaard Stovring,; Erritzøe, L.; H Loft Jakobsen,; Lykke, J.; E Palmgren Colov,; A Husted Madsen,; T Linde Friis,; Kjaer, S.; Rasmussen, S.; Schlesinger, N.; M Dilling Kjaer,; Qvist, N.; Khalid, A.; Ali, G.; El-Hussuna, A.; Hadi, S.; L Rosell Walker,; Kivelä, A.; Lehtonen, T.; Lepistö, A.; Scheinin, T.; Siironen, P.; Kössi, J.; Kuusanmäki, P.; Tomminen, T.; 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doi:10.1111/codi.14308

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.

The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit / J. C Glasbey, D. Nepogodiev, N. Battersby, A. Bhangu, A. El-Hussuna, M. Frasson, B. Singh, S. Vennix, O. Zmora, T. Pinkney, S. Chaudhri, W. Bemelman, P. Christensen, A. D'Hoore, S. Laurberg, D. Morton, T. Pinkney, M. Rubbini, C. Vaizey, S. Mehta, N. Ives, L. Magill, R. Perry, N. Sheward, 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, M. Huyghe, E. De Wolf, D. Reynders, A. D'Hoore, A. de Buck van Overstraeten, A. Wolthuis, S. Delibegovic, A. Christiani, M. Marchiori Jr, C. Rocha de Moraes, V. Tercioti Jr, 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, S. Kjaer, S. Rasmussen, N. Schlesinger, M. Dilling Kjaer, N. Qvist, A. Khalid, G. Ali, A. El-Hussuna, S. Hadi, L. Rosell Walker, A. Kivelä, T. Lehtonen, A. Lepistö, T. 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Tan. - In: COLORECTAL DISEASE. - ISSN 1462-8910. - 20:11(2018 Nov), pp. 1028-1040. [10.1111/codi.14308]

The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit

J C Glasbey;D Nepogodiev;N Battersby;A Bhangu;A El-Hussuna;M Frasson;B Singh;S Vennix;O Zmora;T Pinkney;S Chaudhri;W Bemelman;P Christensen;A D'Hoore;S Laurberg;D Morton;T Pinkney;M Rubbini;C Vaizey;S Mehta;N Ives;L Magill;R Perry;N Sheward;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;M Huyghe;E De Wolf;D Reynders;A D'Hoore;A de Buck van Overstraeten;A Wolthuis;S Delibegovic;A Christiani;M Marchiori Jr;C Rocha de Moraes;V Tercioti Jr;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;S Kjaer;S Rasmussen;N Schlesinger;M Dilling Kjaer;N Qvist;A Khalid;G Ali;A El-Hussuna;S Hadi;L Rosell Walker;A Kivelä;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;B van Geluwe;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;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. 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Barbosa;E Cernadas;A Duarte;P Silva;S Costa;C Martinez Insua;R Marques;J Pereira;C Pereira;M Sacchetti;B Carvalho Pinto;P Jorge Vieira Sousa;A Oliveira;R Cardoso;S Carlos;J Corte-Real;P Moniz Pereira;R Souto;C Carneiro;R Marinho;V Nunes;R Rocha;M Sousa;J Leite;F Melo;J Pimentel;L Ventura;C Vila Nova;C Copăescu;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 Cvetković;M Maravić;B Milovanovic;N Stojakovic;I Tripković;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 Escarrâ;M Gil Barrionuevo;T Golda;E Kreisler Moreno;C Zerpa Martin;C Álvarez Laso;P Cumplido;H Padin;J Baixauli Fons;J Hernández-Lizoain;P Martinez-Ortega;M Molina-Fernández;C Sánchez-Justicia;J Antonio Gracia Solanas;E Córdoba Díaz de Laspra;E Echazarreta-Gallego;M Elia-Guedea;J Ramirez;J Arredondo Chaves;P Diez González;T Elosua;J Sahagún;A Turienzo Frade;J Álvarez Conde;E Castrillo;R Diaz Maag;V Maderuelo;L Saldarriaga;I Aldrey Cao;X Fernández Varela;S Núñez Fernández;A Parajó Calvo;S Villar Álvarez;I Blesa Sierra;A Duarte;R Lozano;M Márquez;O Porcel;P Menendez;M Fernández Hevia;L Flores Sigüenza;M Jimenez Toscano;A Lacy Fortuny;J Ordoñez Trujillo;A Espi;S Garcia-Botello;J Martín-Arévalo;D Moro-Valdezate;V Pla-Martí;F Blanco-Antona;J Abrisqueta;N Ibañez Canovas;J Lujan Mompean;D Escolá Ripoll;S Martinez Gonzalez;J Parodi;A Fernández López;M Ramos Fernández;J Castellvi Valls;L Ortiz de Zarate;R Ribas;D Sabia;L Viso;S Alonso Gonçalves;M José Gil Egea;M Pascual 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Enriquez-Navascues;Y Saralegui;G Febles Molina;E Nogues;Á Rodríguez 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 Gómez;J Martín-Parra;M Mengual Ballester;E Pellicer Franco;V Soria Aledo;G Valero Navarro;E Caballero Rodríguez;P Gonzalez De Chaves;G Hernandez;A Perez Alvarez;A Soto Sanchez;F Cesar Becerra Garcia;J Guillermo Alonso Roque;F López Rodríguez Arias;S R Del Valle Ruiz;G Sánchez De La Villa;A Compañ;A García Marín;C Nofuentes;F Orts Micó;V Pérez Auladell;M Carrasco;C Duque Perez;S Gálvez-Pastor;I Navarro Garcia;A Sanchez Perez;D Enjuto;F Manuel Bujalance;N Marcelin;M Pérez;R Serrano García;A Cabrera;F de la Portilla;J Diaz-Pavon;R Jimenez-Rodriguez;J Vazquez-Monchul;J Daza González;R Gómez Pérez;J Rivera Castellano;J Roldán de la Rua;J Errasti Alustiza;L Fernandez;J Romeo Ramirez;J Sardon Ramos;B Cermeño Toral;D Alias;D Garcia-Olmo;H Guadalajara;M Herreros;P Pacheco;F Del Castillo Díez;F Lima Pinto;J Martínez Alegre;I Ortega;A Picardo Nieto Antonio;A Caro;J Escuder;F Feliu;M Millan;R Alos Company;A Frangi Caregnato;R Lozoya Trujillo;R Rodríguez Carrillo;M Ruiz Carmona;N Alonso;D Ambrona Zafra;B Amilka Ayala Candia;J Bonnin Pascual;C Pineño Flores;J Alcazar Montero;M Angoso Clavijo;J Garcia;J Sanchez Tocino;C Gómez-Alcazar;D Costa-Navarro;J Ferri-Romero;M Rey-Riveiro;M Romero-Simó;B Arencibia;P Esclapez;M Frasson;E García-Granero;P Granero;F J Medina Fernández;A B Gallardo Herrera;C Diaz López;E Navarro Rodriguez;E Torres Tordera;J Arenal;M Citores;J Marcos;J Sánchez;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;J French;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;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;T Pinkney;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;M Warner;J Yan Qi Tan;A Iqbal;A Khan;K Perrin;A Raza;S Tan

2018

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.

Scheda breve

Scheda completa

Scheda completa (DC)

	Parole chiave
	
			bowel anastomosis; Crohn's disease; anastomotic leak; colorectal cancer; epidemiology; international; oversewn; stapler; surgery; surgical technique;
		
	Settori scientifico-disciplinari dell'articolo
	
			Settore MED/18 - Chirurgia Generale
		
	Data di pubblicazione
	
			nov-2018
		
	Rivista in ANCE
	
			COLORECTAL DISEASE
		
	DOI
	
			https://dx.doi.org/10.1111/codi.14308
		
	Tipologia
	
			Article (author)
		
	Appare nelle tipologie:
	
			01 - Articolo su periodico

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