Predictors for anastomotic leak, postoperative complications, and mortality after right colectomy for cancer: Results from an international snapshot audit

Frasson, M.; Battersby, N.; Bhangu, A.; Hervas, D.; El-Hussuna, A.; Gallo, G.; Pata, F.; Pinkney, T.; Poskus, T.; Singh, B.; Chaudhri, S.; Nepogodiev, D.; Vennix, S.; Zmora, O.; Bemelman, W.; Christensen, P.; D’Hoore, A.; Laurberg, S.; Morton, D.; Rubbini, M.; Vaizey, C.; Magill, L.; Perry, R.; Sheward, N.; Cillo, M.; Estefania, D.; J Patron Uriburu,; Ruiz, H.; Solomon, 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.; Houben, B.; Haeck, L.; Lange, C.; Sommeling, C.; Vindevoghel, K.; Castro, S.; H De Bruyn,; Huyghe, M.; E De Wolf,; Reynders, D.; A de Buck van Overstraete,; Wolthuis, A.; Delibegovic, S.; Christiani, A.; M Marchiori, J.; C Rocha de Moraes,; V Tercioti, J.; 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.; 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,; 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 Palmgren Colov,; T Linde Friis,; J Amstrup Funder,; Dich, R.; Kjær, S.; Rasmussen, S.; Schlesinger, N.; M Dilling Kjae,; Qvist, N.; Khalid, A.; Ali, G.; Hadi, S.; L Rosell Walker,; Kivelä, A.; Lehtonen, T.; Lepistö, A.; Scheinin, T.; Siironen, P.; Kössi, J.; Kuusanmäki, P.; Tomminen, T.; Turunen, A.; Rautio, T.; Vierimaa, M.; Huhtinen, H.; Karvonen, J.; Lavonius, M.; Rantala, A.; Varpe, P.; Cotte, E.; Francois, Y.; Francois, O.; 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doi:10.1097/dcr.0000000000001590

BACKGROUND: A right hemicolectomy is among the most commonly performed operations for colon cancer, but modern high-quality, multination data addressing the morbidity and mortality rates are lacking.OBJECTIVE: This study reports the morbidity and mortality rates for right-sided colon cancer and identifies predictors for unfavorable short-term outcome after right hemicolectomy.DESIGN: This was a snapshot observational prospective study.SETTING: The study was conducted as a multicenter international study.PATIENTS: The 2015 European Society of Coloproctology snapshot study was a prospective multicenter international series that included all patients undergoing elective or emergency right hemicolectomy or ileocecal resection over a 2-month period in early 2015. This is a subanalysis of the colon cancer cohort of patients.MAIN OUTCOME MEASURES: Predictors for anastomotic leak and 30-day postoperative morbidity and mortality were assessed using multivariable mixed-effect logistic regression models after variables selection with the Lasso method.RESULTS: Of the 2515 included patients, an anastomosis was performed in 97.2% (n = 2444), handsewn in 38.5% (n = 940) and stapled in 61.5% (n = 1504) cases. The overall anastomotic leak rate was 7.4% (180/2444), 30-day morbidity was 38.0% (n = 956), and mortality was 2.6% (n = 66). Patients with anastomotic leak had a significantly increased mortality rate (10.6% vs 1.6% no-leak patients; p > 0.001). At multivariable analysis the following variables were associated with anastomotic leak: longer duration of surgery (OR = 1.007 per min; p = 0.0037), open approach (OR = 1.9; p = 0.0037), and stapled anastomosis (OR = 1.5; p = 0.041).LIMITATIONS: This is an observational study, and therefore selection bias could be present. For this reason, a multivariable logistic regression model was performed, trying to correct possible confounding factors.CONCLUSIONS: Anastomotic leak after oncologic right hemicolectomy is a frequent complication, and it is associated with increased mortality. The key contributing surgical factors for anastomotic leak were anastomotic technique, surgical approach, and duration of surgery. See Video Abstract at http://links.lww.com/DCR/B165.

Predictors for anastomotic leak, postoperative complications, and mortality after right colectomy for cancer: Results from an international snapshot audit / M. Frasson, N. Battersby, A. Bhangu, D. Hervas, A. El-Hussuna, G. Gallo, F. Pata, T. Pinkney, T. Poskus, B. Singh, S. Chaudhri, D. Nepogodiev, S. Vennix, O. Zmora, W. Bemelman, P. Christensen, A. D’Hoore, S. Laurberg, D. Morton, M. Rubbini, C. Vaizey, L. Magill, R. Perry, N. Sheward, M. Cillo, D. Estefania, J. Patron Uriburu, H. Ruiz, M. Solomon, 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, B. Houben, L. Haeck, C. Lange, C. Sommeling, K. Vindevoghel, S. Castro, H. De Bruyn, M. Huyghe, E. De Wolf, D. Reynders, A. de Buck van Overstraete, A. Wolthuis, S. Delibegovic, A. Christiani, M.M. Jr., C. Rocha de Moraes, V.T. 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, 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, 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. Palmgren Colov, T. Linde Friis, J. Amstrup Funder, R. Dich, S. Kjær, S. Rasmussen, N. Schlesinger, M. Dilling Kjae, N. Qvist, A. Khalid, G. Ali, 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. Francois, V. Kepenekian, G. Passot, L. Maggiori, G. Manceau, Y. Panis, M. Gout, E. Rullier, B. van Geluwe, N. Chafai, J. Lefevre, Y. Parc, E. Tire, 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-Mag, 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. Magdeburg, K. Batzalexis, S. Germanos, C. Agalianos, C. Dervenis, N. Gouvas, P. Kanavidis, A. Kottikias, I. 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, R. O'Connell, D. Winter, T. Connelly, W. Joyce, P. Wrafter, R. Berkovitz, S. Avital, I. Haj Yahia, N. Herman, B. Shpitz, I. White, Y. Lishtzinsky, A. Tsherniak, N. Wasserberg, N. Horesh, U. Keler, R. Pery, R. Shapiro, 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. Iambrenghi, P. Marsanic, A. Mellano, A. Mellano, M. Annecchiarico, L. Bencini, S. Bonapasta, A. Coratti, F. Guerra, C. Asteria, L. Boccia, L. Gerard, A. Pascariello, G. Manca, F. Marino, A. Casaril, M. Inama, G. Moretto, C. Bacchelli, M. Carvello, N. 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, M. Lemma, R. Rosati, A. Tamburini, M. De Luca, A. Sartori, A. Benevento, C. Bottini, C. Ferrari, 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, Ž. Saladžinskas, S. Švagždys, A. Tamelis, A. Razbadauskas, M. Sokolovas, A. Dulskas, N. Samalavicius, V. Jotautas, S. Mikalauskas, E. Poskus, K. Strupas, C. Camenzuli, C. Cini, A. Predrag, J. Psaila, N. Spiteri, C. Buskens, J. de Groof, J. Gooszen, P. Tanis, E. Belgers, P. Davids, E. Furnee, E. Postma, A. Pronk, N. Smakman, S. Clermonts, D. Zimmerman, J. Omloo, E. van der Zaag, P. van Duijvendijk, E. Wassenaar, M. Bruijninckx, E. de Graf, P. Doornebosch, G. Tetteroo, M. Vermaas, G. Iordens, S. Knops, B. Toorenvliet, E. van Westereenen, E. Boerma, P. Coene, E. van der Hars, A. Van Der Poo, M. Raber, J. Melenhorst, S. de Castro, M. Gerhards, M. Arron, A. Bremers, H. de Wilt, F. Ferenschild, S. Yauw, H. Cense, A. Demirkiran, M. Hunfeld, I. Mulder, J. Nonner, H. Swank, B. van Wagensveld, M. Bolmers, J. Briel, N. van Geloven, C. van Rossem, 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, Y. Peyman, I. Flåten Backe, O. Helmer Sjo, A. Nesbakken, M. Tandberg-Eriksen, A. Cais, J. Hallvard Træland, R. Herikstad, H. Kørner, 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, R. Abreu Marques Ferreira, 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. Domansky, 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, R. Dragana, D. Lukic, T. Petrovic, Z. Radovanovic, V. Cuk, 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, M. Elia-Guedea, E. Gallego, 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 Sigüenzo, M. Jimenez Toscano, A. Lacy Fortuny, J. Ordoñez Trujillo, A. Espi, S. Garcia-Botello, J. Martín-Aréval, D. Moro-Valdezat, V. Pla-Martí, F. Blanco-Antona, J. Abrisqueta, N. Ibañez Canovas, J. Lujan Mompean, D. Escolá Ripol, 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. J Gil Egea, M. Pascual Damieta, M. Pera, S. Salvans Ruiz, J. Bernal, F. Landete, G. Ais, E. Alonso, J. Aguiló Lucia, A. Boscá, S. Deusa, J. García del Caño, V. Viciano, J. García-Armengol, J. Roig, J. Blas, J. Escartin, J. Fatás, J. Fernando, R. Ferrer, R. Arias Pacheco, L. García Flórez, M. Moreno Gijón, J. Otero Díez, L. Solar Garcia, F. Aguilar Teixido, C. Balaguer Ojo, J. Bargallo Berzosa, S. Lamas Moure, J. Enrique Sierra, A. Fermiñán, F. Herrerias, M. Rufas, J. Viñas, A. Codina-Cazador, R. Farrés, N. Gómez, D. Julià, P. Planellas, J. López, A. Luna, C. Maristany, A. Muñoz Duyos, N. Puértolas, M. Alcantara Moral, X. Serra-Aracil, P. Concheiro Coello, D. Gómez, C. Carton, A. Miguel, F. Reoyo Pascual, X. Valero Cerrato, R. Zambrano Muñoz, J. Cervera-Aldama, J. García González, J. Ramos-Prada, M. Santamaría-Olabarrieta, A. Urigüen-Echeverría, R. Coves Alcover, J. Espinosa Soria, E. Fernandez Rodriguez, J. Hernandis, V. Maturana Ibañez, F. De la Torre Gonzalez, D. Huerga, E. Pérez Viejo, A. Rivera, E. Ruiz Ucar, J. Garcia-Septiem, V. Jiménez, J. Jiménez Miramón, J. Ramons Rodriquez, V. Rodriguez Alvarez, A. Garcea, L. Ponchietti, N. Borda, J. Enriquez-Navascues, Y. Saralegui, G. Febles Molina, E. Nogues, Á. Rodríguez Méndez, C. Roque Castellano, Y. Sosa Quesada, M. Gallego, I. Pascual, I. Perez, B. San Andrés, F. 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 Rodriquez, P. Gonzalez De Chaves, G. Hernandez, A. Perez Alvarez, A. Soto Sanchez, F. C Becerra Garcia, J. G Alonso Roque, F. López Rodríguez Aria, 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, B. Cermeño Toral, J. Errasti Alustiza, L. Fernández, J. Romeo Ramirez, J. Sardón Ramos, 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. Alcazar, D. Costa Navarro, J. Ferri Romero, M. Rey Riveiro, M. Romero, B. Arencibia, P. Esclapez, E. García-Granero, P. Granero, A. Belen Gallardo Herrera, L. Diaz, E. María Torres Tordera, F. Medina Fernandez, E. Navarro Rodriguez, 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. 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Predictors for anastomotic leak, postoperative complications, and mortality after right colectomy for cancer: Results from an international snapshot audit

M Frasson;N Battersby;A Bhangu;D Hervas;A El-Hussuna;G Gallo;F Pata;T Pinkney;T Poskus;B Singh;S Chaudhri;D Nepogodiev;S Vennix;O Zmora;W Bemelman;P Christensen;A D’Hoore;S Laurberg;D Morton;M Rubbini;C Vaizey;L Magill;R Perry;N Sheward;M Cillo;D Estefania;J Patron Uriburu;H Ruiz;M Solomon;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;B Houben;L Haeck;C Lange;C Sommeling;K Vindevoghel;S Castro;H De Bruyn;M Huyghe;E De Wolf;D Reynders;A de Buck van Overstraete;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;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;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 Palmgren Colov;T Linde Friis;J Amstrup Funder;R Dich;S Kjær;S Rasmussen;N Schlesinger;M Dilling Kjae;N Qvist;A Khalid;G Ali;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 Francois;V Kepenekian;G Passot;L Maggiori;G Manceau;Y Panis;M Gout;E Rullier;B van Geluwe;N Chafai;J Lefevre;Y Parc;E Tire;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-Mag;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 Magdeburg;K Batzalexis;S Germanos;C Agalianos;C Dervenis;N Gouvas;P Kanavidis;A Kottikias;I 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;R O'Connell;D Winter;T Connelly;W Joyce;P Wrafter;R Berkovitz;S Avital;I Haj Yahia;N Herman;B Shpitz;I White;Y Lishtzinsky;A Tsherniak;N Wasserberg;N Horesh;U Keler;R Pery;R Shapiro;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 Iambrenghi;P Marsanic;A Mellano;A Mellano;M Annecchiarico;L Bencini;S Bonapasta;A Coratti;F Guerra;C 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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2020

Abstract

BACKGROUND: A right hemicolectomy is among the most commonly performed operations for colon cancer, but modern high-quality, multination data addressing the morbidity and mortality rates are lacking.OBJECTIVE: This study reports the morbidity and mortality rates for right-sided colon cancer and identifies predictors for unfavorable short-term outcome after right hemicolectomy.DESIGN: This was a snapshot observational prospective study.SETTING: The study was conducted as a multicenter international study.PATIENTS: The 2015 European Society of Coloproctology snapshot study was a prospective multicenter international series that included all patients undergoing elective or emergency right hemicolectomy or ileocecal resection over a 2-month period in early 2015. This is a subanalysis of the colon cancer cohort of patients.MAIN OUTCOME MEASURES: Predictors for anastomotic leak and 30-day postoperative morbidity and mortality were assessed using multivariable mixed-effect logistic regression models after variables selection with the Lasso method.RESULTS: Of the 2515 included patients, an anastomosis was performed in 97.2% (n = 2444), handsewn in 38.5% (n = 940) and stapled in 61.5% (n = 1504) cases. The overall anastomotic leak rate was 7.4% (180/2444), 30-day morbidity was 38.0% (n = 956), and mortality was 2.6% (n = 66). Patients with anastomotic leak had a significantly increased mortality rate (10.6% vs 1.6% no-leak patients; p > 0.001). At multivariable analysis the following variables were associated with anastomotic leak: longer duration of surgery (OR = 1.007 per min; p = 0.0037), open approach (OR = 1.9; p = 0.0037), and stapled anastomosis (OR = 1.5; p = 0.041).LIMITATIONS: This is an observational study, and therefore selection bias could be present. For this reason, a multivariable logistic regression model was performed, trying to correct possible confounding factors.CONCLUSIONS: Anastomotic leak after oncologic right hemicolectomy is a frequent complication, and it is associated with increased mortality. The key contributing surgical factors for anastomotic leak were anastomotic technique, surgical approach, and duration of surgery. See Video Abstract at http://links.lww.com/DCR/B165.

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	Parole chiave
	
			Anastomotic leak; Colon cancer; Postoperative outcome; Right colectomy; Aged; Aged, 80 and over; Anastomotic Leak; Cohort Studies; Colectomy; Colonic Neoplasms; Female; Humans; Male; Medical Audit; Middle Aged; Risk Factors; Survival Rate
		
	Settori scientifico-disciplinari dell'articolo
	
			Settore MED/18 - Chirurgia Generale
		
	Data di pubblicazione
	
			mag-2020
		
	Rivista in ANCE
	
			DISEASES OF THE COLON & RECTUM
		
	DOI
	
			https://dx.doi.org/10.1097/dcr.0000000000001590
		
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			01 - Articolo su periodico

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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/827267

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