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Colorectal Dis. 2017 Mar 6. doi: 10.1111/codi.13646. [Epub ahead of print]

The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit.

Collaborators (1105)

Pinkney T, Battersby N, Bhangu A, Chaudhri S, El-Hussuna A, Frasson M, Nepogodiev D, Singh B, Vennix S, Zmora O, Altomare D, Bemelman W, Christensen P, D'Hoore A, Laurberg S, Morton D, Pinkney T, Rubbini M, Vaizey C, Magill L, Perry R, Sheward N, Ives N, Mehta S, Cillo M, Estefania D, Patron Uriburu J, 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, De Bruyn H, Huyghe M, De Wolf E, Reynders D, D'Hoore A, de Buck van Overstraeten A, Wolthuis A, Delibegovic S, Christiani A, Marchiori M Jr, Rocha de Moraes C, Tercioti V 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, Gotschalck Sunesen K, Leunbach J, Thorlacius-Ussing O, Uth Oveson A, Christensen P, Dahl Chirstensen S, Gamez V, Oeting M, Schou Loeve U, Ugianskis A, Jessen M, Krarup P, Linde K, Mirza Q, Overgaard Stovring J, Erritzøe L, Loft Jakobsen H, Lykke J, Palmgren Colov E, Husted Madsen A, Linde Friis T, Amstrup Funder J, Dich R, Kjaer S, Rasmussen S, Schlesinger N, Dilling Kjaer M, Qvist N, Khalid A, Ali G, El-Hussuna A, Hadi S, Rosell Walker L, 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, Glehen O, Kepenekian V, Passot G, Manceau G, Panis Y, Gout M, Rullier E, van Geluwe B, Chafai N, Lefevre JH, Parc Y, Tiret E, Couette C, Duchalais E, Agha A, Hornberger M, Hungbauer A, Iesalnieks I, Weindl I, Crescenti F, Keller M, Kolodziejski N, Scherer R, Sterzing D, Bock B, Boehm G, El-Magd M, Krones C, Niewiera M, Buhr J, Cordesmeyer S, Hoffmann M, Krückemeier K, Vogel T, Schön M, Baral J, Lukoschek T, Münch S, Pullig F, Horisberger K, Kienle P, Magdeburg J, Post S, Batzalexis K, Germanos S, Agalianos C, Dervenis C, Gouvas N, Kanavidis P, Kottikias A, Katsoulis IE, Korkolis D, Plataniotis G, Sakorafas G, Akrida I, Argentou M, Kollatos C, Lampropoulos C, Tsochatzis S, Besznyák I, Bursics A, Egyed T, Papp G, Svastics I, Atladottir J, Möller P, Sigurdsson H, Stefánsson T, Valsdottir E, Andrews E, Foley N, Hechtl D, Majeed M, McCourt M, Hanly A, Hyland J, Martin S, O'Connell PR, Winter D, Connelly T, Joyce W, Wrafter P, Berkovitz R, Avital S, Haj Yahia I, Hermann N, Shpitz B, White I, Lishtzinsky Y, Tsherniak A, Wasserberg N, Horesh N, Keler U, Pery R, Shapiro R, Zmora O, Tulchinsky H, Badran B, Dayan K, Iskhakov A, Lecaros J, Nabih N, Angrima I, Bardini R, Pizzolato E, Tonello M, Arces F, Balestri R, Ceccarelli C, Prosperi V, Rossi E, Giannini I, Vincenti L, Altomare DF, Di Candido F, Di Iena M, Guglielmi A, Caputi-Iambrenghi O, Marsanic P, Mellano A, Muratore A, Annecchiarico M, Bencini L, Amore Bonapasta S, Coratti A, Guerra F, Asteria CR, Boccia L, Gerard L, Pascariello A, Manca G, Marino F, Casaril A, Inama M, Moretto G, Bacchelli C, Carvello M, Mariani N, Montorsi M, Spinelli A, Romairone E, Scabini S, Belli A, Bianco F, De Franciscis S, Maria Romano G, Delrio P, Pace U, Rega D, Sassaroli C, Scala D, De Luca R, Ruggieri E, Elbetti C, Garzi A, Romoli L, Scatizzi M, Vannucchi A, Curletti G, Durante V, Galleano R, Mariani F, Reggiani L, Bellomo R, Infantino A, Franceschilli L, Sileri P, Clementi I, Coletta D, La Torre F, Mingoli A, Velluti F, Di Giacomo A, Fiorot A, Massani M, Padoan L, Ruffolo C, Caruso S, Franceschini F, Laessig R, Monaci I, Rontini M, De Nardi P, Elmore U, Lemma M, Rosati R, Tamburini A, De Luca M, Sartori A, Benevento A, Bottini C, Ferrari CC, Pata F, Tessera G, Pellino G, Selvaggi F, Lanzani A, Romano F, Sgroi G, Steccanella F, Turati L, Yamamoto T, Ancans G, Gerkis S, Leja M, Pcolkins A, Sivins A, Latkauskas T, Lizdenis P, Saladžinskas Ž, Švagždys S, Tamelis A, Razbadauskas A, Sokolovas M, Dulskas A, Samalavicius N, Jotautas V, Mikalauskas S, Poskus E, Poskus T, Strupas K, Camenzuli C, Cini C, Predrag A, Psaila J, Spiteri N, Bemelman W, Buskens C, de Groof EJ, Gooszen J, Tanis P, Belgers E, Davids P, Furnee E, Postma E, Pronk A, Smakman N, Clermonts S, Zimmerman D, Omloo J, van der Zaag E, van Duijvendijk P, Wassenaar E, Bruijninckx M, de Graff E, Doornebosch P, Tetteroo G, Vermaas M, Iordens G, Knops S, Toorenvliet B, van Westereenen HL, Boerma E, Coene P, van der Harst E, Van Der Pool A, Raber M, Melenhorst J, de Castro S, Gerhards M, Arron M, Bremers A, de Wilt H, Ferenschild F, Yauw S, Cense H, Demirkiran A, Hunfeld M, Mulder I, Nonner J, Swank H, van Wagensveld B, Bolmers M, Briel J, van Geloven A, van Rossem C, Klemann V, Konsten J, Leenders B, Schok T, Bleeker W, Gidwani A, Lawther R, Loughlin P, Skelly B, Spence R, Brun M, Helgeland M, Ignjatovic D, Øresland T, Yousefi P, Flåten Backe I, Helmer Sjo O, Nesbakken A, Tandberg-Eriksen M, Cais A, Hallvard Traeland J, Herikstad R, Kørner H, Lauvland N, Jajtner D, Kabiesz W, Rak M, Gmerek L, Horbacka K, Horst N, Krokowicz P, Kwiatkowski A, Pasnik K, Karcz P, Romaniszyn M, Rusek T, Walega P, Czarencki R, Obuszko Z, Sitarska M, Wojciech W, Zawadzki M, Amado S, Clara P, Couceiro A, Malaquias R, Rama N, Almeida A, Barbosa E, Cernadas E, Duarte A, Silva P, Costa S, Martinez Insua C, Pereira J, Pereira C, Sacchetti M, Carvalho Pinto B, Jorge Vieira Sousa P, Marques R, Oliveira A, Cardoso R, Carlos S, Corte-Real J, Moniz Pereira P, Souto R, Carneiro C, Marinho R, Nunes V, Rocha R, Sousa M, Leite J, Melo F, Pimentel J, Ventura L, Vila Nova C, Copăescu C, Bintintan V, Ciuce C, Dindelegan G, Scurtu R, Seicean R, Domansky N, Karachun A, Moiseenko A, Pelipas Y, Petrov A, Pravosudov I, Aiupov R, Akmalov Y, Parfenov A, Suleymanov N, Tarasov N, Jumabaev H, Mamedli Z, Rasulov A, Aliev I, Chernikovskiy I, Kochnev V, Komyak K, Pravosudov I, Smirnov A, Achkasov S, Bolikhov K, Shelygin Y, Sushkov O, Zapolskiy A, Gvozdenovic M, Jovanovic D, Lausevic Z, Cvetković D, Maravić M, Milovanovic B, Stojakovic N, Tripković I, Mihajlovic D, Nestorovic M, Pecic V, Petrovic D, Stanojevic G, Barisic G, Dimitrijevic I, Krivokapic Z, Markovic V, Popovic M, Aleksic A, Dabic D, Kostic I, Milojkovic A, Perunicic V, Lukic D, Petrovic T, Radovanovic D, Radovanovic Z, Cuk VM, Cuk VV, Kenic M, Kovacevic B, Krdzic I, Korcek J, Rems M, Toplak J, Escarrâ J, Gil Barrionuevo M, Golda T, Kreisler Moreno E, Zerpa Martin C, Álvarez Laso C, Cumplido P, Padin H, Baixauli Fons J, Hernández-Lizoain J, Martinez-Ortega P, Molina-Fernández M, Sánchez-Justicia C, Antonio Gracia Solanas J, Córdoba Díaz de Laspra E, Echazarreta-Gallego E, Elia-Guedea M, Ramirez J, Arredondo Chaves J, Diez González P, Elosua T, Sahagún J, Turienzo Frade A, Álvarez Conde J, Castrillo E, Diaz Maag R, Maderuelo V, Saldarriaga L, Aldrey Cao I, Fernández Varela X, Núñez Fernández S, Parajó Calvo A, Villar Álvarez S, Blesa Sierra I, Duarte A, Lozano R, Márquez M, Porcel O, Menendez P, Fernández Hevia M, Flores Sigüenza L, Jimenez Toscano M, Lacy Fortuny A, Ordoñez Trujillo J, Espi A, Garcia-Botello S, Martín-Arévalo J, Moro-Valdezate D, Pla-Martí V, Blanco-Antona F, Abrisqueta J, Ibañez Canovas N, Lujan Mompean J, Escolá Ripoll D, Martinez Gonzalez S, Parodi J, Fernández López A, Ramos Fernández M, Castellvi Valls J, Ortiz de Zarate L, Ribas R, Sabia D, Viso L, Alonso Gonçalves S, José Gil Egea M, Pascual Damieta M, Pera M, Salvans Ruiz S, Bernal J, Landete F, Ais G, Etreros J, Aguiló Lucia J, Boscá A, Deusa S, García Del Caño J, Viciano V, García-Armengol J, Roig J, Blas J, Escartin J, Fatás J, Fernando J, Ferrer R, Arias Pacheco R, García Flórez L, Moreno Gijón M, Otero Díez J, Solar Garcia L, Aguilar Teixido F, Balaguer Ojo C, Bargallo Berzosa J, Lamas Moure S, Enrique Sierra J, Fermiñán A, Herrerias F, Rufas M, Viñas J, Codina-Cazador A, Farrés R, Gómez N, Julià D, Planellas P, López J, Luna A, Maristany C, Muñoz Duyos A, Puértolas N, Alcantara Moral M, Serra-Aracil X, Concheiro Coello P, Gómez D, Carton C, Miguel A, Reoyo Pascual F, Valero Cerrato X, Zambrano Muñoz R, Cervera-Aldama J, García González J, Ramos-Prada J, Santamaría-Olabarrieta M, Urigüen-Echeverría A, Coves Alcover R, Espinosa Soria J, Fernandez Rodriguez E, Hernandis Villalba J, Maturana Ibañez V, De la Torre Gonzalez F, Huerga D, Pérez Viejo E, Rivera A, Ruiz Ucar E, Garcia-Septiem J, Jiménez V, Jiménez Miramón J, Ramons Rodriquez J, Rodriguez Alvarez V, Garcea A, Ponchietti L, Borda N, Enriquez-Navascues J, Saralegui Y, Febles Molina G, Nogues E, Rodríguez Méndez Á, Roque Castellano C, Sosa Quesada Y, Alvarez-Gallego M, Pascual I, Rubio-Perez I, Diaz-San Andrés B, Tone-Villanueva F, Alonso J, Cagigas C, Castillo J, Gómez M, Martín-Parra J, Mengual Ballester M, Pellicer Franco E, Soria Aledo V, Valero Navarro G, Caballero Rodríguez E, Gonzalez De Chaves P, Hernandez G, Perez Alvarez A, Soto Sanchez A, Cesar Becerra Garcia F, Guillermo Alonso Roque J, López Rodríguez Arias F, Del Valle Ruiz SR, Sánchez De La Villa G, Compañ A, García Marín A, Nofuentes C, Orts Micó F, Pérez Auladell V, Carrasco M, Duque Perez C, Gálvez-Pastor S, Navarro Garcia I, Sanchez Perez A, Enjuto D, Manuel Bujalance F, Marcelin N, Pérez M, Serrano García R, Cabrera A, de la Portilla F, Diaz-Pavon J, Jimenez-Rodriguez R, Vazquez-Monchul J, Daza González J, Gómez Pérez R, Rivera Castellano J, Roldán de la Rua J, Errasti Alustiza J, Fernandez L, Romeo Ramirez J, Sardon Ramos J, Cermeño Toral B, Alias D, Garcia-Olmo D, Guadalajara H, Herreros M, Pacheco P, Del Castillo Díez F, Lima Pinto F, Martínez Alegre J, Ortega I, Picardo A, Caro A, Escuder J, Feliu F, Millan M, Alos Company R, Frangi Caregnato A, Lozoya Trujillo R, Rodríguez Carrillo R, Ruiz Carmona M, Alonso N, Ambrona Zafra D, Amilka Ayala Candia B, Bonnin Pascual J, Pineño Flores C, Alcazar Montero J, Angoso Clavijo M, Garcia J, Sanchez Tocino J, Gómez-Alcazar C, Costa-Navarro D, Ferri-Romero J, Rey-Riveiro M, Romero-Simó M, Arencibia B, Esclapez P, Frasson M, García-Granero E, Granero P, Medina Fernández FJ, Gallardo Herrera AB, Diaz López C, Navarro Rodriguez E, Torres Tordera E, Arenal J, Citores M, Marcos J, Sánchez J, Tinoco C, Espin E, Garcia Granero A, Jimenez Gomez L, Sanchez Garcia J, Vallribera F, Folkesson J, Sköldberg F, Bergman K, Borgström E, Frey J, Silfverberg A, Söderholm M, Nygren J, Segelman J, Gustafsson D, Lagerqvist A, Papp A, Pelczar M, Abraham-Nordling M, Ahlberg M, Sjovall A, Tengstrom J, Hagman K, Chabok A, Ezra E, Nikberg M, Smedh K, Tiselius C, Al-Naimi N, Dao Duc M, Meyer J, Mormont M, Ris F, Prevost G, Villiger P, Hoffmann H, Kettelhack C, Kirchhoff P, Oertli D, Weixler B, Aytac B, Leventoglu S, Mentes B, Yuksel O, Demirbas S, Busra Ozkan B, Selçuk Özbalci G, Sungurtekin U, Gülcü B, Ozturk E, Yilmazlar T, Challand C, Fearnhead N, Hubbard R, Kumar S, Arthur J, Barben C, Skaife P, Slawik S, Williams M, Zammit M, Barker J, French J, Sarantitis I, Slawinski C, Clifford R, Eardley N, Johnson M, McFaul C, Vimalachandran D, Allan S, Bell A, Oates E, Shanmugam V, Brigic A, Halls M, Pucher P, Stubbs B, Agarwal T, Chopada A, Mallappa S, Pathmarajah M, Sugden C, Brown C, Macdonald E, Mckay A, Richards J, Robertson A, Kaushal M, Patel P, Tezas S, Touqan N, Ayaani S, Marimuthu K, Piramanayagam B, Vourvachis M, Iqbal N, Korsgen S, Seretis C, Shariff U, Arnold S, Battersby N, Chan H, Clark E, Fernandes R, Moran B, Bajwa A, McArthur D, Cao K, Cunha P, Pardoe H, Quddus A, Theodoropoulou K, Bolln C, Denys G, Gillespie M, Manimaran N, Reidy J, Malik AI, Malik A, Pitt J, Aryal K, El-Hadi A, Lal R, Pal 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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. This article is protected by copyright. All rights reserved.

KEYWORDS:

anastomotic leak; colorectal cancer; crohn's disease; epidemiology; international

PMID:
28263043
DOI:
10.1111/codi.13646

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