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Title: | Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: An international snapshot audit |
Authors: | Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı. Yılmazlar, Tuncay CKK-3621-2022 6701800362 |
Keywords: | Gastroenterology & hepatology Surgery Anastomotic leak Colorectal cancer Crohn's disease Epidemiology International Risk-factors Leak Complications Definition Mortality |
Issue Date: | Aug-2017 |
Publisher: | Wiley |
Citation: | Pinkney, T. vd. (2017). ''Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: An international snapshot audit''. Colorectal Disease, 19(8), O296-O311. |
Abstract: | Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified 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) underwent surgery 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). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5% handsewn vs 12.9% stapled) and to undergo open surgery (54.7% handsewn vs 36.6% stapled). 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 OR = 1.43; 95% CI: 1.04-1.95; P = 0.03). Conclusion 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. |
Description: | Çalışmada 1077 yazar bulunmaktadır. Bu yazarlardan sadece Bursa Uludağ Üniversitesi mensuplarının girişleri yapılmıştır. |
URI: | https://doi.org/10.1111/codi.13646 https://onlinelibrary.wiley.com/doi/10.1111/codi.13646 http://hdl.handle.net/11452/33995 |
ISSN: | 1462-8910 1463-1318 |
Appears in Collections: | Scopus Web of Science |
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Yılmazlar_vd_2017.pdf | 818.1 kB | Adobe PDF | View/Open |
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