Javascript must be enabled to continue!

Anastomotic leak after manual circular stapled left-sided bowel surgery: analysis of technology-, disease-, and patient-related factors

Abstract Background Anastomotic leak rates after colorectal surgery remain high. In most left-sided colon and rectal resection surgeries, a circular stapler is utilized to create the primary bowel anastomosis. However, it remains unclear whether a relationship between circular stapler technology and anastomotic leak in left-sided colorectal surgery exists. Methods A post-hoc analysis was conducted using a prospectively collected data set of patients from the 2017 European Society of Coloproctology snapshot audit who underwent elective left-sided resection (left hemicolectomy, sigmoid colectomy, or rectal resection) with a manual circular stapled anastomosis. Rates of anastomotic leak and unplanned intensive care unit stay in association with manual circular stapling were assessed. Patient-, disease-, geographical-, and surgeon-related factors as well as stapler brand were explored using multivariable regression models to identify predictors of adverse outcomes. Results Across 3305 procedures, 8.0% of patients had an anastomotic leak and 2.1% had an unplanned intensive care unit stay. Independent predictors of anastomotic leak were male sex, minimal-access surgery converted to open surgery, and anastomosis height C11 (lower third rectum) (all P < 0.050). Independent predictors of unplanned intensive care unit stay were minimal-access surgery converted to open surgery and American Society of Anesthesiologists grade IV (all P < 0.050). Stapler device brand was not a predictor of anastomotic leak or unplanned intensive care unit stay in multivariable regression analysis. There were no differences in rates of anastomotic leak and unplanned intensive care unit stay according to stapler head diameter, geographical region, or surgeon experience. Conclusion In patients undergoing left-sided bowel anastomosis, choice of manual circular stapler, in terms of manufacturer or head diameter, is not associated with rates of anastomotic leak and unplanned intensive care unit stay.

Oxford University Press (OUP)

C Tong N Jamous N-D Schmitz K Szwarcensztein DG Morton TD Pinkney A El-Hussuna N Battersby A Bhangu S Blackwell N Buchs S Chaudhri D Dardanov A Dulskas A El-Hussuna M Frasson G Gallo J Glasbey J Keatley M Kelly C Knowles YE Li V McCourt A Minaya-Bravo P Neary I Negoi D Nepogodiev F Pata G Pellino T Poskus L Sanchez-Guillen B Singh E Sivrikoz G van Ramshorst O Zmora TD Pinkney R Perry EL Magill J Keatley C Tong SE Ahmed M Abdalkoddus A Abelevich S Abraham M Abraham-Nordling SI Achkasov M Adamina C Agalar F Agalar T Agarwal O Agcaoglu F Agresta G Ahmad A Ainkov R Aiupov VS Aledo A Aleksic F Aleotti D Alias AS Allison A Alonso S Alonso R Alós Y Altinel M Alvarez-Gallego E Amorim G Anania PS Andreev P Andrejevic V Andriola N Antonacci F Antos M Anwer P Aonzo JJ Arenal B Arencibia S Argeny SJ Arnold S Arolfo DY Artioukh MA Ashraf MI Aslam CR Asteria M Atif S Avital M Bacchion SM Bach R Balestri A Balfour E Balik I Baloyiannis GS Banipal JEM Baral B Barišić I Bartella G Barugola GA Bass MR Bedford A Bedzhanyan A Belli J Beltrán de Heredia WA Bemelman V Benčurik A Benevento DJ Bergkvist JC Bernal-Sprekelsen I Besznyák V Bettencourt AJ Beveridge C Bhan S Bilali V Bilali E Binboga V Bintintan A Birindelli T Birsan F Blanco-Antona RLGM Blom EG Boerma M Bogdan MZ Boland P Bondeven A Bondurri J Broadhurst SA Brown P Buccianti NC Buchs P Buchwald D Bugra A Bursics HLE Burton CJ Buskens C Bustamante Recuenco C Cagigas-Fernandez A Calero-Lillo V Calu I Camps AE Canda L Canning S Cantafio A Carpelan MJ Carrillo Lopez JM Carvas M Carvello J Castellvi J Castillo J Castillo-Diego V Cavenaile L Cayetano Paniagua AA Ceccotti J Cervera-Aldama A Chabok PC Chandrasinghe N Chandratreya SS Chaudhri ZU Chaudhry P Chirletti J Chi-Yong Ngu C Chouliaras M Chowdhary NA Chowdri AB Christiano P Christiansen MA Citores C Ciubotaru C Ciuce N Clemente D Clerc A Codina-Cazador E Colak L Colao García D Coletta F Colombo TM Connelly S Cornaglia J Corte Real J Costa Pereira S Costa E Cotte ED Courtney AP Coveney P Crapa DA Cristian M Cuadrado K Cuinas MV Cuk VV Cuk MF Cunha R Curinga N Curtis E Dainius A d'Alessandro RSJ Dalton IR Daniels D Dardanov B Dauser O Davydova B De Andrés-Asenjo EJR de Graaf F De la Portilla FB de Lacy ECD De Laspra B Defoort T Dehli L Del Prete P Delrio S Demirbas A Demirkiran FC Den Boer S Di Saverio A Diego B Dieguez M Diez-Alonso I Dimitrijevic B Dimitrios N Dimitriou G Dindelegan S Dindyal H Domingos PG Doornebosch S Dorot M Draga I Drami A Dulskas A Dzulkarnaen Zakaria E Echazarreta-Gallego Y Edden M Egenvall V Eismontas A El Nakeeb M El Sorogy H Elfike A Elgeidie A El-Hussuna M Elía Guedea S Ellul S El-Masry U Elmore SH Emile O Enciu JM Enriquez-Navascues JC Epstein D Escolà Ripoll B Espina E Espin-Basany AM Estévez Diz MD Evans PA Farina Fatayer F Feliu C Feo CV Feo J Fernando F Feroci L Ferreira T Feryn B Flor-Lorente A Forero-Torres N Francis M Frasson MR Freund M Fróis Borges A Frontali AB Gallardo R Galleano G Gallo D Garcia LJ García Flórez JA García Marín J García Septiem AM Garcia-Cabrera JM García-González E Garcia-Granero M Garipov R Gefen P Gennadiy S Gerkis A Germain S Germanos L Gianotti M Gil Santos C Gingert O Glehen T Golda M Gómez Ruiz D Gonçalves JS González J Grainger F Grama C Grant J Griniatsos T Grolich J Grosek J Guevara-Martínez B Gulcu SK Gupta SV Gurjar S Haapaniemi Y Hamad M Hamid J Hardt RL Harries GJC Harris L Harsanyi J Hayes ER Hendriks F Herbst N Hermann A Heuberger R Hompes A Hrora M Hübner H Huhtinen L Hunt M Hyöty N Ibañez D Ignjatovic A Ilkanich M Inama MS Infantino MR Iqbal A Isik O Isik M Ismaiel SO Ivanovich V Jadhav D Jajtner V Jiménez Carneros RM Jimenez-Rodriguez V Jotautas K Jukka J Juloski B Jung Y Kara U Karabacak A Karachun S Karagul M Kassai E Katorkin Sergei D Katsaounis IE Katsoulis ME Kelly B Kenjić S Keogh-Bootland D Khasan A Khazov SH Kho GN Khrykov AJ Kivelä MD Kjaer JS Knight P Kocián T Koëter JLM Konsten J Korček D Korkolis S Korsgen IS Kostić PM Krarup P Krastev I Krdzic E Kreisler Moreno Z Krivokapic CJ Krones D Kršul N Kumar Kaul F La Torre N Lahodzich CW Lai JLB Laina Z Lakkis S Lamas CP Lange A Lauretta KA Lee J Lefèvre T Lehtonen CA Leo KJ Leong A Lepistö L Licari P Lizdenis P Loftås M Longhi J Lopez-Dominguez J López-Fernández H Lovén R Lozoya Trujillo R Lunin AP Luzzi ML Lydrup J Lykke VM Maderuelo-Garcia T Madsboell AH Madsen A Maffioli MA Majbar A Makhmudov D Makhmudov KI Malik SS Malik ZZ Mamedli DK Manatakis R Mankotia J Maria NM Mariani K Marimuthu F Marinello F Marino G Marom N Maroni I Maroulis P Marsanic HA Marsman M Martí-Gallostra ST Martin J Martinez Alegre A Martinez Manzano R Martins S Maslyankov K McArdle DR McArthur C McFaul D McWhirter D Mege A Mehraj MZ Metwally IH Metwally M Millan AS Miller A Minaya-Bravo A Mingoli G Minguez Ruiz C Minusa B Mirshekar-Syahkal M Mistrangelo SS Mogoanta I Mohamed PH Möller T Möller M Molteni S Mompart B Monami M Mondragon-Pritchard Pedro Moniz-Pereira D Montesdeoca Cabrera M Morais BJ Moran G Moretto M Morino A Moscovici S Muench H Mukhtar P Muller A Muñoz-Duyos A Muratore P Muriel P Myrelid M Nachtergaele H Nadav K Nastos A Navarro-Sánchez I Negoi A Nesbakken G Nestler J Nicholls D Nicol M Nikberg JMS Nobre J Nonner G Norčič S Norderval MGA Norwood J Nygren JW O’Brien PR O’Connell J O'Kelly N Okkabaz M Oliveira-Cunha GEEI Omar P Onody E Opocher J Orhalmi FJ Orts-Micó GS Ozbalci U Ozgen BB Ozkan E Ozturk K Pace MH Padín SB Pandey JA Pando I Papaconstantinou A Papadopoulos G Papadopoulos G Papp S Paraskakis Y Parc P Parra Baños FQ Parray R Parvuletu A Pascariello I Pascual Migueláñez F Pata H Patel PK Patel HM Paterson JC Patrón Uriburu GC Pattacini V Pavlov A Pcolkins EM Pellicer-Franco E Peña Ros HD Pérez P Petkov P Picarella AJ Pikarsky A Pisani Ceretti E Platt P Pletinckx M Podda D Popov E Poskus T Poskus MC Prats I Pravosudov V Primo-Romaguera V Prochazka I Pros Ribas D Proud J Psaila F Pullig MS Qureshi Jinnah J Rachadell Montero D Radovanovic Z Radovanovic MM Rahman R Rainho N Rama D Ramos A Ramsanahie A Rantala A Rasulov T Rautio T Raymond A Raza A Reddy B Refky L Regusci P Reissman M Rems ML Reyes-Diaz R Riccardo G Richiteanu F Richter A Rios F Ris FL Rodriguez P Rodriguez Garcia JA Rojo Lopez M Romaniszyn GM Romano AS Romero M Romero-Simó A Roshan Lal B Rossi A Ruano Poblador M Rubbini I Rubio-Perez H Ruiz E Rullier O Ryska D Sabia M Sacchi N Saffaf A Sakr Z Saladzinskas I Sales M Salomon S Salvans NE Samalavicius G Sammarco GM Sampietro D Samsonov JL Sanchez-Garcia L Sánchez-Guillén E Sanchiz G Šantak J Santos Torres F Saraceno IS Sarici PB Sarmah G Savino S Scabini C Schafmayer B Schiltz A Schofield R Scurtu E Segalini J Segelman JJ Segura Sampedro R Seicean A Sekulic D Selwyn P Serrano Paz J Shabbir IA Shaikh M Shalaby A Sharma A Shukla N Shussman ZA Siddiqui P Siironen P Sileri P Silva-Vaz JF Simoes H Sinan B Singh A Sivins G Skroubis M Skrovina AJ Skull M Slavchev M Slavin AAP Slesser CJ Smart NJ Smart K Smedh S Smolarek M Sokolov O Sotona D Spacca A Spinelli G Stanojevic A Stearns S Stefan A Stift J Stijns V Stoyanov D Straarup R Strouhal BM Stubbs C Suero Rodríguez U Sungurtekin S Svagzdys I Svastics I Syk MJM Tabares A Tamelis RG Tamhane N Tamini A Tamosiunas SA Tan PJ Tanis SJ Tate V Tercioti Junior C Terzi V Testa MA Thaha JC Tham N Thavanesan JE Theodore C Tinoco M Todorovic A Tomazic V Tomulescu V Tonini BR Toorenvliet J Torkington A Torrance MJ Toscano I Tóth S Trampus E Travaglio I Trostchanky N Truan H Tulchinsky V Turrado-Rodriguez R Tutino A Tzivanakis GA Tzovaras LW Unger S Vaccari CJ Vaizey G Valero-Navarro I Valverde Nuñez K Van Belle K Van Belle I van den Berg AAW van Geloven YT Van Loon L van Steensel M Varcada AV Vardanyan P Varpe VR Velchuru J Vencius D Venskutonis M Vermaas M Vertruyen M Vicente-Ruiz A Vignali V Vigorita M Vila Tura D Vimalachandran L Vincenti L Viso RGJ Visschers YS Voronin P Walega WZ Wan Zainira JH Wang X Wang R Wani J Warusavitarne A Warwick N Wasserberg DJ Weiss E Westerduin JR Wheat I White G Williams GL Williams TR Wilson JM Wilson D Winter AM Wolthuis MPK Wong J Worsøe E Xynos S Yahia T Yamamoto A Yanishev Z Zaidi MA Zairul Azwan S Zaman A Zaránd A Zarco M Zawadzki M Zelic P Žeromskas M Zilvetti O Zmora

BJS Open

2024

Title: Anastomotic leak after manual circular stapled left-sided bowel surgery: analysis of technology-, disease-, and patient-related factors

Description:

Abstract Background Anastomotic leak rates after colorectal surgery remain high.

In most left-sided colon and rectal resection surgeries, a circular stapler is utilized to create the primary bowel anastomosis.

However, it remains unclear whether a relationship between circular stapler technology and anastomotic leak in left-sided colorectal surgery exists.

Methods A post-hoc analysis was conducted using a prospectively collected data set of patients from the 2017 European Society of Coloproctology snapshot audit who underwent elective left-sided resection (left hemicolectomy, sigmoid colectomy, or rectal resection) with a manual circular stapled anastomosis.

Rates of anastomotic leak and unplanned intensive care unit stay in association with manual circular stapling were assessed.

Patient-, disease-, geographical-, and surgeon-related factors as well as stapler brand were explored using multivariable regression models to identify predictors of adverse outcomes.

Results Across 3305 procedures, 8.

0% of patients had an anastomotic leak and 2.

1% had an unplanned intensive care unit stay.

Independent predictors of anastomotic leak were male sex, minimal-access surgery converted to open surgery, and anastomosis height C11 (lower third rectum) (all P < 0.

050).

Independent predictors of unplanned intensive care unit stay were minimal-access surgery converted to open surgery and American Society of Anesthesiologists grade IV (all P < 0.

050).

Stapler device brand was not a predictor of anastomotic leak or unplanned intensive care unit stay in multivariable regression analysis.

There were no differences in rates of anastomotic leak and unplanned intensive care unit stay according to stapler head diameter, geographical region, or surgeon experience.

Conclusion In patients undergoing left-sided bowel anastomosis, choice of manual circular stapler, in terms of manufacturer or head diameter, is not associated with rates of anastomotic leak and unplanned intensive care unit stay.

Back

Abstarct Introduction Isolated brain hydatid disease (BHD) is an extremely rare form of echinococcosis. A prompt and timely diagnosis is a crucial step in disease management. This ...

Non-Gastrointestinal Complications and Short-Term Outcomes in Patients With Anastomotic Leak After Colon Resection: A Propensity Matched Analysis of American College of Surgeons National Surgical Quality Improvement Program Database

Introduction: Anastomotic leak is a devastating complication after colorectal surgery. There is paucity of data on non-gastrointestinal complications after anastomotic leak in this...

Risk factor analysis of enterocutaneous fistula after small bowel surgery

Abstract: Background: ECF most frequently follows a complication of abdominal surgery, although a smaller number occur spontaneously in association with conditia Background: Entero...

Radiological appearances of Anastomotic Leakage after Radical Gastrectomy

Abstract Background Anastomotic leakage is a critical postoperative complication after gastric cancer surgery. Previous studies...

Single layer vs double layer intestinal anastomosis- a prospective comparative study.

Abstract Gastrointestinal anastomosis is one of the commonest surgical procedure performed worldwide. The aim of the anastomosis is to make a sound alignment of the bowel t...

Treatment of Intrathoracic Anastomotic Leak After Esophagectomy with the Sump Drainage Tube

Abstract Background: Intrathoracic esophagogastric anastomotic leak is one of the deadliest complications after esophagectomy. In recent years, we have implemented new meth...

320. RISK FACTORS FOR BENIGN ANASTOMOTIC STENOSIS AFTER ESOPHAGEAL CANCER SURGERY

Abstract Background Benign strictures occur frequently following an esophagectomy, causing dysphagia, problems with eating, and ...

Blunt Chest Trauma and Chylothorax: A Systematic Review

Abstract Introduction: Although traumatic chylothorax is predominantly associated with penetrating injuries, instances following blunt trauma, as a rare and challenging condition, ...

Email:
Password:

Email:

Anastomotic leak after manual circular stapled left-sided bowel surgery: analysis of technology-, disease-, and patient-related factors

Related Results