Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit.
Details
Serval ID
serval:BIB_268AF3E1CCFD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit.
Journal
Colorectal disease
Working group(s)
2017 European Society of Coloproctology (ESCP) collaborating group
Contributor(s)
Nepogodiev D., Sivrikoz E., van Elst T., Minaya-Bravo A.M., Pata F., Glasbey J., Pinkney T., Bhangu A., El-Hussuna A., Bhangu A., Buchs N., Buskens C., Chaudri S., Frasson M., Gallo G., Minaya A., Morton D., Negoi I., Pata F., Singh B., Zmora O., Pinkney T., Perry R., Magill L., Bhangu A., Altomare D., Bemelman W., Brown S., Denost Q., Knowles C., Laurberg S., Lefèvre J., Möeslein G., Pinkney T., Vaizey C., Bilali S., Bilali V., Salomon M., Cillo M., Estefania D., Patron Uriburu J., Ruiz H., Farina P., Carballo F., Guckenheimer S., Proud D., Brouwer R., Bui A., Nguyen B., Smart P., Warwick A., Theodore J., Herbst F., Birsan T., Dauser B., Ghaffari S., Hartig N., Stift A., Argeny S., Unger L., Strouhal R., Heuberger A., Varabei A., Lahodzich N., Makhmudov A., Selniahina L., Feryn T., Leupe T., Maes L., Reynvoet E., Van Langenhove K., Nachtergaele M., Monami B., Francart D., Jehaes C., Markiewicz S., Weerts J., Van Belle K., Bomans B., Cavenaile V., Nijs Y., Vertruyen M., Pletinckx P., Claeys D., Defoort B., Muysoms F., Van Cleven S., Lange C., Vindevoghel K., Wolthuis A., Todorovic M., Dabic S., Kenjic B., Lovric S., Vidovic J., Delibegovic S., Mehmedovic Z., Christiano A., Lombardi B., Marchiori M., Tercioti V., Dardanov D., Petkov P., Simonova L., Yonkov A., Zhivkov E., Maslyankov S., Pavlov V., Sokolov M., Todorov G., Stoyanov V., Batashki I., Iarumov N., Lozev I., Moshev B., Slavchev M., Atanasov B., Belev N., Krstev P., Penkov R., Šantak G., Ćosić J., Previšić A., Vukušić L., Zukanović G., Zelić M., Kršul D., Lekić Vitlov V., Mendrila D., Orhalmi J., Dusek T., Maly O., Paral J., Sotona O., Skrovina M., Bencurik V., Machackova M., Kala Z., Farkašová M., Grolich T., Procházka V., Hoch J., Kocian P., Martinek L., Antos F., Pruchova V., El-Hussuna A., Ceccotti A., Madsbøll T., Straarup D., Uth Ovesen A., Christensen P., Bondeven P., Edling P., Elfeki H., Alexandrovich Gameza V., Michelsen Bach S., Zheltiakova I., Krarup P.M., Krogh A., Rolff H.C., Lykke J., Juvik A.F., Lóven HHK, Marckman M., Osterkamp JTF, Madsen A.H., Worsøe J., Ugianskis A., Kjaer M.D., Youn Cho Lee B., Khalid A., Kristensen M.H., El Sorogy M., Elgeidie A., Elhemaly M., ElNakeeb A., Elrefai M., Shalaby M., Emile S., Omar W., Sakr A., Thabet W., Awny S., Metwally I., Refky B., Shams N., Zuhdy M., Lepistö A., Keränen I., Kivelä A., Lehtonen T., Siironen P., Rautio T., Ahonen-Siirtola M., Klintrup K., Paarnio K., Takala H., Hyöty M., Haukijärvi E., Kotaluoto S.M., Lehto K., Tomminen T., Huhtinen H., Carpelan A., Karvonen J., Rantala A., Varpe P., Cotte E., Francois Y., Glehen O., Passot G., d'Alessandro A., Chouillard E., Etienne J.C., Ghilles E., Vinson-Bonnet B., Germain A., Ayav A., Bresler L., Chevalier R., Denost Q., Didailler R., Rullier E., Tiret E., Chafai N., Lefevre J., Parc Y., Sielezneff I., Mege D., Lakkis Z., Barussaud M., Krones C., Bock B., Webler R., Baral J., Lang T., Münch S., Pullig F., Schön M., Hinz S., Becker T., Möller T., Richter F., Schafmayer C., Hardt J., Kienle P., Crescenti F., Ahmad M., Soleiman Y., Papaconstantinou I., Gklavas A., Nastos K., Theodosopoulos T., Vezakis A., Stamou K., Saridaki A., Xynos E., Paraskakis S., Zervakis N., Skroubis G., Amanatidis T., Germanos S., Maroulis I., Papadopoulos G., Dimitriou N., Alexandrou A., Felekouras E., Griniatsos J., Karavokyros I., Papadopoulos A., Chouliaras C., Ioannidis P., Katsounis D., Kefalou E., Katsoulis I., Balalis D., Manatakis D., Tzovaras G., Baloyiannis I., Mamaloudis I., Lázár G., Ábraham S., Paszt A., Simonka Z., Zaránd A., Baranyai Z., Ferreira G., Harsányi L., Ónody P., Banky B., Burány Á., Lakatos M., Marton J., Solymosi A., Besznyák I., Bursics A., Papp G., Saftics G., Svastics I., Valsdottir E., Atladottir J., Jonsson T., Moller P., Sigurdsson H., Gupta S.K., Gupta S., Kaul N., Mohan S., Sharma G., Wani R., Chowdri N., Khan M., Mehraj A., Parray F., Coveney A., Burke J., Deasy J., El-Masry S., McNamara D., Khan M.F., Cahill R., Faul E., Mulsow J., Shields C., Kelly M.E., Bass G., Martin S.T., O'Connell R., Ryan E., Connelly T., Ahmad G., Bukhari W., Cooke F., Zmora O., Gold Deutch R., Haim N., Lavy R., Moscovici A., Shussman N., Gefen R., Marom G., Pikarsky A., Weiss D., Avital S., Hermann N., Raguan B., Slavin M., White I., Wasserberg N., Arieli H., Gurevich N., Freund M.R., Dorot S., Halfteck G., Reissman P., Yair E., Eden Y., Pery R., Tulchinsky H., Weizman A., Agresta F., Curinga R., Finotti E., Savino G., Verza L.A., Asteria C.R., Boccia L., Pascariello A., Tamini N., Bugatti A., Gianotti L., Totis M., Vincenti L., Andriola V., Giannini I., Travaglio E., Balestri R., Buccianti P., Roffi N., Rossi E., Urbani L., Mellano A., Cinquegrana A., Lauretta A., Belluco C., Mistrangelo M., Allaix M.E., Arolfo S., Morino M., Testa V., Delrio P., Pace U., Rega D., Scala D., Gallo G., Clerico G., Cornaglia S., Realis Luc A., Trompetto M., Ugolini G., Antonacci N., Fabbri S., Montroni I., Zattoni D., D'Urbano C., Cornelli A., Viti M., Inama M., Bacchion M., Casaril A., Impellizzeri H., Moretto G., Spinelli A., Carvello M., David G., Di Candido F., Sacchi M., Frontali A., Ceriani V., Molteni M., Rosati R., Aleotti F., Elmore U., Lemma M., Vignali A., Scabini S., Casoni Pattacini G., Luzzi A., Romairone E., Marino F., Lorusso D., Pezzolla F., Colombo F., Baldi C., Foschi D., Sampietro G., Sorrentino L., Di Saverio S., Birindelli A., Segalini E., Spacca D., Romano G.M., Belli A., Bianco F., De Franciscis S., Falato A., Muratore A., Marsanic P., Grimaldi S., Castaldo N., Ciolli M.G., Picarella P., Porfidia R., Di Saverio S., Tugnoli G., Bondurri A., Cavallo D., Maffioli A., Pertusati A., Pulighe F., Balestra F., De Nisco C., Podda M., Opocher E., Longhi M., Mariani N.M., Maroni N., Pisani Ceretti A., Galleano R., Aonzo P., Curletti G., Reggiani L., Marconi M., Del Prete L., Oldani M., Pappalardo R., Zaccone L S., Scatizzi M., Baraghini M., Cantafio S., Feroci F., Giani I., Tutino R., Cocorullo G., Gulotta G., Licari L., Salamone G., Sileri P., Saraceno F., La Torre F., Chirletti P., Coletta D., De Toma G., Mingoli A., Papandrea M., De Luca E., Sacco R., Sammarco G., Vescio G., Tonini V., Bianchini S., Cervellera M., Vaccari S., Cracco N., Barugola G., Bertocchi E., Rossini R., Ruffo G., Sartori A., Clemente N., De Luca M., De Luca A., Scaffidi G., Lorenzon L., Balducci G., Bocchetti T., Ferri M., Mercantini P., Pata F., Bauce S., Benevento A., Bottini C., Crapa P.R., Rubbini M., Anania G., Carcoforo P., Cavallesco G., Feo C., Yamamoto T., Sivins A., Ancans G., Gerkis S., Lunis R., Pcolkins A., Venskutonis D., Bradulskis S., Dainius E., Subocius A., Vencius J., Zeromskas P., Eismiontas V., Nutautiene V., Simcikas D., Tamosiunas A., Svagzdys S., Latkauskas T., Lizdenis P., Saladzinskas Z., Tamelis A., Dulskas A., Kuliavas J., Samalavicius N.E., Poskus T., Jotautas V., Mikalauskas S., Poskus E., Strupas K., Zakaria A., Lah N.N., Wong M., Zain Z., Zakaria Z., Mazlan L., Mohd Azman Z.A., Sagap I., Psaila J., Andrejevic P., Cini C., Ellul S., Pace K., Ahallat M., Hamid M., Hrora A., Majbar M.A., Raiss M., Westerduin E., Bemelman W., Buskens C., Tanis P., van der Sluis P.C., Davids P.H., Pronk A., Schiphorst AHW, Smakman N., Zimmerman D., Koeter T., Stijns J., van Loon Y.T., Vermaas M., de Graaf E., Doornebosch P., van Hagen P., van Ruler O., Toorenvliet B., Nonner J., van den Berg I., van Steensel L., Vles W., Melenhorst J., Orsini R., Visschers R., Hoff C., Blom R., Marsman H., Mulder I., Cense H., de Castro S., Demirkiran A., Hunfeld M., van Geloven A., de Groof J., Hendriks E., Leeuwenburg M., van Oorschot N., Wit F., Rupert C., Veldman P., Keijzers M., Konsten J., Den Boer F., Corver M., Boerma E.J., Koolen L., Martens M., Van Wijck K., Ignjatovic D., Breuer R., Gurpreet B., Oresland T., Tetens Moe T., Nesbakken A., Flateh Backe I., Wik T.A., Radiya K., Dehli T., Gjessing P., Norderval S., Woll K., Anwer M., Qureshi M.S., Qureshi A.U., Billah M., Jawad M.Y., Raza A., Urooj N., Wang X., Li L., Jajtner D., Gasinski B., Kabiesz W., Walega P., Romaniszyn M., Zawadzki M., Czarnecki R., Obuszko Z., Rzaca M., Sitarska M., Silva P., Duarte A., Gonçalves D., Morais M., Rama N., Nobre J., Sales I., Costa Pereira J., Costa S., Costa Pereira C., Insua C., Romero I., Figueiredo N., Cunha J., Domingos H., Vieira P., Cunha M., Americano M., Amorim E., Rachadell J., Carvas J., Armas I., Fernandes P., Pires C., Reis R., Martins R., Dos Santos M., Henriques P., Oliveira O., Duarte M., Ferreira L., Miranda J., Vilela N., Corte Real J., Carlos S., Frois Borges M., Moniz Pereira P., Simões J., Silva-Vaz P., Bettencourt V., Gouveia A., Perez H., Rainho R., Bintintan V., Ciuce C., Dindelegan G., Scurtu R., Seicean R., Cristian D., Burcos T., Grama F., Mandi D.M., Richiteanu G., Miron A., Calu V., Enciu O., Nadragea M., Parvuletu R., Mogoanta S.S., Crafciuc A., Paitici S., Negoi I., Beuran M., Ciubotaru C., Prodan A., Vartic M., Tomulescu V., Copaescu C., Popov D., Sednev A., Klimenko A., 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Soler Humanes R., Jimenez-Rodriguez R.M., De la Portilla F., Diaz Pavon J.M., Garcia Cabrera A.M., Reyes Diaz M.L., Espin E., Marinello F., Martí M., Sanchez J.L., Vallribera F., Orts Mico F.J., Ortin Navarro M., Perez Climent M., Serra Diaz C., Millan M., Caro A., Escuder J., Espina B., Feliu F., Climent Aira A., Estévez Diz A., Moreno Asencio M.T., Varela Mato A., Vázquez Bouzán R., Minaya-Bravo A.M., Diez-Alonso M.M., Villeta-Plaza R., Guadalajara H., Alías D., García Olmo D., Pastor C., Valverde I., Sanchez Romero A., Gardea A., Gil Santos M., Nimmersgern T., Serrano Paz P., Romero-Simó M., Blasco-Segura T., Caravaca-García I., Costa-Navarro D., Zarco-Pleguezuelos A., Sánchez-Guillén L., Flor-Lorente B., Frasson M., García-Granero Á., García-Granero E., Arencibia B., Alonso J., Febles G., Nogués E.M., Roque C., Segelman J., Nygren J., Nestler G., Abraham-Nordling M., Egenvall M., Myrelid P., Jung B., Loftås P., Lydrup M.L., Azahr N., Buchwald P., Mangell P., Syk I., Nikberg M., 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Shabbir J., Jones C., Kynaston J., Vimalachandran D., Blower E., McFaul C., McWhirter D., Pilkington J., Wilson T., Chowdhary M., Stubbs B., Abdalkoddus M., Lai C., Thavanesan N., Yao C., Agarwal T., Dindyal S., Hill RMC, Reade S., Slesser A., Paterson H., Balfour A., Boland M., Geraghty A., O'Kelly J., Patel P., Tezas S., Yahia S., Jadhav V., Marimuthu K., Narayanan A., Piramanayagam B., Bradley N., Buchanan F., Paul K., Singh J., Thomson K., Korsgen S., Bedford M., Lee K., Leong K., McArthur D., Bhangu A., Malik S., Mohamed I., Cunha P., Pilavas A., Reddy A., Ahmed S., Ahmed A., Voll J., Velchuru V., Lal R., Mirshekar-Syahkal B., Kassai M., Aleem M., Keogh-Bootland S., Sarmah P., Brown S., Keegan R., Kelkar A., Sen P., Oliveira-Cunha M., Chaudhri S., Fares R., Singh B., Thomas W.M., Aslam M.I., Boyle K., Hemingway D., Miller A., Norwood M., Gurjar S., Al-Saeedi M., Anandan L., Sudlow A., Zampitis N., Malik K., Bogdan M., Smart C., Iqbal M.R., Bailey S., Lawes D., Omar G., Tamhane R., Evans M., Ather S., Lim J., Nageswaran H., Taylor G., Hunt L., Nicholls J., Shaikh I., Muscara F., O'Brien J., Photi E., Stearns A., Meylemans D., Cunningham C., Hompes R., Tennakoon A., Kumarasinghe N., Rao M., Upanishad I., Smolarek S., Platt E., Rossi B., Tham J.C., Khan J., Ahmad N., Shweejawee Z., Stefan S., Smart N., Daniels I., Gregoir T., Longstaff L., McDermott F., Varcada M., Drami I., Gala T., Moggia E., Ratnatunga K., Harries R., Hayes J., Williams G., Raymond T., Bronder C., Davies E., Hawkin P., Ryska O., Ayral K., Beveridge A., Bhowmik A., Gill M., Simpson R., Schofield A., McArdle K., Parmar M., Williamson M., Burton H., Courtney E., Grant C., Saracino A., Newton K., Epstein J., Branagan G., Bignell M., Symankewicz M., Zaman S., Mankotia R., Siddiqui Z., Torrance A., Artioukh D., Eggleston M., Gokul K., Selwyn D., Warusavitarne J., Chandrasinghe P., Grainger J., Leo C.A., Vaizey C.J., Harris G., Levy B., Skull A., Thaha M., Ahmed S., Garg A., Patel H., Ramsanahie A., Mondragon-Pritchard M., Cuinas Leon K., Shukla A., Brewer H., Fitzgerald J., Kho H., Torkington J., Tate S., Wheat J., Knight J., Richardson J., Tzivanakis A., Gregori M., Ashraf M.A., Atif M., Santos J., Saffaf N., Canning L., Chandratreya N., Bowen M., Graham B., Hamad Y., Kaubrys M., Chaudhry Z.U., Bhan C., Mukhtar H., Oshowo A., Wilson J., Richardson J., Gouvas N., Nicol D., Pandey S., Zilvetti M., Sharma A., Fatayer T., Mothe S., Rahman M., Curtis N., Allison A., Dalton R., Francis N., Ockrim J., Psaras G., Dudarovaska H., Marharint T., Mostovoy E., Voloshin S., Kolesnik O., Makhmudov D., Altinel Y., Iqbal A., Cunningham L., Go K., Tan S.
ISSN
1463-1318 (Electronic)
ISSN-L
1462-8910
Publication state
Published
Issued date
09/2018
Peer-reviewed
Oui
Volume
20
Number
Suppl 6
Pages
47-57
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection.
A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (> 16 years) who underwent emergency (unplanned, within 24 h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5).
From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83-2.79, P = 0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43-11.02, P = 0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur.
Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications.
A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (> 16 years) who underwent emergency (unplanned, within 24 h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5).
From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83-2.79, P = 0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43-11.02, P = 0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur.
Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications.
Keywords
Adolescent, Adult, Aged, Anastomosis, Surgical/methods, Colectomy/adverse effects, Colectomy/methods, Emergency Treatment/adverse effects, Emergency Treatment/methods, Europe, Female, Humans, Male, Medical Audit, Middle Aged, Multivariate Analysis, Postoperative Complications/etiology, Postoperative Complications/surgery, Proctectomy/adverse effects, Proctectomy/methods, Prospective Studies, Surgical Stomas/statistics & numerical data, Treatment Outcome, Young Adult, Surgery, anastomotic leak, colon cancer, emergency surgery, gastrointestinal surgery, rectal cancer, surgical complications, surgical outcomes
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Web of science
Open Access
Yes
Create date
26/09/2023 14:23
Last modification date
27/09/2023 5:59