Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit

6533b856fe1ef96bd12b1d2f

RESEARCH PRODUCT

Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit

L Sánchez-guillén D Nepogodiev E Sivrikoz T Van Elst A Minaya F Pata J Glasbey T Pinkney A Bhangu A El-hussuna A Bhangu N Buchs C Buskens S Chaudri M Frasson G Gallo A Minaya D Morton I Negoi F Pata B Singh O Zmora T Pinkney R Perry L Magill A Bhangu D Altomare W Bemelman S Brown Q Denost C Knowles S Laurberg J Lefèvre G Möeslein T Pinkney C Vaizey S Bilali V Bilali M Salomon M Cillo D Estefania J Patron Uriburu H Ruiz P Farina F Carballo S Guckenheimer D Proud R Brouwer A Bui B Nguyen P Smart A Warwick J Theodore F Herbst T Birsan B Dauser S Ghaffari N Hartig A Stift S Argeny L Unger R Strouhal A Heuberger A Varabei N Lahodzich A Makhmudov L Selniahina T Feryn T Leupe L Maes E Reynvoet K Van Langenhove M Nachtergaele B Monami D Francart C Jehaes S Markiewicz J Weerts K Van Belle B Bomans V Cavenaile Y Nijs M Vertruyen P Pletinckx D Claeys B Defoort F Muysoms S Van Cleven C Lange K Vindevoghel A Wolthuis M Todorovic S Dabic B Kenjic S Lovric J Vidovic S Delibegovic Z Mehmedovic A Christiano B Lombardi M Jr Marchiori V Jr Tercioti D Dardanov P Petkov L Simonova A Yonkov E Zhivkov S Maslyankov V Pavlov M Sokolov G Todorov V Stoyanov I Batashki N Iarumov I Lozev B Moshev M Slavchev B Atanasov N Belev P Krstev R Penkov G ŠAntak J ĆOsić A Previšić L Vukušić G Zukanović M Zelić D Kršul V Lekić Vitlov D Mendrila J Orhalmi T Dusek O Maly J Paral O Sotona M Skrovina V Bencurik M Machackova Z Kala M Farkašová T Grolich V Procházka J Hoch P Kocian L Martinek F Antos V Pruchova A El-hussuna A Ceccotti T Madsbøll D Straarup A Uth Ovesen P Christensen P Bondeven P Edling H Elfeki V Alexandrovich Gameza S Michelsen Bach I Zheltiakova Pm Krarup A Krogh Hc Rolff J Lykke Af Juvik Hhk Lóven M Marckman Jtf Osterkamp Ah Madsen J Worsøe A Ugianskis Md Kjaer B Youn Cho Lee A Khalid Mh Kristensen M El Sorogy A Elgeidie M Elhemaly A Elnakeeb M Elrefai M Shalaby S Emile W Omar A Sakr W Thabet S Awny I Metwally B Refky N Shams M Zuhdy A Lepistö I Keränen A Kivelä T Lehtonen P Siironen T Rautio M Ahonen-siirtola K Klintrup K Paarnio H Takala M Hyöty E Haukijärvi Sm Kotaluoto K Lehto T Tomminen H Huhtinen A Carpelan J Karvonen A Rantala P Varpe E Cotte Y Francois O Glehen G Passot A D'alessandro E Chouillard Jc Etienne E Ghilles B Vinson-bonnet A Germain A Ayav L Bresler R Chevalier Q Denost R Didailler E Rullier E Tiret N Chafai J Lefevre Y Parc I Sielezneff D Mege Z Lakkis M Barussaud C Krones B Bock R Webler J Baral T Lang S Münch F Pullig M Schön S Hinz T Becker T Möller F Richter C Schafmayer J Hardt P Kienle F Crescenti M Ahmad Y Soleiman I Papaconstantinou A Gklavas K Nastos T Theodosopoulos A Vezakis K Stamou A Saridaki E Xynos S Paraskakis N Zervakis G Skroubis T Amanatidis S Germanos I Maroulis G Papadopoulos N Dimitriou A Alexandrou E Felekouras J Griniatsos I Karavokyros A Papadopoulos C Chouliaras P Ioannidis D Katsounis E Kefalou I Katsoulis D Balalis D Manatakis G Tzovaras I Baloyiannis I Mamaloudis G Lázár S ÁBraham A Paszt Z Simonka A Zaránd Z Baranyai G Ferreira L Harsányi P ÓNody B Banky Á Burány M Lakatos J Marton A Solymosi I Besznyák A Bursics G Papp G Saftics I Svastics E Valsdottir J Atladottir T Jonsson P Moller H Sigurdsson Sk Gupta S Gupta N Kaul S Mohan G Sharma R Wani N Chowdri M Khan A Mehraj F Parray A Coveney J Burke J Deasy S El-masry D Mcnamara Mf Khan R Cahill E Faul J Mulsow C Shields Me Kelly G Bass St Martin R O'connell E Ryan T Connelly G Ahmad W Bukhari F Cooke O Zmora R Gold Deutch N Haim R Lavy A Moscovici N Shussman R Gefen G Marom A Pikarsky D Weiss S Avital N Hermann B Raguan M Slavin I White N Wasserberg H Arieli N Gurevich Mr Freund S Dorot G Halfteck P Reissman E Yair Y Eden R Pery H Tulchinsky A Weizman F Agresta R Curinga E Finotti G Savino La Verza Cr Asteria L Boccia A Pascariello N Tamini A Bugatti L Gianotti M Totis L Vincenti V Andriola I Giannini E Travaglio R Balestri P Buccianti N Roffi E Rossi L Urbani A Mellano A Cinquegrana A Lauretta C Belluco M Mistrangelo Me Allaix S Arolfo M Morino V Testa P Delrio U Pace D Rega D Scala G Gallo G Clerico S Cornaglia A Realis Luc M Trompetto G Ugolini N Antonacci S Fabbri I Montroni D Zattoni C D'urbano A Cornelli M Viti M Inama M Bacchion A Casaril H Impellizzeri G Moretto A Spinelli M Carvello G David F Di Candido M Sacchi A Frontali V Ceriani M Molteni R Rosati F Aleotti U Elmore M Lemma A Vignali S Scabini G Casoni Pattacini A Luzzi E Romairone F Marino D Lorusso F Pezzolla F Colombo C Baldi D Foschi G Sampietro L Sorrentino S Di Saverio A Birindelli E Segalini D Spacca Gm Romano A Belli F Bianco S De Franciscis A Falato A Muratore P Marsanic S Grimaldi N Castaldo Mg Ciolli P Picarella R Porfidia S Di Saverio G Tugnoli A Bondurri D Cavallo A Maffioli A Pertusati F Pulighe F Balestra C De Nisco M Podda E Opocher M Longhi Nm Mariani N Maroni A Pisani Ceretti R Galleano P Aonzo G Curletti L Reggiani M Marconi L Del Prete M Oldani R Pappalardo Zaccone L S M Scatizzi M Baraghini S Cantafio F Feroci I Giani R Tutino G Cocorullo G Gulotta L Licari G Salamone P Sileri F Saraceno F La Torre P Chirletti D Coletta G De Toma A Mingoli M Papandrea E De Luca R Sacco G Sammarco G Vescio V Tonini S Bianchini M Cervellera S Vaccari N Cracco G Barugola E Bertocchi R Rossini G Ruffo A Sartori N Clemente M De Luca A De Luca G Scaffidi L Lorenzon G Balducci T Bocchetti M Ferri P Mercantini F Pata S Bauce A Benevento C Bottini Pr Crapa M Rubbini G Anania P Carcoforo G Cavallesco C Feo T Yamamoto A Sivins G Ancans S Gerkis R Lunis A Pcolkins D Venskutonis S Bradulskis E Dainius A Subocius J Vencius P Zeromskas V Eismiontas V Nutautiene D Simcikas A Tamosiunas S Svagzdys T Latkauskas P Lizdenis Z Saladzinskas A Tamelis A Dulskas J Kuliavas Ne Samalavicius T Poskus V Jotautas S Mikalauskas E Poskus K Strupas A Zakaria Nn Lah M Wong Z Zain Z Zakaria L Mazlan Mohd Azman Za I Sagap J Psaila P Andrejevic C Cini S Ellul K Pace M Ahallat M Hamid A Hrora Ma Majbar M Raiss E Westerduin W Bemelman C Buskens P Tanis Van Der Sluis Pc Ph Davids A Pronk Ahw Schiphorst N Smakman D Zimmerman T Koeter J Stijns Van Loon Yt M Vermaas E De Graaf P Doornebosch P Van Hagen O Van Ruler B Toorenvliet J Nonner I Van Den Berg L Van Steensel W Vles J Melenhorst R Orsini R Visschers C Hoff R Blom H Marsman I Mulder H Cense S De Castro A Demirkiran M Hunfeld A Van Geloven J De Groof E Hendriks M Leeuwenburg N Van Oorschot F Wit C Rupert P Veldman M Keijzers J Konsten F Den Boer M Corver Ej Boerma L Koolen M Martens K Van Wijck D Ignjatovic R Breuer B Gurpreet T Oresland T Tetens Moe A Nesbakken I Flateh Backe Ta Wik K Radiya T Dehli P Gjessing S Norderval K Woll M Anwer Ms Qureshi Au Qureshi M Billah My Jawad A Raza N Urooj X Wang L Li D Jajtner B Gasinski W Kabiesz P Walega M Romaniszyn M Zawadzki R Czarnecki Z Obuszko M Rzaca M Sitarska P Silva A Duarte D Gonçalves M Morais N Rama J Nobre I Sales J Costa Pereira S Costa C Costa Pereira C Insua I Romero N. Figueiredo J Cunha H Domingos P Vieira M Cunha M Americano E Amorim J Rachadell J Carvas I Armas P Fernandes C Pires R Reis R Martins M Dos Santos P Henriques O Oliveira M Duarte L Ferreira J Miranda N Vilela J Corte Real S Carlos M Frois Borges P Moniz Pereira J Simões P Silva-vaz V Bettencourt A Gouveia H Perez R Rainho V Bintintan C Ciuce G Dindelegan R Scurtu R Seicean D Cristian T Burcos F Grama Dm Mandi G Richiteanu A Miron V Calu O Enciu M Nadragea R Parvuletu Ss Mogoanta A Crafciuc S Paitici I Negoi M Beuran C Ciubotaru A Prodan M Vartic V Tomulescu C Copaescu D Popov A Sednev A Klimenko A Semenov S Vasilyev A Pozdnyakov D Cherdancev D Mahotin A Nesytykh V Samsonyuk I Pravosudov D Ivlev A Karachun K Lebedev D Samsonov R Aiupov D Feoktistov M Garipov S Nail N Tarasov A Yanishev A Abelevich A Kokobelyan M Lebedeva R Luzan A Rasulov H Dzhumabaev Z Mamedli A Bedzhanyan A Khazov M Khanevich G Khrykov S Katorkin P Andreev A Chernov O Davidova A Zhuravlev S Achkasov D Shakhmatov Y Shelygin O Sushkov A Vardanyan A Ilkanich N Barbashinov V Darvin S Onishchenko Y Voronin Z Krivokapić G Barišić I Dimitrijević V Marković A Sekulić G Stanojevic B Brankovic M Nestorovic V Pecic D Petrovic I Kostic A Aleksic D Dabic B Maric V Perunicic Z. Radovanovic M Djuric D Lukic D Radovanovic V Cuk J Juloski M Kenic I Krdzic Jc Ngu Yy Ng N Teo J Korcek A Lazorisak M Rems Š Ramovš Trampuš A Tomazic J Grosek J Kosir G Norcic V Vigorita N Caceres E Casal A Ruano I Trostchansky T Golda A Galvez Saldaña E Kreisler Moreno J Lopez Dominguez M Vila Tura F Labarga P Galvez V Maderuelo C Suero J Bargallo L Cayetano S Lamas Mc Silva Jc Bernal-sprekelsen R Gómez S Jareño A Ríos D Vercher Jm García-gonzález J Cervera-aldama J Ramos-prada M Santamaría-olabarrieta N Borda Jm Enrriquez-navascués Y Saralegui A Calero-lillo S Aznar-puig Ma López-lara S Muñoz-collado J Valverde-sintas P Menendez C Leon N Truan R Baldonedo D Martínez J Otero L Solar Victor Turrado-rodriguez F De Lacy Oliver Lacy Fortuny Am B Martin Perez Otero Piñeiro Am J Paredes F Fernandez Mj Ladra A Paulos D Prieto Beltrán De Heredia Jp F Blanco Antona B De Andrés Asenjo C Ferreras García A Romero De Diego E Cordoba Diaz De Laspra E Echazarreta Gallego M Elia Guedea D Escola S Martinez V Primo Romaguera R Parreño L Pastor E Rosell R Lozoya Trujillo R Alós Company Ruiz Carmona Md A Solana Bueno S Salvans Ruiz S Alonso Gonçalves M Jiménez-toscano M Pascual Damieta M Pera Roman Em Pellicer-franco Ja Garcia-marin M Mengual-ballester V Soria-aledo G Valero-navarro M Vicente-ruiz C Garcia-zamora A Gonzalez-gil Mj Montoya-tabares M Paredes-quiles J Die Trill P Abadia I Moreno Jd Pina D Ramos Rubio J Escartin Jl Blas J Fernando R Ferrer J Garcia Egea I Pros W Martinez J Rius M Socías D Sabia J Castellvi Valls V Gonzalez Santin S Mompart Garcia L Viso Pons D Julià A Codina-cazador R Farrés N Gómez P Planellas M Cuadrado I Camps M Rufas J Escoll A Fermiñán P Muriel E Sierra C Alvarez-laso P Lora H Padin J Garcia-septiem C Bustamante V Jimenez J Jimenez-miramon Jl Ramos Ab Gallardo P Benito L Colao P Galindo C Garcia A Forero-torres A Alonso Poza B Dieguez Fernandez C Gilsanz Martin M Hernandez Garcia Rojo López Ja Gil López Jm M González Zunzárren J Martínez Alegre Zorrilla Matilla Jp A Navarro-sánchez Alcalá Serrano Fj J López-fernández D Montesdeoca Cabrera M Alvarez-gallego J Guevara I Pascual Miguelañez I Rubio-perez M Gomez Ruiz J Alonso Martín C Cagigas Fernández J Castillo Diego Ja Pando C Maristany A Muñoz-duyos A Rada-palomino H Vargas-pierola E Peña Ros Benavides Buleje Ja Muñoz Camarena Jm Parra Baños Pa M Ramirez Faraco Jj Arenal Ma Citores Jl Marcos J Sánchez C Tinoco García Flórez Lj Arias Pacheco Rd G Mínguez Ruiz N Rodríguez Corral A Rodríguez Infante Carrillo López Mj Carrasco Prats Mm A Lage Laredo Á Martínez Manzano P Rodríguez García Jj Segura-sampedro N Alonso-hernández M Fernandez Isart M Gamundi Cuesta A Ochogavia Segui N Ibañez J Abrisqueta J Lujan R Gómez Pérez E Corrales Valero C Monje Salazar E Sanchiz Cardenas R Soler Humanes Rm Jimenez-rodriguez F De La Portilla Diaz Pavon Jm Garcia Cabrera Am Reyes Diaz Ml E Espin F Marinello M Martí Jl Sanchez F Vallribera Orts Mico Fj M Ortin Navarro M Perez Climent C Serra Diaz M Millan A Caro J Escuder B Espina F Feliu A Climent Aira A Estévez Diz Moreno Asencio Mt A Varela Mato R Vázquez Bouzán Am Minaya-bravo Mm Diez-alonso R Villeta-plaza H Guadalajara D Alías D García Olmo C Pastor I Valverde A Sanchez Romero A Gardea M Gil Santos T Nimmersgern P Serrano Paz M Romero-simó T Blasco-segura I Caravaca-garcía D Costa-navarro A Zarco-pleguezuelos L Sánchez-guillén B Flor-lorente M Frasson Á García-granero E García-granero B Arencibia J Alonso G Febles Em Nogués C Roque J Segelman J Nygren G Nestler M Abraham-nordling M Egenvall P Myrelid B Jung P Loftås Ml Lydrup N Azahr P Buchwald P Mangell I Syk M Nikberg J Carlander A Chabok K Smedh C Tiselius S Haapaniemi A Benckert M Adamina C Freil-lanter C Gingert P Müller J Schäfli L Regusci M Brenna F Fasolini H Misteli P Kirchhoff D Oertli D Hahnloser D Clerc M Hübner F Ris Nc Buchs M Chevallay P Morel B Schiltz Jy Wang Wc Su Cw Huang Cj Ma Hl Tsai Gs ÖZbalcı Bb ÖZkan U Karabacak D Bugra F Agalar H Baloglu I Basoglu N Okkabaz E Binboga A Biricik A Celik E Yavuz Ae Canda C Agalar M Fuzun S Sokmen C Terzi A Isik B Karip Ac Bilgili S Leventoglu B Aytac A Yıldız O Yuksel H Sinan O Hancerliogullari S Kaymak O Kozak Mt Ozer Is Sarici O Akca Mu Kalayci Y Kara D Bugra O Agcaoglu E Balik O Bayram U Sungurtekin U Ozgen S Demirbas E ÖZtürk O Isik T Yilmazlar E Colak S Karagul V Kinas N Fearnhead I Lord P Stewart M Zammit S Arnold N Battersby J Broadhurst A Mehta F Seretis J Shabbir C Jones J Kynaston D Vimalachandran E Blower C Mcfaul D Mcwhirter J Pilkington T Wilson M Chowdhary B Stubbs M Abdalkoddus C Lai N Thavanesan C Yao T Agarwal S Dindyal Rmc Hill S Reade A Slesser H Paterson A Balfour M Boland A Geraghty J O'kelly P Patel S Tezas S Yahia V Jadhav K Marimuthu A Narayanan B Piramanayagam N Bradley F Buchanan K Paul J Singh K Thomson S Korsgen M Bedford K Lee K Leong D Mcarthur A Bhangu S Malik I Mohamed P Cunha A Pilavas A Reddy S Ahmed A Ahmed J Voll V Velchuru R Lal B Mirshekar-syahkal M Kassai M Aleem S Keogh-bootland P Sarmah S Brown R Keegan A Kelkar P Sen M Oliveira-cunha S Chaudhri R Fares B Singh Wm Thomas Mi Aslam K Boyle D Hemingway A Miller M Norwood S Gurjar M Al-saeedi L Anandan A Sudlow N Zampitis K Malik M Bogdan C Smart Mr Iqbal S Bailey D Lawes G Omar R Tamhane M Evans S Ather J Lim H Nageswaran G Taylor L Hunt J Nicholls I Shaikh F Muscara J O'brien E Photi A Stearns D Meylemans C Cunningham R Hompes A Tennakoon N Kumarasinghe M Rao I Upanishad S Smolarek E Platt B Rossi Jc Tham J Khan N Ahmad Z Shweejawee S Stefan N Smart I Daniels T Gregoir L Longstaff F Mcdermott M Varcada I Drami T Gala E Moggia K Ratnatunga R Harries J Hayes G Williams T Raymond C Bronder E Davies P Hawkin O Ryska K Ayral A Beveridge A Bhowmik M Gill R Simpson A Schofield K Mcardle M Parmar M Williamson H Burton E Courtney C Grant A Saracino K Newton J Epstein G Branagan M Bignell M Symankewicz S Zaman R Mankotia Z Siddiqui A Torrance D Artioukh M Eggleston K Gokul D Selwyn J Warusavitarne P Chandrasinghe J Grainger Ca Leo Cj Vaizey G Harris B Levy A Skull M Thaha S Ahmed A Garg H Patel A Ramsanahie M Mondragon-pritchard K Cuinas Leon A Shukla H Brewer J Fitzgerald H Kho J Torkington S Tate J Wheat J Knight J Richardson A Tzivanakis M Gregori Ma Ashraf M Atif J Santos N Saffaf L Canning N Chandratreya M Bowen B Graham Y Hamad M Kaubrys Zu Chaudhry C Bhan H Mukhtar A Oshowo J Wilson J Richardson N Gouvas D Nicol S Pandey M Zilvetti A Sharma T Fatayer S Mothe M Rahman N Curtis A Allison R Dalton N Francis J Ockrim G Psaras H Dudarovaska T Marharint E Mostovoy S Voloshin O Kolesnik D Makhmudov Y Altinel A Iqbal L Cunningham K Go S. Tan

subject

Male Medical audit Treatment outcome anastomotic leak 030230 surgery 0302 clinical medicine Postoperative Complications Prospective Studies Multi centre emergency surgery Prospective cohort study Colectomy Medical Audit Proctectomy Proctectomy/adverse effects Prospective audit Primary anastomosis Anastomosis Surgical Gastroenterology Middle Aged surgical complications Europe Treatment Outcome colon cancer anastomotic leak; colon cancer; emergency surgery; gastrointestinal surgery; rectal cancer; Surgery; surgical complications; surgical outcomes; Gastroenterology 030220 oncology & carcinogenesis Postoperative Complications/etiology Female Colectomy/adverse effects Emergency Treatment/adverse effects Adult medicine.medical_specialty Adolescent surgical outcome surgical outcomes Left sided NO 03 medical and health sciences Young Adult surgical complication medicine Humans gastrointestinal surgery rectal cancer Emergency Treatment Colorectal resection Aged ta3126 Anastomosis Surgical/methods business.industry General surgery Surgical Stomas Surgical Stomas/statistics & numerical data Settore MED/18 - Chirurgia Generale Multivariate Analysis Surgery business

description

Introduction: 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. Methods: 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). Results: 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. Conclusions: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications.

year	journal	country	edition	language
2018-09-01

10.1111/codi.14373 http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1463-1318