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

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

Authors :
Sánchez-Guillén, L
Nepogodiev, D
Sivrikoz, E
van Elst, T
Minaya, A
Pata, F
Glasbey, J
Pinkney, T
Bhangu, A
El-Hussuna, A
Buchs, N
Buskens, C
Chaudri, S
Frasson, M
Gallo, G
Morton, D
Negoi, I
Singh, B
Zmora, O
Perry, R
Magill, L
Altomare, D
Bemelman, W
Brown, S
Denost, Q
Knowles, C
Laurberg, S
Lefèvre, J
Möeslein, G
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 Jr
Tercioti, V Jr
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
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, Pm
Krogh, A
Rolff, Hc
Lykke, J
Juvik, Af
Lóven, Hhk
Marckman, M
Osterkamp, Jtf
Madsen, Ah
Worsøe, J
Ugianskis, A
Kjaer, Md
Youn Cho Lee, B
Khalid, A
Kristensen, Mh
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, Sm
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, Jc
Ghilles, E
Vinson-Bonnet, B
Germain, A
Ayav, A
Bresler, L
Chevalier, R
Didailler, R
Rullier, E
Tiret, E
Chafai, N
Lefevre, J
Parc, Y
Sielezneff, I
Mege, D
Lakkis, Z
Barussaud, M
Krones, C
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Webler, R
Baral, J
Lang, T
Münch, S
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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
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Papp, G
Saftics, G
Svastics, I
Valsdottir, E
Atladottir, J
Jonsson, T
Moller, P
Sigurdsson, H
Gupta, Sk
Gupta, S
Kaul, N
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Sharma, G
Wani, R
Chowdri, N
Khan, M
Mehraj, A
Parray, F
Coveney, A
Burke, J
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El-Masry, S
Mcnamara, D
Khan, Mf
Cahill, R
Faul, E
Mulsow, J
Shields, C
Kelly, Me
Bass, G
Martin, St
O'Connell, R
Ryan, E
Connelly, T
Ahmad, G
Bukhari, W
Cooke, F
Gold Deutch, R
Haim, N
Lavy, R
Moscovici, A
Shussman, N
Gefen, R
Marom, G
Pikarsky, A
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Raguan, B
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Wasserberg, N
Arieli, H
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European Society of Coloproctology (ESCP) Cohort Studie
Tonini V, Cervellera M, Vaccari S
Source :
Christensen, P & 2017 European Society of Coloproctology (ESCP) collaborating group 2018, ' Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit ', Colorectal Disease, vol. 20 Suppl 6, pp. 47-57 . https://doi.org/10.1111/codi.14373, El-Hussuna, A, Ceccotti, A A, Madsbøll, T K, Ovesen, A U, Straarup, D & 2017 European Society of Coloproctology (ESCP) collaborating group 2018, ' Safety of primary anastomosis following emergency left sided colorectal resection : an international, multi-centre prospective audit ', Colorectal Disease, vol. 20, no. Suppl. 6, pp. 47-57 . https://doi.org/10.1111/codi.14373
Publication Year :
2018
Publisher :
Blackwell Publishing Ltd, 2018.

Abstract

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 (>16years) who underwent emergency (unplanned, within 24h 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.

Details

Language :
English
Database :
OpenAIRE
Journal :
Christensen, P & 2017 European Society of Coloproctology (ESCP) collaborating group 2018, ' Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit ', Colorectal Disease, vol. 20 Suppl 6, pp. 47-57 . https://doi.org/10.1111/codi.14373, El-Hussuna, A, Ceccotti, A A, Madsbøll, T K, Ovesen, A U, Straarup, D & 2017 European Society of Coloproctology (ESCP) collaborating group 2018, ' Safety of primary anastomosis following emergency left sided colorectal resection : an international, multi-centre prospective audit ', Colorectal Disease, vol. 20, no. Suppl. 6, pp. 47-57 . https://doi.org/10.1111/codi.14373
Accession number :
edsair.doi.dedup.....72b97a38f34f567c979bddaacc9c29ed
Full Text :
https://doi.org/10.1111/(ISSN)1463-1318