Anastomosis configuration and technique following ileocaecal resection for Crohn’s disease: a multicentre study
| Autor: | Celentano, V, Pellino, G, Spinelli, A, Selvaggi, F, SICCR Current status of Crohn’s disease surgery collaborative, Rottoli, M, Poggioli, G, Sica, G, Giglio, Mc, Campanelli, M, Coco, C, Rizzo, G, Sionne, F, Colombo, F, Sampietro, G, Lamperti, G, Foschi, D, Ficari, F, Vacca, L, Cricchio, M, Giudici, F, Selvaggi, L, Sciaudone, G, Peltrini, R, Manfreda, A, Bucci, L, Galleano, R, Ghazouani, O, Zorcolo, L, Deidda, S, Restivo, A, Braini, A, Di Candido, F, Sacchi, M, Carvello, M, Martorana, S, Bordignon, G, Angriman, I, Variola, A, Di Ruscio, M, Barugola, G, Geccherle, A, Tropeano, Fp, Luglio, G, Tanzanu, M, Sasia, D, Migliore, M, Giuffrida, Mc, Marrano, E, Moretto, G, Impellizzeri, H, Gallo, G, Vescio, G, Sammarco, G, Terrosu, G, Calini, G, Bondurri, A, Maffioli, A, Zaffaroni, G, Resegotti, A, Mistrangelo, M, Allaix, Me, Botti, F, Prati, M, Boni, L, Perotti, S, Mineccia, M, Giuliani, A, Romano, L, Graziano, Gmp, Pugliese, L, Pietrabissa, A, Delaini, G, on behalf of the Italian Society of Colorectal Surgery SICCR. |
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| Přispěvatelé: | Celentano, Valerio, Pellino, Gianluca, Spinelli, Antonino, Selvaggi, Francesco, Rottoli, Matteo, Poggioli, Gilberto, Sica, Giuseppe, Giglio, Mariano Cesare, Campanelli, Michela, Coco, Claudio, Rizzo, Gianluca, Sionne, Francesco, Colombo, Francesco, Sampietro, Gianluca, Lamperti, Giulia, Foschi, Diego, Ficari, Ferdinando, Vacca, Ludovica, Cricchio, Marta, Giudici, Francesco, Selvaggi, Lucio, Sciaudone, Guido, Peltrini, Roberto, Manfreda, Andrea, Bucci, Luigi, Galleano, Raffaele, Ghazouani, Omar, Zorcolo, Luigi, Deidda, Simona, Restivo, Angelo, Braini, Andrea, Di Candido, Francesca, Sacchi, Matteo, Carvello, Michele, Martorana, Stefania, Bordignon, Giovanni, Angriman, Imerio, Variola, Angela, Di Ruscio, Mirko, Barugola, Giuliano, Geccherle, Andrea, Tropeano, Francesca Paola, Luglio, Gaetano, Tanzanu, Marta, Sasia, Diego, Migliore, Marco, Giuffrida, Maria Carmela, Marrano, Enrico, Moretto, Gianluigi, Impellizzeri, Harmony, Gallo, Gaetano, Vescio, Giuseppina, Sammarco, Giuseppe, Terrosu, Giovanni, Calini, Giacomo, Bondurri, Andrea, Maffioli, Anna, Zaffaroni, Gloria, Resegotti, Andrea, Mistrangelo, Massimiliano, Allaix, Marco Ettore, Botti, Fiorenzo, Prati, Matteo, Boni, Luigi, Perotti, Serena, Mineccia, Michela, Giuliani, Antonio, Romano, Lucia, Graziano, Giorgio Maria Paolo, Pugliese, Luigi, Pietrabissa, Andrea, Delaini, GianGaetano, Celentano, V., Pellino, G., Spinelli, A., Selvaggi, F., Rottoli, M., Poggioli, G., Sica, G., Giglio, M. C., Campanelli, M., Coco, C., Rizzo, G., Sionne, F., Colombo, F., Sampietro, G., Lamperti, G., Foschi, D., Ficari, F., Vacca, L., Cricchio, M., Giudici, F., Selvaggi, L., Sciaudone, G., Peltrini, R., Manfreda, A., Bucci, L., Galleano, R., Ghazouani, O., Zorcolo, L., Deidda, S., Restivo, A., Braini, A., Di Candido, F., Sacchi, M., Carvello, M., Martorana, S., Bordignon, G., Angriman, I., Variola, A., Di Ruscio, M., Barugola, G., Geccherle, A., Tropeano, F. P., Luglio, G., Tanzanu, M., Sasia, D., Migliore, M., Giuffrida, M. C., Marrano, E., Moretto, G., Impellizzeri, H., Gallo, G., Vescio, G., Sammarco, G., Terrosu, G., Calini, G., Bondurri, A., Maffioli, A., Zaffaroni, G., Resegotti, A., Mistrangelo, M., Allaix, M. E., Botti, F., Prati, M., Boni, L., Perotti, S., Mineccia, M., Giuliani, A., Romano, L., Graziano, G. M. P., Pugliese, L., Pietrabissa, A., Delaini, G. G., Delaini, Giangaetano, Jinodg, G., Candido, F. D., Ruscio, M. D. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Ileocaecal resection
Male Crohn’s disease Leak Settore MED/18 - CHIRURGIA GENERALE Anastomotic Leak Inflammatory bowel disease Postoperative Complications 0302 clinical medicine Crohn Disease Retrospective Studie Surgical 80 and over Clinical endpoint Colorectal surgery National audit Adolescent Adult Aged Aged 80 and over Anastomosis Surgical Cecum Digestive System Surgical Procedures Elective Surgical Procedures Female Humans Ileum Laparoscopy Length of Stay Middle Aged Reconstructive Surgical Procedures Retrospective Studies Treatment Outcome Young Adult Crohn's disease 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Human medicine.medical_specialty Anastomosis 03 medical and health sciences medicine Performed Procedure Reconstructive Surgical Procedure colorectal surgery national audit Elective Surgical Procedure business.industry Digestive System Surgical Procedure Plastic Surgery Procedures medicine.disease Settore MED/18 Surgery Crohn’s disease · Inflammatory bowel disease · Ileocaecal resection · Colorectal surgery · National audit Postoperative Complication business |
| Popis: | A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD. A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD. |
| Databáze: | OpenAIRE |
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