Anastomosis technique and leakage rates in minimally invasive surgery for right-sided colon cancer. A retrospective national cohort study
| Autor: | Helene Juul Würtz, Lars Bundgaard, Hans B. Rahr, Erik Frostberg |
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| Rok vydání: | 2022 |
| Předmět: |
Extracorporeal
Adolescent Anastomosis Colon Anastomotic Leak Colon/surgery Cohort Studies Laparoscopic Surgical Stapling Minimally Invasive Surgical Procedures/adverse effects Humans Minimally Invasive Surgical Procedures Colectomy Retrospective Studies Anastomosis Surgical Anastomosis Surgical/adverse effects Gastroenterology Surgical Stapling/adverse effects Colon cancer Colonic Neoplasms Ileocolic Intracorporeal Colectomy/adverse effects Anastomotic Leak/etiology Colonic Neoplasms/etiology |
| Zdroj: | Würtz, H J, Bundgaard, L, Rahr, H B & Frostberg, E 2022, ' Anastomosis technique and leakage rates in minimally invasive surgery for right-sided colon cancer : A retrospective national cohort study ', International Journal of Colorectal Disease, vol. 37, pp. 701-708 . https://doi.org/10.1007/s00384-022-04107-9 |
| ISSN: | 1432-1262 |
| DOI: | 10.1007/s00384-022-04107-9 |
| Popis: | Purpose: The aim of this study was to describe the different techniques currently used in Denmark to construct right-sided ileocolic anastomoses in minimally invasive surgery, and investigate, compare and analyse the anastomotic configurations and their anastomotic leakage (AL) rates. Methods: This was a retrospective register-based, study design using prospectively collected data from the Danish Colorectal Cancer Group (DCCG) database. All patients aged 18 years or older with a malignant colorectal tumour in Denmark in the period of 1 February 2015 until 31 December 2019, and who had an elective, curative, minimally invasive right hemicolectomy (MIRH) with ileocolic anastomosis, were included. Results: Three thousand three hundred ninety-eight patients were included. The most commonly used anastomotic approach was the extracorporeal (EC) hand-sewn anastomosis (HA) with end-to-end configuration (59%) and the second most used was the EC stapled anastomosis (SA) side-to-side configuration (20%). The latter had a higher AL rate compared with the hand-sewn technique (3.8% vs. 1.3%), and had significantly higher odds ratio (OR) (OR: 2.85, 95% CI: 1.56–4.92, p < 0.0001) for AL in the adjusted regression model. The least used technique was the end-to-side HA which also had a significantly higher OR (OR: 3.05, 95% CI: 1.30–7.15, p = 0.010) compared with the end-to-end HA. Smoking was an independent factor associated with higher OR for AL. Conclusion: The ileocolic end-to-end HA was the most commonly used technique and had the lowest AL rate in MIRH for colon cancer. The EC SA technique and tobacco smoking were independent risk factors for leakage of the ileocolic anastomosis. |
| Databáze: | OpenAIRE |
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