The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit

[EN]There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure. Any unit performing gastrointestinal surgery wa...

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Autores: European Society of Coloproctology Collaborating Group, Glasbey, J., Nepogodiev, D., Alcázar Montero, José Antonio, Angoso Clavijo, María
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2018
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/161042
Acceso en línea:http://hdl.handle.net/10366/161042
Access Level:acceso abierto
Palabra clave:Bowel anastomosis
Stapler
Oversewn
Surgi-cal technique
Anastomotic leak
Colorectal cancer
Crohn’s disease
Epidemiology
Surgery
Aged
Surgical Stapling
Colon
Young Adult
Colorectal Surgery
Adult
Humans
Adolescent
Middle Aged
General Surgery
Prospective Studies
Colectomy
Colorectal Neoplasms
Anastomotic Leak
Treatment Failure
3213 Cirugía
3207.13 Oncología
humanos
anciano
neoplasias colorrectales
mediana edad
adolescente
estudios prospectivos
adulto
adulto joven
cirugía colorrectal
colon
grapado quirúrgico
colectomía
fracaso del tratamiento
cirugía general
fuga anastomótica
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repository_id_str
spelling The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective auditEuropean Society of Coloproctology Collaborating GroupGlasbey, J.Nepogodiev, D.Alcázar Montero, José AntonioAngoso Clavijo, MaríaBowel anastomosisStaplerOversewnSurgi-cal techniqueAnastomotic leakColorectal cancerCrohn’s diseaseEpidemiologySurgeryAgedSurgical StaplingColonYoung AdultColorectal SurgeryAdultHumansAdolescentMiddle AgedGeneral SurgeryProspective StudiesColectomyColorectal NeoplasmsAnastomotic LeakTreatment Failure3213 Cirugía3207.13 Oncologíahumanosancianoneoplasias colorrectalesmediana edadadolescenteestudios prospectivosadultoadulto jovencirugía colorrectalcolongrapado quirúrgicocolectomíafracaso del tratamientocirugía generalfuga anastomótica[EN]There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure. Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side-to-side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak. One thousand three hundred and forty-seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54-1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52-1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46-4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04-2.64, P = 0.04). This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high-risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration.Wiley202420242018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10366/161042reponame:GREDOS. Repositorio Institucional de la Universidad de Salamancainstname:Universidad de Salamanca (USAL)InglésAttribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:gredos.usal.es:10366/1610422026-06-07T06:28:51Z
dc.title.none.fl_str_mv The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit
title The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit
spellingShingle The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit
European Society of Coloproctology Collaborating Group
Bowel anastomosis
Stapler
Oversewn
Surgi-cal technique
Anastomotic leak
Colorectal cancer
Crohn’s disease
Epidemiology
Surgery
Aged
Surgical Stapling
Colon
Young Adult
Colorectal Surgery
Adult
Humans
Adolescent
Middle Aged
General Surgery
Prospective Studies
Colectomy
Colorectal Neoplasms
Anastomotic Leak
Treatment Failure
3213 Cirugía
3207.13 Oncología
humanos
anciano
neoplasias colorrectales
mediana edad
adolescente
estudios prospectivos
adulto
adulto joven
cirugía colorrectal
colon
grapado quirúrgico
colectomía
fracaso del tratamiento
cirugía general
fuga anastomótica
title_short The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit
title_full The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit
title_fullStr The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit
title_full_unstemmed The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit
title_sort The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit
dc.creator.none.fl_str_mv European Society of Coloproctology Collaborating Group
Glasbey, J.
Nepogodiev, D.
Alcázar Montero, José Antonio
Angoso Clavijo, María
author European Society of Coloproctology Collaborating Group
author_facet European Society of Coloproctology Collaborating Group
Glasbey, J.
Nepogodiev, D.
Alcázar Montero, José Antonio
Angoso Clavijo, María
author_role author
author2 Glasbey, J.
Nepogodiev, D.
Alcázar Montero, José Antonio
Angoso Clavijo, María
author2_role author
author
author
author
dc.subject.none.fl_str_mv Bowel anastomosis
Stapler
Oversewn
Surgi-cal technique
Anastomotic leak
Colorectal cancer
Crohn’s disease
Epidemiology
Surgery
Aged
Surgical Stapling
Colon
Young Adult
Colorectal Surgery
Adult
Humans
Adolescent
Middle Aged
General Surgery
Prospective Studies
Colectomy
Colorectal Neoplasms
Anastomotic Leak
Treatment Failure
3213 Cirugía
3207.13 Oncología
humanos
anciano
neoplasias colorrectales
mediana edad
adolescente
estudios prospectivos
adulto
adulto joven
cirugía colorrectal
colon
grapado quirúrgico
colectomía
fracaso del tratamiento
cirugía general
fuga anastomótica
topic Bowel anastomosis
Stapler
Oversewn
Surgi-cal technique
Anastomotic leak
Colorectal cancer
Crohn’s disease
Epidemiology
Surgery
Aged
Surgical Stapling
Colon
Young Adult
Colorectal Surgery
Adult
Humans
Adolescent
Middle Aged
General Surgery
Prospective Studies
Colectomy
Colorectal Neoplasms
Anastomotic Leak
Treatment Failure
3213 Cirugía
3207.13 Oncología
humanos
anciano
neoplasias colorrectales
mediana edad
adolescente
estudios prospectivos
adulto
adulto joven
cirugía colorrectal
colon
grapado quirúrgico
colectomía
fracaso del tratamiento
cirugía general
fuga anastomótica
description [EN]There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure. Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side-to-side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak. One thousand three hundred and forty-seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54-1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52-1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46-4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04-2.64, P = 0.04). This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high-risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration.
publishDate 2018
dc.date.none.fl_str_mv 2018
2024
2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10366/161042
url http://hdl.handle.net/10366/161042
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Wiley
publisher.none.fl_str_mv Wiley
dc.source.none.fl_str_mv reponame:GREDOS. Repositorio Institucional de la Universidad de Salamanca
instname:Universidad de Salamanca (USAL)
instname_str Universidad de Salamanca (USAL)
reponame_str GREDOS. Repositorio Institucional de la Universidad de Salamanca
collection GREDOS. Repositorio Institucional de la Universidad de Salamanca
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.811543

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