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

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00179906%3A_____%2F18%3A10387925" target="_blank" >RIV/00179906:_____/18:10387925 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11130/18:10387925 RIV/00064203:_____/18:10387925 RIV/00216208:11150/18:10387925

Result on the web

<a href="https://doi.org/10.1111/codi.14373" target="_blank" >https://doi.org/10.1111/codi.14373</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1111/codi.14373" target="_blank" >10.1111/codi.14373</a>

Result language

angličtina

Original language name

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

Original language 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 (&gt; 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. Colorectal Disease (C) 2018 The Association of Coloproctology of Great Britain and Ireland

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30212 - Surgery

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Colorectal Disease

ISSN

1462-8910

e-ISSN

—

Volume of the periodical

20

Issue of the periodical within the volume

Supplement: 6

Country of publishing house

GB - UNITED KINGDOM

Number of pages

11

Pages from-to

47-57

UT code for WoS article

000445602400007

EID of the result in the Scopus database

2-s2.0-85053853532