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

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11130%2F18%3A10387925" target="_blank" >RIV/00216208:11130/18:10387925 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00064203:_____/18:10387925 RIV/00216208:11150/18:10387925 RIV/00179906:_____/18:10387925

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

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

Popis výsledku v původním jazyce

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

Název v anglickém jazyce

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

Popis výsledku anglicky

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

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30212 - Surgery

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2018

Kód důvěrnosti údajů

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

Název periodika

Colorectal Disease

ISSN

1462-8910

e-ISSN

—

Svazek periodika

20

Číslo periodika v rámci svazku

Supplement: 6

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

11

Strana od-do

47-57

Kód UT WoS článku

000445602400007

EID výsledku v databázi Scopus

2-s2.0-85053853532