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Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit

Author: Pinkney T. and Battersby, N. and Bhangu, A. and Chaudhri, S. and El-Hussuna, A. and Frasson, M. and Nepogodiev, D. and Singh, B. and Vennix, S. and Zmora, O. and Altomare, D. and Bemelman, W. and Christensen, P. and D'Hoore, A. and Laurberg, S. and Morton, D. and Pinkney, T. and Rubbini, M. and Vaizey, C. and Magill, L. and Perry, R. and Sheward, N. and Ives, N. and Mehta, S. and Cillo, M. and Estefania, D. and Patron Uriburu, J. and Ruiz, H. and Salomon, M. and Makhmudov, A. and Selnyahina, L. and Varabei, A. and Vizhynis, Y. and Claeys, D. and Defoort, B. and Muysoms, F. and Pletinckx, P. and Vergucht, V. and Debergh, I. and Feryn, T. and Reusens, H. and Nachtergaele, M. and Francart, D. and Jehaes, C. and Markiewicz, S. and Monami, B. and Weerts, J. and Bouckaert, W. and Houben, B. and Knol, J. and Sergeant, G. and Vangertruyden, G. and Haeck, L. and Lange, C. and Sommeling, C. and Vindevoghel, K. and Castro, S. and De Bruyn, H. and Huyghe, M. and De Wolf, E. and Reynders, D. and D'Hoore, A. and van Overstraeten, A. de Buck and Wolthuis, A. and Delibegovic, S. and Christiani, A. and Marchiori, Jr., M. and Rocha de Moraes, C. and Tercioti, Jr., V. and Arabadjieva, E. and Bulanov, D. and Dardanov, D. and Stoyanov, V. and Yonkov, A. and Angelov, K. and Maslyankov, S. and Sokolov, M. and Todorov, G. and Toshev, S. and Georgiev, Y. and Karashmalakov, A. and Zafirov, G. and Wang, X. and Condic, D. and Kraljik, D. and Mrkovic, H. and Pavkovic, V. and Raguz, K. and Bencurik, V. and Holaskova, E. and Skrovina, M. and Farkasova, M. and Grolich, T. and Kala, Z. and Antos, F. and Pruchova, V. and Sotona, O. and Chobola, M. and Dusek, T. and Ferko, A. and Orhalmi, J. and Hoch, J. and Kocian, P. and Martinek, L. and Bernstein, I. and Sunesen, K. Gotschalck and Leunbach, J. and Thorlacius-Ussing, O. and Oveson, A. Uth and Christensen, P. and Chirstensen, S. Dahl and Gamez, V. and Oeting, M. and Loeve, U. Schou and Ugianskis, A. and Jessen, M. and Krarup, P. and Linde, K. and Mirza, Q. and Stovring, J. Overgaard and Erritzoe, L. and Jakobsen, H. Loft and Lykke, J. and Colov, E. Palmgren and Madsen, A. Husted and Friis, T. Linde and Funder, J. Amstrup and Dich, R. and Kjaer, S. and Rasmussen, S. and Schlesinger, N. and Kjaer, M. Dilling and Qvist, N. and Khalid, A. and Ali, G. and El-Hussuna, A. and Hadi, S. and Walker, L. Rosell and Kivela, A. and Lehtonen, T. and Lepisto, A. and Scheinin, T. and Siironen, P. and Kossi, J. and Kuusanmaki, P. and Tomminen, T. and Turunen, A. and Rautio, T. and Vierimaa, M. and Huhtinen, H. and Karvonen, J. and Lavonius, M. and Rantala, A. and Varpe, P. and Cotte, E. and Francois, Y. and Glehen, O. and Kepenekian, V. and Passot, G. and Maggiori, L. and Manceau, G. and Panis, Y. and Gout, M. and Rullier, E. and van Geluwe, B. and Chafai, N. and Lefevre, J. H. and Parc, Y. and Tiret, E. and Couette, C. and Duchalais, E. and Agha, A. and Hornberger, M. and Hungbauer, A. and Iesalnieks, I. and Weindl, I. and Crescenti, F. and Keller, M. and Kolodziejski, N. and Scherer, R. and Sterzing, D. and Bock, B. and Boehm, G. and El-Magd, M. and Krones, C. and Niewiera, M. and Buhr, J. and Cordesmeyer, S. and Hoffmann, M. and Krueckemeier, K. and Vogel, T. and Schoen, M. and Baral, J. and Lukoschek, T. and Muench, S. and Pullig, F. and Horisberger, K. and Kienle, P. and Magdeburg, J. and Post, S. and Batzalexis, K. and Germanos, S. and Agalianos, C. and Dervenis, C. and Gouvas, N. and Kanavidis, P. and Kottikias, A. and Katsoulis, I. E. and Korkolis, D. and Plataniotis, G. and Sakorafas, G. and Akrida, I. and Argentou, M. and Kollatos, C. and Lampropoulos, C. and Tsochatzis, S. and Besznyak, I. and Bursics, A. and Egyed, T. and Papp, G. and Svastics, I. and Atladottir, J. and Moller, P. and Sigurdsson, H. and Stefansson, T. and Valsdottir, E. and Andrews, E. and Foley, N. and Hechtl, D. and Majeed, M. and McCourt, M. and Hanly, A. and Hyland, J. and Martin, S. and O'Connell, P. R. and Winter, D. and Connelly, T. and Joyce, W. and Wrafter, P. and Berkovitz, R. and Avital, S. and Yahia, I. Haj and Hermann, N. and Shpitz, B. and White, I. and Lishtzinsky, Y. and Tsherniak, A. and Wasserberg, N. and Horesh, N. and Keler, U. and Pery, R. and Shapiro, R. and Zmora, O. and Tulchinsky, H. and Badran, B. and Dayan, K. and Iskhakov, A. and Lecaros, J. and Nabih, N. and Angrima, I. and Bardini, R. and Pizzolato, E. and Tonello, M. and Arces, F. and Balestri, R. and Ceccarelli, C. and Prosperi, V. and Rossi, E. and Giannini, I. and Vincenti, L. and Altomare, D. F. and Di Candido, F. and Di Iena, M. and Guglielmi, A. and Caputi-Iam-Brenghi, O. and Marsanic, P. and Mellano, A. and Muratore, A. and Annecchiarico, M. and Bencini, L. and Bona-Pasta, S. Amore and Coratti, A. and Guerra, F. and Asteria, C. R. and Boccia, L. and Gerard, L. and Pascariello, A. and Manca, G. and Marino, F. and Casaril, A. and Inama, M. and Moretto, G. and Bacchelli, C. and Carvello, M. and Mariani, N. and Montorsi, M. and Spinelli, A. and Romairone, E. and Scabini, S. and Belli, A. and Bianco, F. and De Franciscis, S. and Romano, G. Maria and Delrio, P. and Pace, U. and Rega, D. and Sassaroli, C. and Scala, D. and De Luca, R. and Ruggieri, E. and Elbetti, C. and Garzi, A. and Romoli, L. and Scatizzi, M. and Vannucchi, A. and Curletti, G. and Durante, V. and Galleano, R. and Mariani, F. and Reggiani, L. and Bellomo, R. and Infantino, A. and Franceschilli, L. and Sileri, P. and Clementi, I. and Coletta, D. and La Torre, F. and Mingoli, A. and Velluti, F. and Di Giacomo, A. and Fiorot, A. and Massani, M. and Padoan, L. and Ruffolo, C. and Caruso, S. and Franceschini, F. and Laessig, R. and Monaci, I. and Rontini, M. and De Nardi, P. and Elmore, U. and Lemma, M. and Rosati, R. and Tamburini, A. and De Luca, M. and Sartori, A. and Benevento, A. and Bottini, C. and Ferrari, C. C. and Pata, F. and Tessera, G. and Pellino, G. and Selvaggi, F. and Lanzani, A. and Romano, F. and Sgroi, G. and Steccanella, F. and Turati, L. and Yamamoto, T. and Ancans, G. and Gerkis, S. and Leja, M. and Pcolkins, A. and Sivins, A. and Latkauskas, T. and Lizdenis, P. and Saladzin-Skas, Z. and Svagzdys, S. and Tamelis, A. and Razbadauskas, A. and Sokolovas, M. and Dulskas, A. and Samalavicius, N. and Jotautas, V. and Mikalauskas, S. and Poskus, E. and Poskus, T. and Strupas, K. and Camenzuli, C. and Cini, C. and Predrag, A. and Psaila, J. and Spiteri, N. and Bemelman, W. and Buskens, C. and de Groof, E. J. and Gooszen, J. and Tanis, P. and Belgers, E. and Davids, P. and Furnee, E. and Postma, E. and Pronk, A. and Smakman, N. and Clermonts, S. and Zimmerman, D. and Omloo, J. and van der Zaag, E. and van Duijvendijk, P. and Wassenaar, E. and Bruijninckx, M. and de Graff, E. and Doornebosch, P. and Tetteroo, G. and Vermaas, M. and Iordens, G. and Knops, S. and Toorenvliet, B. and van Westereenen, H. L. and Boerma, E. and Coene, P. and van der Harst, E. and Van der Pool, A. and Raber, M. and Melenhorst, J. and de Castro, S. and Gerhards, M. and Arron, M. and Bremers, A. and de Wilt, H. and Ferenschild, F. and Yauw, S. and Cense, H. and Demirkiran, A. and Hunfeld, M. and Mulder, I. and Nonner, J. and Swank, H. and van Wagensveld, B. and Bolmers, M. and Briel, J. and van Geloven, A. and van Rossem, C. and Klemann, V. and Konsten, J. and Leenders, B. and Schok, T. and Bleeker, W. and Brun, M. and Helgeland, M. and Ignjatovic, D. and Oresland, T. and Yousefi, P. and Backe, I. Faten and Sjo, O. Helmer and Nesbakken, A. and Tandberg-Eriksen, M. and Cais, A. and Traeland, J. Hallvard and Herikstad, R. and Korner, H. and Lauvland, N. and Jajtner, D. and Kabiesz, W. and Rak, M. and Gmerek, L. and Horbacka, K. and Horst, N. and Krokowicz, P. and Kwiatkowski, A. and Pasnik, K. and Karcz, P. and Romaniszyn, M. and Rusek, T. and Walega, P. and Czarencki, R. and Obuszko, Z. and Sitarska, M. and Wojciech, W. and Zawadzki, M. and Amado, S. and Clara, P. and Couceiro, A. and Malaquias, R. and Rama, N. and Almeida, A. and Barbosa, E. and Cernadas, E. and Duarte, A. and Silva, P. and Costa, S. and Martinez Insua, C. and Pereira, J. and Pereira, C. and Sacchetti, M. and Carvalho Pinto, B. and Jorge Vieira Sousa, P. and Marques, R. and Oliveira, A. and Cardoso, R. and Carlos, S. and Corte-Real, J. and Moniz Pereira, P. and Souto, R. and Carneiro, C. and Marinho, R. and Nunes, V. and Rocha, R. and Sousa, M. and Leite, J. and Melo, F. and Pimentel, J. and Ventura, L. and Vila Nova, C. and Copacscu, C. and Bintintan, V. and Ciuce, C. and Dindelegan, G. and Scurtu, R. and Seicean, R. and Domansky, N. and Karachun, A. and Moiseenko, A. and Pelipas, Y. and Petrov, A. and Pravosudov, I. and Aiupov, R. and Akmalov, Y. and Parfenov, A. and Suleymanov, N. and Tarasov, N. and Jumabaev, H. and Mamedli, Z. and Rasulov, A. and Aliev, I. and Chernikovskiy, I. and Kochnev, V. and Komyak, K. and Pravosudov, I. and Smirnov, A. and Achkasov, S. and Bolikhov, K. and Shelygin, Y. and Sushkov, O. and Zapolskiy, A. and Gvozdenovic, M. and Jovanovic, D. and Lausevic, Z. and Cvetkovic, D. and Maravic, M. and Milovanovic, B. and Stojakovic, N. and Tripkovic, I. and Mihajlovic, D. and Nestorovic, M. and Pecic, V. and Petrovic, D. and Stanojevic, G. and Barisic, G. and Dimitrijevic, I. and Krivokapic, Z. and Markovic, V. and Popovic, M. and Aleksic, A. and Dabic, D. and Kostic, I. and Milojkovic, A. and Perunicic, V. and Lukic, D. and Petrovic, T. and Radovanovic, D. and Radovanovic, Z. and Cuk, V. M. and Cuk, V. V. and Kenic, M. and Kovacevic, B. and Krdzic, I. and Korcek, J. and Rems, M. and Toplak, J. and Escarra, J. and Gil Barrionuevo, M. and Golda, T. and Kreisler Moreno, E. and Zerpa Martin, C. and Alvarez Laso, C. and Cumplido, P. and Padin, H. and Baixauli Fons, J. and Hernandez-Lizoain, J. and Martinez-Ortega, P. and Molina-Fernandez, M. and Sanchez-Justicia, C. and Gracia Solanas, J. Antonio and Diaz de laspra, E. Cordoba and Echazarreta-Gallego, E. and Elia-Guedea, M. and Ramirez, J. and Arredondo Chaves, J. and Gonzalez, P. Diez and Elosua, T. and Sahagun, J. and Turienzo Frade, A. and Alvarez Conde, J. and Castrillo, E. and Diaz Maag, R. and Maderuelo, V. and Saldarriaga, L. and Aldrey Cao, I. and Fernandez Varela, X. and Nunez Fernandez, S. and Parajo Calvo, A. and Villar Alvarez, S. and Blesa Sierra, I. and Duarte, A. and Lozano, R. and Marquez, M. and Porcel, O. and Menendez, P. and Fernandez Hevia, M. and Flores Siguenza, L. and Jimenez Toscano, M. and Lacy Fortuny, A. and Ordonez Trujillo, J. and Espi, A. and Garcia-Botello, S. and Martin-Arevalo, J. and Moro-Valdezate, D. and Pla-Marti, V. and Blanco-Antona, F. and Abrisqueta, J. and Ibanez Canovas, N. and Lujan Mompean, J. and Escola Ripoll, D. and Martinez Gonzalez, S. and Parodi, J. and Fernandez Lopez, A. and Ramos Fernandez, M. and Castellvi Valls, J. and Ortiz de Zarate, L. and Ribas, R. and Sabia, D. and Viso, L. and Alonso Goncalves, S. and Gil Egea, M. Jose and Pascual Damieta, M. and Pera, M. and Salvans Ruiz, S. and Bernal, J. and Landete, F. and Ais, G. and Etreros, J. and Aguilo Lucia, J. and Bosca, A. and Deusa, S. and Garcia del Cano, J. and Viciano, V. and Garcia-Armengol, J. and Roig, J. and Blas, J. and Escartin, J. and Fatas, J. and Fernando, J. and Ferrer, R. and Arias Pacheco, R. and Garcia Florez, L. and Moreno Gijon, M. and Otero Diez, J. and Solar Garcia, L. and Aguilar Teixido, F. and Balaguer Ojo, C. and Bargallo Berzosa, J. and Lamas Moure, S. and J., Enrique Sierra and Ferminan, A. and Herrerias, F. and Rufas, M. and Vinas, J. and Codina-Cazador, A. and Farres, R. and Gomez, N. and Julia, D. and Planellas, P. and Lopez, J. and Luna, A. and Maristany, C. and Munoz Duyos, A. and Puertolas, N. and Alcantara Moral, M. and Serra-Aracil, X. and Concheiro Coello, P. and Gomez, D. and Carton, C. and Miguel, A. and Reoyo Pascual, F. and Valero Cerrato, X. and Zambrano Munoz, R. and Cervera-Aldama, J. and Gonzalez, J. Garcia and Ramos-Prada, J. and Santamaria-Olabarrieta, M. and Uriguen-Echeverria, A. and Coves Alcover, R. and Espinosa Soria, J. and Fernandez Rodriguez, E. and Hernandis Villalba, J. and Maturana Ibanenz, V. and De la Torre Gonzalez, F. and Huerga, D. and Perez Viejo, E. and Rivera, A. and Ruiz Ucar, E. and Garcia-Septiem, J. and Jimenez, V. and Jimenez Miramon, J. and Ramons Rodriquez, J. and Rodriguez Alvarez, V. and Garcea, A. and Ponchietti, L. and Borda, N. and Enriquez-Navascues, J. and Saralegui, Y. and Febles Molina, G. and Nogues, E. and Rodriguez Mendez, A. and Roque Castellano, C. and Sosa Quesada, Y. and Alvarez-Gallego, M. and Pascual, I. and Rubio-Perez, I. and Diaz-San Andres, B. and Tone-Villanueva, F. and Alonso, J. and Cagigas, C. and Castillo, J. and Gomez, M. and Martin-Parra, J. and Mengual Ballester, M. and Pellicer Franco, E. and Soria Aledo, V. and Valero Navarro, G. and Caballero Rodriguez, E. and Gonzalez De Chaves, P. and Hernandez, G. and Perez Alvarez, A. and Soto Sanchez, A. and Becerra Garcia, F. Cesar and Alonso Roque, J. Guillermo and Rodriguez Arias, F. Lopez and Del Valle Ruiz, S. R. and Sanchez De la Villa, G. and Compan, A. and Garcia Marin, A. and Nofuentes, C. and Orts Mico, F. and Perez Auladell, V. and Carrasco, M. and Duque Perez, C. and Galvez-Pastor, S. and Navarro Garcia, I. and Sanchez Perez, A. and Enjuto, D. and Manuel Bujalance, F. and Marcelin, N. and Perez, M. and Serrano Garcia, R. and Cabrera, A. and de la Portilla, F. and Diaz-Pavon, J. and Jimenez-Rodriguez, R. and Vazquez-Monchul, J. and Daza Gonzalez, J. and Gomez Perez, R. and Rivera Castellano, J. and Roldan de la Rua, J. and Errasti Alustiza, J. and Fernandez, L. and Romeo Ramirez, J. and Sardon Ramos, J. and Cermeno Toral, B. and Alias, D. and Garcia-Olmo, D. and Guadalajara, H. and Herreros, M. and Pacheco, P. and del Castillo Diez, F. and Lima Pinto, F. and Martinez Alegre, J. and Ortega, I. and Nieto Antonio, A. Picardo and Caro, A. and Escuder, J. and Feliu, F. and Millan, M. and Alos Company, R. and Frangi Caregnato, A. and Lozoya Trujillo, R. and Rodriguez Carrillo, R. and Ruiz Carmona, M. and Alonso, N. and Ambrona Zafra, D. and Ayala Candia, B. Amilka and Bonnin Pascual, J. and Pineno Flores, C. and Alcazar Montero, J. and Angoso Clavijo, M. and Garcia, J. and Sanchez Tocino, J. and Gomez-Alcazar, C. and Costa-Navarro, D. and Ferri-Romero, J. and Rey-Riveiro, M. and Romero-Simo, M. and Arencibia, B. and Esclapez, P. and Frasson, M. and Garcia-Granero, E. and Granero, P. and Medina Fernandez, F. J. and Gallardo Herrera, A. B. and Diaz Lopez, C. and Navarro Rodriguez, E. and Torres Tordera, E. and Arenal, J. and Citores, M. and Marcos, J. and Sanchez, J. and Tinoco, C. and Espin, E. and Garcia Granero, A. and Jimenez Gomez, L. and Sanchez Garcia, J. and Vallribera, F. and Folkesson, J. and Skoldberg, F. and Bergman, K. and Borgstrom, E. and Frey, J. and Silfverberg, A. and Soderholm, M. and Nygren, J. and Segelman, J. and Gustafsson, D. and Lagerqvist, A. and Papp, A. and Pelczar, M. and Abraham-Nordling, M. and Ahlberg, M. and Sjovall, A. and Tengstrom, J. and Hagman, K. and Chabok, A. and Ezra, E. and Nikberg, M. and Smedh, K. and Tiselius, C. and Al-Naimi, N. and Duc, M. Dao and Meyer, J. and Mormont, M. and Ris, F. and Prevost, G. and Villiger, P. and Hoffmann, H. and Kettelhack, C. and Kirchhoff, P. and Oertli, D. and Weixler, B. and Aytac, B. and Leventoglu, S. and Mentes, B. and Yuksel, O. and Demirbas, S. and Ozkan, B. Busra and Ozbalci, G. Selcuk and Sungurtekin, U. and Gulcu, B. and Ozturk, E. and Yilmazlar, T. and Challand, C. and Fearnhead, N. and Hubbard, R. and Kumar, S. and Arthur, J. and Barben, C. and Skaife, P. and Slawik, S. and Williams, M. and Zammit, M. and Barker, J. and French, J. and Sarantitis, I. and Slawinski, C. and Clifford, R. and Eardley, N. and Johnson, M. and McFaul, C. and Vimalachandran, D. and Allan, S. and Bell, A. and Oates, E. and Shanmugam, V. and Brigic, A. and Halls, M. and Pucher, P. and Stubbs, B. and Agarwal, T. and Chopada, A. and Mallappa, S. and Pathmarajah, M. and Sugden, C. and Brown, C. and Macdonald, E. and Mckay, A. and Richards, J. and Robertson, A. and Kaushal, M. and Patel, P. and Tezas, S. and Touqan, N. and Ayaani, S. and Marimuthu, K. and Piramanayagam, B. and Vourvachis, M. and Iqbal, N. and Korsgen, S. and Seretis, C. and Shariff, U. and Arnold, S. and Battersby, N. and Chan, H. and Clark, E. and Fernandes, R. and Moran, B. and Bajwa, A. and McArthur, D. and Cao, K. and Cunha, P. and Pardoe, H. and Quddus, A. and Theodoropoulou, K. and Bolln, C. and Denys, G. and Gillespie, M. and Manimaran, N. and Reidy, J. and Malik, A. I. and Malik, A. and Pitt, J. and Aryal, K. and El-Hadi, A. and Lal, R. and Pal, A. and Velchuru, V. and Chaudhri, S. and Cunha, M. Oliveira and Singh, B. and Thomas, M. and Bains, S. and Boyle, K. and Miller, A. and Norwood, M. and Yeung, J. and Goian, L. and Gurjar, S. and Saghir, W. and Sengupta, N. and Stewart-Parker, E. and Bailey, S. and Khalil, T. and Lawes, D. and Nikolaou, S. and Omar, G. and Church, R. and Muthiah, B. and Garrett, W. and Marsh, P. and Obeid, N. and Chandler, S. and Coyne, P. and Evans, M. and Hunt, L. and Lim, J. and Oliphant, Z. and Papworth, E. and Weaver, H. and Leon, K. Cuinas and Williams, G. and Hernon, J. and Kapur, S. and Moosvi, R. and Shaikh, I. and Swafe, L. and Aslam, M. and Evans, J. and Ihedioha, U. and Kang, P. and Merchant, J. and Hompes, R. and Middleton, R. and Broomfield, A. and Crutten-Wood, D. and Foster, J. and Nash, G. and Akhtar, M. and Boshnaq, M. and Eldesouky, S. and Mangam, S. and Rabie, M. and Ahmed, J. and Khan, J. and Goh, N. Ming and Shamali, A. and Stefan, S. and Nepogodiev, D. and Pinkney, T. and Thompson, C. and Amin, A. and Docherty, J. and Lim, M. and Walker, K. and Watson, A. and Hossack, M. and Mackenzie, N. and Paraoan, M. and Alam, N. and Daniels, I. and Narang, S. and Pathak, S. and Smart, N. and Al-Qaddo, A. and Codd, R. and Rutka, O. and Williams, G. and Bronder, C. and Crighton, I. and Davies, E. and Raymond, T. and Bookless, L. and Griffiths, B. and Plusa, S. and Carlson, G. and Harrison, R. and Lees, N. and Mason, C. and Quayle, J. and Branagan, G. and Broadhurst, J. and Chave, H. and Sleight, S. and Awad, F. and Bhangu, A. and Cruickshank, N. and Joy, H. and Boereboom, C. and Daliya, P. and Dhillon, A. and Watson, N. and Watson, R. and Artioukh, D. and Gokul, K. and Javed, M. and Kong, R. and Sutton, J. and Faiz, O. and Jenkins, I. and Leo, C. A. and Samaranayake, S. F. and Warusavitarne, J. and Arya, S. and Bhan, C. and Mukhtar, H. and Oshowo, A. and Wilson, J. and Duff, S. and Fatayer, T. and Mbuvi, J. and Sharma, A. and Cornish, J. and Davies, L. and Harries, R. and Morris, C. and Torkington, J. and Knight, J. and Lai, C. and Shihab, O. and Tzivanakis, A. and Hussain, A. and Luke, D. and Padwick, R. and Torrance, A. and Tsiamis, A. and Dawson, P. and Balfour, A. and Brady, R. and Mander, J. and Paterson, H. and Chandratreya, N. and Chu, H. and Cutting, J. and Vernon, S. and Ho, C. Wai and Andreani, S. and Patel, H. and Warner, M. and Tan, J. Yan Qi and Gidwani, A. and Lawther, R. and Loughlin, P. and Skelly, B. and Spence, R. and Iqbal, A. and Khan, A. and Perrin, K. and Raza, A. and Tan, S. and European Soc Coloproctology Collab and Writing Grp ESCP Cohort Studies and Audits Sub-Comm and ESCP Res Comm and Logistical Support Data Collation and Local Investigators
Publication venue: 'Wiley'
Publication date: 01/01/2017
Field of study

Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results This study included 3208 patients, of whom 78.4\% (n = 2515) underwent surgery for malignancy and 11.7\% (n = 375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8\% (n = 3041) of patients, which was handsewn in 38.9\% (n = 1183) and stapled in 61.1\% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5\% handsewn vs 12.9\% stapled) and to undergo open surgery (54.7\% handsewn vs 36.6\% stapled). The overall anastomotic leak rate was 8.1\% (245/3041), which was similar following handsewn (7.4\%) and stapled (8.5\%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95\% CI: 1.04-1.95; P = 0.03). Conclusion Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe

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