10 research outputs found
Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate
- Author
- Abraham Nordling M
- Abrisqueta J
- Achkasov S
- Agalianos C
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- Publication venue
- 'Baishideng Publishing Group Inc.'
- Publication date
- 01/01/2019
- Field of study
BACKGROUNDRight hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIMTo investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODSThis is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTSThree hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSIONPatients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complication's rate was not different between the two groups
Strong disorder RG approach – a short review of recent developments
- Author
- A. Amir
- A. Bellafard
- A. Del Maestro
- A. Del Maestro
- A. Dutta
- A. Friedenauer
- A. Lavarelo
- A. Leggett
- A. Pikovsky
- A. Saguia
- A. Saguia
- A.C. Potter
- A.J. Friedman
- A.K. Ibrahim
- A.K. Ibrahim
- A.M. Goldsborough
- A.M. Goldsborough
- A.P. Vieira
- A.P. Vieira
- B. Kang
- C. Chatelain
- C. Chatelain
- C. Dasgupta
- C. Holzhey
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C.A. Lamas
- C.E. Fiore
- C.R. Laumann
- Cécile Monthus
- D. Nozadze
- D. Pekker
- D. Pekker
- D.S. Fisher
- D.S. Fisher
- E. Altman
- E. Altman
- E. Altman
- E. Altman
- E. Altman
- E. Bertin
- E. Tarquini
- E.V.H. Doggen
- F. Alet
- F. Angeletti
- F. Evers
- F. Hrahsheh
- F. Hrahsheh
- F. Hrahsheh
- F. Iglói
- F. Iglói
- F. Iglói
- F. Iglói
- F. Iglói
- F. Iglói
- F. Iglói
- F. J. Dyson
- F. Vazquez
- F.J.O. Filho
- Fabien Alet
- Ferenc Iglói
- G. De Chiara
- G. Györgyi
- G. Ramirez
- G. Ramirez
- G. Ramirez
- G. Ramirez
- G. Refael
- G. Refael
- G. Refael
- G. Roósz
- G. Roósz
- G. Schehr
- G. Schehr
- G. Schehr
- G. Torlai
- G. Vidal
- G.C. Levine
- H. Aoki
- H. Aoki
- H. Barghathi
- H. Barghathi
- H. Barghathi
- H. Barghathi
- H. Barghathi
- H. Tran
- H.J. Mard
- H.J. Mard
- H.L. Casa Grande
- I. Calvo
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- J. Cardy
- J. Herbrych
- J. Hide
- J. Kokalj
- J. Rodriguez-Laguna
- J. Rodriguez-Laguna
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.C. Getelina
- J.C. Getelina
- J.H. Bardarson
- J.I. Cirac
- J.W. Britton
- J.Z. Imbrie
- K. Agarwal
- K. Hyatt
- K. Kim
- K. Slagle
- L. Amico
- L. Fidkowski
- L. Fidkowski
- L. Rademaker
- L. Rademaker
- L. Zhang
- L.B. Ioffe
- M. Bukov
- M. Fagotti
- M. Heyl
- M. Pouranvari
- M.A. Munoz
- M.B. Hastings
- M.C. Strinati
- M.V. Feigel’man
- N. Laflorencie
- N. Ma
- N. Moure
- N. Moure
- N.E. Bonesteel
- N.T. Jacobson
- O. Dimitrova
- O. Gittsovich
- O. Kogan
- P. Calabrese
- P. Calabrese
- P. Calabrese
- P. Goswami
- P. Hauke
- P. Lajkó
- P. Le Doussal
- P. Mohan
- P. Ruggiero
- P.T. Dumitrescu
- Q. Zhu
- R. Islam
- R. Islam
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Miyazaki
- R. Moessner
- R. Mélin
- R. Nandkishore
- R. Santachiara
- R. Vasseur
- R. Vasseur
- R. Vasseur
- R. Vasseur
- R. Vosk
- R. Vosk
- R. Vosk
- R. Vosk
- R. Yu
- R. Yu
- R.N. Bhatt
- S. Bo
- S. Garnerone
- S. Iyer
- S. Iyer
- S. Johri
- S. Savitz
- S. Zhou
- S.-K. Ma
- S.A. Parameswaran
- S.H. Strogatz
- S.J. Thomson
- T. Devakul
- T. Senthil
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T.E. Harris
- T.E. Lee
- U. Divakaran
- U. Divakaran
- V. Gurarie
- V. Shivamoggi
- V.L. Quito
- V.L. Quito
- V.L. Quito
- W. Berdanier
- W. De Roeck
- W. Wang
- W. Wang
- Y-C. Lin
- Y. Huang
- Y. Huang
- Y. Zhao
- Y.-R. Shu
- Y.C. Lin
- Y.C. Lin
- Y.P. Lin
- Y.R. Shu
- Y.Z. You
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- 01/01/2018
- Field of study
The strong disorder RG approach for random systems has been extended in many new directions since our previous review of 2005 [F. Igloi, C. Monthus, Phys. Rep. 412, 277 (2005)]. The aim of the present colloquium paper is thus to give an overview of these various recent developments. In the field of quantum disordered models, recent progress concern infinite disorder fixed points for short-ranged models in higher dimensions d > 1, strong disorder fixed points for long-ranged models, scaling of the entanglement entropy in critical ground-states and after quantum quenches, the RSRG-X procedure to construct the whole set excited stated and the RSRG-t procedure for the unitary dynamics in many-body-localized phases, the Floquet dynamics of periodically driven chains, the dissipative effects induced by the coupling to external baths, and Anderson Localization models. In the field of classical disordered models, new applications include the contact process for epidemic spreading, the strong disorder renormalization procedure for general master equations, the localization properties of random elastic networks, and the synchronization of interacting non-linear dissipative oscillators. Application of the method for aperiodic (or deterministic) disorder is also mentioned
The impact of stapling technique and surgeon specialism on anastomotic failure after right?sided colorectal resection: an international multicentre, prospective audit
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- Abraham-Nordling M
- Abrisqueta J
- Achkasov S
- Agalianos C
- Agarwal T
- Agha A
- Aguilar Teixido F
- Aguiló Lucia J
- Ahlberg M
- Ahmed J
- Ais G
- Aiupov R
- Akhtar M
- Akmalov Y
- Akrida I
- Al-Naimi N
- Al-Qaddo A
- Alam N
- Alcantara Moral M
- Alcazar Montero J
- Aldrey Cao I
- Aleksic A
- Ali G
- Alias D
- Aliev I
- Allan S
- Almeida A
- Alonso Gonçalves S
- Alonso J
- Alonso N
- Alos Company R
- Alvarez-Gallego M
- Amado S
- Ambrona Zafra D
- Amilka Ayala Candia B
- Amin A
- Amore Bonapasta S
- Amstrup Funder J
- Ancans G
- Andreani S
- Andrews E
- Angelov K
- Angoso Clavijo M
- Angrima I
- Annecchiarico M
- Annunziata Azienda Sm
- Antonio Gracia Solanas J
- Antos F
- Arabadjieva E
- Arces F
- Arenal J
- Arencibia B
- Argentou M
- Arias Pacheco R
- Arnold S
- Arredondo Chaves J
- Arron M
- Arthur J
- Artioukh D
- Arya S
- Aryal K
- Aslam M
- Asteria Cr
- Atladottir J
- Avital S
- Awad F
- Ayaani S
- Aytac B
- Bacchelli C
- Badran B
- Bailey S
- Bains S
- Baixauli Fons J
- Bajwa A
- Balaguer Ojo C
- Balestri R
- Balfour A
- Baral J
- Barben C
- Barbosa E
- Bardini R
- Bargallo Berzosa J
- Barisic G
- Barker J
- Battersby N
- Battersby N
- Batzalexis K
- Belgers E
- Bell A
- Belli A
- Bellomo R
- Bemelman W
- Bemelman W
- Bencini L
- Bencurik V
- Benevento A
- Bergman K
- Berkovitz R
- Bernal J
- Bernstein I
- Besznyák I
- Bhan C
- Bhangu A
- Bhangu A
- Bianco F
- Bintintan V
- Blanco-Antona F
- Blas J
- Bleeker W
- Blesa Sierra I
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- Boereboom C
- Boerma E
- Bolikhov K
- Bolln C
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- Borgström E
- Boscá A
- Boshnaq M
- Bottini C
- Bouckaert W
- Boyle K
- Brady R
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- Bremers A
- Briel J
- Brigic A
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- Bronder C
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- Bulanov D
- Bursics A
- Buskens C
- Busra Ozkan B
- Caballero Rodríguez E
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- Carvello M
- Casaril A
- Castellvi Valls J
- Castillo J
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- Ceccarelli C
- Cense H
- Cermeño Toral B
- Cernadas E
- Cervera-Aldama J
- Cesar Becerra Garcia F
- Chabok A
- Chafai N
- Challand C
- Chan H
- Chandler S
- Chandratreya N
- Chaudhri S
- Chaudhri S
- Chave H
- Chernikovskiy I
- Chobola M
- Chopada A
- Christensen P
- Christensen P
- Christiani A
- Chu H
- Church R
- Cillo M
- Cini C
- Citores M
- Ciuce C
- Claeys D
- Clara P
- Clark E
- Clementi I
- Clermonts S
- Clifford R
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- Codina-Cazador A
- Coene P
- Coletta D
- Compañ A
- Concheiro Coello P
- Condic D
- Connelly T
- Copăescu C
- Coratti A
- Cordesmeyer S
- Cornish J
- Corte-Real J
- Costa S
- Costa-Navarro D
- Cotte E
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- Coyne P
- Crescenti F
- Crighton I
- Cruickshank N
- Crutten-Wood D
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- Cuk Vm
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- Cunha P
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- Cutting J
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- Dayan K
- Daza González J
- De Bruyn H
- de Buck van Overstraeten A
- de Castro S
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- de la Portilla F
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- de Wilt H
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- Helmer Sjo O
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- Milojkovic A
- Milovanovic B
- Ming Goh N
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- Mirza Q
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- Molina-Fernández M
- Monaci I
- Monami B
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- Nash G
- Navarro Garcia I
- Navarro Rodriguez E
- Nepogodiev D
- Nepogodiev D
- Nesbakken A
- Nestorovic M
- Niewiera M
- Nikberg M
- Nikolaou S
- Nofuentes C
- Nogues E
- Nonner J
- Norwood M
- Nunes V
- Nygren J
- Núñez Fernández S
- O'Connell Pr
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- Obuszko Z
- Oertli D
- Oeting M
- Oliphant Z
- Oliveira Cunha M
- Oliveira A
- Omar G
- Omloo J
- Ordoñez Trujillo J
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- Publication venue
- 'Wiley'
- Publication date
- 01/01/2018
- Field of study
Aim
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.
Method
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.
Results
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).
Conclusion
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
Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit
- Author
- Abraham Nordling M
- Abrisqueta J
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- 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\ua0days 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\ua0=\ua02515) underwent surgery for malignancy and 11.7% (n\ua0=\ua0375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8% (n\ua0=\ua03041) of patients, which was handsewn in 38.9% (n\ua0=\ua01183) and stapled in 61.1% (n\ua0=\ua01858). Patients undergoing handsewn 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\ua0=\ua00.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR\ua0=\ua01.43; 95% CI: 1.04\u20131.95; P\ua0=\ua00.03). 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
The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit.
- Author
- Abraham Nordling M
- Abrisqueta J
- Achkasov S
- Agalianos C
- Agarwal T
- Agha A
- Aguilar Teixido F
- Aguiló Lucia J
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- Akrida I
- Al Naimi N
- Al Qaddo A
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- Alcazar Montero J
- Aldrey Cao I
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- Örhalmi J
- Øresland T
- Švagždys S
- Publication venue
- 'Wiley'
- Publication date
- 01/01/2017
- Field of study
BACKGROUND:
Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified 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) 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) cases. Patients undergoing handsewn anastomosis were more likely to be emergency admissions (20.5% handsewn versus 12.9% stapled) and to undergo open surgery (54.7% versus 36.6%). 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 odds ratio 1.43, 95% confidence interval 1.04-1.95, p=0.03).
DISCUSSION:
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. This article is protected by copyright. All rights reserve
Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO
- Author
- 6rhalmi J.
- 8resland T.
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- Publication venue
- 'Wiley'
- Publication date
- 15/09/2017
- Field of study
Aim: Patient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. Method: This was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien\u2013Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals. Results: In all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10\u20134.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13\u20133.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20\u20134.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08\u20131.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07\u20131.37). Conclusion: Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients
Recent Advances in the Liquid-Phase Syntheses of Inorganic Nanoparticles
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- Tsai E. H.
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- Weisbecker C. S.
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- Publication venue
- 'American Chemical Society (ACS)'
- Publication date
- Field of study
Strong disorder RG approach – a short review of recent developments
- Author
- A. Amir
- A. Bellafard
- A. Del Maestro
- A. Del Maestro
- A. Dutta
- A. Friedenauer
- A. Lavarelo
- A. Leggett
- A. Pikovsky
- A. Saguia
- A. Saguia
- A.C. Potter
- A.J. Friedman
- A.K. Ibrahim
- A.K. Ibrahim
- A.M. Goldsborough
- A.M. Goldsborough
- A.P. Vieira
- A.P. Vieira
- B. Kang
- C. Chatelain
- C. Chatelain
- C. Dasgupta
- C. Holzhey
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C. Monthus
- C.A. Lamas
- C.E. Fiore
- C.R. Laumann
- Cécile Monthus
- D. Nozadze
- D. Pekker
- D. Pekker
- D.S. Fisher
- D.S. Fisher
- E. Altman
- E. Altman
- E. Altman
- E. Altman
- E. Altman
- E. Bertin
- E. Tarquini
- E.V.H. Doggen
- F. Alet
- F. Angeletti
- F. Evers
- F. Hrahsheh
- F. Hrahsheh
- F. Hrahsheh
- F. Iglói
- F. Iglói
- F. Iglói
- F. Iglói
- F. Iglói
- F. Iglói
- F. Iglói
- F. J. Dyson
- F. Vazquez
- F.J.O. Filho
- Fabien Alet
- Ferenc Iglói
- G. De Chiara
- G. Györgyi
- G. Ramirez
- G. Ramirez
- G. Ramirez
- G. Ramirez
- G. Refael
- G. Refael
- G. Refael
- G. Roósz
- G. Roósz
- G. Schehr
- G. Schehr
- G. Schehr
- G. Torlai
- G. Vidal
- G.C. Levine
- H. Aoki
- H. Aoki
- H. Barghathi
- H. Barghathi
- H. Barghathi
- H. Barghathi
- H. Barghathi
- H. Tran
- H.J. Mard
- H.J. Mard
- H.L. Casa Grande
- I. Calvo
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- I.A. Kovács
- J. Cardy
- J. Herbrych
- J. Hide
- J. Kokalj
- J. Rodriguez-Laguna
- J. Rodriguez-Laguna
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.A. Hoyos
- J.C. Getelina
- J.C. Getelina
- J.H. Bardarson
- J.I. Cirac
- J.W. Britton
- J.Z. Imbrie
- K. Agarwal
- K. Hyatt
- K. Kim
- K. Slagle
- L. Amico
- L. Fidkowski
- L. Fidkowski
- L. Rademaker
- L. Rademaker
- L. Zhang
- L.B. Ioffe
- M. Bukov
- M. Fagotti
- M. Heyl
- M. Pouranvari
- M.A. Munoz
- M.B. Hastings
- M.C. Strinati
- M.V. Feigel’man
- N. Laflorencie
- N. Ma
- N. Moure
- N. Moure
- N.E. Bonesteel
- N.T. Jacobson
- O. Dimitrova
- O. Gittsovich
- O. Kogan
- P. Calabrese
- P. Calabrese
- P. Calabrese
- P. Goswami
- P. Hauke
- P. Lajkó
- P. Le Doussal
- P. Mohan
- P. Ruggiero
- P.T. Dumitrescu
- Q. Zhu
- R. Islam
- R. Islam
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Juhász
- R. Miyazaki
- R. Moessner
- R. Mélin
- R. Nandkishore
- R. Santachiara
- R. Vasseur
- R. Vasseur
- R. Vasseur
- R. Vasseur
- R. Vosk
- R. Vosk
- R. Vosk
- R. Vosk
- R. Yu
- R. Yu
- R.N. Bhatt
- S. Bo
- S. Garnerone
- S. Iyer
- S. Iyer
- S. Johri
- S. Savitz
- S. Zhou
- S.-K. Ma
- S.A. Parameswaran
- S.H. Strogatz
- S.J. Thomson
- T. Devakul
- T. Senthil
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T. Vojta
- T.E. Harris
- T.E. Lee
- U. Divakaran
- U. Divakaran
- V. Gurarie
- V. Shivamoggi
- V.L. Quito
- V.L. Quito
- V.L. Quito
- W. Berdanier
- W. De Roeck
- W. Wang
- W. Wang
- Y-C. Lin
- Y. Huang
- Y. Huang
- Y. Zhao
- Y.-R. Shu
- Y.C. Lin
- Y.C. Lin
- Y.P. Lin
- Y.R. Shu
- Y.Z. You
- Publication venue
- 'Springer Science and Business Media LLC'
- Publication date
- Field of study
Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit
- 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