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Multicenter Study
. 2018 Sep 27;3(2):203-209.
doi: 10.1002/bjs5.101. eCollection 2019 Apr.

Effects of anastomotic technique on early postoperative outcome in open right-sided hemicolectomy

C Jurowich  1   2 , S Lichthardt  2 , N Matthes  2 , C Kastner  2 , I Haubitz  2 , A Prock  1 , J Filser  1 , C-T Germer  2   3 , A Wiegering  2   3   4
Affiliations
Multicenter Study

Effects of anastomotic technique on early postoperative outcome in open right-sided hemicolectomy

C Jurowich et al. BJS Open. .

Abstract

Background: Despite recent improvements in colonic cancer surgery, the rate of anastomotic leakage after right hemicolectomy is still around 6-7 per cent. This study examined whether anastomotic technique (handsewn or stapled) after open right hemicolectomy for right-sided colonic cancer influences postoperative complications.

Methods: Patient data from the German Society for General and Visceral Surgery (StuDoQ) registry from 2010 to 2017 were analysed. Univariable and multivariable analyses were performed. The primary endpoint was anastomotic leakage; secondary endpoints were postoperative ileus, complications and length of postoperative hospital stay (LOS).

Results: A total of 4062 patients who had undergone open right hemicolectomy for colonic cancer were analysed. All patients had an ileocolic anastomosis, 2742 handsewn and 1320 stapled. Baseline characteristics were similar. No significant differences were identified in anastomotic leakage, postoperative ileus, reoperation rate, surgical-site infection, LOS or death. The stapled group had a significantly shorter duration of surgery and fewer Clavien-Dindo grade I-II complications. In multivariable logistic regression analysis, ASA grade and BMI were found to be significantly associated with postoperative complications such as anastomotic leakage, postoperative ileus and reoperation rate.

Conclusion: Handsewn and stapled ileocolic anastomoses for open right-sided colonic cancer resections are equally safe. Stapler use was associated with reduced duration of surgery and significantly fewer minor complications.

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Figures

Figure 1
Figure 1
Patient selection
Figure 2
Figure 2
Forest plot of various outcomes by type of anastomosis. Odds ratios are shown with 95 per cent confidence intervals. LOS, length of postoperative hospital stay
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester RGS, Barzi A et al Colorectal cancer statistics, 2017. CA Cancer J Clin 2017; 67: 177–193. - PubMed
    1. Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet 2014; 383: 1490–1502. - PubMed
    1. Rogers SO Jr, Wolf RE, Zaslavsky AM, Wright WE, Ayanian JZ. Relation of surgeon and hospital volume to processes and outcomes of colorectal cancer surgery. Ann Surg 2006; 244: 1003–1011. - PMC - PubMed
    1. Krarup PM, Jorgensen LN, Andreasen AH, Harling H; Danish Colorectal Cancer Group . A nationwide study on anastomotic leakage after colonic cancer surgery. Colorectal Dis 2012; 14: e661–e667. - PubMed
    1. Bakker IS, Grossmann I, Henneman D, Havenga K, Wiggers T. Risk factors for anastomotic leakage and leak‐related mortality after colonic cancer surgery in a nationwide audit. Br J Surg 2014; 101: 424–432. - PubMed

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