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. 2021 Jun;36(6):1209-1219.
doi: 10.1007/s00384-021-03860-7. Epub 2021 Jan 28.

Outcomes of elective left colectomy in renal-transplanted patients: a single-center case-control study (LECoRT study)

Thomas Bardol  1 , Regis Souche  2 , Diane Genet  2 , Charlotte Ferrandis  2 , Françoise Guillon  2 , Isabelle Pirlet  2   3 , Jean-Michel Fabre  2
Affiliations

Outcomes of elective left colectomy in renal-transplanted patients: a single-center case-control study (LECoRT study)

Thomas Bardol et al. Int J Colorectal Dis. 2021 Jun.

Abstract

Purpose: Renal-transplanted patients are reported to have a high anastomotic leakage (AL) rate after colorectal surgery. We aimed to define AL-related morbidity and mortality rates after elective left colectomy in renal-transplanted patients.

Methods: Data were prospectively collected between 2010 and 2015 from patients who underwent elective left colectomy with supra-peritoneal anastomosis in a single French referral hospital. We compared AL rate, and morbidity and mortality rates between renal-transplanted patients and controls.

Results: We identified 120 patients who underwent elective left colectomy during the study period. We retrospectively divided this cohort into 20 (17%) kidney-transplanted recipients (KTR-group) and the remaining 100 patients comprised the control group (C-group). There were no significant differences in sex, age, ASA score, body mass index, history of abdominal surgery and benign/malignant disease ratio between the KTR-group and the C-group. The AL rate was approximately four times higher in the KTR-group versus the C-group (25% vs 7%, p = 0.028). Intra-abdominal septic complications (p = 0.0005) and reoperation rates (p = 0.025) were also higher in the KTR-group. The laparoscopic approach was performed less in the KTR-group (35% versus 93%, p < 0.0001).

Conclusion: Renal transplantation was identified as a risk factor of AL following elective left colectomy, as well as increased intra-abdominal septic morbidity and higher reoperation rate. Further multicentric studies are required to identify potential independent risk factors of AL after colorectal surgery in these frail populations.

Trial registration: The present study was declared on ClinicalTrials.gov (ID: NCT04495023).

Keywords: Anastomotic leakage; Colorectal surgery; Elective surgery; Left colectomy; Renal transplantation.

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