TY - JOUR
T1 - Predictors for anastomotic leak, postoperative complications, and mortality after right colectomy for cancer
T2 - Results from an international snapshot audit
AU - European Society of Coloproctology Collaborating Group Collaborators
AU - Group
AU - ESCP Cohort Studies Sub-Committee
AU - ESCP Research Committee
AU - Logistical Support and Data Collection
AU - Analysis
AU - Investigators
AU - Gallo, Gaetano
AU - Pata, Francesco
AU - Vennix, S.
AU - Laurberg, S.
AU - Morton, D.
AU - Rubbini, M.
AU - Vaizey, C.
AU - Magill, L.
AU - Perry, R.
AU - Sheward, N.
AU - Hervas, David
AU - Cillo, M.
AU - Estefania, D.
AU - Uriburu, J. Patron
AU - Ruiz, H.
AU - Solomon, M.
AU - Makhmudov, A.
AU - Selnyahina, L.
AU - Varabei, A.
AU - Vizhynis, Y.
AU - Claeys, D.
AU - Defoort, B.
AU - Muysoms, F.
AU - Pletinckx, P.
AU - Vergucht, V.
AU - Debergh, I.
AU - Feryn, T.
AU - Reusens, H.
AU - Nachtergaele, M.
AU - Francart, D.
AU - Jehaes, C.
AU - Markiewicz, S.
AU - Monami, B.
AU - Weerts, J.
AU - Houben, B.
AU - Haeck, L.
AU - Lange, C.
AU - Sommeling, C.
AU - Vindevoghel, K.
AU - Castro, S.
AU - De Bruyn, H.
AU - Huyghe, M.
AU - De Wolf, E.
AU - Reynders, D.
AU - D'Hoore, A.
AU - De Buck Van Overstraeten, A.
AU - Wolthuis, A.
AU - Ancans, G.
AU - Pcolkins, A.
AU - Sivins, A.
PY - 2020
Y1 - 2020
N2 - Background: A right hemicolectomy is among the most commonly performed operations for colon cancer, but modern high-quality, multination data addressing the morbidity and mortality rates are lacking. Objective: This study reports the morbidity and mortality rates for right-sided colon cancer and identifies predictors for unfavorable short-term outcome after right hemicolectomy. Design: This was a snapshot observational prospective study. Setting: The study was conducted as a multicenter international study. Patients: The 2015 European Society of Coloproctology snapshot study was a prospective multicenter international series that included all patients undergoing elective or emergency right hemicolectomy or ileocecal resection over a 2-month period in early 2015. This is a subanalysis of the colon cancer cohort of patients. Main Outcome Measures: Predictors for anastomotic leak and 30-day postoperative morbidity and mortality were assessed using multivariable mixed-effect logistic regression models after variables selection with the Lasso method. Results: Of the 2515 included patients, an anastomosis was performed in 97.2% (n = 2444), handsewn in 38.5% (n = 940) and stapled in 61.5% (n = 1504) cases. The overall anastomotic leak rate was 7.4% (180/2444), 30-day morbidity was 38.0% (n = 956), and mortality was 2.6% (n = 66). Patients with anastomotic leak had a significantly increased mortality rate (10.6% vs 1.6% no-leak patients; p ≥ 0.001). At multivariable analysis the following variables were associated with anastomotic leak: longer duration of surgery (OR = 1.007 per min; p = 0.0037), open approach (OR = 1.9; p = 0.0037), and stapled anastomosis (OR = 1.5; p = 0.041). Limitations: This is an observational study, and therefore selection bias could be present. For this reason, a multivariable logistic regression model was performed, trying to correct possible confounding factors. Conclusions: Anastomotic leak after oncologic right hemicolectomy is a frequent complication, and it is associated with increased mortality. The key contributing surgical factors for anastomotic leak were anastomotic technique, surgical approach, and duration of surgery.
AB - Background: A right hemicolectomy is among the most commonly performed operations for colon cancer, but modern high-quality, multination data addressing the morbidity and mortality rates are lacking. Objective: This study reports the morbidity and mortality rates for right-sided colon cancer and identifies predictors for unfavorable short-term outcome after right hemicolectomy. Design: This was a snapshot observational prospective study. Setting: The study was conducted as a multicenter international study. Patients: The 2015 European Society of Coloproctology snapshot study was a prospective multicenter international series that included all patients undergoing elective or emergency right hemicolectomy or ileocecal resection over a 2-month period in early 2015. This is a subanalysis of the colon cancer cohort of patients. Main Outcome Measures: Predictors for anastomotic leak and 30-day postoperative morbidity and mortality were assessed using multivariable mixed-effect logistic regression models after variables selection with the Lasso method. Results: Of the 2515 included patients, an anastomosis was performed in 97.2% (n = 2444), handsewn in 38.5% (n = 940) and stapled in 61.5% (n = 1504) cases. The overall anastomotic leak rate was 7.4% (180/2444), 30-day morbidity was 38.0% (n = 956), and mortality was 2.6% (n = 66). Patients with anastomotic leak had a significantly increased mortality rate (10.6% vs 1.6% no-leak patients; p ≥ 0.001). At multivariable analysis the following variables were associated with anastomotic leak: longer duration of surgery (OR = 1.007 per min; p = 0.0037), open approach (OR = 1.9; p = 0.0037), and stapled anastomosis (OR = 1.5; p = 0.041). Limitations: This is an observational study, and therefore selection bias could be present. For this reason, a multivariable logistic regression model was performed, trying to correct possible confounding factors. Conclusions: Anastomotic leak after oncologic right hemicolectomy is a frequent complication, and it is associated with increased mortality. The key contributing surgical factors for anastomotic leak were anastomotic technique, surgical approach, and duration of surgery.
UR - https://www.scopus.com/pages/publications/85083539715
U2 - 10.1097/DCR.0000000000001590
DO - 10.1097/DCR.0000000000001590
M3 - Article
C2 - 32032201
AN - SCOPUS:85083539715
SN - 0012-3706
VL - 63
SP - 606
EP - 618
JO - Diseases of the Colon and Rectum
JF - Diseases of the Colon and Rectum
IS - 5
ER -
SDG 3 Good Health and Well-being