Complications after end-to-end vs. side-to-side anastomosis in ileocecal Crohn’s disease—early postoperative results from a randomized controlled multi-center trial (ISRCTN-45665492)

Zurbuchen, Urte; Kroesen, A. J.; Knebel, Philipp; Betzler, M.; Becker, H.; Bruch, Hans‐Peter; Senninger, N.; Post, Stefan; Buhr, H. J.; Ritz, Jörg‐Peter

doi:10.1007/s00423-012-0904-1

Cited by 39 publications

(19 citation statements)

References 21 publications

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“…Endoscopic recurrence was the most frequent endpoint, especially in maintenance trials (19, 26.8%). Only two induction studies reported endoscopic recurrence, both of which involved surgery. Endoscopic response was more frequently reported in induction trials (10, 9.1%) than in maintenance trials (6, 8.5%).…”

Section: Resultsmentioning

confidence: 97%

“…The search identified 9561 unique records (Figure ) and included 181 RCTs (characteristics in Table S5). Induction of remission was the focus of 110 studies: 104 (94.5%) through medical and six (5.5%) through surgical approaches(Table ). Nine (of 110, 8.2%) induction studies solely treated patients with fistula with medical or surgical therapies.…”

Section: Resultsmentioning

confidence: 99%

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Systematic review: outcomes and adverse events from randomised trials in Crohn's disease

Catt

Hughes

Kirkham

et al. 2019

Aliment Pharmacol Ther

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Summary Background The suitability of disease activity indices has been challenged, with growing interest in objective measures of inflammation. Aim To undertake a systematic review of efficacy and safety outcomes in placebo‐controlled randomised controlled trials (RCTs) of patients with Crohn's disease. Methods MEDLINE, EMBASE, CINAHL and Cochrane Library were searched until November 2015, for RCTs of adult Crohn's disease patients treated with medical or surgical therapies. Data on efficacy and safety outcomes, end‐point definitions, and measurement instruments were extracted and stratified by publication date (pre‐2009 and 2009 onwards). Results One hundred and eighty‐one RCTs (110 induction and 71 maintenance) were identified, including 23 850 patients. About 92.3% reported clinical efficacy endpoints. The Crohn's Disease Activity Index (CDAI) dominated, defining clinical response or remission in 63.5% of trials (35 definitions of response or remission). CDAI < 150 was the commonest endpoint, but reporting reduced between periods (46.4%‐41.1%), whilst use of CDAI100 increased (16.8%‐30.4%). Fistula studies most commonly reported fistula closure (9, 90.0%). Reporting of biomarker, endoscopy and histology endpoints increased overall (33.3%‐40.6%, 14.4%‐30.4% and 3.2%‐12.5%, respectively), but were heterogeneous and rarely reported in fistula trials. Patient‐reported outcome measures were reported in 41.4% of trials and safety endpoints in 35.4%. Many of the common adverse events relate to disease exacerbation or treatment failure. Conclusions Trial endpoints vary across studies, over time and are distinct in fistula studies. Despite growth in reporting of objective measures of inflammation and in patient‐reported outcome measures, there is a lack of standardisation. This confirms the need for a core outcome set for comparative effectiveness research in Crohn's disease.

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Section: Resultsmentioning

confidence: 97%

Section: Resultsmentioning

confidence: 99%

Systematic review: outcomes and adverse events from randomised trials in Crohn's disease

Catt

Hughes

Kirkham

et al. 2019

Aliment Pharmacol Ther

View full text Add to dashboard Cite

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“…At present there is no consensus on the optimal approach to prevent disease recurrence in CD after surgery. Operative technique, mode of surgery (laparoscopic or open) and length of resection do not seem to influence the recurrence rate [4,32,33].…”

Section: Discussionmentioning

confidence: 95%

Myenteric plexitis at the proximal resection margin is a predictive marker for surgical recurrence of ileocaecal Crohn's disease

et al. 2015

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“…Because of its wider diameter and superior blood supply, FEEA may reduce intraluminal pressure and proximal ischemia [ 20 ]. The rates of anastomotic leakage following FEEA have been reported to range from 0 to 7.1% [ 21 – 23 ]. A recent retrospective, multicentric study comparing the incidence of anastomotic leakage in ileocolonic anastomosis showed ESA to be superior to FEEA [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side?

et al. 2014

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BackgroundThe purpose of this study was to compare short-term clinical outcomes of ileocolonic functional end-to-end anastomosis (FEEA) and end-to-side anastomosis (ESA) following resection of the right colon for cancer.MethodsWe enrolled 379 patients who underwent ileocolonic anastomosis following resection of the right colon for cancer by a single surgeon, from January 2009 through June 2012. Patient characteristics, operative results, and postoperative complications were analyzed.ResultsA total of 164 patients received ESA and 215 patients received FEEA. The FEEA group had a lower incidence of anastomotic error (0.9% versus 4.3%; P = 0.04) and a shorter operating time (140.4 ± 14.9 min versus 150.5 ± 20.1 min; P = 0.001). The length of hospital stay (10.9 ± 3.5 days versus 11.3 ± 4.0 days; P = 0.36) and anastomotic leakage (1.8% versus 0.5%; P = 0.20) were similar in both groups. No relevant differences between FEEA and ESA were observed for blood loss, retrieved lymph nodes, first flatus and postoperative complications.ConclusionAn FEEA after right hemicolectomy for colon cancer is a safe and reliable anastomotic technique, resulting in a favorable outcome in selected patients with the right colon cancer.

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Complications after end-to-end vs. side-to-side anastomosis in ileocecal Crohn’s disease—early postoperative results from a randomized controlled multi-center trial (ISRCTN-45665492)

Abstract: Because of the early discontinuation of the study, it is not possible to provide a statement about the perianastomotic recurrence rates regarding the primary endpoint. With regard to the early postoperative outcome, we observed no difference between the two types of anastomosis.

Cited by 39 publications

References 21 publications

Systematic review: outcomes and adverse events from randomised trials in Crohn's disease

Systematic review: outcomes and adverse events from randomised trials in Crohn's disease

Myenteric plexitis at the proximal resection margin is a predictive marker for surgical recurrence of ileocaecal Crohn's disease

Ileocolonic anastomosis after right hemicolectomy for colon cancer: functional end-to-end or end-to-side?

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