Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis

Abstract

This study aimed to review the outcomes of redo procedures for failed colorectal or coloanal anastomoses. Methods: A systematic review was performed using the PubMed, Embase, Cochrane, and LILACS databases (PROSPERO: CRD42021267715). The inclusion criteria were adult patients undergoing colectomy with primary colorectal or coloanal anastomosis and studies that assessed the postoperative results. Results: Eleven articles met the eligibility criteria and were selected. The studied population size ranged from 7 to 78 patients. The overall mortality rate was 0% (95% confidence interval [CI], 0%-0.01%). The postoperative complication rate was 40% (95% CI, 40%-50%). The length of hospital stay was 13.68 days (95% CI, 11.3-16.06 days). After redo surgery, 82% of the patients were free of stoma (95% CI, 75%-90%), and 24% of patients (95% CI, 0%-39%) had fecal incontinence. Neoadjuvant chemoradiotherapy (P = 0.002) was associated with a lower probability of being free of stoma in metaregression. Conclusion: Redo colorectal and coloanal anastomoses are strategies to restore colonic continuity. The decision to perform a redo operation should be based on a proper evaluation of the morbidity and mortality risks, the probability of remaining free of stoma, the quality of life, and a functional assessment.

Laparoscopic redo endorectal pull‐through procedure for complex rectovaginal fistula after rectal resection for endometriosis: A Video Vignette

“…Some experts have proposed the pull‐through procedure with delayed anastomosis as an alternative to the traditional immediate anastomosis when the patient does not wish to have an ostomy [2, 3].…”

“…Dear Editor, Anastomotic redo procedures to restore bowel continuity are challenging and are associated with a high risk of morbidity and failure [1]. Some experts have proposed the pull-through procedure with delayed anastomosis as an alternative to the traditional immediate anastomosis when the patient does not wish to have an ostomy [2,3].…”