Predictors of complications and mortality following left colectomy with primary stapled anastomosis for cancer: results of a multicentric study with 1111 patients

Pellino, Gianluca; Frasson, Matteo; García-Granero, Álvaro; Granero-Castro, Pablo; Rodríguez, José Luis Ramos; Flor-Lorente, Blas; Berzosa, J. Bargallo; Hernandez, Naomi A.; Vallverdú, F. J. Labrador; Baños, Pedro Antonio Parra; Conde, Guillermo Ais; García‐Granero, Eduardo

doi:10.1111/codi.14309

Cited by 19 publications

(4 citation statements)

References 35 publications

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“…The comorbidity that marked an association with mortality in our study was cardiovascular comorbidity because of ith high prevalence, similar to that reported by Pellino G. et al, who documented this pathology in 52.8% of the patients in their study 19 .…”

Section: Discussionsupporting

confidence: 92%

“…The percentage of anastomotic dehiscence is below the average reported in the international literature, our work obtained a 3.8% average, data concordant with work by Martin in 2013 12 , 18 , which reports percentages ranging from 1.2 to 13% in anterior rectal resections by laparoscopy. The use of double staple suture in the creation of the anastomosis was an important factor associated with tumors located less than 10 cm and on the other hand a comparative study of no inferiority describes laparoscopic surgery as a protective factor for anastomotic dehiscence compared to open surgery (9.42% vs 13.47%) 18 , 19 .…”

Section: Discussionmentioning

confidence: 99%

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Features and outcomes of rectal cancer patients treated in a hospital in Bogotá, Colombia: a retrospective cohort study

Romo,

Figueroa Avendaño,

López

et al. 2023

Sci Rep

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Rectal cancer is an increasing disease worldwide. The outcomes of its treatment are related to the preoperative characteristics of the patient. The objective of this study was to describe sociodemographic, clinical and surgical characteristics and outcomes of patients operated on for rectal cancer at Hospital Universitario Mayor Méderi (HUM) during the period within 2013–2017.A retrospective descriptive cohort-type study was carried out by consulting the clinical records of patients above the age of 18 years with a clinical/histopathological diagnosis of rectal cancer and an institutional follow-up in those who underwent surgery with laparoscopic anterior resection of the rectum carried out by the coloproctology service of the HUM between 2013 and 2017. For statistical analysis, the SPSS V22 program was used.Data from 133 patients were collected during the study period, most of them male, with more frequent involvement of the lower rectum. Complications occurred in 25% of the patients. Conversion rate to open surgery was 8.6%, in-hospital death was associated with cardiovascular comorbidity, corticosteroid uses and with the presence of complications. Sociodemographic characteristics of the patients were similar to the world population. The institution has a low prevalence of anastomotic dehiscence, global complications are comparable with international statistics.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Features and outcomes of rectal cancer patients treated in a hospital in Bogotá, Colombia: a retrospective cohort study

Romo,

Figueroa Avendaño,

López

et al. 2023

Sci Rep

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show abstract

“…As operative morbidity is dependent, among others, on the patient’s age, sex, weight, and health status [ 58 , 59 , 60 ], the potential effects of age, sex, BMI, and ASA and CCI grade on metabolite dynamics in the postoperative period were examined. None were found except for arginine and the arginine-to-ADMA ratio, which decreased directly following surgery exclusively in female patients.…”

Section: Discussionmentioning

confidence: 99%

L-Arginine/NO Pathway Metabolites in Colorectal Cancer: Relevance as Disease Biomarkers and Predictors of Adverse Clinical Outcomes Following Surgery

Bednarz−Misa

Fleszar

Zawadzki

et al. 2020

JCM

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The L-Arginine/NO pathway is involved in carcinogenesis and immunity. Its diagnostic and prognostic value in colorectal cancer (CRC) was determined using tandem mass spectrometry in 199 individuals (137 with CRC) and, during a three-day follow up, in 60 patients undergoing colorectal surgery. Citrulline was decreased and asymmetric (ADMA) and symmetric (SDMA) dimethylarginines and dimethylamine (DMA) were increased in CRC. The DMA increase corresponded with CRC advancement while arginine, ADMA, and SDMA levels were higher in left-sided cancers. Arginine, citrulline, ADMA, and DMA dropped and SDMA increased post incision. Females experienced a more substantial drop in arginine. The arginine and ADMA dynamics depended on blood loss. The initial SDMA increase was higher in patients requiring transfusions. Postoperative dynamics in arginine and dimethylarginines differed in robot-assisted and open surgery. Concomitant SDMA, citrulline, and DMA quantification displayed a 92% accuracy in detecting CRC. Monitoring changes in arginine, ADMA, and SDMA in the early postoperative period predicted postoperative ileus with 84% and surgical site infections with 90% accuracy. Changes in ADMA predicted operative morbidity with 90% and anastomotic leakage with 77% accuracy. If positively validated, L-arginine/NO pathway metabolites may facilitate CRC screening and surveillance, support differential diagnosis, and assist in clinical decision-making regarding patients recovering from colorectal surgery.

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“…In most patients, it is possible to re-establish gut continuity with an anastomosis, and the surgical wound in the intestine usually heals within 7–10 days. However, a major complication is anastomotic leakage (AL), which occurs in 2–15% of the patients, with the occurrence rate depending on the specific location of the anastomosis [ 1 – 6 ]. Anastomoses in the right side of the colon have the lowest risk of AL (2–5%), and anastomoses to the rectum have the greatest risk of AL (10–15%).…”

Section: Introductionmentioning

confidence: 99%

Collagenase-producing bacteria are common in anastomotic leakage after colorectal surgery: a systematic review

Jørgensen,

Jonsson,

Friis-Hansen

et al. 2023

Int J Colorectal Dis

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Purpose Some gut bacteria can produce enzymes (collagenases) that can break down collagen in the intestinal wall. This could be a part of the pathophysiology of anastomotic leakage (AL). This systematic review aimed to investigate if such bacteria were present more frequently in AL patients versus non-AL patients following colorectal surgery. Methods This systematic review was reported according to the PRISMA and AMSTAR guidelines. Before the literature search, a study protocol was registered at PROSPERO (CRD42022363454). We searched PubMed, EMBASE, Google Scholar, and Cochrane CENTRAL on April 9th, 2023, for randomized and observational human studies of AL following colorectal surgery with information on gastrointestinal bacteria. The primary outcome was bacteria with the potential to produce collagenase. The risk of bias was assessed with the Newcastle–Ottawa Scale, as all studies were observational. Results We included 15 studies, with a total of 52,945 patients, of which 1,747 had AL, and bacteriological information from feces, mucosa, the resected specimen, or drain fluid was presented. In 10 of the 15 studies, one or more collagenase-producing bacteria were identified in the patients with AL. Neither the bacteria nor the collagenase production were quantified in any of the studies. The studies varied greatly in terms of sample material, analytical method, and time of collection. Studies using DNA sequencing methods did not report findings of collagenase-producing bacteria. Conclusion Collagenase-producing bacteria are more common in patients with AL following colorectal surgery than in patients without AL, but the significance is unclear. From the current studies, it is not possible to determine the pathogenicity of the individual gut bacteria.

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Predictors of complications and mortality following left colectomy with primary stapled anastomosis for cancer: results of a multicentric study with 1111 patients

Cited by 19 publications

References 35 publications

Features and outcomes of rectal cancer patients treated in a hospital in Bogotá, Colombia: a retrospective cohort study

Features and outcomes of rectal cancer patients treated in a hospital in Bogotá, Colombia: a retrospective cohort study

L-Arginine/NO Pathway Metabolites in Colorectal Cancer: Relevance as Disease Biomarkers and Predictors of Adverse Clinical Outcomes Following Surgery

Collagenase-producing bacteria are common in anastomotic leakage after colorectal surgery: a systematic review

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