Rate of anastomotic leak following right hemicolectomy by general surgical trainees

Ng, Chu Woon; Prabhakaran, Swetha; Chakraborty, J.; Lutton, Nicholas; Gourlas, Peter; Gillespie, Christopher; Kong, Joseph

doi:10.1007/s00384-020-03730-8

Cited by 4 publications

(3 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…AL is probably the most serious and feared complication specific to colorectal surgery as it is associated with significant morbidity and mortality [ 28 , 29 ]. The literature reports a risk of AL post RH between 3 and 8% [ 30 , 31 ]. From this cohort of selected patients, we found a lower overall rate of only 2.6%.…”

Section: Discussionmentioning

confidence: 99%

Impact of preoperative smoking on patients undergoing right hemicolectomies for colon cancer

Badiani

Diab

Woodford

et al. 2022

Langenbecks Arch Surg

View full text Add to dashboard Cite

Purpose The tobacco epidemic is one of the biggest global public health issues impacting quality of life and surgical outcomes. Although 30% of colon cancers warrant a right hemicolectomy (RH), there is no specific data on the influence of smoking on postoperative complications following RH for cancer. The aim of this study was to determine its effect on post-surgical outcomes. Methods Patients who underwent elective RH for colon cancer between 2016 and 2019 were identified from the ACS-NSQIP database. Propensity score matching (PSM) was used with a maximum absolute difference of 0.05 between propensity scores. Primary outcome was to assess the 30-day complication risk profile between smokers and non-smokers. Secondary outcomes included smoking impact on wound and major medico-surgical complication rates, as well as risk of anastomotic leak (AL) using multivariable logistic regression models. Results Following PSM, 5652 patients underwent RH for colon cancer with 1,884 (33.3%) identified as smokers. Smokers demonstrated a higher rate of organ space infection (4.1% vs 3.1%, p = 0.034), unplanned return to theatre (4.8% vs 3.7%, p = 0.045) and risk of AL (3.5% vs 2.1%, p = 0.005). Smoking was found to be an independent risk factor for wound complications (OR 1.32, 95% CI 1.03–1.71, p = 0.032), primary pulmonary complications (OR 1.50, 95% CI 1.06–2.13, p = 0.024) and AL (OR 1.66, 95% CI 1.19–2.31, p = 0.003). Conclusion Smokers have increased risk of developing major post-operative complications compared to non-smokers. Clinicians and surgeons must inform smokers of these surgical risks and potential benefit of smoking cessation prior to undergoing major colonic resection.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of preoperative smoking on patients undergoing right hemicolectomies for colon cancer

Badiani

Diab

Woodford

et al. 2022

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…[27][28][29][30] These data reinforce that training should be supervised to ensure the best patient outcomes yet allow appropriate trainee experience and professional development. 31 The large sample size in this study has provided significant statistical strength in its analysis. There is however potential for under-reporting of anastomotic leaks, with leaks classified as abdominal collections and reporting bias.…”

Section: Discussionmentioning

confidence: 94%

“…Thus far, only a few studies in the literature have compared surgical outcomes after colorectal cancer resections among operators with different levels of experience and technical expertise 27–30 . These data reinforce that training should be supervised to ensure the best patient outcomes y et al low appropriate trainee experience and professional development 31 …”

Section: Discussionmentioning

confidence: 97%

Influence of the type of anatomic resection on anastomotic leak after surgery for colon cancer

Ng,

McCombie,

Frizelle

et al. 2023

ANZ Journal of Surgery

View full text Add to dashboard Cite

IntroductionAnastomotic leak (AL) after colon cancer resection is feared by surgeons because of its associated morbidity and mortality. Considerable research has been directed at predictive factors for AL, but not the anatomic type of colonic resection. Anecdotally, certain types of resection are associated with higher leak rates although there remains a paucity of data on this. This study aimed to determine the AL rate for different types of colon cancer resection to inform decisions regarding the choice of operation.MethodologyRetrospective analysis of Bowel Cancer Outcome Registry (BCOR) for all colonic cancer resections with anastomosis between January 2007 and December 2020. Demographic, patient, tumour and outcome data were analysed. AL rates were compared among the different colonic procedures with both univariate and multivariate analysis.Results20 191 patients who underwent resection with anastomosis for cancer were included in this study. Of these 535 (2.6%) suffered ALs. While the univariate analysis found male sex, procedure type, symptomatic cancers, emergency surgery, unsupervised registrars, conversion to open surgery, medical complications and higher TNM staging were associated with AL, multivariate analysis, found only procedure type remained a significant predictor of AL (total colectomy (OR 4.049, P<0.001), subtotal colectomy (OR 2.477, P<0.001) and extended right hemicolectomy (OR 2.171, P < 0.001)).ConclusionAL is more common in extended colonic resections. With growing evidence of similar oncological outcomes between subtotal colectomy and left hemicolectomy for splenic flexure cancers, more limited resections should be considered. The type of colonic resection should be integrated into prediction tools for AL.

show abstract

Mechanical bowel preparation combined with oral antibiotics reduces infectious complications and anastomotic leak in elective colorectal surgery: a pooled-analysis with trial sequential analysis

Yue

Chen

Wang

et al. 2023

Int J Colorectal Dis

View full text Add to dashboard Cite

Rate of anastomotic leak following right hemicolectomy by general surgical trainees

Cited by 4 publications

References 12 publications

Impact of preoperative smoking on patients undergoing right hemicolectomies for colon cancer

Impact of preoperative smoking on patients undergoing right hemicolectomies for colon cancer

Influence of the type of anatomic resection on anastomotic leak after surgery for colon cancer

Mechanical bowel preparation combined with oral antibiotics reduces infectious complications and anastomotic leak in elective colorectal surgery: a pooled-analysis with trial sequential analysis

Contact Info

Product

Resources

About