Abstract
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.
Originalsprog | Engelsk |
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Tidsskrift | Diseases of the Colon and Rectum |
Vol/bind | 63 |
Udgave nummer | 5 |
Sider (fra-til) | 606-618 |
Antal sider | 13 |
ISSN | 0012-3706 |
DOI | |
Status | Udgivet - maj 2020 |
Begivenhed | 11th Scientific and Annual Meeting of the European Society of Coloproctology - Milano, Milano, Italien Varighed: 28 sep. 2016 → 30 sep. 2016 |
Konference
Konference | 11th Scientific and Annual Meeting of the European Society of Coloproctology |
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Lokation | Milano |
Land/Område | Italien |
By | Milano |
Periode | 28/09/2016 → 30/09/2016 |
Emneord
- Anastomotic leak
- Colon cancer
- Postoperative outcome
- Right colectomy