TY - GEN
T1 - Predictors for Anastomotic Leak, Postoperative Complications, and Mortality after Right Colectomy for Cancer
T2 - 11th Scientific and Annual Meeting of the European Society of Coloproctology
AU - Local Investigators
AU - 2015 European Society of Coloproctology collaborating group
AU - Paper Writing Group
A2 - Frasson, Matteo
A2 - Battersby, Nick J.
A2 - Bhangu, Aneel
A2 - Hervás, David
A2 - El-Hussuna, Alaa Abdul-Hussein Hmood
A2 - Gallo, Gaetano
A2 - Pata, Francesco
A2 - Pinkney, Thomas D.
A2 - Poskus, Tomas
A2 - Singh, Baljit
A2 - Bernstein, Inge
A2 - Sunesen, Kåre Gotschalck
A2 - Leunbach, Jonathan
A2 - Thorlacius-Ussing, Ole
A2 - Ovesen, Anders Uth
PY - 2020/5
Y1 - 2020/5
N2 - 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.
AB - 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.
KW - Anastomotic leak
KW - Colon cancer
KW - Postoperative outcome
KW - Right colectomy
UR - http://www.scopus.com/inward/record.url?scp=85083539715&partnerID=8YFLogxK
U2 - 10.1097/DCR.0000000000001590
DO - 10.1097/DCR.0000000000001590
M3 - Conference article in Journal
SN - 0012-3706
VL - 63
SP - 606
EP - 618
JO - Diseases of the Colon and Rectum
JF - Diseases of the Colon and Rectum
IS - 5
Y2 - 28 September 2016 through 30 September 2016
ER -