Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery
Anastomotic leakage reflects a major problem in visceral surgery, leading to increased morbidity, mortality, and costs. This review is aimed at evaluating and summarizing risk factors for colorectal anastomotic leakage. A generalized discussion first introduces risk factors beginning with nonalterab...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2020/9057963 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849396407824285696 |
|---|---|
| author | Bradley Wallace Fabia Schuepbach Stefan Gaukel Ahmed I. Marwan Ralph F. Staerkle Raphael N. Vuille-dit-Bille |
| author_facet | Bradley Wallace Fabia Schuepbach Stefan Gaukel Ahmed I. Marwan Ralph F. Staerkle Raphael N. Vuille-dit-Bille |
| author_sort | Bradley Wallace |
| collection | DOAJ |
| description | Anastomotic leakage reflects a major problem in visceral surgery, leading to increased morbidity, mortality, and costs. This review is aimed at evaluating and summarizing risk factors for colorectal anastomotic leakage. A generalized discussion first introduces risk factors beginning with nonalterable factors. Focus is then brought to alterable impact factors on colorectal anastomoses, utilizing Cochrane systematic reviews assessed via systemic literature search of the Cochrane Central Register of Controlled Trials and Medline until May 2019. Seventeen meta-anaylses covering 20 factors were identified. Thereof, 7 factors were preoperative, 10 intraoperative, and 3 postoperative. Three factors significantly reduced the incidence of anastomotic leaks: high (versus low) surgeon’s operative volume (RR=0.68), stapled (versus handsewn) ileocolic anastomosis (RR=0.41), and a diverting ostomy in anterior resection for rectal carcinoma (RR=0.32). Discussion of all alterable factors is made in the setting of the pre-, intra-, and postoperative influencers, with the only significant preoperative risk modifier being a high colorectal volume surgeon and the only significant intraoperative factors being utilizing staples in ileocolic anastomoses and a diverting ostomy in rectal anastomoses. There were no measured postoperative alterable factors affecting anastomotic integrity. |
| format | Article |
| id | doaj-art-b2a3797e9fe34f52893c8f9284b4c231 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-b2a3797e9fe34f52893c8f9284b4c2312025-08-20T03:39:21ZengWileyGastroenterology Research and Practice1687-61211687-630X2020-01-01202010.1155/2020/90579639057963Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal SurgeryBradley Wallace0Fabia Schuepbach1Stefan Gaukel2Ahmed I. Marwan3Ralph F. Staerkle4Raphael N. Vuille-dit-Bille5Department of Pediatric Surgery, Children’s Hospital Colorado, USAUniversity of Zürich, SwitzerlandDepartment of Orthopaedics and Traumatology, Cantonal Hospital Winterthur, SwitzerlandDepartment of Pediatric Surgery, Children’s Hospital Colorado, USAClarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, SwitzerlandDepartment of Pediatric Surgery, University Children’s Hospital of Basel, SwitzerlandAnastomotic leakage reflects a major problem in visceral surgery, leading to increased morbidity, mortality, and costs. This review is aimed at evaluating and summarizing risk factors for colorectal anastomotic leakage. A generalized discussion first introduces risk factors beginning with nonalterable factors. Focus is then brought to alterable impact factors on colorectal anastomoses, utilizing Cochrane systematic reviews assessed via systemic literature search of the Cochrane Central Register of Controlled Trials and Medline until May 2019. Seventeen meta-anaylses covering 20 factors were identified. Thereof, 7 factors were preoperative, 10 intraoperative, and 3 postoperative. Three factors significantly reduced the incidence of anastomotic leaks: high (versus low) surgeon’s operative volume (RR=0.68), stapled (versus handsewn) ileocolic anastomosis (RR=0.41), and a diverting ostomy in anterior resection for rectal carcinoma (RR=0.32). Discussion of all alterable factors is made in the setting of the pre-, intra-, and postoperative influencers, with the only significant preoperative risk modifier being a high colorectal volume surgeon and the only significant intraoperative factors being utilizing staples in ileocolic anastomoses and a diverting ostomy in rectal anastomoses. There were no measured postoperative alterable factors affecting anastomotic integrity.http://dx.doi.org/10.1155/2020/9057963 |
| spellingShingle | Bradley Wallace Fabia Schuepbach Stefan Gaukel Ahmed I. Marwan Ralph F. Staerkle Raphael N. Vuille-dit-Bille Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery Gastroenterology Research and Practice |
| title | Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery |
| title_full | Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery |
| title_fullStr | Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery |
| title_full_unstemmed | Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery |
| title_short | Evidence according to Cochrane Systematic Reviews on Alterable Risk Factors for Anastomotic Leakage in Colorectal Surgery |
| title_sort | evidence according to cochrane systematic reviews on alterable risk factors for anastomotic leakage in colorectal surgery |
| url | http://dx.doi.org/10.1155/2020/9057963 |
| work_keys_str_mv | AT bradleywallace evidenceaccordingtocochranesystematicreviewsonalterableriskfactorsforanastomoticleakageincolorectalsurgery AT fabiaschuepbach evidenceaccordingtocochranesystematicreviewsonalterableriskfactorsforanastomoticleakageincolorectalsurgery AT stefangaukel evidenceaccordingtocochranesystematicreviewsonalterableriskfactorsforanastomoticleakageincolorectalsurgery AT ahmedimarwan evidenceaccordingtocochranesystematicreviewsonalterableriskfactorsforanastomoticleakageincolorectalsurgery AT ralphfstaerkle evidenceaccordingtocochranesystematicreviewsonalterableriskfactorsforanastomoticleakageincolorectalsurgery AT raphaelnvuilleditbille evidenceaccordingtocochranesystematicreviewsonalterableriskfactorsforanastomoticleakageincolorectalsurgery |