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Does laparoscopic low anterior resections have higher rate of anastomotic dehiscencence? (CROSBI ID 205887)

Prilog u časopisu | ostalo

Stipančić, Igor ; Knežević, Mario ; Baković, Josip ; Kolak, Toni ; Runjić, Ivana ; Kliček, Robert ; Miočinović, Milan ; Does laparoscopic low anterior resections have higher rate of anastomotic dehiscencence? Surgical endoscopy, 28 (2014), S116-S116. doi: 10.1007/s00464-014-3484-z

Podaci o odgovornosti

Stipančić, Igor ; Knežević, Mario ; Baković, Josip ; Kolak, Toni ; Runjić, Ivana ; Kliček, Robert ; Miočinović, Milan ;

engleski

Does laparoscopic low anterior resections have higher rate of anastomotic dehiscencence?

Aims: Anastomotic leak is one of the most serious complications of colorectal surgery and may result in inadequate functional and oncological outcomes. The aim of this study is to assess the incidence and outcomes of clinical anastomotic leak in patients submitted to laparoscopic and open colorectal resections performed by single surgeon. Methods: All colorectal resections with primary anastomosis (n=180) performed between 2005. and 2012. were prospectively entered into database. Results: Of 180 resections 92 pts was done by laparoscopic and 88 by open approach. In 87 pts anastomosis was hand-made and in 93 created by stapler. The most common procedures were low anterior resection (n=61, open/lap 34/27), left and sigmoid resection (n=60, open/lap 29/31) and right colectomy (n=52, open/lap 27/25). Overall anastomotic leak rate was 5.0 %. Anastomotic leak mortality rate was 11.1% (1/9). In univariate analysis, the following parameters were associated with an increased risk for anastomotic leak: (1) ASA score≥3 (p=0.05), (2) prolonged (>3 h) operative time (p=0.03), (3) rectal location of the disease (p<0.001). There was no difference in overall clinical anastomotic leak between laparoscopic (5.43%) and open procedures (4.54%). All cases of clinical anastomotic leak (n=9) occurred after low anterior resections: after low colorectal in 6 and after coloanal anastomosis in 3 patients. Low anterior resection was performed in 61 patients: in 27 by laparoscopic and in 34 by open approach. Rate of clinical anastomotic leak after low anterior resections was 14.75% (9 of 61). Leaks occurred in 18.51% (5 of 27) after laparoscopic and in 11.76% (4 of 34) low or ultra-low anterior resections. Eight patients required reoperation with two needing the anastomosis take down and 6 patients had the anastomosis defunctioned by loop ileostomy without taking down primary anastomosis. Conclusion: In our series anastomotic leak occurred only after low and ultra-low anterior resections. Our data have raised concern that laparoscopic rectal resections are associated with increased risk of anastomotic leakage suggesting that we need more experience and better technical support in this type of surgery.

laparoscopy ; rectal cancer ; surgery ; anastomotic leak

nije evidentirano

nije evidentirano

nije evidentirano

nije evidentirano

nije evidentirano

nije evidentirano

Podaci o izdanju

28

2014.

S116-S116

objavljeno

0930-2795

10.1007/s00464-014-3484-z

Povezanost rada

Kliničke medicinske znanosti

Poveznice