Early and late anastomotic leak after colorectal surgery: A systematic review of the literature

Škrabec, Clara Gené; Carné, Anna Vidal; Pérez, Manel Cremades; Corral, Javier; Pujol, Andrea; Cuadrado, Marta; Troya, José M.; Ibáñez, Joan-Francesc Julián; Parés, David

doi:10.1016/j.cireng.2022.07.011

Cited by 4 publications

(1 citation statement)

References 35 publications

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“…Efforts have been made to develop predictive scores, identify risk factors and to assess blood supply, fecal microbiome, and other agents that might be involved in AL. At present, the focus is set on detecting biochemical markers to identify AL as soon as possible as it can be handled less aggressively than when it is clinically evident 4 , 5 . Even though patient-related risk factors such as age, comorbidities, drug use, and nutritional status, cannot be modified, surgeons may have an opportunity to act considering technical factors.…”

Section: Introductionmentioning

confidence: 99%

Clinical results after external reinforcement of colorectal anastomosis: A systematic review

Škrabec,

Pérez,

Pujol

et al. 2023

International Journal of Surgery

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Objective: The aim of this review is to describe and assess the existing methods to cover colorectal anastomoses with biomaterials and their clinical impact in reducing anastomotic leakage. (AL). Summary Background Data: The most serious complication in colorectal surgery is AL. Despite improvements in its diagnosis and management, AL remains an unresolved issue. To prevent its appearance and clinical consequences, different external reinforcement techniques with synthetic or biomaterials have been described. Methods: A systematic review search of the available literature until June 2022 was performed, looking for all literature regarding external reinforcement of colonic or colorectal anastomoses. After the review process, a classification of materials was proposed into solid and liquid materials, and an assessment of their clinical impact was performed. The study protocol has been registered at PROSPERO and has been reported in the line with PRISMA and AMSTAR Guidelines 10,11. Results: 97 articles fulfilled inclusion criteria, were identified and revised. Overall, 18 of the selected articles focused on human clinical trials and 79 on animal models. Only Fibrin sealants, collagen patches and omentoplasty have shown positive results in humans. Conclusions: Fibrin sealants, collagen patches and omentoplasty are, so far, the most studied biomaterials. However, further studies are required to confirm these findings before definite recommendations can be made.

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Section: Introductionmentioning

confidence: 99%

Clinical results after external reinforcement of colorectal anastomosis: A systematic review

Škrabec,

Pérez,

Pujol

et al. 2023

International Journal of Surgery

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Short-Term Outcomes in Patients Undergoing Virtual/Ghost Ileostomy or Defunctioning Ileostomy after Anterior Resection of the Rectum: A Meta-Analysis

Zizzo

Morini

Zanelli

et al. 2023

JCM

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Background and Objectives: Anterior rectal resection (ARR) represents one of the most frequently performed methods in colorectal surgery, mainly carried out for rectal cancer (RC) treatment. Defunctioning ileostomy (DI) has long been chosen as a method to “protect” colorectal or coloanal anastomosis after ARR. However, DI does not rule out risks of more or less serious complications. A proximal intra-abdominal closed-loop ileostomy, the so-called virtual/ghost ileostomy (VI/GI), could limit the number of DIs and the associated morbidity. Materials and Methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Meta-analysis was performed by use of RevMan [Computer program] Version 5.4. Results: The five included comparative studies (VI/GI or DI) covering an approximately 20-year study period (2008–2021). All included studies were observational ones and originated from European countries. Meta-analysis indicated VI/GI as significantly associated with lower short-term morbidity rates related to VI/GI or DI after primary surgery (RR: 0.21, 95% CI: 0.07–0.64, p = 0.006), fewer dehydration (RR: 0.17, 95% CI: 0.04–0.75, p = 0.02) and ileus episodes after primary surgery (RR: 0.20, 95% CI: 0.05–0.77, p = 0.02), fewer readmissions after primary surgery (RR: 0.17, 95% CI: 0.07–0.43, p = 0.0002) and readmissions after primary surgery plus stoma closure surgery (RR: 0.14, 95% CI: 0.06–0.30, p < 0.00001) than the DI group. On the contrary, no differences were identified in terms of AL after primary surgery, short-term morbidity after primary surgery, major complications (CD ≥ III) after primary surgery and length of hospital stay after primary surgery. Conclusions: Given the significant biases among meta-analyzed studies (small overall sample size and the small number of events analyzed, in particular), our results require careful interpretation. Further randomized, possibly multi-center trials may be of paramount importance in confirming our results.

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Relationship between Soil Organic Carbon, Soil Nutrients, and Land Use in Linyi City (East China)

Wang

et al. 2022

Sustainability

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The distribution characteristics of soil organic carbon (SOC) and soil nutrients under different land-use types in Linyi City, East China, were studied. The spatial distribution of SOC under different land-use types and the relationship between SOC and soil nutrients were analyzed using remote sensing interpretation and soil sample analyses. The results showed that SOC in Linyi was mainly stored in drylands and paddy fields. SOC and total nitrogen (TN) levels were positively correlated for most land use types. There was a positive linear correlation between SOC and total K in the paddy fields. The coefficients of variation for SOC and TN differed greatly among the land use types studied. Total SOC storage was 8772.73 × 103 kg in the surface 0.2 m soil layer. The order of total SOC storage was drylands (6771.45 × 103 ton) > paddy field (764.67 × 103 ton) > nurseries (510.79 × 103 ton) > forest land (413.49 × 103 ton) > low-cover grasslands (238 × 103 ton) > bare land (74.35 × 103 ton). With the largest SOC storage, and C density, respectively, drylands and paddy fields are conducive to enhancing soil C sequestration, achieving low-carbon goals, and mitigating climate change.

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Early and late anastomotic leak after colorectal surgery: A systematic review of the literature

Cited by 4 publications

References 35 publications

Clinical results after external reinforcement of colorectal anastomosis: A systematic review

Clinical results after external reinforcement of colorectal anastomosis: A systematic review

Short-Term Outcomes in Patients Undergoing Virtual/Ghost Ileostomy or Defunctioning Ileostomy after Anterior Resection of the Rectum: A Meta-Analysis

Relationship between Soil Organic Carbon, Soil Nutrients, and Land Use in Linyi City (East China)

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