Intraoperative Endoscopy for the Assessment of Circular-stapled Anastomosis in Laparoscopic Colon Surgery

Shamiyeh, Andreas; Szabó, K; Wayand, W.; Zehetner, Joerg

doi:10.1097/sle.0b013e3182401e20

Cited by 59 publications

(51 citation statements)

References 7 publications

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“…The thirteen reviewed studies included a total of N=3,023 patients (Table 3), [16,17,[19][20][21][22][23][24][25][26][27][28][29]. Study sample size and design was variable.…”

Section: Resultsmentioning

confidence: 99%

“…Suture repair (74.7%) was the most common method of anastomosis correction used followed by takedown and re-anastomosis (17.3%) and diversion (8.0%). No significant differences in intraoperative leak rates were found were found across anastomosis types (staple: 4.9%, suture: 2.3%, and compression: 0.0%, p=0.066) in the 10 studies that reported leak based on type of anastomosis employed [16,[19][20][21][22][24][25][26][27][28]. Six articles reported on the rate of intraoperative leaks by surgical technique used (laparoscopic v. open) [22,[25][26][27][28][29].…”

Section: Search Term Description Definitionmentioning

confidence: 93%

“…Hand sewn sutured anastomosis was used in a total of n=273 cases (9.0%) and a compression anastomosis was employed in the remaining n=38 cases (1.3%). Seven studies required that staple anastomosis be employed [20][21][22][24][25][26][27], while the remaining six studies allowed multiple methods of anastomosis closure. Within these six studies that employed multiple anastomosis methods [16,19,23,[28][29][30], stapled anastomosis was always one of the methods used.…”

Section: Search Term Description Definitionmentioning

confidence: 99%

“…Eight studies required the use of intraoperative testing as part of the study protocol. Presence of leak testing across the 13 studies ranged from a rate of 45.2% in Lieto et al, which included a no test control group, to 100% in the eight studies, which required the use of intra-operative leak testing [19,20,22,[26][27][28][29][30]. The rate of intraoperative testing observed in the two studies (Riccardi et al, Leahy et al) where the decision to test was left up to the surgeon was 82.3% (1,243 of 1,023 patients).…”

Section: Search Term Description Definitionmentioning

confidence: 99%

See 3 more Smart Citations

Intra-Operative Anastomotic Leak Rates and Testing Methodology in Colorectal Resection Surgery

Schiff¹,

Brady²,

Ghosh³

et al. 2016

J Surg Surgical Res

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048 AbstractPurpose: Anastomotic leak following colorectal resection surgery is associated with high rates of morbidity, infection, and escalated healthcare expenditures. One method to prevent leaks includes early detection through intra-operative testing. This study employed systematic review of the literature to estimate the rate of intra-operative anastomotic leaks in colorectal resection surgery. Method:The Medline and Embase databases were searched to identify articles published between January 1 st , 2003 and August 8 th , 2015 reporting on intra-operative leaks in colorectal resection. The rate of intra-operative testing, intra-and post-operative anastomotic leaks, and surgical methodology were extracted from the final sample of 13 articles.Results: A total of 167 intra-operative leaks were reported within 2,598 colorectal resection surgeries that used intra-operative testing, yielding an average leak rate of 6.4%. Use of laparoscopic techniques was significantly associated with a reduced rate of intra-operative leak (p<0.001). Eight articles reported on the rate of post-operative anastomotic leak in relation to intraoperative testing. Within this sample of 2,098 cases a non-significant trend towards a lower leak rate in the tested population was identified (4.3% v. 6.8%, p=0.051); cases whose leak test was initially positive exhibited a significantly higher rate of post-operative leaks compared to cases with a negative leak test (p=0.006). Conclusion:Intra-operative anastomotic leak testing allows surgeons to address leaks at the time of surgery, and may help to prevent complications in colorectal resection surgery. This study identified a mean intra-operative leak rate of 6.4% in colorectal resection surgery.

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“…The thirteen reviewed studies included a total of N=3,023 patients (Table 3), [16,17,[19][20][21][22][23][24][25][26][27][28][29]. Study sample size and design was variable.…”

Section: Resultsmentioning

confidence: 99%

Section: Search Term Description Definitionmentioning

confidence: 93%

Section: Search Term Description Definitionmentioning

confidence: 99%

Section: Search Term Description Definitionmentioning

confidence: 99%

See 2 more Smart Citations

Intra-Operative Anastomotic Leak Rates and Testing Methodology in Colorectal Resection Surgery

Schiff¹,

Brady²,

Ghosh³

et al. 2016

J Surg Surgical Res

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show abstract

“…In these cases, additional transanal sutures and a covering stoma were added, and no clinical AL occurred. Although intraoperative endoscopy has not been reported to reduce AL 30) , we still recommend endoscopic assessment of circular-stapled anastomosis as a routine procedure in rectal surgery since it is not a complicated or time-consuming procedure and does not increase the risk for AL, but rather has potential benefits for reducing AL and postoperative bleeding 31) . Other risk factors for AL after laparoscopic anterior resection include male sex, preoperative CRT, obesity, and low rectal tumor 14,15,32,33) .…”

Section: Discussionmentioning

confidence: 99%

Smoking and tumor obstruction are risk factors for anastomotic leakage after laparoscopic anterior resection during rectal cancer treatment

Matsuzaki

Ishihara

Kawai

et al. 2017

J Anus Rectum Colon

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Abstract:Objectives: To clarify the surgical outcomes and risk factors for anastomotic leakage (AL) following laparoscopic anterior resection (Lap-AR) for the treatment of rectal cancer. Methods: We retrospectively reviewed the records of 175 consecutive primary rectal cancer patients who had undergone Lap-AR at our institution between April 2012 and November 2015. Patient, tumor, and surgical variables were analyzed using univariate analyses. Results: Of 175 patients, 116 were men (66.3%). All four patients who had AL (2.3%) were men and current smokers with heavy smoking histories. In three of the AL cases, preoperative total colonoscopy was impossible owing to tumor obstruction, and the other case had concomitant obstructive colitis after oral bowel preparation. Univariate analysis identified tumor size, tumor obstruction, and smoking history as factors significantly associated with AL development. Conclusions: Tumor size, tumor obstruction, and smoking history were risk factors for AL following Lap-AR for the treatment of primary rectal cancer.

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Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks

McDermott

Heeney

Kelly

et al. 2015

British Journal of Surgery

696

525

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Intraoperative Endoscopy for the Assessment of Circular-stapled Anastomosis in Laparoscopic Colon Surgery

Cited by 59 publications

References 7 publications

Intra-Operative Anastomotic Leak Rates and Testing Methodology in Colorectal Resection Surgery

Intra-Operative Anastomotic Leak Rates and Testing Methodology in Colorectal Resection Surgery

Smoking and tumor obstruction are risk factors for anastomotic leakage after laparoscopic anterior resection during rectal cancer treatment

Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks

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