Long‐term functional results and quality of life after redo rectal surgery: delayed versus immediate colo‐anal anastomosis

Boullenois, H.; Lefèvre, Jérémie H.; Creavin, Ben; Voron, Thibaut; Debove, Clotilde; Chafaı̈, Najim; Parc, Yann

doi:10.1111/codi.14983

Cited by 13 publications

(14 citation statements)

References 30 publications

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“…We initially identified a total of 5,641 articles in the databases, and after removing duplicates, 4,059 were screened. Of those articles, 11 [5][6][7][8][9][10][11][12][13][14][15] met all the eligibility criteria and were selected (Fig. 1).…”

Section: Baseline Characteristics Of the Included Studiesmentioning

confidence: 99%

Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis

et al. 2023

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This study aimed to review the outcomes of redo procedures for failed colorectal or coloanal anastomoses. Methods: A systematic review was performed using the PubMed, Embase, Cochrane, and LILACS databases (PROSPERO: CRD42021267715). The inclusion criteria were adult patients undergoing colectomy with primary colorectal or coloanal anastomosis and studies that assessed the postoperative results. Results: Eleven articles met the eligibility criteria and were selected. The studied population size ranged from 7 to 78 patients. The overall mortality rate was 0% (95% confidence interval [CI], 0%-0.01%). The postoperative complication rate was 40% (95% CI, 40%-50%). The length of hospital stay was 13.68 days (95% CI, 11.3-16.06 days). After redo surgery, 82% of the patients were free of stoma (95% CI, 75%-90%), and 24% of patients (95% CI, 0%-39%) had fecal incontinence. Neoadjuvant chemoradiotherapy (P = 0.002) was associated with a lower probability of being free of stoma in metaregression. Conclusion: Redo colorectal and coloanal anastomoses are strategies to restore colonic continuity. The decision to perform a redo operation should be based on a proper evaluation of the morbidity and mortality risks, the probability of remaining free of stoma, the quality of life, and a functional assessment.

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Section: Baseline Characteristics Of the Included Studiesmentioning

confidence: 99%

Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis

et al. 2023

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“…Subsequently, an immediate or delayed (Turnbull-Cutait) handsewn coloanal anastomosis can be performed. 27,28 A recent systematic review, including 276 patients treated with EVT for AL found a healed anastomosis rate of 85.3% and a stoma reversal rate of 75.9%. 29 Critical appraisal showed a wide variety in patients (rectal cancer, IBD, FAP, etc.)…”

Section: Transanal Surgery For Acute Leaksmentioning

confidence: 99%

“…However, immediate coloanal anastomosis has better functional outcomes, when compared with delayed. 28 A recent review on redo anastomosis for complicated colorectal or coloanal anastomoses showed a pooled 79% anastomotic integrity rate during follow-up with a 16% major complication rate. 44 The major complication rate appears low, when compared with the individual cohort studies including only redo anastomosis for chronic pelvic sepsis (41% AL rate, 38 40.6% morbidity rate 37 ) and might be explained by the heterogeneity in indication for redo surgery.…”

Section: Transanal Surgery For Chronic Leaksmentioning

confidence: 99%

Dealing with Complications of Colorectal Surgery Using the Transanal Approach—When and How?

Talboom

Tanis

Bemelman

et al. 2022

Clin Colon Rectal Surg

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The transanal approach is a new and exciting addition to the surgeons' repertoire to deal with complications after colorectal surgery. Improved exposure, accessibility, and visibility greatly facilitate adequate dissection of the affected area with potential increase in effectiveness and reduced morbidity. An essential component in salvaging anastomotic leaks of low colorectal, coloanal, or ileoanal anastomoses is early diagnosis and early treatment, especially when starting with endoscopic vacuum therapy, followed by early surgical closure (endoscopic vacuum-assisted surgical closure). Redo surgery using a transanal minimally invasive surgery platform for chronic leaks after total mesorectal excision surgery or surgical causes of pouch failure successfully mitigates limited visibility and exposure by using a bottom-up approach.

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“…Immediate pull-through shows better functional results, when compared with a two-step approach. 48 In a recent review, redo-anastomosis for either recurrent rectal cancer or chronic pelvic sepsis resulted in a successful restoration of bowel continuity in 79%, with a major complication rate of 16%. 49 The major complication rate appears low when compared with the individual cohort studies including only redo anastomosis for chronic pelvic sepsis.…”

Section: Surgical Interventionmentioning

confidence: 99%

Treatment Modalities for Anastomotic Leakage in Rectal Cancer Surgery

Keller

Talboom

Helsdingen

et al. 2021

Clin Colon Rectal Surg

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Despite advances in rectal cancer surgery, anastomotic leakage (AL) remains a common complication with a significant impact on patient recovery, health care costs, and oncologic outcomes. The spectrum of clinical severity associated with AL is broad, and treatment options are diverse with highly variable practices across the colorectal community. To be effective, the treatment must match not only the patient's current status but also the type of leak, the surgeon's skill, and the resources available. In this chapter, we will review the current and emergent treatment modalities for AL after rectal cancer surgery.

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Long‐term functional results and quality of life after redo rectal surgery: delayed versus immediate colo‐anal anastomosis

Abstract: Long term functional results and quality of life in rectal redo surgery: delayed vs. immediate colo-anal anastomosis, a case-matched study of 52 patients.

Cited by 13 publications

References 30 publications

Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis

Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis

Dealing with Complications of Colorectal Surgery Using the Transanal Approach—When and How?

Treatment Modalities for Anastomotic Leakage in Rectal Cancer Surgery

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