1. Retrospective multicenter study of post-operative stenosis after stapled colorectal anastomosis
- Author
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Sartori A, De Luca M, Fiscon V, Frego M, Vigna S, Mazzeo A, Coco D, Agresta F, Finotti E, Antoniutti M, Carnio S, Elio A, Brunelli M, Ruffo G, Bertocchi E, Parini D, Losacco L, Poli F, Santoro G, Massani M, Ruffolo C, Cian E, Zanatta L, Genna M, Ballarin A, Rebonato M, Fontana M, Moretto G, Impellizzeri H, Merenda R, Margani G, Merigliano S, Baldan N, Ubiali P, Braini A, Balani A, Kosuta M, Infantino A, Giacomel G, Armatura G, Patauner S, de Manzini N, Palmisano S, Sorrentino M, Brizzolari M, Belluco C, Olivieri M, Lauro E, Scudo G, Valduga P, Brolese A, Pignata G, Andreucetti J, Caruso A, Zappalà F, Portale G ., Sartori, A, De Luca, M, Fiscon, V, Frego, M, Vigna, S, Mazzeo, A, Coco, D, Agresta, F, Finotti, E, Antoniutti, M, Carnio, S, Elio, A, Brunelli, M, Ruffo, G, Bertocchi, E, Parini, D, Losacco, L, Poli, F, Santoro, G, Massani, M, Ruffolo, C, Cian, E, Zanatta, L, Genna, M, Ballarin, A, Rebonato, M, Fontana, M, Moretto, G, Impellizzeri, H, Merenda, R, Margani, G, Merigliano, S, Baldan, N, Ubiali, P, Braini, A, Balani, A, Kosuta, M, Infantino, A, Giacomel, G, Armatura, G, Patauner, S, de Manzini, N, Palmisano, S, Sorrentino, M, Brizzolari, M, Belluco, C, Olivieri, M, Lauro, E, Scudo, G, Valduga, P, Brolese, A, Pignata, G, Andreucetti, J, Caruso, A, Zappalà, F, and Portale G, .
- Subjects
Male ,medicine.medical_specialty ,Colorectal anastomosis ,Constriction, Pathologic ,Anastomosis ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Risk Factors ,Surgical Stapling ,Prevalence ,medicine ,Humans ,Colorectal anastomosi ,Retrospective Studies ,Stenosis ,business.industry ,Stapled anastomosis ,Anastomosis, Surgical ,Retrospective cohort study ,Endoscopic dilatation ,medicine.disease ,Colorectal surgery ,Surgery ,Italy ,Multicenter study ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,Colorectal Neoplasms ,business ,Complication ,Stapled anastomosi - Abstract
Anastomotic stenosis after colorectal surgery is usually considered low-rate complication and often is under-reported in most studies. Few data are available on management strategies. The aim of the study was to assess the prevalence of stenosis after stapled colorectal anastomosis, performed either in elective or emergent setting, for benign or malignant disease, and to evaluate treatment profiles. This retrospective study was a survey conducted in a large Italian North-Eastern area including three regions (Triveneto), over a 12-month period (January–December 2015). Patients’ characteristics and surgical technique details were recorded, along with data on the prevalence of stenosis and its treatment. Patients with mid or low rectal resection and/or neoadjuvant chemo-radio therapy and/or diverting stoma were excluded. The study was promoted by the Italian Association of Hospital Surgeons (ACOI) and the Society of Surgeons of the Triveneto Region. Twenty-eight surgical units were enrolled in the survey, accounting for over 1400 patients studied. Fifty percent of the units performed laparoscopically > 70% of the colorectal resections and 7.5% of the procedures were emergent. Less than 60% of the units planned regular endoscopic follow-up after colorectal resection. Anastomotic stricture was recorded in 2% of the patients; 88% of the stenoses were diagnosed within 6 months from surgery. Only one anastomotic stricture required re-do surgery. The CANSAS study confirms that colorectal anastomotic stenosis is low-rate—but still present—complication. Treatment strategies vary according to surgeons’ and endoscopists’ preferences. Commonly endoscopic dilatation is preferred, but re-do surgery is required in some cases.
- Published
- 2019