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Anastomotic tension "Bridging": a risk factor for anastomotic leakage following low anterior resection.
- Source :
-
Surgical endoscopy [Surg Endosc] 2024 Sep; Vol. 38 (9), pp. 4916-4925. Date of Electronic Publication: 2024 Jul 08. - Publication Year :
- 2024
-
Abstract
- Background: Excessive tension at the anastomosis contributes to anastomotic leakage (AL) in low anterior resection (LAR). However, the specific tension has not been measured. We assessed whether "Bridging," characterized by the proximal colon resembling a suspension bridge above the pelvic floor, is a significant risk factor for AL following LAR for rectal cancer.<br />Methods: This retrospective study reviewed the medical records and laparoscopic videos of 102 patients who underwent laparoscopic LAR using the double stapling technique at Yachiyo Hospital between January 2014 and December 2023. Patients were classified based on whether they had Bridging (tight or sagging) or were in a Resting state of the proximal colon, and the association between Bridging and AL was examined.<br />Results: AL occurred in 31.3% of the Tight Bridging group, 20% of the Sagging Bridging group, and 2.2% of the Resting group (P = 0.002). The incidence of AL was significantly higher in patients with Bridging than in those without (23.2% vs. 2.2%, P = 0.003). Multivariate analysis revealed that Bridging is an independent risk factor for AL (odds ratio = 6.97; 95% confidence interval: 1.45-33.6; P = 0.016).<br />Conclusions: The presence of Bridging is a significant risk factor for AL following LAR for rectal cancer, suggesting the need for implementing preventive measures in patients with this condition.<br /> (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Subjects :
- Humans
Female
Retrospective Studies
Male
Risk Factors
Middle Aged
Aged
Proctectomy adverse effects
Proctectomy methods
Surgical Stapling adverse effects
Adult
Aged, 80 and over
Colon surgery
Anastomotic Leak etiology
Anastomotic Leak epidemiology
Rectal Neoplasms surgery
Anastomosis, Surgical adverse effects
Anastomosis, Surgical methods
Laparoscopy adverse effects
Laparoscopy methods
Subjects
Details
- Language :
- English
- ISSN :
- 1432-2218
- Volume :
- 38
- Issue :
- 9
- Database :
- MEDLINE
- Journal :
- Surgical endoscopy
- Publication Type :
- Academic Journal
- Accession number :
- 38977498
- Full Text :
- https://doi.org/10.1007/s00464-024-11008-1