Guillén MJ, García FIG, Rodríguez SJF

Language: Spanish
References: 24
Page: 29-33
PDF size: 274.39 Kb.

ABSTRACT

Introduction: intestinal anastomosis is a common surgery with a high rate of complications that justifies the study of risk factors. Objective: to determine whether prolonged surgical time is a risk factor for the incidence of colorectal anastomotic dehiscence. Material and methods: retrospective, analytical study, patients with colorectal anastomosis from January 2022 to January 2024, by sampling consecutive cases. They are described in means, standard deviations, medians and interquartile ranges. Results: anastomotic dehiscence occurred in 20% of surgeries lasting less than 180 minutes and in 21% of those lasting longer than 180 minutes, with no significant differences between both groups (p = 0.889). Conclusion: no significance was found between prolonged surgical time and anastomotic dehiscence. However, the study demonstrated a risk in patients with a history of two or more previous surgeries, so preventive measures could be suggested in the future.

REFERENCES

1. Sripathi S, Khan MI, Patel N, Meda RT, Nuguru SP, Rachakonda S. Factors contributing to anastomotic leakage following colorectal surgery: Why, when, and who leaks? Cureus. 2022; 14: e29964.

2. Tomori K, Eto K, Haruki K, Sugano H, Imaizumi Y, Kumamoto T, et al. Comparison of strength of anastomosis between four different techniques for colorectal surgery. Anticancer Res. 2020; 40: 1891-1896.

3. Ong SY, Tan ZZX, Teo NZ, Ngu JCY. Surgical considerations for the "perfect" colorectal anastomosis. J Gastrointest Oncol. 2023; 14: 2243-2248.

4. Meyer J, Naiken S, Christou N, Liot E, Toso C, Buchs NC, et al. Reducing anastomotic leak in colorectal surgery: The old dogmas and the new challenges. World J Gastroenterol. 2019; 25: 5017-5025.

5. Zarnescu EC, Zarnescu NO, Costea R. Updates of risk factors for anastomotic leakage after colorectal surgery. Diagnostics (Basel). 2021; 11: 2382.

6. Ghuman A, Ganga R, Parisi Severino N, Krizzuk D, Li QZ, Wexner SD, et al. Clinical factors contributing to anastomotic leak after mid-to-high colorectal anastomosis. Am Surg. 2023; 89: 778-783.

7. Liu Y, Li B, Wei Y. New understanding of gut microbiota and colorectal anastomosis leak: a collaborative review of the current concepts. Front Cell Infect Microbiol. 2022; 12: 1022603.

8. Tsalikidis C, Mitsala A, Mentonis VI, Romanidis K, Pappas-Gogos G, Tsaroucha AK, et al. Predictive factors for anastomotic leakage following colorectal cancer surgery: where are we and where are we going? Curr Oncol. 2023; 30: 3111-3137.

9. Wako G, Teshome H, Abebe E. Colorectal anastomosis leak: Rate , risk factors and outcome in a tertiary teaching hospital, Addis Ababa Ethiopia, a five year retrospective study. Ethiop J Health Sci. 1970; 29: 767.

10. Do Woong Choi J, Kwik C, Vivekanandamoorthy N, Shanmugalingam A, Allan L, Gavegan F, et al. Is preoperative hypoalbuminemia or hypoproteinemia a reliable marker for anastomotic leakage risk in patients undergoing elective colorectal surgery in an enhanced recovery after surgery (ERAS) program? Int J Colorectal Dis. 2023; 38: 152.

11. Rudnicki Y, White I, Tiomkin V, Lahav L, Raguan B, Avital S. Evaluación intraoperatoria de la integridad anastomótica colorrectal: una comparación de las pruebas de fuga de aire y de fuga de tinte. Tecnología Coloproctol. 2021; 25: 841-847.

12. Nordholm-Carstensen A, Schnack-Rasmussen M, Krarup P-M. Increased leak rates following stapled versus handsewn ileocolic anastomosis in patients with right-sided colon cancer: A nationwide cohort study. Dis Colon Rectum. 2019; 62: 542-548.

13. Espin E, Vallribera F, Kreisler E, Biondo S. Clinical impact of leakage in patients with handsewn vs stapled anastomosis after right hemicolectomy: a retrospective study. Colorectal Dis. 2020; 22: 1286-1292.

14. Huang E. Constructing a sound anastomosis. Semin Colon Rectal Surg. 2022; 33: 100878.

15. Unruh KR, Bastawrous AL, Kanneganti S, Kaplan JA, Moonka R, Rashidi L, et al. The impact of prolonged operative time associated with minimally invasive colorectal surgery: A report from the Surgical Care Outcomes Assessment Program. Dis Colon Rectum. 2024; 67: 302-312.

16. Jasarovic D, Stojanovic D, Mitrovic N, Stevanovic D. Anastomotic leak after colorectal cancer surgery - risk factors in 21th century. J BUON. 2020; 25: 2199-2204.

17. Gray M, Marland JRK, Murray AF, Argyle DJ, Potter MA. Predictive and diagnostic biomarkers of anastomotic leakage: a precision medicine approach for colorectal cancer patients. J Pers Med. 2021; 11: 47.

18. Bostrom P, Svensson J, Brorsson C, Rutegard M. Early postoperative pain as a marker of anastomotic leakage in colorectal cancer surgery. Int J Colorectal Dis. 2021; 36: 1955-1963.

19. Kassahun CW, Melekamu S, Alemu MT. Clinical anastomosis leakage and associated factors among patients who had intestinal anastomosis in northwest referral hospitals, Ethiopia. PLoS One. 2022; 17: e0275536.

20. Campos-Campos SF, Ureña-Álvarez JA, Fuentes-Orozco C, Barbosa-Camacho FJ, Barrera-López FJ, Jiménez-Ley VB, et al. Dehiscencia de anastomosis gastrointestinal. Qué hacer y qué no hacer. Cir Gen. 2019; 41: 243-255.

21. Challine A, Lefévre JH, Creavin B, Benoit O, Chafai N, Debove C, et al. Can a local drainage salvage a failed colorectal or coloanal anastomosis? A prospective cohort of 54 patients. Dis Colon Rectum. 2020; 63: 93-100.

22. Manzini JL. Declaración de Helsinki: principios éticos para la investigación médica sobre sujetos humanos. Acta Bioeth. 2000; 6: 321-334.

23. Sánchez-López JD, Cambil-Martín J, Luque-Martínez F. Informe Belmont. Una crítica teórica y práctica actualizada. J Health Qual Res. 2021; 36: 179-180.

24. Kühn F, Hasenhütl S, Hofmann F, Wirth U, Drefs M, Werner J, et al. Endoscopic vacuum therapy for left-sided colorectal anastomotic leak without fecal diversion. Dis Colon Rectum. 2022; 65: 421-428.