Insufficient Anastomoses in Sigmoideal and Rectal Resections. A Retrospective Study Conducted in a Surgical Clinic in Hradec Králové
Authors:
P. Motyčka 1; B. Doležal 2; A. Ferko 1,3; Z. Šubrt 1,3
Authors place of work:
Chirurgická klinika LF UK v Hradci Králové a FN Hradec Králové
přednosta: prof. MUDr. Z. Vobořil, DrSc.
1; 6. polní nemocnice Olomouc, velitel: pplk. MUDr. M. Kocvrlich
2; Katedra válečné chirurgie Fakulta vojenského zdravotnictví Hradec Králové Univerzity obrany Brno, vedoucí katedry: doc. MUDr. A. Ferko, CSc.
3
Published in the journal:
Rozhl. Chir., 2007, roč. 86, č. 1, s. 17-23.
Category:
Monothematic special - Original
Summary
Introduction:
Anastomotic insufficiency is the primary cause of postoperative morbidity and mortality following resection procedures of the large intestine and rectum.
Material and Methodology:
In the retrostpective study, the authors analysed rates of rectal and sigmoideal anastomotic insufficiencies in patients operated for rectal and sigmoideal carcinomas in the Faculty Hospital Surgical Clinic in Hradec Králové from 2000 to 2004. At the same time, the authors analysed risk factors of the insufficiencies. The subject of protective derivation stomies is discussed.
Results:
In the group with primary colorectal anastomosis, the anastomotic insufficiency occured in 11% of the group subjects, in the group with primary sigmoideal anastomosis in 9.1% of the group subjects. Out of the total of 215 subjects, the anastomotic insufficiency occurred in 23 subjects (10.7 %), 6 cases were fatal and the overall postoperative mortality was 1.56 % . In the anastomotic insufficiency group, it reached 13.04 %. The difference between the studied groups is significant (p<0,001, OR = 10.5).
Conclusion:
Postoperative mortality in sigmoideal and rectal resection procedures correlates with anastomotic insufficiency.
Key words:
anastomosis of the large intestine and rectum – anastomotic insufficiency
Zdroje
1. Makela, J. T., Kiviniemi, H., Laitinen, S. Risk factors for anastomotic leakage after left-sided colorectal resection with rectal anastomosis. Dis. Colon Rectum, 2003, 46, s. 653–660.
2. Law, W. L., Chu K. W. Anterior resection for rectal cancer with mesorectal excision: a prospective evaluation of 622 patients. Ann. Surg., 2004, 240 (2), s. 260–268.
3. Goldberg, S., Klas, J. V. Total mesorectal excision in the treatment of rectal cancer: a view from the USA. Semin. Surg. Oncol., 1998, 15 (2), s. 87–90.
4. Mangram, A. J., Horan, T. C., Pearson, M. L., Silver, L. Ch., Narcis, W. R. The hospital infection control practises advisory committee: Guideline for prevention of surgical site infection. Infection kontrol and hospital epidemiology, 1999, 20 (4), s. 247–278.
5. Eckman, C.,Kujath, P., Schiedeck, T. H. K., Shekarriz, H., Bruch, H. P. Anastomotic leakage following low anterior resection: results of standartized diagnostic and therapeutic approach. Int. J. Colorectal Dis., 2004, 19, s. 128–133.
6. Eriksen, M. T., Wibe, A., Norstein, J., Haffner, J., Wiig, J. N. Anastomotic leakage following routine mesorectal excision for rectal cancer in a national cohort of patiens. Colorectal disease, 2005, 7, s. 51–57.
7. Law, W. L., Chu, K. W., Ho, J. W. C., Chan, Ch. W. Risk factors for anastomotic leakage after low anterior resection with total mesorectal excision. Am. J. Surg., 2000, 179, s. 92–96.
8. Nesbakken, A., Nygaard, K., Westerheim, O., Lunde, O. C., Mala, T. Audit of intraoperative and early postoperative complications after introduction of mesorectal excision for rectal cancer. Eur. J. Surg., 2002, 168, s. 229–235.
9. Poon, R. T. P., Chu, K. W., Ho, J. W. Ch., Chan, Ch. W., Law, W. L., Wong, J. Prospective evaluation of selective defunctioning stoma for low anterior resection with total mesorectal excision. World J. Surg., 1999, 23, s. 463–468.
10. Marush, F., Koch, A., Schmidt, U., Geibetaler, S., Dralle, H., Saeger, H. D., Wolff, S., Nestler, G., Pross, M., Gastinger, I., Lippert, H. Value of a protective stoma in low anterior resections for rectal cancer. Dis. Colon Rectum, 2002, 45, s. 1164–1171.
11. Kanellos, I., Zacharakis, E., Christoforidis, E., Demetriades, H., Betsis, D. Low anterior resection without defunctioning stoma. Tech. Coloproctol., 2002, 6 (3), s. 153–156, discussion s. 156–157.
12. Rullier, E., Le Toux, N., Laureat, C., Garrelon, J. L., Parneix, M., Saric, J. Loop ileostomy versus loop colostomy for defunctioning low anastomoses during rectal cancer surgery. World J. Surg., 2001, 25(3), s. 274–277, discussion s. 277–278.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
2007 Číslo 1
- Spasmolytic Effect of Metamizole
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole in perioperative treatment in children under 14 years – results of a questionnaire survey from practice
Najčítanejšie v tomto čísle
- Liver Hemangiomas – Diagnostic and Treatment Strategy
- Undiagnosed Posterior Dislocations of the Shoulder Joint. A Preliminary Report
- Multiple Diverticulosis of the Small and Large Intestine. A Case Review
- Insufficient Anastomoses in Sigmoideal and Rectal Resections. A Retrospective Study Conducted in a Surgical Clinic in Hradec Králové