scholarly journals Tailored treatment of anastomotic leak after rectal cancer surgery according to the presence of a diverting stoma

2020 ◽  
Vol 99 (3) ◽  
pp. 171
Author(s):  
Chang Hyun Kim ◽  
Jaram Lee ◽  
Han Deok Kwak ◽  
Soo Young Lee ◽  
Jae Kyun Ju ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leak ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Tailored Treatment ◽  
Diverting Stoma

Volume-outcome Relationship in Rectal Cancer Surgery

2021 ◽  
Author(s):  
Leandro Siragusa ◽  
Bruno Sensi ◽  
Danilo Vinci ◽  
Marzia Franceschilli ◽  
Giulia Bagaglini ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Blood Transfusion ◽  
Hospital Stay ◽  
Anastomotic Leak ◽  
Operative Time ◽  
Cancer Surgery ◽  
Leak Rate ◽  
Perioperative Outcomes ◽  
Rectal Cancer Surgery ◽  
Anastomotic Leak Rate

Abstract Introduction Hospital centralization effect is reported to lower complications and mortality for high risk and complex surgery operations, including colorectal surgery. However, no linear relation between volume and outcome has been demonstrated. Aim of the study was to evaluate the increased surgical volume effect on early outcomes of patient undergoing laparoscopic restorative anterior rectal resection (ARR).Methods A retrospective analysis of all consecutive patients undergoing ARR with primary anastomosis between November 2016 and December 2020 after centralization of rectal cancer cases in an academic Centre. Short outcomes are compared to those of patients operated in the same unit during the previous 10 years before service centralization. The primary outcome was anastomotic leak rate. Mean operative time, need of conversion, postoperative use of blood transfusion, radicality, in-hospital stay, number and type of complications, readmission and reoperation rate, mortality and 1-year and stoma persistence rates were evaluated as secondary outcomes.Results 86 patients were operated in the study period and outcomes compared to those of 101 patients operated during the previous ten years. Difference in volume of surgery was significant between the two periods (p 0.019) and the estimated leak rate was significantly lower in the higher volume unit (p 0.05). Mean operative time, need of conversion, postoperative use of blood transfusion and in-hospital stay (p <0.05) were also significantly reduced in Group A.Conclusion: This study suggests that the shift toward higher volume in rectal cancer surgery is associated to decreased anastomotic leak rate. Potentiation of lower volume surgical units may yield optimal perioperative outcomes.

Diverting stoma in rectal cancer surgery. A retrospective study of 329 patients from Japanese cancer centers

2010 ◽  
Vol 26 (1) ◽  
pp. 79-87 ◽  
Author(s):  
Akio Shiomi ◽  
Masaaki Ito ◽  
Norio Saito ◽  
Masayuki Ohue ◽  
Takashi Hirai ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Retrospective Study ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Cancer Centers ◽  
Diverting Stoma

Long-term Oncological Outcomes Following Anastomotic Leak in Rectal Cancer Surgery

2020 ◽  
Vol 63 (6) ◽  
pp. 769-777 ◽  
Author(s):  
Jacopo Crippa ◽  
Emilie Duchalais ◽  
Nikolaos Machairas ◽  
Amit Merchea ◽  
Scott R. Kelley ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leak ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Oncological Outcomes

A new aortoiliac calcification scoring system to predict grade C anastomotic leak following rectal cancer surgery

2020 ◽  
Vol 24 (8) ◽  
pp. 843-849
Author(s):  
S. Y. Lee ◽  
S.-S. Yeom ◽  
C. H. Kim ◽  
Y. J. Kim ◽  
H. R. Kim
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leak ◽  
Scoring System ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery

scholarly journals Volume-outcome relationship in rectal cancer surgery

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
L. Siragusa ◽  
B. Sensi ◽  
D. Vinci ◽  
M. Franceschilli ◽  
C. Pathirannehalage Don ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Blood Transfusion ◽  
Hospital Stay ◽  
Anastomotic Leak ◽  
Operative Time ◽  
Cancer Surgery ◽  
Leak Rate ◽  
Perioperative Outcomes ◽  
Rectal Cancer Surgery ◽  
Anastomotic Leak Rate

Abstract Introduction Hospital centralization effect is reported to lower complications and mortality for high risk and complex surgery operations, including colorectal surgery. However, no linear relation between volume and outcome has been demonstrated. Aim of the study was to evaluate the increased surgical volume effect on early outcomes of patient undergoing laparoscopic restorative anterior rectal resection (ARR). Methods A retrospective analysis of all consecutive patients undergoing ARR with primary anastomosis between November 2016 and December 2020 after centralization of rectal cancer cases in an academic Centre. Short-term outcomes are compared to those of patients operated in the same unit during the previous 10 years before service centralization. The primary outcome was estimated anastomotic leak rate. Mean operative time, need of conversion, postoperative use of blood transfusion, radicality, in-hospital stay, number and type of complications, readmission and reoperation rate, mortality and 1-year and stoma persistence rates were evaluated as secondary outcomes. Results 86 patients were operated in the study period and outcomes compared to those of 101 patients operated during the previous ten years. Difference in volume of surgery was significant between the two periods (p 0.019) and the estimated leak rate was significantly lower in the higher volume unit (p 0.047). Mean operative time, need of conversion, postoperative use of blood transfusion and in-hospital stay (p < 0.05) were also significantly reduced in Group A. Conclusion This study suggests that the shift toward higher volume in rectal cancer surgery is associated to decreased anastomotic leak rate. Potentiation of lower volume surgical units may yield optimal perioperative outcomes.

Diverting Stoma Complications in Rectal Cancer Surgery.

2021 ◽  
Author(s):  
Masaya Kawai ◽  
Kazuhiro Sakamoto ◽  
Kumpei Honjo ◽  
Yu Okazawa ◽  
Rina Takahashi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Bowel Obstruction ◽  
Cancer Surgery ◽  
Perioperative Outcomes ◽  
Rectal Cancer Surgery ◽  
Intergroup Difference ◽  
Stoma Complications ◽  
Diverting Stoma ◽  
Grade 3

Abstract Background: A consensus regarding diverting stoma (DS) construction in rectal cancer surgery was reached to avoid reoperation related to anastomotic leakage. However, the incidence of stoma-related complications (SRCs) remains high. In this study, we aimed to examine the perioperative outcomes of DS construction in patients who underwent sphincter-preserving surgery for rectal cancer.Methods: Between 2005 and 2017, we included 400 participants who underwent radical sphincter-preserving surgery for rectal cancer. These participants were divided into two groups: DS (+) and DS (-) groups, and the outcomes, including postoperative complications (POCs), were compared.Results and conclusion: The incidence of ileus was higher in the DS (+) group (P<0.01); however, no patient showed anastomotic leakage of grade3. Furthermore, early SRCs were observed in 33 patients (21.6%) and bowel obstruction -related stoma outlet syndrome occurred in 19 patients (12.4%). There was no intergroup difference in the incidence of grade 3b POCs. However, the most common reason for reoperation was different in the two groups: anastomotic leakage in 91.7% of patients with 3b POCs in the DS (-) group, and SRCs in 85.7% of patients with 3b POCs in the DS (+) group.In patients with DS, there was an increase in the incidence of overall POCs, severe POCs (grade 3), and bowel obstruction, including stoma outlet syndrome, compared to patients without DS. Therefore, it is important to construct an appropriate DS to avoid SRCs and to be more selective in assigning patients for DS construction.

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