AIM: This study aimed at testing feasibility of a standardised postoperative surveillance protocol to reduce delay in the diagnosis of anastomotic leakage (AL) and, subsequently, mortality. MATERIAL AND METHODS: Patient files of patients operated between 1996 and 1999 were reviewed and used as historical controls (n=1066). As a result, a protocol for standardised post-operative surveillance was designed using easily accessible, clinical parameters. Between August 2004 and August 2006, all operated patients with a colorectal anastomosis (n=223) were prospectively subjected to this standardised surveillance. RESULTS: AL was diagnosed in 7.0% of patients in the historical control group and 9.4% of patients in the standardised surveillance group. AL mortality decreased from 39% to 24% with standardised surveillance (n.s.). The delay in AL diagnosis was significantly reduced during standardised surveillance (4 versus 1.5 days, p=0.01), which was confirmed in the multivariate analysis. CONCLUSION: With non-standardised postoperative monitoring, AL was associated with a high mortality rate. Patients were subjected to several additional tests, which were not primarily useful to diagnose AL. Standardised postoperative surveillance for AL was introduced successfully and resulted in a shorter delay between the first signs and symptoms to the confirmation of AL.
AIM: This study aimed at testing feasibility of a standardised postoperative surveillance protocol to reduce delay in the diagnosis of anastomotic leakage (AL) and, subsequently, mortality. MATERIAL AND METHODS:Patient files of patients operated between 1996 and 1999 were reviewed and used as historical controls (n=1066). As a result, a protocol for standardised post-operative surveillance was designed using easily accessible, clinical parameters. Between August 2004 and August 2006, all operated patients with a colorectal anastomosis (n=223) were prospectively subjected to this standardised surveillance. RESULTS: AL was diagnosed in 7.0% of patients in the historical control group and 9.4% of patients in the standardised surveillance group. AL mortality decreased from 39% to 24% with standardised surveillance (n.s.). The delay in AL diagnosis was significantly reduced during standardised surveillance (4 versus 1.5 days, p=0.01), which was confirmed in the multivariate analysis. CONCLUSION: With non-standardised postoperative monitoring, AL was associated with a high mortality rate. Patients were subjected to several additional tests, which were not primarily useful to diagnose AL. Standardised postoperative surveillance for AL was introduced successfully and resulted in a shorter delay between the first signs and symptoms to the confirmation of AL.
Authors: Sami A Chadi; Abe Fingerhut; Mariana Berho; Steven R DeMeester; James W Fleshman; Neil H Hyman; David A Margolin; Joseph E Martz; Elisabeth C McLemore; Daniela Molena; Martin I Newman; Janice F Rafferty; Bashar Safar; Anthony J Senagore; Oded Zmora; Steven D Wexner Journal: J Gastrointest Surg Date: 2016-09-16 Impact factor: 3.452
Authors: Niels Komen; Juliette Slieker; Paul Willemsen; Guido Mannaerts; Piet Pattyn; Tom Karsten; Hans de Wilt; Erwin van der Harst; Willem van Leeuwen; Christine Decaestecker; Hans Jeekel; Johan F Lange Journal: Int J Colorectal Dis Date: 2014-01 Impact factor: 2.571
Authors: S Giuratrabocchetta; M Rinaldi; F Cuccia; M Lemma; D Piscitelli; P Polidoro; D F Altomare Journal: Tech Coloproctol Date: 2011-01-25 Impact factor: 3.781
Authors: Jeroen L A van Vugt; Kostan W Reisinger; Joep P M Derikx; Djamila Boerma; Jan H M B Stoot Journal: World J Gastroenterol Date: 2014-09-21 Impact factor: 5.742