J Tankel1, H Gilshtein2, M Neymark2, M Zuckerman3, R Spira3, S Yellinek3. 1. Department of General Surgery, Shaare Zedek Medical Center, Faculty of Medicine, The Hebrew University School of Medicine, 12 Shmeul Bait Street, 9103102, Jerusalem, Israel. jamietankel@hotmail.com. 2. Division of General Surgery, Rambam Health Care Campus, Haifa, Israel. 3. Department of General Surgery, Shaare Zedek Medical Center, Faculty of Medicine, The Hebrew University School of Medicine, 12 Shmeul Bait Street, 9103102, Jerusalem, Israel.
Abstract
BACKGROUND: Anastomotic leak following elective sigmoidectomy performed due to sigmoid volvulus (SV) is a devastating complication. The aim of this study was to identify the incidence and risk factors associated with leak in this specific group of patients. METHODS: A retrospective study was performed at two university-affiliated tertiary centres in Israel. All consecutive patients between January 2014 and April 2020 treated for SV with elective sigmoidectomy and primary anastomosis were reviewed and those suffering from anastomotic leak identified. Factors associated with this complication were assessed using univariate analysis and odds ratios subsequently calculated. RESULTS: Of the 99 patients initially identified, 58 were included in the study group [45 males and 13 females (77.6% versus 22.4% respectively) mean age 67.4 years, range 13-97]. There were 10 anastomotic leaks identified (17.2%). On univariate analysis recurrent decompression (OR 8.28, p = 0.027), age > 80-years (OR 6.88, p = 0.027), open rather than laparoscopic surgery (OR = 5.83, p = 0.005) and ASA grade 3/4 (OR 0.132, p = 0.023) were significantly associated with anastomotic leak. Male sex approached but not reach statistical significance. CONCLUSIONS: Recurrent endoscopic decompression, age > 80 years, open surgery and ASA grade 3/4 are associated with anastomotic leak and these patients should be considered for formation of a colostomy instead. If an anastomosis is performed, patients should be appropriately counselled and monitored in the perioperative period.
BACKGROUND: Anastomotic leak following elective sigmoidectomy performed due to sigmoid volvulus (SV) is a devastating complication. The aim of this study was to identify the incidence and risk factors associated with leak in this specific group of patients. METHODS: A retrospective study was performed at two university-affiliated tertiary centres in Israel. All consecutive patients between January 2014 and April 2020 treated for SV with elective sigmoidectomy and primary anastomosis were reviewed and those suffering from anastomotic leak identified. Factors associated with this complication were assessed using univariate analysis and odds ratios subsequently calculated. RESULTS: Of the 99 patients initially identified, 58 were included in the study group [45 males and 13 females (77.6% versus 22.4% respectively) mean age 67.4 years, range 13-97]. There were 10 anastomotic leaks identified (17.2%). On univariate analysis recurrent decompression (OR 8.28, p = 0.027), age > 80-years (OR 6.88, p = 0.027), open rather than laparoscopic surgery (OR = 5.83, p = 0.005) and ASA grade 3/4 (OR 0.132, p = 0.023) were significantly associated with anastomotic leak. Male sex approached but not reach statistical significance. CONCLUSIONS: Recurrent endoscopic decompression, age > 80 years, open surgery and ASA grade 3/4 are associated with anastomotic leak and these patients should be considered for formation of a colostomy instead. If an anastomosis is performed, patients should be appropriately counselled and monitored in the perioperative period.
Authors: Jon D Vogel; Daniel L Feingold; David B Stewart; Jacquelyn S Turner; Marylise Boutros; Jonathan Chun; Scott R Steele Journal: Dis Colon Rectum Date: 2016-07 Impact factor: 4.585
Authors: A H Gama; J Haddad; O Simonsen; P Warde; A Manzione; J Hyppölito da Silva; M Ioshimoto; D Cutait; A Raia Journal: Dis Colon Rectum Date: 1976 May-Jun Impact factor: 4.585
Authors: Hussein A Heis; Kamal E Bani-Hani; Daher K Rabadi; Mwaffaq A Elheis; Bayan K Bani-Hani; Tagleb S Mazahreh; Ziyad A Bataineh; Nabeil A Al-Zoubi; Mohammed S Obeidallah Journal: World J Surg Date: 2008-03 Impact factor: 3.352