N Moreno-Lopez1, S Mvouama2, A Bourredjem3,4, I Fournel3,4, T Perrin5, A Flaris6, P Rat5, O Facy5. 1. Department of Digestive Surgery, Dijon University Hospital, Dijon, France. nathan.moreno-lopez@chu-dijon.fr. 2. Department of Radiology, Dijon University Hospital, Dijon, France. 3. Department of Statistics and Clinical Epidemiology, Dijon University Hospital, Dijon, France. 4. CIC INSERM 1432, Clinical Epidemiology Unit, University Hospital of Dijon, Dijon, France. 5. Department of Digestive Surgery, Dijon University Hospital, Dijon, France. 6. Department of Digestive Surgery, Lyon University Hospital, Pierre-Bénite, France.
Abstract
BACKGROUND: Computed tomography (CT) scan with rectal contrast enema (RCE-CT) could increase the detection rate of anastomotic leaks (AL) in the early postoperative period following colorectal surgery, compared to CT scan without RCE. The aim of this study was to assess the benefit of RCE-CT for the early diagnosis of AL following colorectal surgery. METHODS: Patients who had a RCE-CT for suspected AL in the early postoperative period following colorectal surgery with anastomosis between January 2012 and July 2019 at the Dijon University Hospital were retrospectively included. All images were reviewed by two independent observers who were blinded to the original report. The reviewers reported for each patient whether an AL was present or not in each imaging modality (CT scan, then RCE-CT). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were then calculated to determine the diagnostic performance of each modality. RESULTS: One hundred and thirty-nine patients were included. RCE-CT had an increased NPV compared to CT scan (82% vs 77% (p = 0.02) and 84% vs 68% (p < 0.0001) for observers 1 and 2, respectively). RCE-CT had an increased sensitivity compared to CT scan (79% vs 48% (p < 0.0001) for observer 2). RCE-CT had a significant lower false-negative rate for both observers: 18% vs 23% (p = 0.02) and 16% vs 32% (p < 0.0001). CONCLUSIONS: RCE-CT improved the detection rates of AL in the early period following colorectal surgery. RCE-CT should be recommended when a CT scan is negative and AL is still suspected.
BACKGROUND: Computed tomography (CT) scan with rectal contrast enema (RCE-CT) could increase the detection rate of anastomotic leaks (AL) in the early postoperative period following colorectal surgery, compared to CT scan without RCE. The aim of this study was to assess the benefit of RCE-CT for the early diagnosis of AL following colorectal surgery. METHODS: Patients who had a RCE-CT for suspected AL in the early postoperative period following colorectal surgery with anastomosis between January 2012 and July 2019 at the Dijon University Hospital were retrospectively included. All images were reviewed by two independent observers who were blinded to the original report. The reviewers reported for each patient whether an AL was present or not in each imaging modality (CT scan, then RCE-CT). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were then calculated to determine the diagnostic performance of each modality. RESULTS: One hundred and thirty-nine patients were included. RCE-CT had an increased NPV compared to CT scan (82% vs 77% (p = 0.02) and 84% vs 68% (p < 0.0001) for observers 1 and 2, respectively). RCE-CT had an increased sensitivity compared to CT scan (79% vs 48% (p < 0.0001) for observer 2). RCE-CT had a significant lower false-negative rate for both observers: 18% vs 23% (p = 0.02) and 16% vs 32% (p < 0.0001). CONCLUSIONS: RCE-CT improved the detection rates of AL in the early period following colorectal surgery. RCE-CT should be recommended when a CT scan is negative and AL is still suspected.
Authors: Verena N N Kornmann; Bert van Ramshorst; Anke B Smits; Thomas L Bollen; Djamila Boerma Journal: Int J Colorectal Dis Date: 2013-12-20 Impact factor: 2.571
Authors: Olivier Facy; Brice Paquette; David Orry; Christine Binquet; David Masson; Aurélie Bouvier; Isabelle Fournel; Pierre E Charles; Patrick Rat; Pablo Ortega-Deballon Journal: Ann Surg Date: 2016-05 Impact factor: 12.969
Authors: Pablo Ortega-Deballon; François Radais; Olivier Facy; Philippe d'Athis; David Masson; Pierre E Charles; Nicolas Cheynel; Jean-Pierre Favre; Patrick Rat Journal: World J Surg Date: 2010-04 Impact factor: 3.352
Authors: Olivier Facy; Brice Paquette; David Orry; Nicolas Santucci; Paul Rat; Patrick Rat; Christine Binquet; Pablo Ortega-Deballon Journal: Int J Colorectal Dis Date: 2017-04-06 Impact factor: 2.571