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  • Greijdanus, Nynke G.Department of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (författare)

Stoma-free survival after anastomotic leak following rectal cancer resection : worldwide cohort of 2470 patients

  • Artikel/kapitelEngelska2023

Förlag, utgivningsår, omfång ...

  • Oxford University Press,2023
  • electronicrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:umu-217021
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-217021URI
  • https://doi.org/10.1093/bjs/znad311DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:237819790URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:154917274URI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

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Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • BACKGROUND: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied.METHODS: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2 : 1).RESULTS: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of -1.1 (95 per cent c.i. -9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (-28 to 52) days).CONCLUSION: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding.

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Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Wienholts, KiedoDepartment of Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands; Cancer Centre Amsterdam, Treatment and Quality of Life, Amsterdam, Netherlands; Cancer Centre Amsterdam, Amsterdam, Netherlands (författare)
  • Ubels, SanderDepartment of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (författare)
  • Talboom, KevinDepartment of Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands; Cancer Centre Amsterdam, Treatment and Quality of Life, Amsterdam, Netherlands; Cancer Centre Amsterdam, Amsterdam, Netherlands (författare)
  • Hannink, GerjonDepartment of Medical Imaging, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (författare)
  • Wolthuis, AlbertDepartment of Surgery, UZ Leuven, Leuven, Belgium (författare)
  • de Lacy, F BorjaGastrointestinal Surgery Department, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain (författare)
  • Lefevre, Jérémie HDepartment of Digestive Surgery, Sorbonne Université, AP-HP, Hôpital Saint Antoine, Paris, France (författare)
  • Solomon, MichaelDepartment of Surgery, University of Sydney Central Clinical School, Camperdown, NSW, Australia (författare)
  • Frasson, MatteoDepartment of Surgery, Valencia University Hospital La Fe, Valencia, Spain (författare)
  • Rotholtz, NicolasDepartment of Surgery, Hospital Alemán, Buenos Aires, Argentina (författare)
  • Denost, QuentinClinique Tivoli, Bordeaux, France (författare)
  • Perez, Rodrigo O.Colorectal Surgery, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil (författare)
  • Konishi, TsuyoshiDepartment of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center, TX, Anderson, United States (författare)
  • Panis, YvesColorectal Surgery Centre, Groupe Hospitalier Privé Ambroise Paré-Hartmann, Neuilly Seine, France (författare)
  • Rutegård, Martin,1982-Umeå universitet,Institutionen för kirurgisk och perioperativ vetenskap,Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM)(Swepub:umu)maru0039 (författare)
  • Hompes, RoelDepartment of Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands; Cancer Centre Amsterdam, Treatment and Quality of Life, Amsterdam, Netherlands; Cancer Centre Amsterdam, Amsterdam, Netherlands (författare)
  • Rosman, CamielDepartment of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (författare)
  • van Workum, FransDepartment of Surgery, Canisius Wilhelmina Hospital, Nijmegen, Netherlands (författare)
  • Tanis, Pieter J.Department of Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands; Cancer Centre Amsterdam, Treatment and Quality of Life, Amsterdam, Netherlands; Cancer Centre Amsterdam, Amsterdam, Netherlands; Erasmus Medical Centre, Department of Surgical Oncology and Gastrointestinal Surgery, Rotterdam, Netherlands (författare)
  • de Wilt, Johannes H WDepartment of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, Netherlands (författare)
  • Tsuyoshi, T (författare)
  • Department of Surgery, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, NetherlandsDepartment of Surgery, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands; Cancer Centre Amsterdam, Treatment and Quality of Life, Amsterdam, Netherlands; Cancer Centre Amsterdam, Amsterdam, Netherlands (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:British Journal of Surgery: Oxford University Press110:12, s. 1863-18760007-13231365-2168

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