Sökning: WFRF:(Svensson Marie Louise)
> (2020-2024) >
Anastomotic Leakage...
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Rutegård, MartinUmeå University
(författare)
Anastomotic Leakage in Relation to Type of Mesorectal Excision and Defunctioning Stoma Use in Anterior Resection for Rectal Cancer
- Artikel/kapitelEngelska2024
Förlag, utgivningsår, omfång ...
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Springer,2024
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:oru-109872
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-109872URI
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https://doi.org/10.1097/DCR.0000000000003050DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:237994449URI
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https://gup.ub.gu.se/publication/331776URI
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https://lup.lub.lu.se/record/f75957bb-39d9-487b-bf86-bd40970451ceURI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:155235434URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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BACKGROUND: Anastomotic leakage after anterior resection for rectal cancer is more common after total compared to partial mesorectal excision but might be mitigated by a defunctioning stoma.OBJECTIVE: The aim is to assess how anastomotic leakage is affected by type of mesorectal excision and defunctioning stoma use.DESIGN: This is a retrospective multicenter cohort study evaluating anastomotic leakage after anterior resection. Multivariable Cox regression with hazard ratios and 95% confidence intervals was employed to contrast mesorectal excision types and defunctioning stoma use with respect to anastomotic leakage, with adjustment for confounding.SETTINGS: This multicenter study included patients from 11 Swedish hospitals between 2014 and 2018.PATIENTS: Patients who underwent anterior resection for rectal cancer were included.MAIN OUTCOMES MEASURES: Anastomotic leakage rates within and after 30 days of surgery are described up to one year after surgery.RESULTS: Anastomotic leakage occurred in 24.2% and 9.0% of 1126 patients operated with total and partial mesorectal excision, respectively. Partial compared to total mesorectal excision was associated with a reduction in leakage, with an adjusted HR of 0.46 (95% CI: 0.29-0.74). Early leak rates within 30 days were 14.9% with and 12.5% without a stoma, while late leak rates after 30 days were 7.5% with and 1.9% without a stoma. After adjustment, defunctioning stoma was associated with a lower early leak rate (HR 0.47; 95% CI: 0.28-0.77). However, the late leak rate was non-significantly higher in defunctioned patients (HR 1.69; 95% CI: 0.59-4.85).LIMITATIONS: This study was limited by its retrospective observational study design.CONCLUSIONS: Anastomotic leakage is common up to one year after anterior resection for rectal cancer, where partial mesorectal excision is associated with a lower leak rate. Defunctioning stomas seem to decrease the occurrence of leakage, though partially by only delaying the diagnosis.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Svensson, JohanUmeå University
(författare)
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Segelman, JosefinDepartment of Molecular Medicine and Surgery, Karolinska Institutet, and Department of Surgery, Ersta Hospital, Stockholm, Sweden
(författare)
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Matthiessen, Peter,1957-Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgery, Faculty of Medicine and Health, Örebro University, Örebro, Sweden(Swepub:oru)pemn
(författare)
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Lydrup, Marie LouiseLund University,Lunds universitet,Kirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital(Swepub:lu)med-msl
(författare)
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Park, JenniferGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Sahlgrenska Academy(Swepub:gu)xparje
(författare)
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RectoLeak Study Group, -
(bidragsgivare)
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Umeå UniversityDepartment of Molecular Medicine and Surgery, Karolinska Institutet, and Department of Surgery, Ersta Hospital, Stockholm, Sweden
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Diseases of the Colon & Rectum: Springer67:3, s. 398-4050012-37061530-0358
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