Anastomosis configuration and technique following ileocaecal resection for Crohn’s disease: a multicentre study

Claudio Coco, Gianluca Rizzo, Francesco Sionne, Antonio Giuliani, Valerio Celentano, Gianluca Pellino, Antonino Spinelli, Francesco Selvaggi, Valerio Celentano, Gianluca Pellino, Lucio Selvaggi, Guido Sciaudone, Francesco Selvaggi, Matteo Rottoli, Gilberto Poggioli, Marta Tanzanu, Giuseppe Sica, Michela Campanelli, Mariano Cesare Giglio, Francesco ColomboGianluca Sampietro, Giulia Lamperti, Diego Foschi, Ferdinando Ficari, Ludovica Vacca, Marta Cricchio, Francesco Giudici, Roberto Peltrini, Andrea Manfreda, Luigi Bucci, Raffaele Galleano, Omar Ghazouani, Luigi Zorcolo, Simona Deidda, Angelo Restivo, Andrea Braini, Francesca Di Candido, Matteo Sacchi, Michele Carvello, Stefania Martorana, Antonino Spinelli, Giovanni Bordignon, Imerio Angriman, Angela Variola, Mirko Di Ruscio, Giuliano Barugola, Andrea Geccherle, Francesca Paola Tropeano, Gaetano Luglio, Diego Sasia, Marco Migliore, Maria Carmela Giuffrida, Enrico Marrano, Gianluigi Moretto, Gaetano Gallo, Giuseppina Vescio, Giuseppe Sammarco, Giovanni Terrosu, Giacomo Calini, Andrea Bondurri, Anna Maffioli, Gloria Zaffaroni, Andrea Resegotti, Massimiliano Mistrangelo, Fiorenzo Botti, Matteo Prati, Luigi Boni, Serena Perotti, Lucia Romano, Giorgio Maria Paolo Graziano, Luigi Pugliese, Andrea Pietrabissa, Antonino Spinelli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

1 Citazioni (Scopus)

Abstract

A limited ileocaecal resection is the most frequently performed procedure for ileocaecal CD and different anastomotic configurations and techniques have been described. This manuscript audited the different anastomotic techniques used in a national study and evaluated their influence on postoperative outcomes following ileocaecal resection for primary CD. This is a retrospective, multicentre, observational study promoted by the Italian Society of Colorectal Surgery (SICCR), including all adults undergoing elective ileocaecal resection for primary CD from June 2018 May 2019. Postoperative morbidity within 30 days of surgery was the primary endpoint. Postoperative length of hospital stay (LOS) and anastomotic leak rate were the secondary outcomes. 427 patients were included. The side to side anastomosis was the chosen configuration in 380 patients (89%). The stapled anastomotic (n = 286; 67%), techniques were preferred to hand-sewn (n = 141; 33%). Postoperative morbidity was 20.3% and anastomotic leak 3.7%. Anastomotic leak was independent of the type of anastomosis performed, while was associated with an ASA grade ≥ 3, presence of perianal disease and ileocolonic localization of disease. Four predictors of LOS were identified after multivariate analysis. The laparoscopic approach was the only associated with a reduced LOS (p = 0.017), while age, ASA grade ≥ 3 or administration of preoperative TPN were associated with increased LOS. The side to side was the most commonly used anastomotic configuration for ileocolic reconstruction following primary CD resection. There was no difference in postoperative morbidity according to anastomotic technique and configuration. Anastomotic leak was associated with ASA grade ≥ 3, a penetrating phenotype of disease and ileo-colonic distribution of CD.
Lingua originaleEnglish
pagine (da-a)149-156
Numero di pagine8
RivistaUpdates in Surgery
Volume73
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Colorectal surgery
  • Crohn’s disease
  • Ileocaecal resection
  • Inflammatory bowel disease
  • National audit

Fingerprint

Entra nei temi di ricerca di 'Anastomosis configuration and technique following ileocaecal resection for Crohn’s disease: a multicentre study'. Insieme formano una fingerprint unica.

Cita questo