Stapler size independently predicts postoperative complications following stapled ileocolic anastomosis: A retrospective cohort study-Reference-Cited by-同舟云学术

Stapler size independently predicts postoperative complications following stapled ileocolic anastomosis: A retrospective cohort study

Published:2023-12-29 Issue: Volume: Page:
ISSN:1462-8910
Container-title:Colorectal Disease
language:en
Short-container-title:Colorectal Disease

Author:

Garoufalia Zoe¹^ORCID,Emile Sameh Hany¹²^ORCID,Zhou Peige¹³,Gefen Rachel¹⁴^ORCID,Horesh Nir¹⁵^ORCID,Strassmann Victor¹^ORCID,Ray‐Offor Emeka¹⁶^ORCID,DaSilva Giovanna¹,Wexner Steven D.¹^ORCID

Affiliation:

1. Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida Weston Florida USA

2. General Surgery Department, Colorectal Surgery Unit Mansoura University Hospitals Mansoura Egypt

3. Georgia Colon and Rectal Surgical Associates Northside Hospital Atlanta Georgia USA

4. Department of General Surgery, Faculty of Medicine Hadassah Medical Organization, Hebrew University of Jerusalem Jerusalem Israel

5. Department of Surgery and Transplantations Sheba Medical Center Ramat Gan Israel

6. Department of Surgery University of Port Harcourt Choba Choba Nigeria

Abstract

AbstractAimStaplers used in ileocolic anastomosis construction differ in length and height. We assessed the impact of stapler type in creating ileocolic anastomoses on postoperative outcomes.MethodsThis retrospective cohort study of an Institutional Review Board approved database included patients who underwent laparoscopic right colectomy for cancer between January 2011 and August 2021. All patients had construction of extracorporeal antiperistaltic stapled ileocolic anastomosis using a linear cutting stapler. Main outcome measures were short‐term (<30 day) morbidity and mortality.ResultsIn all, 270 patients (136 men; median age 70.2 years) were included. A 75 mm stapler was used in 49 (18.1%) patients, 80 mm in 97 (35.9%) and 100 mm in 124 (45.9%). Blue cartridge (stapler height 3.5 mm) was used in 175 (64.5%) and green cartridge (4.8 mm) in 18 (7%) patients; this information was unavailable in 77 (28.5%) cases. Apical enterotomy closure was performed by linear stapler in 54% and linear cutting stapler in 46%. Apical staple line reinforcement or imbrication suturing was used in 26.3%. The overall postoperative complication rate was 28.9%. The anastomotic leak rate was 2.6%. Independent predictors of complications after laparoscopic right colectomy were older age (OR 1.03, 95%CI 1–1.06; P = 0.01), extended colectomy (OR 2.76, 95%CI 1.07–7.08; P = 0.035) and emergency surgery (OR 4.5, 95%CI 1.3–14.9; P = 0.014). A 100‐mm linear cutting stapler was an independent protective factor against postoperative complications (OR 0.3, 95%CI 0.18–0.85; P = 0.019). Stapler height and closure technique of apical enterotomy did not affect postoperative complications.ConclusionIndependent predictors of complications after laparoscopic right colectomy were older age, extended colectomy and emergency surgery. Using a 100 mm stapler was an independent protective factor against postoperative complications.

Publisher

Wiley

Subject

Gastroenterology

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/codi.16841

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