Evidence map›Paper›PMID 27270479›Full record

ArticleInternational journal of colorectal disease2016

Management of postoperative bleeding after laparoscopic left colectomy.

Romain Besson, Christos Christidis, Christine Denet, Laurence Bruyns, Hugues Levard, Brice Gayet, David Fuks, Thierry Perniceni

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In one paragraph

Article in International journal of colorectal disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 24 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Review
  5. Review
  6. The Association of Coloproctology of Great Britain and Ireland consensus guidelines in emergency colorectal surgery.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2021
    Article
  7. Article
  8. Article
  9. Article
  10. [Procedure-specific postoperative gastrointestinal hemorrhage].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2019
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Romain BessonDepartment of Digestive Disease, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.
Christos ChristidisDepartment of Digestive Disease, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.
Christine DenetDepartment of Digestive Disease, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.
Laurence BruynsDepartment of Digestive Disease, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.
Hugues LevardDepartment of Digestive Disease, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.
Brice GayetDepartment of Digestive Disease, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.
David FuksDepartment of Digestive Disease, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France. david.fuks@imm.fr.
Thierry PerniceniDepartment of Digestive Disease, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France.
Institute Mutualiste Montsouris · FRDélégation Paris 5 · FR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLower gastrointestinal bleeding after left colectomy is an uncommon complication that can lead to critical situation. Diagnostic and therapeutic manoeuvres should be performed in emergency with step-by-step strategy in order to avoid reoperation. This study aims to identify bleeding risks factors and describe a management strategy.

methodsThis is a retrospective study of patients who underwent left colectomy with primary anastomosis, from May 2004 to December 2013. We studied their demographic characteristics, surgical procedures and postoperative courses, more specifically hemorrhagic complications, management of bleeding and outcomes.

resultsHemorrhagic anastomotic complication occurred in 47 of the 729 (6.4 %) patients after left colectomy. Neither anticoagulant nor antiaggregant treatment was associated with postoperative bleeding. Among the 47 patients with bleeding, endoscopy was performed in 37 (78.7 %). At the time of endoscopy, the bleeding was spontaneously stopped in nine (24.3 %). Therapeutic strategy used clips in 10 (27.0 %) cases, mucosal sclerosis in 11 (29.7 %) and both in 7 (18.9 %) cases. Four (8.5 %) patients required blood transfusion for treatment of this gastrointestinal bleeding. Five (10.6 %) patients with bleeding were reoperated in this group because early endoscopy showed associated anastomotic leakage. Based on a multivariate analysis, stapled anastomosis and diverticular disease were independent factors associated with anastomotic bleeding.

conclusionsPostoperative anastomotic bleeding is not so uncommon after left colectomy. This complication should be particularly dreaded in patients who underwent stapled colorectal anastomosis for diverticular disease. With the use of clip or mucosal sclerosis, early endoscopy is a safe and efficient treatment.

Indexed as

AdultAgedAged, 80 and overAnastomosis, SurgicalColectomyColonoscopyDemographyFemaleHumansLaparoscopyMaleMiddle AgedMultivariate AnalysisPostoperative HemorrhageTreatment OutcomeYoung AdultAnastomotic bleedingColonoscopyHaemostasisLaparoscopic left colectomy

Identifiers

PMID27270479
OpenAlexW2417660956

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.