ArticleWorld journal of surgery2018
Changes in Clinical Practice Reduce the Rate of Anastomotic Leakage After Colorectal Resections.
Article in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 21 citations in OpenAlex.
- From Recognition to Prevention: Modern Approaches to Complication Reduction in Colorectal Surgery.Journal of clinical medicine · 2026Review
- Incidence of anastomotic leakage using powered circular staplers versus manual circular staplers for left colorectal anastomosis: a cost-effectiveness analysis.Techniques in coloproctology · 2024Observational
- Does mechanical bowel preparation really prevent complications after colorectal surgery depending on the lesion localization? A myth or fact?Turkish journal of surgery · 2023Article
- Impact of the novel powered circular stapler on risk of anastomotic leakage in colorectal anastomosis: a propensity score-matched study.Techniques in coloproctology · 2021Article
- Reinforcement of Colonic Anastomosis with Improved Ultrafine Nanofibrous Patch: Experiment on Pig.Biomedicines · 2021Article
- Review of Colonic Anastomotic Leakage and Prevention Methods.Journal of clinical medicine · 2020Review
- Safety of anastomotic techniques and consequences of anastomotic leakage in patients with colorectal cancer: a single surgeon experience.Medicine and pharmacy reports · 2020Article
- Risk Factors and Preventive Measures for Anastomotic Leak in Colorectal Cancer.Technology in cancer research & treatmentReview
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAnastomotic leakage is a serious clinical problem after colorectal resections and is associated with a significantly increased length of stay, morbidity and mortality. The aim of the present study was to evaluate the effect of changes in clinical practice on anastomotic leakage rate after colorectal resections.
methodsRetrospective cohort study based on prospectively collected data. All 894 patients with primary anastomosis after colorectal resection at a tertiary referral center between 2006 and 2013 were analyzed. Changes in clinical practice aiming at reducing the rate of anastomotic leakages were introduced in January 2010 and were characterized by exclusion of perioperative nonsteroidal anti-inflammatory drugs, introduction of intra-operative goal-directed fluid therapy and avoidance of primary anastomoses in emergency resections. The study population was divided into two groups, one treated before and one after the introduction of changes in clinical practice. Groups were compared regarding patient characteristics and incidence of anastomotic leakage.
resultsThe cumulative incidence of anastomotic leakage after colorectal resections decreased from 10.0% (41 of 409) to 4.5% (22 of 485) after changing clinical practice, relative risk 0.45 (95% CI 0.27-0.75, p = 0.002). The adjusted odds ratio was 0.45 (0.26-0.78, p = 0.004). A separate analysis showed a decrease after colon resections from 9.1% (23 of 252) to 4.5% (14 of 310), relative risk 0.49 (0.26-0.94, p = 0.039), and from 11.5% (18 of 157) to 4.6% (8 of 175) after rectal resections, relative risk 0.40 (0.18-0.89, p = 0.024).
conclusionImplementing a structured change of clinical practice can significantly reduce the anastomotic leakage rate after colorectal resections.
trial registrationClinical trial registration number: ACTRN12617001497392.
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