Evidence map›Paper›PMID 30267282›Full record

Observational studySurgical endoscopy2019

Perforation in the peritoneal cavity during transanal endoscopic microsurgery for rectal tumors: a real surgical complication with a challenging prognosis?

Xavier Serra-Aracil, Anna Pallisera-Lloveras, Laura Mora-Lopez, Pere Rebasa, Sheila Serra-Pla, Salvador Navarro

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
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

8 citing papers in PubMed.

  1. Article
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  4. Review
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  7. Observational
  8. Observational
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

6 authors.

Xavier Serra-AracilColoproctology Unit, General and Digestive Surgery Department,, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de Barcelona, Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain.
Anna Pallisera-LloverasColoproctology Unit, General and Digestive Surgery Department,, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de Barcelona, Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain. apallill@gmail.com.ORCID http://orcid.org/0000-0001-6572-7356
Laura Mora-LopezColoproctology Unit, General and Digestive Surgery Department,, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de Barcelona, Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain.
Pere RebasaColoproctology Unit, General and Digestive Surgery Department,, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de Barcelona, Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain.
Sheila Serra-PlaColoproctology Unit, General and Digestive Surgery Department,, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de Barcelona, Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain.
Salvador NavarroColoproctology Unit, General and Digestive Surgery Department,, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de Barcelona, Parc Taulí s/n, 08208, Sabadell, Barcelona, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerforation in the peritoneal cavity during transanal endoscopic microsurgery represents a major challenge. It is usually treated by primary suture, though some authors propose laparoscopic repair with or without ostomy. It is unclear whether perforation increases the risk of tumor dissemination.

aimThe purpose of the study is to assess the safety of primary suture of peritoneal perforation and the long-term risk of dissemination, also, to determine risk factors for perforation and to propose a predictive model for lesions with risk of perforation.

methodThis is an observational study with prospective data collection at Parc Taulí University Hospital, Sabadell, of patients undergoing transanal surgery with perforation into the peritoneal cavity from June 2004 to September 2017. The main variable is postoperative morbidity and mortality. The long-term follow-up of local recurrence and peritoneal tumor dissemination is described, and a quantitative predictive model for peritoneal cavity perforation is proposed.

resultsForty-five patients out of 686 (6.6%) presented perforation into the peritoneal cavity. Ten patients (22.2%) in the perforation group had morbidity, a rate similar to the non-perforated group. There was no peritoneal dissemination in patients with adenoma or with carcinoma treated with curative intent. In the quantitative predictive model, risk factors for perforation were proximal edge of tumor > 14 cm from anal verge (6 points), size ≥ 6 cm (2), age ≥ 85 years (4), anterior quadrant (3) , and sex (2). Total scores of ≥ 6 points predicted perforation.

conclusionsPrimary suture after peritoneal cavity perforation during transanal surgery is safe and does not increase the risk of recurrence or peritoneal dissemination. Our predictive model provides guidance regarding the risk of perforation and the need to suture the defect after transanal surgery resection.

Indexed as

Suture TechniquesAdenocarcinomaAdenomaAdultAgedAged, 80 and overClinical Decision RulesFemaleFollow-Up StudiesHumansIntraoperative ComplicationsMaleMiddle AgedPeritoneumPrognosisRectal NeoplasmsPeritoneal perforationTEMTEOTransanal endoscopic microsurgery

Identifiers

PMID30267282

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Registered trials

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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.