Evidence map›Paper›PMID 30719528›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2020

A differentiated approach to repeat small-bowel anastomoses in patients with postoperative peritonitis: a prospective cohort study.

Andrey N Zharikov, Vladimir G Lubyansky, Andrey A Zharikov

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03690687 (Delayed Small-Bowel Anastomosis in Patients With Postoperative Peritonitis Due to Nontraumatic Small-Bowel Perforation and Anastomotic Leak), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 31% 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.

NCT03690687 unknown statusnot on this map

Delayed Small-Bowel Anastomosis in Patients With Postoperative Peritonitis Due to Nontraumatic Small-Bowel Perforation and Anastomotic Leak: Cohort Study

TypeobservationalSponsorAndrey Nikolayevich ZharikovRan2010 to 2025Enrolled114ConditionsPostoperative Peritonitis, Anastomotic Leakage, Intestinal Perforation SmallArmsPrimary anastomosis, Delayed anastomosis, Enterostomy
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 3 citations in OpenAlex.

  1. Small bowel anastomosis in peritonitis compared to enterostomy formation: a systematic review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Pooled it
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

3 authors at 1 institution in 1 country.

Andrey N ZharikovChair of Neymark Departmental Surgery and Hospital Surgery, Altai State Medical University, Prospect Lenina 40, Barnaul, Altai Krai, 656038, Russia. zhar67@mail.ru.ORCID http://orcid.org/0000-0003-4292-4781
Vladimir G LubyanskyChair of Neymark Departmental Surgery and Hospital Surgery, Altai State Medical University, Prospect Lenina 40, Barnaul, Altai Krai, 656038, Russia.
Andrey A ZharikovChair of Neymark Departmental Surgery and Hospital Surgery, Altai State Medical University, Prospect Lenina 40, Barnaul, Altai Krai, 656038, Russia.
Altai State Medical University · RU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative peritonitis still remains the cause of a high mortality rate in emergency abdominal surgery. Here we aimed to evaluate the efficacy of different surgical strategies for small-bowel perforations that resulted in postoperative peritonitis.

methodsSurgical management results for 140 patients with postoperative peritonitis due to small-bowel perforations, necrosis and anastomotic leakage were comparatively analyzed. Using the APACHE-II and MPI scoring systems, different surgeon attitudes were examined in three patient groups (primary anastomosis, delayed anastomosis, and enterostomy).

resultsThe surgical approach in patient group I (n = 47, APACHE-II 11.7 ± 1.2, MPI 14.7 ± 1.3) involved the closure of small-bowel perforations or small-bowel resection to place primary anastomosis. The mortality rate was 17%. Patient group II (n = 48, APACHE-II 16.8 ± 0.7, MPI 19.3 ± 0.3) underwent delayed small-bowel anastomosis during planned relaparotomies. The mortality rate was 18.8%. Because patients in patient group III (n = 45, APACHE-II 22.3 ± 1.3, MPI 24.6 ± 1.2) were in very critical condition, anastomoses were not placed after bowel resection, and the surgical procedure was completed with enterostomy. The highest mortality rate of 37.8% was documented in this patient group.

conclusionThe differentiated surgical approach undertaken herein using delayed small-bowel anastomosis in more serious patients with postoperative peritonitis was able to mitigate the risk of recurrent anastomotic leaks and was not accompanied by a considerable rise in mortality. The mortality for primary repair and delayed primary closure was basically the same (17.0% and 18.8%, p = 0.03); however, delayed anastomosis in the patients with postoperative peritonitis at higher APACHE-II and MPI scores for severity of illness showed 15.1% less complications in the form of anastomotic leaks (p = 0.04).

Indexed as

Intestine, SmallAnastomosis, SurgicalAnastomotic LeakAPACHEEnterostomyFemaleHumansIntestinal PerforationMaleMiddle AgedNecrosisPeritonitisPostoperative ComplicationsProspective StudiesReoperationDelayed anastomosisNontraumatic small-bowel perforationPostoperative peritonitisPrimary anastomosisSmall-bowel anastomotic leakage

Identifiers

PMID30719528
OpenAlexW2914552163

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.