Observational studyUpdates in surgery2025
Open versus laparoscopic right colectomy: does the initial approach impact on management and outcomein anastomotic leakage? A multicenter cohort study.
Observational study in Updates in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- From Recognition to Prevention: Modern Approaches to Complication Reduction in Colorectal Surgery.Journal of clinical medicine · 2026Review
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Authors and funding
19 authors.
Funding
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Abstract
backgroundAnastomotic leakage still represents the most feared complication in colorectal surgery. However, there is limited data focusing on management and how this affects outcome in case of leakage following open versus laparoscopic right colectomy. We, therefore, performed an observational multicenter study addressing this issue.
methodsData of patients undergoing elective right colectomy for benign and malignant disease using an open or laparoscopic approach were collected in seven colorectal units among Austria between January 2010 and December 2019. Patients undergoing emergency surgery or suffering from Crohn's disease with chronic anastomotic fistula were excluded. Demographic, peri- and postoperative data were analyzed retrospectively.
resultsDuring the study, a total of 3446 patients were operated on using an open (n = 2282, 66.2%) or laparoscopic (n = 1164, 33.8%) approach. Anastomotic leak rates accounted for 2.8% (65/2281) and 3.2% (37/1165), respectively (p = .588). Age at operation (p < .001), initial surgical approach (open versus laparoscopic; p = .034) and the Mannheim Peritonitis Index (MPI; p < .001) at revision represented independent risk factors for mortality. We divided the surgical strategy during revision into three subgroups: suturing of leak (SD), formation of new anastomosis (NA) or fecal diversion with or without formation of new anastomosis (FD). SD, NA or FD had no influence on clinical outcome and mortality (p = .599). The initial approach had no influence on which strategy was used later, but time to revision was significantly shorter following initial laparoscopic resection (6.2 versus 8.8 days, p = .008). Leak-associated mortality was lower in the minimally invasive group (8.1% vs 23.1%; p = .057).
conclusionsTiming of revision and not the surgical strategy (± fecal diversion) has an impact on the clinical outcome of patients with a leak following right colectomy. An initial laparoscopic approach may lead to an earlier revision resulting in a lower mortality rate.
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