Stenosis of the colorectal anastomosis after surgery for diverticulitis: A national retrospective cohort study Article Swipe

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Jean‐François Hamel , Arnaud Alvès , Laura Beyer-Bergot , Philippe Zerbib , Valérie Bridoux , Gilles Manceau , Yves Panís , Étienne Buscail , Iman Khaoudy , Martin Gaillard , Manon Viennet , Alexandre Thobie , Benjamin Menahem , Clarisse Eveno , Catherine Bonnel , Jean‐Yves Mabrut , Bogdan Badic , Camille Godet , Yassine Eid , Émilie Duchalais , Zaher Lakkis , Eddy Cotte , A. Laforest , Véronique Defourneaux , Léon Maggiorri , Lionel Rebibo , Niki Christou , Ali Talal , Diane Mège , Mathilde Aubert , Cécile Bonnamy , Adeline Germain , F. Mauvais , C. Trésallet , Jean Roudié , Alexis Laurent , Bertrand Trilling , Martin Bertrand , Damien Massalou , B. Romain , Hadrien Tranchart , Mehdi Ouaïssi , Alexandra Pellegrin , Charles Sabbagh , Aurélien Venara ·

YOU? · · 2024 · Open Access · · DOI: https://doi.org/10.1111/codi.17076

Aim The aim of this work was to investigate the association between early postoperative anastomotic leakage or pelvic abscess (AL/PA) and symptomatic anastomotic stenosis (SAS) in patients after surgery for left colonic diverticulitis. Method This is a retrospective study based on a national cohort of diverticulitis surgery patients carried out by the Association Française de Chirurgie . The assessment was performed using path analyses. The database included 7053 patients operated on for colonic diverticulitis, with surgery performed electively or in an emergency, by open access or laparoscopically. Patients were excluded from the study analysis where there was (i) right‐sided diverticulitis (the initial database included all consecutive patients operated on for colonic diverticulitis), (ii) no anastomosis was performed during the first procedure or (iii) missing information about stenosis, postoperative abscess or anastomotic leakage. Results Of the 4441 patients who were included in the final analysis, AL/PA occurred in 327 (4.6%) and SAS occurred in 82 (1.8%). AL/PA was a significant independent factor associated with a risk for occurrence of SAS (OR = 3.41, 95% CI = 1.75–6.66), as was the case for diverting stoma for ≥100 days (OR = 2.77, 95% CI = 1.32–5.82), while central vessel ligation proximal to the inferior mesenteric artery was associated with a reduced risk (OR = 0.41; 95% CI = 0.19–0.88). Diverting stoma created for <100 days or ≥100 days was also a factor associated with a risk for AL/PA (OR = 3.08, 95% CI = 2–4.75 and OR = 12.95, 95% CI = 9.11–18.50). Interestingly, no significant association between radiological drainage or surgical management of AL/PA and SAS could be highlighted. Conclusion AL/PA was an independent factor associated with the risk for SAS. The treatment of AL/PA was not associated with the occurrence of anastomotic stenosis. Diverting stoma was associated with an increased risk of both AL/PA and SAS, especially if it was left for ≥100 days. Physicians must be aware of this information in order to decide on the best course of action when creating a stoma during elective or emergency surgery.

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Concepts

Medicine Diverticulitis Anastomosis Stenosis Retrospective cohort study Surgery Inferior mesenteric artery Inferior mesenteric vein Diverticulosis Stoma (medicine) General surgery Internal medicine Portal vein

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Type: article
Language: en
Landing Page: https://doi.org/10.1111/codi.17076
PDF: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/codi.17076
OA Status: bronze
Cited By: 3
References: 31
Related Works: 10
OpenAlex ID: https://openalex.org/W4399790756

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OpenAlex ID: https://openalex.org/W4399790756

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DOI: https://doi.org/10.1111/codi.17076

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Title: Stenosis of the colorectal anastomosis after surgery for diverticulitis: A national retrospective cohort study

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Type: article

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Language: en

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Publication year: 2024

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Publication date: 2024-06-17

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Authors: Jean‐François Hamel, Arnaud Alvès, Laura Beyer-Bergot, Philippe Zerbib, Valérie Bridoux, Gilles Manceau, Yves Panís, Étienne Buscail, Iman Khaoudy, Martin Gaillard, Manon Viennet, Alexandre Thobie, Benjamin Menahem, Clarisse Eveno, Catherine Bonnel, Jean‐Yves Mabrut, Bogdan Badic, Camille Godet, Yassine Eid, Émilie Duchalais, Zaher Lakkis, Eddy Cotte, A. Laforest, Véronique Defourneaux, Léon Maggiorri, Lionel Rebibo, Niki Christou, Ali Talal, Diane Mège, Mathilde Aubert, Cécile Bonnamy, Adeline Germain, F. Mauvais, C. Trésallet, Jean Roudié, Alexis Laurent, Bertrand Trilling, Martin Bertrand, Damien Massalou, B. Romain, Hadrien Tranchart, Mehdi Ouaïssi, Alexandra Pellegrin, Charles Sabbagh, Aurélien Venara

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Landing page: https://doi.org/10.1111/codi.17076

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PDF URL: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/codi.17076

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OA status: bronze

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OA URL: https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/codi.17076

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Concepts: Medicine, Diverticulitis, Anastomosis, Stenosis, Retrospective cohort study, Surgery, Inferior mesenteric artery, Inferior mesenteric vein, Diverticulosis, Stoma (medicine), General surgery, Internal medicine, Portal vein

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Cited by: 3

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