000132776 001__ 132776 000132776 005__ 20240315113107.0 000132776 0247_ $$2doi$$a10.1111/codi.14308 000132776 0248_ $$2sideral$$a107843 000132776 037__ $$aART-2018-107843 000132776 041__ $$aeng 000132776 100__ $$aOn behalf of the 2015 European Society of Coloproctology Collaborating Group 000132776 245__ $$aThe impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multi-centre, prospective audit 000132776 260__ $$c2018 000132776 5203_ $$aAim: There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure. Method: Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side-to-side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak. Results: One thousand three hundred and forty-seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54–1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52–1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46–4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04–2.64, P = 0.04). Conclusion: This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high-risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration. 000132776 540__ $$9info:eu-repo/semantics/openAccess$$aAll rights reserved$$uhttp://www.europeana.eu/rights/rr-f/ 000132776 590__ $$a2.997$$b2018 000132776 591__ $$aSURGERY$$b49 / 203 = 0.241$$c2018$$dQ1$$eT1 000132776 591__ $$aGASTROENTEROLOGY & HEPATOLOGY$$b45 / 84 = 0.536$$c2018$$dQ3$$eT2 000132776 592__ $$a1.208$$b2018 000132776 593__ $$aGastroenterology$$c2018$$dQ1 000132776 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000132776 700__ $$0(orcid)0000-0001-7964-1166$$aRamírez Rodríguez, J.M.$$uUniversidad de Zaragoza 000132776 700__ $$aEchazarreta-Gallego, E. 000132776 7102_ $$11004$$2090$$aUniversidad de Zaragoza$$bDpto. Cirugía,Ginecol.Obstetr.$$cÁrea Cirugía 000132776 773__ $$g20, 11 (2018), 1028-1040$$pColorectal Disease$$tColorectal Disease$$x1462-8910 000132776 8564_ $$s294750$$uhttps://zaguan.unizar.es/record/132776/files/texto_completo.pdf$$yVersión publicada 000132776 8564_ $$s2265362$$uhttps://zaguan.unizar.es/record/132776/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000132776 909CO $$ooai:zaguan.unizar.es:132776$$particulos$$pdriver 000132776 951__ $$a2024-03-15-08:49:15 000132776 980__ $$aARTICLE