000134994 001__ 134994
000134994 005__ 20240705134228.0
000134994 0247_ $$2doi$$a10.1007/s00423-022-02745-9
000134994 0248_ $$2sideral$$a138439
000134994 037__ $$aART-2023-138439
000134994 041__ $$aeng
000134994 100__ $$0(orcid)0000-0003-4173-7212$$aGracia, J.A.$$uUniversidad de Zaragoza
000134994 245__ $$aTransanal full-thickness excision for rectal neoplasm: is it advisable to leave the defect open?
000134994 260__ $$c2023
000134994 5060_ $$aAccess copy available to the general public$$fUnrestricted
000134994 5203_ $$aPurpose
After a full-thickness total wall excision of a rectal tumor, suturing the defect is generally recommended. Recently, due to various contradictory studies, there is a trend to leave the defects open. Therefore, this study aimed to determine whether leaving the defect open is an adequate management strategy compared with suturing it closed based on postoperative outcomes and recurrences.
Methods
A retrospective review of our prospectively maintained database was conducted. Adult patients who underwent transanal surgery for rectal neoplasm in our institution from 1997 to 2019 were analyzed. Patients were divided into two groups: sutured (group A) or unsutured (group B) rectal defect. The primary outcomes were morbidity (early and late) and recurrence.
Results
In total, 404 (239 men) patients were analyzed, 143 (35.4%) from group A and 261 (64.6%) from group B. No differences were observed in tumor size, distance from the anal verge or operation time. The overall incidence of complications was significantly higher in patients from group B, which nearly double the rate of group A. With a mean follow-up of 58 (range, 12–96) months, seven patients presented with a rectal stricture, all of them from group B.
Conclusions
We acknowledge the occasional impossibility of closing the defect in patients who undergo local excision; however, when it is possible, the present data suggest that there may be advantages to suturing the defect closed.
000134994 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000134994 592__ $$a0.758$$b2023
000134994 593__ $$aSurgery$$c2023$$dQ1
000134994 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000134994 700__ $$0(orcid)0000-0003-2671-061X$$aElia, M.$$uUniversidad de Zaragoza
000134994 700__ $$0(orcid)0000-0002-2274-1593$$aCordoba, E.$$uUniversidad de Zaragoza
000134994 700__ $$aGonzalo, A.
000134994 700__ $$0(orcid)0000-0001-7964-1166$$aRamirez, J.M.$$uUniversidad de Zaragoza
000134994 7102_ $$11013$$2090$$aUniversidad de Zaragoza$$bDpto. Cirugía$$cÁrea Cirugía
000134994 773__ $$g408 (2023), 11 [7 pp.]$$tLangenbeck's Archives of Surgery$$x1435-2451
000134994 8564_ $$s478710$$uhttps://zaguan.unizar.es/record/134994/files/texto_completo.pdf$$yVersión publicada
000134994 8564_ $$s2357607$$uhttps://zaguan.unizar.es/record/134994/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000134994 909CO $$ooai:zaguan.unizar.es:134994$$particulos$$pdriver
000134994 951__ $$a2024-07-05-12:56:09
000134994 980__ $$aARTICLE