High tie in anterior resection for rectal cancer confers no increased risk of anastomotic leakage
Background: It is controversial whether division of the inferior mesenteric artery close to the aorta influences the risk of anastomotic leakage, especially in the elderly and unfit. This population‐based study was carried out to evaluate the independent association between a high arterial ligation...
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Published in | British journal of surgery Vol. 99; no. 1; pp. 127 - 132 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
Published |
Chichester, UK
John Wiley & Sons, Ltd
01.01.2012
Wiley |
Subjects | |
Online Access | Get full text |
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Summary: | Background:
It is controversial whether division of the inferior mesenteric artery close to the aorta influences the risk of anastomotic leakage, especially in the elderly and unfit. This population‐based study was carried out to evaluate the independent association between a high arterial ligation and anastomotic leakage in anterior resection for rectal cancer.
Methods:
All patients who had anterior resection for rectal cancer from 2007 to 2009 inclusive were identified in the Swedish Colorectal Cancer Registry. The association between high tie and anastomotic leakage was evaluated in a logistic regression model, with adjustment for confounders. Stratification was performed for co‐morbidity as judged by the American Society of Anesthesiologists (ASA) classification.
Results:
Symptomatic anastomotic leakage occurred in 81 (9·9 per cent) of 818 patients with a high tie and 108 (9·8 per cent) of 1101 without. Overall, the use of a high tie was not associated with a higher risk of anastomotic leakage (odds ratio (OR) 1·00, 95 per cent confidence interval 0·72 to 1·39). There was no increased risk in patients classifed as ASA grade I or II (OR 0·97, 0·69 to 1·35), or in those graded ASA III or IV (OR 1·26, 0·58 to 2·75).
Conclusion:
In the present population‐based setting, use of a high tie was not associated with an increased rate of symptomatic anastomotic leakage. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Leakage not associated with high tie |
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Bibliography: | ArticleID:BJS7712 istex:CBCE7F1943088ACD399ADC314143B9AB6A9F5CD7 ark:/67375/WNG-8XGDWHHR-N Presented to the 2011 Colorectal Tripartite Meeting, Cairns, Queensland, Australia, July 2011, and the Annual Meeting of the Swedish Surgical Society, Visby, Sweden, August 2011, and published in abstract form as Colorectal Dis 2011; 13(Suppl 5): 16 and Svensk Kirurgi 2011; 69(Suppl 1): 28 13 69 Svensk Kirurgi Colorectal Dis Presented to the 2011 Colorectal Tripartite Meeting, Cairns, Queensland, Australia, July 2011, and the Annual Meeting of the Swedish Surgical Society, Visby, Sweden, August 2011, and published in abstract form as (Suppl 5): 16 and 2011 (Suppl 1): 28 ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0007-1323 1365-2168 1365-2168 |
DOI: | 10.1002/bjs.7712 |