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Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients

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Estaire Gómez, Mercedes & Greijdanu, Nynke G. & Wienholts, Kiedo & Ubels, Sander & Talboom, Kevin & Hannink, Gerjon & Wolthuis, Albert & de Lacy, F. Borja & Lefevre, Jérémie H. & Solomon, Michael & Frasson, Matteo & Rotholtz, Nicolas & Denost, Quentin & Perez, Rodrigo O. & Konishi, Tsuyoshi & Panis, Yves & Rutegård, Martin & Hompes, Roel & Rosman, Camiel & van Workum, Frans & Tanis, Pieter J. & de Wilt, Johannes H. W. & TENTACLE-Rectum Collaborative Group (2023-10 ) .Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients.

ISO 690

Estaire Gómez, Mercedes & Greijdanu, Nynke G. & Wienholts, Kiedo & Ubels, Sander & Talboom, Kevin & Hannink, Gerjon & Wolthuis, Albert & de Lacy, F. Borja & Lefevre, Jérémie H. & Solomon, Michael & Frasson, Matteo & Rotholtz, Nicolas & Denost, Quentin & Perez, Rodrigo O. & Konishi, Tsuyoshi & Panis, Yves & Rutegård, Martin & Hompes, Roel & Rosman, Camiel & van Workum, Frans & Tanis, Pieter J. & de Wilt, Johannes H. W. & TENTACLE-Rectum Collaborative Group. 2023-10 .Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients.

https://hdl.handle.net/20.500.12080/39626
dc.contributor.author Estaire Gómez, Mercedes
dc.contributor.author Greijdanu, Nynke G.
dc.contributor.author Wienholts, Kiedo
dc.contributor.author Ubels, Sander
dc.contributor.author Talboom, Kevin
dc.contributor.author Hannink, Gerjon
dc.contributor.author Wolthuis, Albert
dc.contributor.author de Lacy, F. Borja
dc.contributor.author Lefevre, Jérémie H.
dc.contributor.author Solomon, Michael
dc.contributor.author Frasson, Matteo
dc.contributor.author Rotholtz, Nicolas
dc.contributor.author Denost, Quentin
dc.contributor.author Perez, Rodrigo O.
dc.contributor.author Konishi, Tsuyoshi
dc.contributor.author Panis, Yves
dc.contributor.author Rutegård, Martin
dc.contributor.author Hompes, Roel
dc.contributor.author Rosman, Camiel
dc.contributor.author van Workum, Frans
dc.contributor.author Tanis, Pieter J.
dc.contributor.author de Wilt, Johannes H. W.
dc.contributor.author TENTACLE-Rectum Collaborative Group
dc.date.accessioned 2024-02-09T08:52:15Z
dc.date.available 2024-02-09T08:52:15Z
dc.date.created 2023-10
dc.date.issued 2023-10
dc.identifier.uri https://hdl.handle.net/20.500.12080/39626
dc.description.abstract Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/ secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2 : 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of ¿1.1 (95 per cent c.i. ¿9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (¿28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding. es_ES
dc.format application/pdf es_ES
dc.language eng es_ES
dc.rights CC-BY es_ES
dc.rights.uri http://creativecommons.org/licenses/by/4.0/deed.es es_ES
dc.title Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients es_ES
dc.type info:eu-repo/semantics/article es_ES
dc.rights.accessrights info:eu-repo/semantics/openAccess es_ES
dc.identifier.location N/A es_ES


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