[Early postoperative complications of resection anastomosis in colonic and colorectal surgery. An analysis of 624 cases].
Six hundred twenty seven patients have been studied retrospectively to evaluate early complications after sewn or staples colonic anastomosis. Seventy four per cent of the patients underwent surgery because of malignant lesions and seventy seven per cent had an elective operation. Fourty seven per cent of the patients had a sewn anastomosis, 53% a stapled anastomosis. In elective surgery, most of the right hemicolectomies and partial proctocolectomies have been performed using stapler devices (p < 0.05). In emergency surgery, most of the anastomosis after partial and total colectomy have been hand sewn (p < 0.05). Operative mortality was 5.6%. It was significantly higher in older patients (> 80 years old) (p < 0.01) and after emergency operations (p < 0.0001). The rate of anastomotic leak was 3.7% and it was significantly higher after right hemicolectomy and partial proctocolectomies when anastomosis has been hand sewn compared to stapled anastomosis (p < 0.05). With regard to postoperative mortality, intra-abdominal abscess, intestinal obstruction, evisceration, pulmonary embolism and anastomotic stenosis 1.4% (global: after a 6 months follow-up) no significant differences have been observed between sewn and stapled anastomosis.
Cubertafond
P
P
Chirurgie générale, CHRU Limoges.
Cucchiaro
G
G
Lesourd-Pontonnier
F
F
Gainant
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003082:Colectomy; D003108:Colonic Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016737:Proctocolectomy, Restorative; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D013528:Surgical Staplers; D015996:Survival Rate; D013536:Suture Techniques / Q000009:adverse effects*; D013997:Time Factors
Complications postopératoires précoces des résections anastomoses en chirurgie colique ou colo-rectale. Analyse de 627 observations.