Stenosis of the colorectal anastomosis after surgery for diverticulitis: A national retrospective cohort study - Université de Picardie Jules Verne Accéder directement au contenu
Article Dans Une Revue Colorectal Disease Année : 2024

Stenosis of the colorectal anastomosis after surgery for diverticulitis: A national retrospective cohort study

1 CHU Angers - Centre Hospitalier Universitaire d'Angers
2 CHU Trousseau [Tours]
3 LIRIC - Lille Inflammation Research International Center - U 995
4 ADEN - Nutrition, Inflammation et axe Microbiote-Intestin-Cerveau
5 IRIB - Institute for Research and Innovation in Biomedicine
6 UNIROUEN - Université de Rouen Normandie
7 Service de Chirurgie Digestive [CHU Rouen]
8 CHU Pitié-Salpêtrière [AP-HP]
9 Clinique Hartmann [Neuilly-sur-Seine]
10 IRSD - Institut de Recherche en Santé Digestive
11 Groupe Hospitalier du Havre
12 Chirurgie digestive, hépato-biliaire et endocrinienne [CHU Cochin]
13 Service de Chirurgie Digestive, Cancérologique, Générale, Endocrinienne et Urgences (CHU de Dijon)
14 CH Avranches-Granville - Centre Hospitalier Avranches-Granville
15 Service de Chirurgie Viscérale et Digestive [CHU Caen]
16 Hôpital Claude Huriez [Lille]
17 CANTHER - Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277
18 Groupe Hospitalier Nord Essonne [Longjumeau]
19 Hôpital de la Croix-Rousse [CHU - HCL]
20 CGV - BREST - Service de Chirurgie Générale et Viscérale
21 CH Saint-Lô - Centre Hospitalier Mémorial France États-Unis de Saint-Lô
22 Hôpital privé du Pays d'Auge-site de Lisieux
23 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
24 CHRU Besançon - Centre Hospitalier Régional Universitaire de Besançon
25 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
26 IMM - Institut Mutualiste de Montsouris
27 Hôpital Sud [CHU Rennes]
28 AP-HP - Hopital Saint-Louis [AP-HP]
29 Universite Paris VII
30 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
31 CHU Limoges
32 CH Argentan - Centre Hospitalier Fernand-Léger d'Argentan
33 AMU - Aix Marseille Université
34 TIMONE - Hôpital de la Timone [CHU - APHM]
35 CH Aunay-Bayeux - Centre Hospitalier Aunay-Bayeux
36 Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy]
37 Beauvais Hospital
38 Hôpital Avicenne [AP-HP]
39 Université Sorbonne Paris Nord
40 Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique]
41 CHIC - Centre Hospitalier Intercommunal de Créteil
42 University Grenoble Alpes, Grenoble University Hospital
43 Department of Pharmacy, Nîmes University Hospital, Nimes, France.
44 Hôpital l'Archet
45 UNS - Université Nice Sophia Antipolis (1965 - 2019)
46 Hôpital de Hautepierre [Strasbourg]
47 UNISTRA - Université de Strasbourg
48 AP-HP - Hôpital Antoine Béclère [Clamart]
49 Hôpital Trousseau
50 UT - Université de Tours
51 Chirurgie digestive [CHU Amiens]
52 SSPC - Simplification des soins chez les patients complexes - UR UPJV 7518
53 UA - Université d'Angers
54 TENS - The Enteric Nervous System in gut and brain disorders [U1235]
55 CHU d'Angers [Département Urgences]
Laura Beyer-Bergot
  • Fonction : Auteur
Niki Christou
  • Fonction : Auteur

Résumé

Aim The aim of this work was to investigate the association between early postoperative anastomotic leakage or pelvic abscess (AL/PA) and symptomatic anastomotic stenosis (SAS) in patients after surgery for left colonic diverticulitis. Method This is a retrospective study based on a national cohort of diverticulitis surgery patients carried out by the Association Française de Chirurgie . The assessment was performed using path analyses. The database included 7053 patients operated on for colonic diverticulitis, with surgery performed electively or in an emergency, by open access or laparoscopically. Patients were excluded from the study analysis where there was (i) right‐sided diverticulitis (the initial database included all consecutive patients operated on for colonic diverticulitis), (ii) no anastomosis was performed during the first procedure or (iii) missing information about stenosis, postoperative abscess or anastomotic leakage. Results Of the 4441 patients who were included in the final analysis, AL/PA occurred in 327 (4.6%) and SAS occurred in 82 (1.8%). AL/PA was a significant independent factor associated with a risk for occurrence of SAS (OR = 3.41, 95% CI = 1.75–6.66), as was the case for diverting stoma for ≥100 days (OR = 2.77, 95% CI = 1.32–5.82), while central vessel ligation proximal to the inferior mesenteric artery was associated with a reduced risk (OR = 0.41; 95% CI = 0.19–0.88). Diverting stoma created for <100 days or ≥100 days was also a factor associated with a risk for AL/PA (OR = 3.08, 95% CI = 2–4.75 and OR = 12.95, 95% CI = 9.11–18.50). Interestingly, no significant association between radiological drainage or surgical management of AL/PA and SAS could be highlighted. Conclusion AL/PA was an independent factor associated with the risk for SAS. The treatment of AL/PA was not associated with the occurrence of anastomotic stenosis. Diverting stoma was associated with an increased risk of both AL/PA and SAS, especially if it was left for ≥100 days. Physicians must be aware of this information in order to decide on the best course of action when creating a stoma during elective or emergency surgery.

Dates et versions

hal-04619190 , version 1 (20-06-2024)

Identifiants

Citer

Jean‐francois Hamel, Arnaud Alves, Laura Beyer-Bergot, Philippe Zerbib, Valérie Bridoux, et al.. Stenosis of the colorectal anastomosis after surgery for diverticulitis: A national retrospective cohort study. Colorectal Disease, 2024, 26 (7), pp.1437-1446. ⟨10.1111/codi.17076⟩. ⟨hal-04619190⟩
5 Consultations
0 Téléchargements

Altmetric

Partager

Gmail Mastodon Facebook X LinkedIn More