Introduction
Methods
Study design, setting and participants
Changes in clinical practice
Data source and definition of anastomotic leakage
Surgical techniques
Management of anastomotic leakage
Enhanced recovery protocol
Statistics
Results
Participants
Variable | Period 1 (n = 409) | Period 2 (n = 485) |
p value |
---|---|---|---|
Sex ratio (M:F) | 234:175 | 262:223 | 0.35 |
Age* (years) | 66 (26–89) | 65 (17–97) | 0.54 |
Type of pathology | 0.69 | ||
Cancer | 347 (85) | 412 (85) | |
IBD | 55 (13) | 61 (13) | |
Other | 7 (2) | 12 (2) | |
Type of resection | 0.49 | ||
Colon | 252 (62) | 310 (64) | |
Rectal | 157 (38) | 175 (36) | |
Multivisceral resection | 128 (31) | 163 (34) | 0.47 |
Protective ostomy | |||
Colon | 21 (8) | 26 (8) | 1.00 |
Rectum | 116 (74) | 137 (78) | 0.39 |
Emergency resection | |||
Colon | 36 (14) | 11 (4) | <0.01 |
Rectum | 6 (4) | 0 (0) | 0.01 |
Cumulative incidence of anastomotic leakage
Type of resection | Period 1 | Period 2 |
p value | |||
---|---|---|---|---|---|---|
n
| Leakage |
n
| Leakage | RR (CI) | ||
Colon and rectum | 409 | 41 (10.0) | 485 | 22 (4.5) | 0.45 (0.27–0.75) | 0.002 |
Colon | 252 | 23 (9.1) | 310 | 14 (4.5) | 0.49 (0.26–0.94) | 0.039 |
Rectum | 157 | 18 (11.5) | 175 | 8 (4.6) | 0.40 (0.18–0.89) | 0.024 |
Logistic regression analysis
Variable | Odds ratio | 95% confidence interval |
p value |
---|---|---|---|
Men | 1 (ref) | ||
Women | 0.65 | 0.38–1.11 | 0.114 |
Age (years) | 1.01 | 0.99–1.03 | 0.211 |
Pathology | |||
Cancer | 1 (ref) | ||
IBD | 0.81 | 0.36–1.81 | 0.603 |
Other | n.a. | n.a. | n.a. |
Type of resection | |||
Colon | 1 (ref) | ||
Rectal | 1.21 | 0.72–2.03 | 0.482 |
No multivisceral resection | 1 (ref) | ||
Multivisceral resection | 1.50 | 0.89–2.53 | 0.128 |
Elective resection | 1 (ref) | ||
Emergency resection | 1.40 | 0.54–3.66 | 0.489 |
No protective ostomy | 1 (ref) | ||
Protective ostomy | 0.78 | 0.44–1.37 | 0.386 |
Period 1 (2006–2009) | 1 (ref) | ||
Period 2 (2010–2013) | 0.43 | 0.25–0.73 | 0.002 |
Length of stay
Group |
n
| LOS | Range |
p
|
---|---|---|---|---|
Period 1 | 409 | 10 | 2–190 | |
Period 2 | 485 | 9 | 3–119 | 0.043 |
Leakage | 63 | 25 | 6–190 | |
No leakage | 831 | 9 | 2–167 | <0.001 |