Colorectal surgery in Italy: a snapshot from the iCral study group

被引：19

作者：

Catarci, Marco ^{[2
]}

Ruffo, Giacomo ^{[3
]}

Borghi, Felice ^{[4
]}

Patriti, Alberto ^{[5
]}

Delrio, Paolo ^{[6
]}

Scatizzi, Marco ^{[7
]}

Mancini, Stefano ^{[8
]}

Garulli, Gianluca ^{[9
]}

Carrara, Alessandro ^{[10
]}

Pirozzi, Felice ^{[11
]}

Scabini, Stefano ^{[12
]}

Liverani, Andrea ^{[13
]}

Baiocchi, Gianluca ^{[14
,15
]}

Campagnacci, Roberto ^{[16
]}

Muratore, Andrea ^{[17
]}

Longo, Graziano ^{[18
]}

Caricato, Marco ^{[19
]}

Palmieri, Raffaele Macarone ^{[20
]}

Vettoretto, Nereo ^{[21
]}

Ceccaroni, Marcello ^{[22
]}

Ciano, Paolo ^{[2
]}

Bertocchi, Elisa ^{[3
,22
]}

Cianflocca, Desiree ^{[4
]}

Lambertini, Margherita ^{[5
]}

Pace, Ugo ^{[6
]}

Baraghini, Maddalena ^{[7
]}

Pandolfini, Lorenzo ^{[7
]}

Angeloni, Riccardo ^{[8
]}

Lucchi, Andrea ^{[9
]}

Martorelli, Giacomo ^{[9
]}

Tirone, Giuseppe ^{[10
]}

Motter, Michele ^{[23
]}

Sciuto, Antonio ^{[11
]}

Martino, Antonio ^{[12
]}

Luzzi, Andrea Pierre ^{[12
]}

di Cesare, Tatiana ^{[13
]}

Molfino, Sarah ^{[14
,15
]}

Maurizi, Angela ^{[16
]}

Marsanic, Patrizia ^{[17
]}

Tomassini, Federico ^{[18
]}

Santoni, Simone ^{[18
]}

Capolupo, Gabriella Teresa ^{[19
]}

Amodio, Pietro ^{[20
]}

Arici, Elisa ^{[21
]}

Ruggeri, Benedetta ^{[24
]}

Guercioni, Gianluca ^{[2
]}

机构：

[1] UOC Chirurg Gen, Ascoli Piceno, Italy

[2] Osped C & G Mazzoni, Gen Surg Unit, ASUR Marche AV5 Via Iris Snc, I-63100 Ascoli Piceno, Italy

[3] Sacro Cuore Hosp, Gen Surg Unit, Negrar, VR, Italy

[4] Santa Croce & Carle Hosp, Dept Surg, Cuneo, Italy

[5] Marche Nord Hosp, Dept Surg, Pesaro E Fano, PU, Italy

[6] G Pascale Fdn, IRCCS, Natl Canc Inst, Colorectal Surg Oncol, Naples, Italy

[7] Santo Stefano Hosp, Gen & Oncol Surg Unit, Prato, FI, Italy

[8] San Filippo Neri Hosp, Gen & Oncol Surg Unit, Rome, Italy

[9] Ceccarini Hosp, Gen Surg Unit, Riccione, RN, Italy

[10] Santa Chiara Hosp, Dept Surg, Trento, Italy

[11] Casa Sollievo Sofferenza Hosp, Abdominal Surg Unit, San Giovanni Rotondo, FG, Italy

[12] Natl Canc Ctr San Martino, Gen & Oncol Surg Unit, Genoa, Italy

[13] Regina Apostolorum Hosp, Gen Surg Unit, Albano Laziale, RM, Italy

[14] Univ Brescia, Gen Surg Unit 3, Brescia, Italy

[15] Spedali Civili Brescia, Brescia, Italy

[16] C Urbani Hosp, Dept Surg, Jesi, AN, Italy

[17] E Agnelli Hosp, Gen Surg Unit, Pinerolo, TO, Italy

[18] Policlin Casilino, Gen Surg Unit, Rome, Italy

[19] Policlin Campus BioMed, Geriatr Surg Unit, Rome, Italy

[20] Belcolle Hosp, Gen & Oncol Surg Unit, Viterbo, Italy

[21] Spedali Civili Brescia, Gen Surg Unit, Montichiari, BS, Italy

[22] Sacro Cuore Hosp, Gynecol Unit, Negrar, VR, Italy

[23] Santa Chiara Hosp, Dept Surg, Trento, Italy

[24] C & G Mazzoni Hospi, Clin Governance Unit, Ascoli Piceno, Italy

来源：

UPDATES IN SURGERY | 2019年 / 71卷 / 02期

关键词：

Anastomotic leakage; Colorectal surgery; Multicenter study; Prospective observational study; C-REACTIVE PROTEIN; ANASTOMOTIC LEAKAGE; RISK-FACTORS; SURGICAL COMPLICATIONS; ENHANCED RECOVERY; PROCALCITONIN; CLASSIFICATION; CONSEQUENCES; DIAGNOSIS; RESECTION;

D O I：

10.1007/s13304-018-00612-1

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

During a recent prospective trial on early diagnosis of anastomotic leakage (AL) after colorectal surgery, we gathered a large database on more than 1500 procedures performed in 19 surgical centers in Italy over a 12-month period. Main purpose of the present paper is to show the epidemiological data about colorectal procedures and anastomotic leakage. Prospective enrollment for all elective colorectal resections with anastomosis (September 2017-September 2018). Primary endpoint was AL; secondary endpoints were morbidity and mortality rates, readmission and reoperation rates, and length of post-operative hospital stay (ClinicalTrials.gov; Identifier: NCT03560180). There were 1546 enrolled cases (56.9% of 2717 total resected cases). The rate of minimally invasive resections was 83.5%. Overall AL rate was 4.92% (76 cases; range per center 0-12.12%). Mean +/- SD time to AL diagnosis was 5.95 +/- 4.78days (median 5, range 1-31). Overall morbidity rate was 30.20%, mortality 1.29% (20 cases; range per center 0-3.27), readmission 0.90%, and reoperation 6.92%. Mean +/- SD post-operative LOS was 7.89 +/- 5.97days (median 6; range 1-120). AL significantly influenced all other secondary endpoints. This study offers a good snapshot of colorectal resections in Italy. There was a high rate of laparoscopic resections, reflecting the special interest in this kind of surgery by the participating centers. AL, morbidity, mortality, readmission and reoperation rates are compared to those reported in previous population-based studies. Compared to series dealing with open colorectal resections, the time to diagnosis of AL was shortened by several days.

引用

页码：339 / 347

页数：9

共 28 条

[1]

Agenzia Nazionale per i Servizi Sanitari Regionali (AGENAS), PIAN NAZ ES

[2] Risk factors for anastomotic leakage and leak-related mortality after colonic cancer surgery in a nationwide audit [J].

Bakker, I. S. ;

Grossmann, I. ;

Henneman, D. ;

Havenga, K. ;

Wiggers, T. .

BRITISH JOURNAL OF SURGERY, 2014, 101 (04) :424-432

[3]

Benedetti M, 2019, G CHIR, V40, P20

[4]

Boushey R, 2018, MANAGEMENT ANASTOMOT

[5] Enhanced recovery pathway in elderly patients undergoing colorectal surgery: is there an effect of increasing ages? Results from the perioperative Italian Society Registry [J].

Braga, Marco ;

Beretta, Luigi ;

Pecorelli, Nicolo ;

Maspero, Marianna ;

Casiraghi, Umberto ;

Borghi, Felice ;

Pellegrino, Luca ;

Bona, Stefano ;

Monzani, Roberta ;

Ferrari, Gianluigi ;

Radrizzani, Danilo ;

Iuliani, Riccardo ;

Bima, Carlo ;

Scatizzi, Marco ;

Missana, Giancarlo ;

Guicciardi, Marco Azzola ;

Muratore, Andrea ;

Crespi, Michele ;

Bouzari, Hedayat ;

Ceretti, Andrea Pisani ;

Ficari, Ferdinando .

UPDATES IN SURGERY, 2018, 70 (01) :7-13

[6] Development of an enhanced recovery after surgery (ERAS) protocol in laparoscopic colorectal surgery: results of the first 120 consecutive cases from a university hospital [J].

Brescia, Antonio ;

Tomassini, Federico ;

Berardi, Giammauro ;

Sebastiani, Carola ;

Pezzatini, Massimo ;

Dall'Oglio, Anna ;

Laracca, Giovanni Guglielmo ;

Apponi, Fabrizio ;

Gasparrini, Marcello .

UPDATES IN SURGERY, 2017, 69 (03) :359-365

[7] Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery [J].

Bruce, J ;

Krukowski, ZH ;

Al-Khairy, G ;

Russell, EM ;

Park, KGM .

BRITISH JOURNAL OF SURGERY, 2001, 88 (09) :1157-1168

[8] Leakage after resection and intraperitoneal anastomosis for colorectal malignancy: Analysis of risk factors [J].

Choi, Hok-Kwok ;

Law, Wai-Lun ;

Ho, Judy W. C. .

DISEASES OF THE COLON & RECTUM, 2006, 49 (11) :1719-1725

[9] The Clavien-Dindo Classification of Surgical Complications Five-Year Experience [J].

Clavien, Pierre A. ;

Barkun, Jeffrey ;

de Oliveira, Michelle L. ;

Vauthey, Jean Nicolas ;

Dindo, Daniel ;

Schulick, Richard D. ;

de Santibanes, Eduardo ;

Pekolj, Juan ;

Slankamenac, Ksenija ;

Bassi, Claudio ;

Graf, Rolf ;

Vonlanthen, Rene ;

Padbury, Robert ;

Cameron, John L. ;

Makuuchi, Masatoshi .

ANNALS OF SURGERY, 2009, 250 (02) :187-196

[10] Improved diagnosis and treatment of anastomotic leakage after colorectal surgery [J].

den Dulk, M. ;

Noter, S. L. ;

Hendriks, E. R. ;

Brouwers, M. A. M. ;

van der Viles, C. H. ;

Oostenbroek, R. J. ;

Menon, A. G. ;

Steup, W. H. ;

van de Velde, C. J. H. .

EJSO, 2009, 35 (04) :420-426

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