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Dhanasekara CS, Marschke B, Morris E, Bashrum BS, Shrestha K, Richmond R, Dissanaike S, Ko A, Tennakoon L, Campion EM, Wood FC, Brandt M, Ng G, Regner J, Keith SL, Mcnutt MK, Kregel H, Gandhi R, Schroeppel T, Margulies DR, Hashim Y, Herrold J, Goetz M, Simpson L, Xuan-Lan D. Anastomotic leak rates after repair of mesenteric bucket-handle injuries: A multi-center retrospective cohort study. Am J Surg 2023; 226:770-775. [PMID: 37270399 DOI: 10.1016/j.amjsurg.2023.05.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 05/22/2023] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Primary aim was to assess the relative risk (RR) of anastomotic leak (AL) in intestinal bucket-handle (BH) compared to non-BH injury. METHODS Multi-center study comparing AL in BH from blunt trauma 2010-2021 compared to non-BH intestinal injuries. RR was calculated for small bowel and colonic injury using R. RESULTS AL occurred in 20/385 (5.2%) of BH vs. 4/225 (1.8%) of non-BH small intestine injury. AL was diagnosed 11.6 ± 5.6 days from index operation in small intestine BH and 9.7 ± 4.3 days in colonic BH. Adjusted RR for AL was 2.32 [0.77-6.95] for small intestinal and 4.83 [1.47-15.89] for colonic injuries. AL increased infections, ventilator days, ICU & total length of stay, reoperation, and readmission rates, although mortality was unchanged. CONCLUSION BH carries a significantly higher risk of AL, particularly in the colon, than other blunt intestinal injuries.
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Affiliation(s)
| | - Brianna Marschke
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Erin Morris
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Bryan S Bashrum
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Kripa Shrestha
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Robyn Richmond
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Sharmila Dissanaike
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
| | - Ara Ko
- Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Lakshika Tennakoon
- Department of Surgery, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Eric M Campion
- Department of Surgery, Denver Health Medical Center, Denver, CO, USA
| | - Frank C Wood
- Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Maggie Brandt
- Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Grace Ng
- Department of Surgery, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | - Justin Regner
- Department of Surgery, Baylor Scott and White Health, Temple, TX, USA
| | - Stacey L Keith
- Department of Surgery, Baylor Scott and White Health, Temple, TX, USA
| | - Michelle K Mcnutt
- Department of Surgery, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Heather Kregel
- Department of Surgery, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Rajesh Gandhi
- Department of Surgery, JPS Health Network, Ft. Worth, TX, USA
| | - Thomas Schroeppel
- Department of Surgery, UCHealth, Memorial Hospital, Colorado Springs, CO, USA
| | - Daniel R Margulies
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Yassar Hashim
- Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Joseph Herrold
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Mallory Goetz
- Department of Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - LeRone Simpson
- McAllen Medical Center Trauma Department, McAllen, TX, USA
| | - Doan Xuan-Lan
- McAllen Medical Center Trauma Department, McAllen, TX, USA
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