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Koneru S, Reece MM, Goonawardhana D, Chapuis PH, Naidu K, Ng KS, Rickard MJFX. Right hemicolectomy anastomotic leak study: a review of right hemicolectomy in the binational clinical outcomes registry (BCOR). ANZ J Surg 2023. [PMID: 36825639 DOI: 10.1111/ans.18337] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/07/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUNDS Surgery remains mainstay management for colon cancer. Post-operative anastomotic leak (AL) carries significant morbidity and mortality. Rates of, and risk factors associated with AL following right hemicolectomy remain poorly documented across Australia and New Zealand. This study examines the Bowel Cancer Outcomes Registry (BCOR) to address this. METHODS A retrospective cohort study was undertaken of consecutive BCOR-registered right hemicolectomy patients undergoing resection for colon cancer (2007-2021). The primary outcome measure was AL incidence. Clinicopathological data were extracted from the BCOR. Factors associated with AL and primary anastomosis were identified using logistic regression. AL-rate trends were assessed by linear regression. RESULTS Of 13 512 patients who had a right hemicolectomy (45.2% male, mean age 72.5 years, SD 12.1), 258 (2.0%) had an AL. On multivariate analysis, male sex (OR 1.33; 95% CI 1.03-1.71) and emergency surgery (OR 1.41; 95% CI 1.04-1.92) were associated with AL. Private health insurance status (OR 0.66; 95% CI 0.50-0.88) and minimally-invasive surgery (OR 0.61; 95% CI 0.47-0.79) were protective for AL. Anastomotic technique (handsewn versus stapled) was not associated with AL (P = 0.84). Patients with higher ASA status (OR 0.47; 95% CI 0.39-0.58), advanced tumour stage (OR 0.56; 95% CI 0.50-0.63), and emergency surgery (OR 0.16; 95% CI 0.13-0.20) were less likely to have a primary anastomosis. AL-rate and year of surgery showed no association (P = 0.521). CONCLUSION The AL rate in Australia and New Zealand following right hemicolectomy is consistent with the published literature and was stable throughout the study period. Sex, emergency surgery, insurance status, and minimally invasive surgery are associated with AL incidence.
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Affiliation(s)
- Sireesha Koneru
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mifanwy M Reece
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Dulani Goonawardhana
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Pierre H Chapuis
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Krishanth Naidu
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
| | - Kheng-Seong Ng
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Matthew J F X Rickard
- Department of Colorectal Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Concord Institute of Academic Surgery, Concord Repatriation General Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.,Division of Colorectal Surgery, Macquarie University Hospital, Sydney, New South Wales, Australia
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Reece MM, Chapuis PH, Keshava A, Stewart P, Suen M, Rickard MJFX. When does curatively treated colorectal cancer recur? An Australian perspective. ANZ J Surg 2018; 88:1163-1167. [DOI: 10.1111/ans.14870] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 08/07/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Mifanwy M. Reece
- Department of Colorectal Surgery; Concord Repatriation General Hospital; Sydney New South Wales Australia
| | - Pierre H. Chapuis
- Department of Colorectal Surgery; Concord Repatriation General Hospital; Sydney New South Wales Australia
- Discipline of Surgery, Sydney Medical School; The University of Sydney; Sydney New South Wales Australia
| | - Anil Keshava
- Department of Colorectal Surgery; Concord Repatriation General Hospital; Sydney New South Wales Australia
- Discipline of Surgery, Sydney Medical School; The University of Sydney; Sydney New South Wales Australia
| | - Peter Stewart
- Department of Colorectal Surgery; Concord Repatriation General Hospital; Sydney New South Wales Australia
| | - Michael Suen
- Department of Colorectal Surgery; Concord Repatriation General Hospital; Sydney New South Wales Australia
| | - Matthew J. F. X. Rickard
- Department of Colorectal Surgery; Concord Repatriation General Hospital; Sydney New South Wales Australia
- Discipline of Surgery, Sydney Medical School; The University of Sydney; Sydney New South Wales Australia
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