Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis.

IF 3 Q2 GASTROENTEROLOGY & HEPATOLOGY

Annals of Coloproctology Pub Date : 2023-10-01 Epub Date: 2022-12-20 DOI:10.3393/ac.2022.00605.0086

Ricardo Purchio Galletti, Gabriel Andrade Agareno, Lucas de Abreu Sesconetto, Rafael Benjamim Rosa da Silva, Rafael Vaz Pandini, Lucas Soares Gerbasi, Victor Edmond Seid, Sérgio Eduardo Alonso Araujo, Francisco Tustumi

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引用次数: 1

Abstract

Purpose: This study aimed to review the outcomes of redo procedures for failed colorectal or coloanal anastomoses.

Methods: A systematic review was performed using the PubMed, Embase, Cochrane, and LILACS databases. The inclusion criteria were adult patients undergoing colectomy with primary colorectal or coloanal anastomosis and studies that assessed the postoperative results. The protocol is registered in PROSPERO (No. CRD42021267715).

Results: Eleven articles met the eligibility criteria and were selected. The studied population size ranged from 7 to 78 patients. The overall mortality rate was 0% (95% confidence interval [CI], 0%-0.01%). The postoperative complication rate was 40% (95% CI, 40%-50%). The length of hospital stay was 13.68 days (95% CI, 11.3-16.06 days). After redo surgery, 82% of the patients were free of stoma (95% CI, 75%-90%), and 24% of patients (95% CI, 0%-39%) had fecal incontinence. Neoadjuvant chemoradiotherapy (P=0.002) was associated with a lower probability of being free of stoma in meta-regression.

Conclusion: Redo colorectal and coloanal anastomoses are strategies to restore colonic continuity. The decision to perform a redo operation should be based on a proper evaluation of the morbidity and mortality risks, the probability of remaining free of stoma, the quality of life, and a functional assessment.

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结肠直肠或结肠直肠吻合失败的重做结果：一项系统综述和荟萃分析。

目的：本研究旨在回顾结直肠或结肠直肠吻合失败的重做手术的结果。方法：使用PubMed、Embase、Cochrane和LILACS数据库进行系统综述。纳入标准为接受结肠切除术并初次结肠直肠或结肠肛门吻合的成年患者以及评估术后结果的研究。该方案已在PROSPERO注册（编号CRD42021267715）。结果：11篇文章符合资格标准并入选。研究的人群规模为7至78名患者。总死亡率为0%（95%可信区间，0%-0.01%），术后并发症发生率为40%（95%CI，40%-50%）。住院时间为13.68天（95%可信区间为11.3-16.06天）。重做手术后，82%的患者没有造口（95%置信区间，75%-90%），24%的患者（95%可信区间，0%-39%）有大便失禁。新辅助放化疗（P=0.002）与再进展中无造口的概率较低有关。结论：恢复结肠直肠和结肠肛门吻合是恢复结肠连续性的策略。进行重做手术的决定应基于对发病率和死亡率风险、保持无造口的概率、生活质量和功能评估的适当评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Coloproctology Multiple-

CiteScore

3.30

自引率

3.20%

发文量

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