Mesenteric occlusive disease of the inferior mesenteric artery is associated with anastomotic leak after left-sided colon and rectal cancer surgery : a retrospective cohort study
© 2022. The Author(s)..
PURPOSE: Anastomotic leak (AL) is a serious complication following colorectal surgery. Atherosclerosis causes inadequate anastomotic perfusion and is suggested to be a risk factor for AL. The aim of this study was to investigate the association of mesenteric occlusive disease on preoperative computed tomography (CT) scan with AL after left-sided colon or rectal cancer surgery.
METHODS: This was a retrospective, multicenter cohort study including 1273 patients that underwent left-sided or rectal cancer resection between 2009 and 2018 from three hospitals in the Netherlands. AL patients were 1:1 matched with non-leak patients and preoperative contrast-enhanced CT-scans were retrospectively analyzed for mesenteric atherosclerotic lesions. The main outcome measure was the presence of mesenteric occlusive disease on the preoperative CT-scan.
RESULTS: Anastomotic leak developed in 6% of 1273 patients (N = 76). Low anterior resection and stage I-III disease were statistically significant associated with AL (p = 0.01, p = 0.04). No other statistically significant differences in patient characteristics between AL and non-leak patients were found. A clinically significant stenosis (≥ 70-100%) of the inferior mesenteric artery was statistically significant more frequent present in AL patients, compared to non-leak patients (p < 0.01). No statistically significant differences in the presence of mesenteric occlusive disease of the celiac artery and superior mesenteric artery between AL patients and non-leak patients were found.
CONCLUSION: Mesenteric occlusive disease of the IMA on preoperative CT-scan is associated with AL after left-sided colon or rectal resection for cancer. Preoperative identification of high-risk patients with a preoperative CT-scan of the mesenteric vasculature might be useful to reduce the risk of AL.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:37 |
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| Enthalten in: |
International journal of colorectal disease - 37(2022), 3 vom: 06. März, Seite 631-638 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Arron, Melissa N N [VerfasserIn] |
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| Links: |
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| Themen: |
Anastomotic leakage |
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| Anmerkungen: |
Date Completed 02.03.2022 Date Revised 04.03.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00384-021-04089-0 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM335325920 |
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| 100 | 1 | |a Arron, Melissa N N |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Mesenteric occlusive disease of the inferior mesenteric artery is associated with anastomotic leak after left-sided colon and rectal cancer surgery |b a retrospective cohort study |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 04.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a PURPOSE: Anastomotic leak (AL) is a serious complication following colorectal surgery. Atherosclerosis causes inadequate anastomotic perfusion and is suggested to be a risk factor for AL. The aim of this study was to investigate the association of mesenteric occlusive disease on preoperative computed tomography (CT) scan with AL after left-sided colon or rectal cancer surgery | ||
| 520 | |a METHODS: This was a retrospective, multicenter cohort study including 1273 patients that underwent left-sided or rectal cancer resection between 2009 and 2018 from three hospitals in the Netherlands. AL patients were 1:1 matched with non-leak patients and preoperative contrast-enhanced CT-scans were retrospectively analyzed for mesenteric atherosclerotic lesions. The main outcome measure was the presence of mesenteric occlusive disease on the preoperative CT-scan | ||
| 520 | |a RESULTS: Anastomotic leak developed in 6% of 1273 patients (N = 76). Low anterior resection and stage I-III disease were statistically significant associated with AL (p = 0.01, p = 0.04). No other statistically significant differences in patient characteristics between AL and non-leak patients were found. A clinically significant stenosis (≥ 70-100%) of the inferior mesenteric artery was statistically significant more frequent present in AL patients, compared to non-leak patients (p < 0.01). No statistically significant differences in the presence of mesenteric occlusive disease of the celiac artery and superior mesenteric artery between AL patients and non-leak patients were found | ||
| 520 | |a CONCLUSION: Mesenteric occlusive disease of the IMA on preoperative CT-scan is associated with AL after left-sided colon or rectal resection for cancer. Preoperative identification of high-risk patients with a preoperative CT-scan of the mesenteric vasculature might be useful to reduce the risk of AL | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Anastomotic leakage | |
| 650 | 4 | |a Colorectal cancer | |
| 650 | 4 | |a Colorectal surgery | |
| 650 | 4 | |a Mesenteric occlusive disease | |
| 700 | 1 | |a Broek, Richard P G Ten |e verfasserin |4 aut | |
| 700 | 1 | |a Adriaansens, Carleen M E M |e verfasserin |4 aut | |
| 700 | 1 | |a Bluiminck, Stijn |e verfasserin |4 aut | |
| 700 | 1 | |a van Wely, Bob J |e verfasserin |4 aut | |
| 700 | 1 | |a Ferenschild, Floris T J |e verfasserin |4 aut | |
| 700 | 1 | |a Smits, Henk F M |e verfasserin |4 aut | |
| 700 | 1 | |a van Goor, Harry |e verfasserin |4 aut | |
| 700 | 1 | |a de Wilt, Johannes H W |e verfasserin |4 aut | |
| 700 | 1 | |a van Petersen, André S |e verfasserin |4 aut | |
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