We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
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.
- Authors
Arron, Melissa N. N.; Broek, Richard P. G. ten; Adriaansens, Carleen M. E. M.; Bluiminck, Stijn; van Wely, Bob J.; Ferenschild, Floris T. J.; Smits, Henk F. M.; van Goor, Harry; de Wilt, Johannes H. W.; van Petersen, André S.
- Abstract
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.
- Subjects
NETHERLANDS; MESENTERIC artery; RECTAL cancer; COLON cancer; ONCOLOGIC surgery; RECTAL surgery; CELIAC artery; COHORT analysis
- Publication
International Journal of Colorectal Disease, 2022, Vol 37, Issue 3, p631
- ISSN
0179-1958
- Publication type
Article
- DOI
10.1007/s00384-021-04089-0