Home > Riviste > Minerva Surgery > Fascicoli precedenti > Minerva Surgery 2021 August;76(4) > Minerva Surgery 2021 August;76(4):310-5

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi PROMO
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo
Share

 

ORIGINAL ARTICLE  MANAGEMENT OF INTRAOPERATIVE AND POSTOPERATIVE COMPLICATIONS DURING LAPAROSCOPIC COLORECTAL PROCEDURES 

Minerva Surgery 2021 August;76(4):310-5

DOI: 10.23736/S2724-5691.20.08645-9

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Risk of anastomotic bleeding after left colectomy with preservation of inferior mesenteric artery for diverticular disease: preliminary results

Umberto BRACALE 1 , Roberto PELTRINI 1, Maria M. DI NUZZO 1, Gaia ALTIERI 2, Vania SILVESTRI 1, Pasquale DOLCE 1, Michele D’AMBRA 1, Ruggero LIONETTI 1, Francesco CORCIONE 1

1 Department of Public Health, Federico II University, Naples, Italy; 2 Department of Medical and Surgical Sciences, Sacred Heart Catholic University, Rome, Italy



BACKGROUND: The inferior mesenteric artery (IMA) preservation in elective laparoscopic left colectomy for diverticular disease may reduce the risk of anastomotic leakage. However, an increased risk of bleeding is assumed. The aim of this study was to investigate the risk of colorectal anastomosis bleeding when IMA is resected or preserved during left colectomy.
METHODS: A retrospective study of a prospectively collected database was performed. All patients who underwent elective left colectomy, from December 2018 to September 2020 were included. Patients’ data and clinical information were collected and analyzed. Patients were categorized in two groups: IMA resected (IMA-R) and IMA preserving (IMA-P) left colectomy. Perioperative outcomes between the two groups were compared.
RESULTS: Sixty-three consecutive patients who underwent left colectomy over a period of three years were enrolled: 42 in IMA-R group and 22 in the IMA-P group. There were no significant differences in demographic and intraoperative characteristics between the two groups, except for patients’ age and primary disease. Six patients (9.37%) developed anastomotic bleeding during recovery, more frequently in the IMA-P than IMA-R group, although the difference is not statistically significative (13.6% and 7.3%; P=0.406). All bleedings were self-limited and only one needed red blood cells transfusion. Using the bioabsorbable staple line reinforcement (BSLR) has proved to be advantageous in preventing anastomotic bleeding in the IMA-P group.
CONCLUSIONS: IMA preserving left colectomy seems to be associated with a higher risk of mostly self-limited anastomotic bleeding during recovery. BSLR seems to be effective in this group of patients.


KEY WORDS: Diverticulitis, colonic; Anastomosis, surgical; Hemorrhage; Mesenteric artery, inferior

inizio pagina