Management and 1-year outcomes of anastomotic leakage after elective colorectal surgery

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ORIGINAL ARTICLE

Management and 1-year outcomes of anastomotic leakage after elective colorectal surgery The Italian ColoRectal Anastomotic Leakage (iCral) study group & Felice Borghi 1 & Marco Migliore 1 & Desirée Cianflocca 1 & Giacomo Ruffo 2 & Alberto Patriti 3 & Paolo Delrio 4 & Marco Scatizzi 5 & Stefano Mancini 6 & Gianluca Garulli 7 & Andrea Lucchi 8 & Alessandro Carrara 9 & Felice Pirozzi 10 & Stefano Scabini 11 & Andrea Liverani 12 & Gianluca Baiocchi 13 & Roberto Campagnacci 14 & Andrea Muratore 15 & Graziano Longo 16 & Marco Caricato 17 & Raffaele Macarone Palmieri 18 & Nereo Vettoretto 19 & Paolo Ciano 20 & Michele Benedetti 20 & Elisa Bertocchi 2 & Marcello Ceccaroni 2 & Ugo Pace 4 & Lorenzo Pandolfini 5 & Andrea Sagnotta 6 & Basilio Pirrera 7 & Vincenzo Alagna 7 & Giacomo Martorelli 8 & Giuseppe Tirone 9 & Michele Motter 9 & Antonio Sciuto 10 & Antonio Martino 11 & Andrea Scarinci 12 & Sarah Molfino 13 & Angela Maurizi 14 & Patrizia Marsanic 15 & Federico Tomassini 16 & Simone Santoni 16 & Gabriella Teresa Capolupo 17 & Pietro Amodio 18 & Elisa Arici 19 & Simone Cicconi 20 & Irene Marziali 20 & Gianluca Guercioni 20 & Marco Catarci 20 Accepted: 8 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020

Abstract Purpose To analyze different types of management and one-year outcomes of anastomotic leakage (AL) after elective colorectal resection. Methods All patients with anastomotic leakage after elective colorectal surgery with anastomosis (76/1,546; 4.9%), with the exclusion of cases with proximal diverting stoma, were followed-up for at least one year. Primary endpoints were as follows: composite outcome of one-year mortality and/or unplanned intensive care unit (ICU) admission and additional morbidity rates. Secondary endpoints were as follows: length of stay (LOS), one-year persistent stoma rate, and rate of return to intended oncologic therapy (RIOT). Results One-year mortality rate was 10.5% and unplanned ICU admission rate was 30.3%. Risk factors of the composite outcome included age (aOR = 1.08 per 1-year increase, p = 0.002) and anastomotic breakdown with end stoma at reoperation

* Felice Borghi [email protected]

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Abdominal Surgery Unit, IRCCS Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, FG, Italy

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Department of Surgery, General and Oncologic Surgery Unit, Santa Croce e Carle Hospital, 12100 Cuneo, Italy

General & Oncologic Surgery Unit, National Cancer Center San Martino, Genova, Italy

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General Surgery & Gynecology Units, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, VR, Italy

General Surgery Unit, Regina Apostolorum Hospital, Albano Laziale, RM, Italy

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Department of Surgery, Marche Nord Hospital, Pesaro e Fano, PU, Italy

General Surgery Unit 3, University & Spedali Civili of Brescia, Brescia, Italy

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Department of Surgery, C. Urbani Hospital, Jesi, AN, Italy

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General Surgery Unit, E. Agnelli Hospital, Pinerolo, TO, Italy

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General & Oncologic Surgery Unit, Santo Stefano Hospital, Prato, F