Purposes: We sought to investigate the accuracy of abdominal CT scanning for anastomotic leakage and the effect of false-negative scans on the delay in therapeutic intervention and clinical outcome. Method: Data from a prospectively bi-institutionally maintained database of all patients who underwent elective colorectal surgery with primary anastomosis for malignant or benign disease between 2010 and 2017 were reviewed. Patients with confirmed anastomotic dehiscence at reintervention who underwent a postoperative CT scan for suspected leakage were identified and radiological reports were retrieved. Results: Seventy-six patients with anastomotic dehiscence were included in the study. American Society of Anesthesiologists score, sex, type of surgical procedure, malignancy, and type of anastomosis do not correlate with postoperative false-negative CT imaging. Postoperative false-negative CT scan, however, led to delayed reintervention (3 vs. 6 h, p = 0.023) and increased mortality (five deaths vs. no deaths, p = 0.043). Free abdominal air (p = 0.001) and extraluminal contrast extravasation (p = 0.001) were found to be predictive of accuracy in anastomotic leakage diagnosis. Conclusion: The suboptimal specificity of a postoperative CT scan in suspected anastomotic leakage after colorectal surgery can delay reintervention and increase mortality.

Tamini, N., Cassini, D., Giani, A., Angrisani, M., Famularo, S., Oldani, M., et al. (2020). Computed tomography in suspected anastomotic leakage after colorectal surgery: evaluating mortality rates after false-negative imaging. EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY, 46(5), 1049-1053 [10.1007/s00068-019-01083-8].

Computed tomography in suspected anastomotic leakage after colorectal surgery: evaluating mortality rates after false-negative imaging

Tamini, N
;
Giani, A;ANGRISANI, MARCO;Famularo, S;OLDANI, MASSIMO;Montuori, M;Gianotti, L
2020

Abstract

Purposes: We sought to investigate the accuracy of abdominal CT scanning for anastomotic leakage and the effect of false-negative scans on the delay in therapeutic intervention and clinical outcome. Method: Data from a prospectively bi-institutionally maintained database of all patients who underwent elective colorectal surgery with primary anastomosis for malignant or benign disease between 2010 and 2017 were reviewed. Patients with confirmed anastomotic dehiscence at reintervention who underwent a postoperative CT scan for suspected leakage were identified and radiological reports were retrieved. Results: Seventy-six patients with anastomotic dehiscence were included in the study. American Society of Anesthesiologists score, sex, type of surgical procedure, malignancy, and type of anastomosis do not correlate with postoperative false-negative CT imaging. Postoperative false-negative CT scan, however, led to delayed reintervention (3 vs. 6 h, p = 0.023) and increased mortality (five deaths vs. no deaths, p = 0.043). Free abdominal air (p = 0.001) and extraluminal contrast extravasation (p = 0.001) were found to be predictive of accuracy in anastomotic leakage diagnosis. Conclusion: The suboptimal specificity of a postoperative CT scan in suspected anastomotic leakage after colorectal surgery can delay reintervention and increase mortality.
No
Articolo in rivista - Articolo scientifico
Scientifica
Anastomotic leakage; Colorectal surgery; Computed tomography; Deischence; Surgery; Emergency Medicine; Orthopedics and Sports Medicine; Critical Care and Intensive Care Medicine
English
1049
1053
5
Original Article First Online: 08 February 2019
Tamini, N., Cassini, D., Giani, A., Angrisani, M., Famularo, S., Oldani, M., et al. (2020). Computed tomography in suspected anastomotic leakage after colorectal surgery: evaluating mortality rates after false-negative imaging. EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY, 46(5), 1049-1053 [10.1007/s00068-019-01083-8].
Tamini, N; Cassini, D; Giani, A; Angrisani, M; Famularo, S; Oldani, M; Montuori, M; Baldazzi, G; Gianotti, L
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/221026
Citazioni
  • Scopus 4
  • ???jsp.display-item.citation.isi??? 3
Social impact