gms | German Medical Science

130. Kongress der Deutschen Gesellschaft für Chirurgie

Deutsche Gesellschaft für Chirurgie

30.04. - 03.05.2013, München

Artikel

Artikel empfehlen

Validation of the International Study Group of Rectal Cancer (ISREC) Definition and Severity Grading of Anastomotic Leakage

Meeting Abstract

Suche in Medline nach

  • Yakup Kulu - Universitätsklinik Heidelberg, Allgemein-, Viszeral und Transplantationschirurgie, Heidelberg
  • Alexis Ulrich - Universitätsklinik Heidelberg, Allgemein-, Viszeral und Transplantationschirurgie, Heidelberg
  • Thomas Bruckner - Universität Heidelberg, Medizinische Biometrie und Informatik, Heidelberg
  • Pietro Contin - Universitätsklinik Heidelberg, Allgemein-, Viszeral und Transplantationschirurgie, Heidelberg
  • Thilo Welsch - Universitätsklinik Heidelberg, Allgemein-, Viszeral und Transplantationschirurgie, Heidelberg
  • Nuh N. Rahbari - Universitätsklinik Heidelberg, Allgemein-, Viszeral und Transplantationschirurgie, Heidelberg
  • Markus W. Büchler - Universitätsklinik Heidelberg, Allgemein-, Viszeral und Transplantationschirurgie, Heidelberg
  • Jürgen Weitz - Universitätsklinik Heidelberg, Allgemein-, Viszeral und Transplantationschirurgie, Heidelberg

Deutsche Gesellschaft für Chirurgie. 130. Kongress der Deutschen Gesellschaft für Chirurgie. München, 30.04.-03.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13dgch060

doi: 10.3205/13dgch060, urn:nbn:de:0183-13dgch0604

Veröffentlicht: 26. April 2013

© 2013 Kulu et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

Text

Introduction: The ISREC has proposed a generally applicable definition and severity grading of anastomotic leakage after sphincter-preserving resection of the rectum. This work has been carried out to test for validity.

Material and methods: A total of 746 patients who were identified from a prospective rectal cancer database underwent sphincter-preserving anterior resection of the rectum between October 2001 and January 2011. The incidence and severity of anastomotic leakage was determined using the criteria established by the ISREC. Fifty-six Patients with anastomotic leakage were categorized according to the ISREC scheme. The clinical outcomes were analyzed and compared between the groups.

Results: The overall anastomotic leakage rate was 7.5% (56/746). The 56 patients with anastomotic leakage were distributed among the different groups as follows: grade A – 16%, grade B – 23%, and grade C – 61%. Compared to the grade A patients, grade B and C patients had statistically significant elevated serum CRP levels (p<0.01). None of the grade A patients were transferred to the ICU. Their further hospital stay was uneventful. The length of stay in the ICU was significantly longer in grade C patients compared to grade B patients (p<0.001). The median hospital stay of grade C patients was significantly longer than that of grade A and B patients (p<0.001).

Conclusion: The definition and severity grading of anastomotic leakage after anterior resection of the rectum proposed by the ISREC provides a simple, easily applicable and valid classification. Using this classification system may facilitate comparison of results from different studies on AL following sphincter-preserving rectal surgery.