Imperial College London
Alternate

ProfessorGeorgeHanna

Faculty of Medicine, Department of Surgery & Cancer

Head of Department of Surgery and Cancer
 
 
 
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Contact

 

+44 (0)20 7594 3396g.hanna

 
 
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Assistant

 

Ms Aoibheann Byrne +44 (0)20 7594 3396

 
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Location

 

Block B Hammersmith HospitalHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Penna:2019:10.1097/SLA.0000000000002653,
author = {Penna, M and Hompes, R and Arnold, S and Wynn, G and Austin, R and Warusavitarne, J and Moran, B and Hanna, GB and Mortensen, NJ and Tekkis, PP and International, TaTME Registry Collaborative},
doi = {10.1097/SLA.0000000000002653},
journal = {Annals of Surgery},
pages = {700--711},
title = {Incidence and risk factors for anastomotic failure in 1594 Patients treated by transanal total mesorectal excision: results from the international TaTME registry},
url = {http://dx.doi.org/10.1097/SLA.0000000000002653},
volume = {269},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - To determine the incidence of anastomotic-related morbidity following Transanal Total Mesorectal Excision (TaTME) and identify independent risk factors for failure.Anastomotic leak and its sequelae are dreaded complications following gastrointestinal surgery. TaTME is a recent technique for rectal resection, which includes novel anastomotic techniques.Prospective study of consecutive reconstructed TaTME cases recorded over 30 months in 107 surgical centers across 29 countries. Primary endpoint was "anastomotic failure," defined as a composite endpoint of early or delayed leak, pelvic abscess, anastomotic fistula, chronic sinus, or anastomotic stricture. Multivariate regression analysis performed identifying independent risk factors of anastomotic failure and an observed risk score developed.One thousand five hundred ninety-four cases with anastomotic reconstruction were analyzed; 96.6% performed for cancer. Median anastomotic height from anal verge was 3.0±2.0cm with stapled techniques accounting for 66.0%. The overall anastomotic failure rate was 15.7%. This included early (7.8%) and delayed leak (2.0%), pelvic abscess (4.7%), anastomotic fistula (0.8%), chronic sinus (0.9%), and anastomotic stricture in 3.6% of cases. Independent risk factors of anastomotic failure were: male sex, obesity, smoking, diabetes mellitus, tumors >25mm, excessive intraoperative blood loss, manual anastomosis, and prolonged perineal operative time. A scoring system for preoperative risk factors was associated with observed rates of anastomotic failure between 6.3% to 50% based on the cumulative score.Large tumors in obese, diabetic male patients who smoke have the highest risk of anastomotic failure. Acknowledging such risk factors can guide appropriate consent and clinical decision-making that may reduce anastomotic-related morbidity.
AU  - Penna,M
AU  - Hompes,R
AU  - Arnold,S
AU  - Wynn,G
AU  - Austin,R
AU  - Warusavitarne,J
AU  - Moran,B
AU  - Hanna,GB
AU  - Mortensen,NJ
AU  - Tekkis,PP
AU  - International,TaTME Registry Collaborative
DO  - 10.1097/SLA.0000000000002653
EP  - 711
PY  - 2019///
SN  - 0003-4932
SP  - 700
TI  - Incidence and risk factors for anastomotic failure in 1594 Patients treated by transanal total mesorectal excision: results from the international TaTME registry
T2  - Annals of Surgery
UR  - http://dx.doi.org/10.1097/SLA.0000000000002653
UR  - https://www.ncbi.nlm.nih.gov/pubmed/29315090
UR  - https://journals.lww.com/annalsofsurgery/Fulltext/2019/04000/Incidence_and_Risk_Factors_for_Anastomotic_Failure.17.aspx
UR  - http://hdl.handle.net/10044/1/58553
VL  - 269
ER  -
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