Short-term outcomes associated with the use of a new powered circular stapler for rectal reconstructions: a retrospective study comparing it to manual circular staplers using inverse probability of treatment weight analysis
Abstract Background The most common postoperative complication in malignant rectal surgery is anastomotic leakage (AL). AL after anterior or low anterior resection in rectal tumors is a fatal postoperative complication. Recently, the first automated suture circular stapler, which is expected to redu...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-023-02218-w |
| _version_ | 1797377179190820864 |
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| author | Nobuhisa Matsuhashi Jesse Yu Tajima Ryoma Yokoi Shigeru Kiyama Masahide Endo Yuta Sato Masashi Kuno Hirokatsu Hayashi Ryuichi Asai Masahiro Fukada Itaru Yasufuku Yoshihiro Tanaka Naoki Okumura Katsutoshi Murase Takuma Ishihara Takao Takahashi |
| author_facet | Nobuhisa Matsuhashi Jesse Yu Tajima Ryoma Yokoi Shigeru Kiyama Masahide Endo Yuta Sato Masashi Kuno Hirokatsu Hayashi Ryuichi Asai Masahiro Fukada Itaru Yasufuku Yoshihiro Tanaka Naoki Okumura Katsutoshi Murase Takuma Ishihara Takao Takahashi |
| author_sort | Nobuhisa Matsuhashi |
| collection | DOAJ |
| description | Abstract Background The most common postoperative complication in malignant rectal surgery is anastomotic leakage (AL). AL after anterior or low anterior resection in rectal tumors is a fatal postoperative complication. Recently, the first automated suture circular stapler, which is expected to reduce the incidence of AL, (J&J). Materials and methods This study included a total of 248 rectal tumor patients who underwent double stapler technique (DST) anastomotic procedures in the department of gastroenterological surgery /pediatric surgery at Gifu University School of Medicine from January 2017 to December 2021. The experience of a single institution utilizing the The Echelon circular™ stapler (ECP stapler:Manual VS Automatic) in rectal surgery cases was evaluated retrospectively from maintained database. Result One hundred thirty-nine patients (58.4%) were performed by manual circular stapling, 99 patients (41.6%) by powerd circular stapling. Diverting stoma was performed in 45 cases (32.4%) by manual circular stapling, 42 patients (42.4%) by powerd circular stapling Postoperative complications were occurred clavien-dindo grade II or higher in 57 cases (23.9%) and grade III or higher in 20 cases (8.4%). Anastomotic leakage occurred in 14 patients (5.9%) within all grades. After IPTW, the variables of patient characteristics was SMD ≤ 0.2 (Table.3), and there was a significant difference in anastomotic leakage (Odds Ratio (OR), 0.57; 95% Confidence Interval(CI), 0.34–0.98 and there was a significant difference in anastomotic leakage (Odds Ratio (OR), 0.58; 95% Confidence Interval(CI), 0.34–0.98; p = 0.044). In addition, there was no significant difference in postoperative complications in grade II or higher (OR, 0.88; 95%CI, 0.65–1.18; p = 0.394) and grade III or higher (OR, 0.45; 95%CI, 0.28–0.73; p = 0.001) were significantly remarkable lower in powered circular stapling group. Conclusion In this IPTW comparison of patients undergoing rectal reconstructions, the ECP trial cohort had lower risks of several surgical complications AL and statistically signifcant lower rates of ileus/bowel obstruction, infection, and bleeding as Clavien-Dindo ≥ grade II and III as compared with for whom manual circular staplers were used. |
| first_indexed | 2024-03-08T19:49:00Z |
| format | Article |
| id | doaj.art-0e373df265ab4602a3bb9106e15f6974 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-08T19:49:00Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-0e373df265ab4602a3bb9106e15f69742023-12-24T12:08:46ZengBMCBMC Surgery1471-24822023-10-012311810.1186/s12893-023-02218-wShort-term outcomes associated with the use of a new powered circular stapler for rectal reconstructions: a retrospective study comparing it to manual circular staplers using inverse probability of treatment weight analysisNobuhisa Matsuhashi0Jesse Yu Tajima1Ryoma Yokoi2Shigeru Kiyama3Masahide Endo4Yuta Sato5Masashi Kuno6Hirokatsu Hayashi7Ryuichi Asai8Masahiro Fukada9Itaru Yasufuku10Yoshihiro Tanaka11Naoki Okumura12Katsutoshi Murase13Takuma Ishihara14Takao Takahashi15Department of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineInnovative and Clinical Research Promotion Center, Gifu University Graduate School of MedicineDepartment of Gastroenterological Surgery and Pediatric Surgery, Gifu University Graduate School of MedicineAbstract Background The most common postoperative complication in malignant rectal surgery is anastomotic leakage (AL). AL after anterior or low anterior resection in rectal tumors is a fatal postoperative complication. Recently, the first automated suture circular stapler, which is expected to reduce the incidence of AL, (J&J). Materials and methods This study included a total of 248 rectal tumor patients who underwent double stapler technique (DST) anastomotic procedures in the department of gastroenterological surgery /pediatric surgery at Gifu University School of Medicine from January 2017 to December 2021. The experience of a single institution utilizing the The Echelon circular™ stapler (ECP stapler:Manual VS Automatic) in rectal surgery cases was evaluated retrospectively from maintained database. Result One hundred thirty-nine patients (58.4%) were performed by manual circular stapling, 99 patients (41.6%) by powerd circular stapling. Diverting stoma was performed in 45 cases (32.4%) by manual circular stapling, 42 patients (42.4%) by powerd circular stapling Postoperative complications were occurred clavien-dindo grade II or higher in 57 cases (23.9%) and grade III or higher in 20 cases (8.4%). Anastomotic leakage occurred in 14 patients (5.9%) within all grades. After IPTW, the variables of patient characteristics was SMD ≤ 0.2 (Table.3), and there was a significant difference in anastomotic leakage (Odds Ratio (OR), 0.57; 95% Confidence Interval(CI), 0.34–0.98 and there was a significant difference in anastomotic leakage (Odds Ratio (OR), 0.58; 95% Confidence Interval(CI), 0.34–0.98; p = 0.044). In addition, there was no significant difference in postoperative complications in grade II or higher (OR, 0.88; 95%CI, 0.65–1.18; p = 0.394) and grade III or higher (OR, 0.45; 95%CI, 0.28–0.73; p = 0.001) were significantly remarkable lower in powered circular stapling group. Conclusion In this IPTW comparison of patients undergoing rectal reconstructions, the ECP trial cohort had lower risks of several surgical complications AL and statistically signifcant lower rates of ileus/bowel obstruction, infection, and bleeding as Clavien-Dindo ≥ grade II and III as compared with for whom manual circular staplers were used.https://doi.org/10.1186/s12893-023-02218-wPowered circular staplerRectal reconstructionsShort-term outcomes |
| spellingShingle | Nobuhisa Matsuhashi Jesse Yu Tajima Ryoma Yokoi Shigeru Kiyama Masahide Endo Yuta Sato Masashi Kuno Hirokatsu Hayashi Ryuichi Asai Masahiro Fukada Itaru Yasufuku Yoshihiro Tanaka Naoki Okumura Katsutoshi Murase Takuma Ishihara Takao Takahashi Short-term outcomes associated with the use of a new powered circular stapler for rectal reconstructions: a retrospective study comparing it to manual circular staplers using inverse probability of treatment weight analysis BMC Surgery Powered circular stapler Rectal reconstructions Short-term outcomes |
| title | Short-term outcomes associated with the use of a new powered circular stapler for rectal reconstructions: a retrospective study comparing it to manual circular staplers using inverse probability of treatment weight analysis |
| title_full | Short-term outcomes associated with the use of a new powered circular stapler for rectal reconstructions: a retrospective study comparing it to manual circular staplers using inverse probability of treatment weight analysis |
| title_fullStr | Short-term outcomes associated with the use of a new powered circular stapler for rectal reconstructions: a retrospective study comparing it to manual circular staplers using inverse probability of treatment weight analysis |
| title_full_unstemmed | Short-term outcomes associated with the use of a new powered circular stapler for rectal reconstructions: a retrospective study comparing it to manual circular staplers using inverse probability of treatment weight analysis |
| title_short | Short-term outcomes associated with the use of a new powered circular stapler for rectal reconstructions: a retrospective study comparing it to manual circular staplers using inverse probability of treatment weight analysis |
| title_sort | short term outcomes associated with the use of a new powered circular stapler for rectal reconstructions a retrospective study comparing it to manual circular staplers using inverse probability of treatment weight analysis |
| topic | Powered circular stapler Rectal reconstructions Short-term outcomes |
| url | https://doi.org/10.1186/s12893-023-02218-w |
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