Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis
ABSTRACT Introduction: anastomotic leak (AL) after colectomy for colorectal cancer (CRC) is a life-threatening complication. This systematic review and meta-analysis aimed to evaluate the preoperative risk factors for AL in patients submitted to colectomy. Methods: the bibliographic search cover...
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| Format: | Article |
| Language: | English |
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Colégio Brasileiro de Cirurgiões
2022-11-01
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| Series: | Revista do Colégio Brasileiro de Cirurgiões |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912022000100251&tlng=en |
| _version_ | 1828127480265834496 |
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| author | VINÍCIUS EVANGELISTA DIAS PEDRO ALVES SOARES VAZ DE CASTRO HOMERO TERRA PADILHA LARA VICENTE PILLAR LAURA BOTELHO RAMOS GODINHO AUGUSTO CLAUDIO DE ALMEIDA TINOCO RODRIGO DA COSTA AMIL ALEIDA NAZARETH SOARES GERALDO MAGELA GOMES DA CRUZ JULIANA MARIA TRINDADE BEZERRA THAIS ALMEIDA MARQUES DA SILVA |
| author_facet | VINÍCIUS EVANGELISTA DIAS PEDRO ALVES SOARES VAZ DE CASTRO HOMERO TERRA PADILHA LARA VICENTE PILLAR LAURA BOTELHO RAMOS GODINHO AUGUSTO CLAUDIO DE ALMEIDA TINOCO RODRIGO DA COSTA AMIL ALEIDA NAZARETH SOARES GERALDO MAGELA GOMES DA CRUZ JULIANA MARIA TRINDADE BEZERRA THAIS ALMEIDA MARQUES DA SILVA |
| author_sort | VINÍCIUS EVANGELISTA DIAS |
| collection | DOAJ |
| description | ABSTRACT Introduction: anastomotic leak (AL) after colectomy for colorectal cancer (CRC) is a life-threatening complication. This systematic review and meta-analysis aimed to evaluate the preoperative risk factors for AL in patients submitted to colectomy. Methods: the bibliographic search covered 15 years and 9 months, from 1st January 2005 to 19th October 2020 and was performed using PubMed, Cochrane Library, Scopus, Biblioteca Virtual em Saúde, Europe PMC and Web of Science databases. The inclusion criteria were cross-sectional, cohort and case-control studies on preoperative risk factors for AL (outcome). The Newcastle-Ottawa scale was used for bias assessment within studies. Meta-analysis involved the calculation of treatment effects for each individual study including odds ratio (OR), relative risk (RR) and 95% confidence intervals (95% CI) with construction of a random-effects model to evaluate the impact of each variable on the outcome. Statistical significance was set at p<0.05. Results: cross-sectional studies were represented by 39 articles, cohort studies by 21 articles and case-control by 4 articles. Meta-analysis identified 14 main risk factors for AL in CRC patients after colectomy, namely male sex (RR=1.56; 95% CI=1.40-1.75), smoking (RR=1.48; 95% CI=1.30-1.69), alcohol consumption (RR=1.35; 95% CI=1.21-1.52), diabetes mellitus (RR=1.97; 95% CI=1.44-2.70), lung diseases (RR=2.14; 95% CI=1.21-3.78), chronic obstructive pulmonary disease (RR=1.10; 95% IC=1.04-1.16), coronary artery disease (RR=1.61; 95% CI=1.07-2.41), chronic kidney disease (RR=1.34; 95% CI=1.22-1.47), high ASA grades (RR=1.70; 95% CI=1.37-2.09), previous abdominal surgery (RR=1.30; 95% CI=1.04-1.64), CRC-related emergency surgery (RR=1.61; 95% CI=1.26-2.07), neoadjuvant chemotherapy (RR=2.16; 95% CI=1.17-4.02), radiotherapy (RR=2.36; 95% CI=1.33-4.19) and chemoradiotherapy (RR=1.58; 95% CI=1.06-2.35). Conclusions: important preoperative risk factors for colorectal AL in CRC patients have been identified based on best evidence-based research, and such knowledge should influence decisions regarding treatment. |
| first_indexed | 2024-04-11T15:52:00Z |
| format | Article |
| id | doaj.art-fc3ab2ccb3644378b9b1b8e026be3dfb |
| institution | Directory Open Access Journal |
| issn | 1809-4546 |
| language | English |
| last_indexed | 2024-04-11T15:52:00Z |
| publishDate | 2022-11-01 |
| publisher | Colégio Brasileiro de Cirurgiões |
| record_format | Article |
| series | Revista do Colégio Brasileiro de Cirurgiões |
| spelling | doaj.art-fc3ab2ccb3644378b9b1b8e026be3dfb2022-12-22T04:15:17ZengColégio Brasileiro de CirurgiõesRevista do Colégio Brasileiro de Cirurgiões1809-45462022-11-014910.1590/0100-6991e-20223363-enPreoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysisVINÍCIUS EVANGELISTA DIAShttps://orcid.org/0000-0002-7345-2660PEDRO ALVES SOARES VAZ DE CASTROhttps://orcid.org/0000-0002-1183-7610HOMERO TERRA PADILHAhttps://orcid.org/0000-0001-8487-1257LARA VICENTE PILLARhttps://orcid.org/0000-0001-9828-3675LAURA BOTELHO RAMOS GODINHOhttps://orcid.org/0000-0002-1005-9511AUGUSTO CLAUDIO DE ALMEIDA TINOCOhttps://orcid.org/0000-0003-1386-7239RODRIGO DA COSTA AMILhttps://orcid.org/0000-0003-0068-0651ALEIDA NAZARETH SOAREShttps://orcid.org/0000-0002-2671-3661GERALDO MAGELA GOMES DA CRUZhttps://orcid.org/0000-0003-0794-4269JULIANA MARIA TRINDADE BEZERRAhttps://orcid.org/0000-0001-9840-6217THAIS ALMEIDA MARQUES DA SILVAhttps://orcid.org/0000-0002-5042-2004ABSTRACT Introduction: anastomotic leak (AL) after colectomy for colorectal cancer (CRC) is a life-threatening complication. This systematic review and meta-analysis aimed to evaluate the preoperative risk factors for AL in patients submitted to colectomy. Methods: the bibliographic search covered 15 years and 9 months, from 1st January 2005 to 19th October 2020 and was performed using PubMed, Cochrane Library, Scopus, Biblioteca Virtual em Saúde, Europe PMC and Web of Science databases. The inclusion criteria were cross-sectional, cohort and case-control studies on preoperative risk factors for AL (outcome). The Newcastle-Ottawa scale was used for bias assessment within studies. Meta-analysis involved the calculation of treatment effects for each individual study including odds ratio (OR), relative risk (RR) and 95% confidence intervals (95% CI) with construction of a random-effects model to evaluate the impact of each variable on the outcome. Statistical significance was set at p<0.05. Results: cross-sectional studies were represented by 39 articles, cohort studies by 21 articles and case-control by 4 articles. Meta-analysis identified 14 main risk factors for AL in CRC patients after colectomy, namely male sex (RR=1.56; 95% CI=1.40-1.75), smoking (RR=1.48; 95% CI=1.30-1.69), alcohol consumption (RR=1.35; 95% CI=1.21-1.52), diabetes mellitus (RR=1.97; 95% CI=1.44-2.70), lung diseases (RR=2.14; 95% CI=1.21-3.78), chronic obstructive pulmonary disease (RR=1.10; 95% IC=1.04-1.16), coronary artery disease (RR=1.61; 95% CI=1.07-2.41), chronic kidney disease (RR=1.34; 95% CI=1.22-1.47), high ASA grades (RR=1.70; 95% CI=1.37-2.09), previous abdominal surgery (RR=1.30; 95% CI=1.04-1.64), CRC-related emergency surgery (RR=1.61; 95% CI=1.26-2.07), neoadjuvant chemotherapy (RR=2.16; 95% CI=1.17-4.02), radiotherapy (RR=2.36; 95% CI=1.33-4.19) and chemoradiotherapy (RR=1.58; 95% CI=1.06-2.35). Conclusions: important preoperative risk factors for colorectal AL in CRC patients have been identified based on best evidence-based research, and such knowledge should influence decisions regarding treatment.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912022000100251&tlng=enRisk FactorsAnastomotic LeaksColon SurgeryColon Diseases |
| spellingShingle | VINÍCIUS EVANGELISTA DIAS PEDRO ALVES SOARES VAZ DE CASTRO HOMERO TERRA PADILHA LARA VICENTE PILLAR LAURA BOTELHO RAMOS GODINHO AUGUSTO CLAUDIO DE ALMEIDA TINOCO RODRIGO DA COSTA AMIL ALEIDA NAZARETH SOARES GERALDO MAGELA GOMES DA CRUZ JULIANA MARIA TRINDADE BEZERRA THAIS ALMEIDA MARQUES DA SILVA Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis Revista do Colégio Brasileiro de Cirurgiões Risk Factors Anastomotic Leaks Colon Surgery Colon Diseases |
| title | Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis |
| title_full | Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis |
| title_fullStr | Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis |
| title_full_unstemmed | Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis |
| title_short | Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis |
| title_sort | preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer a systematic review and meta analysis |
| topic | Risk Factors Anastomotic Leaks Colon Surgery Colon Diseases |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912022000100251&tlng=en |
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