Pubblicazioni

Autori:

Catarci, Marco; Guadagni, Stefano; Masedu, Francesco; Guercioni, Gianluca; Ruffo, Giacomo; Viola, Massimo Giuseppe; Borghi, Felice; Scatizzi, Marco; Patriti, Alberto; Baiocchi, Gian Luca; Italian ColoRectal Anastomotic Leakage (iCral) study, Group; Pedrazzani, Corrado

Titolo:

Intraoperative left-sided colorectal anastomotic testing in clinical practice: a multi-treatment machine-learning analysis of the iCral3 prospective cohort

Anno:

2024

Tipologia prodotto:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Lingua:

Inglese

Referee:

No

Nome rivista:

UPDATES IN SURGERY

ISSN Rivista:

2038-131X

N° Volume:

76

Numero o Fascicolo:

5

Intervallo pagine:

1715-1727

Parole chiave:

Air-leak test; Anastomotic leakage; Colorectal surgery; ICG fluorescent angiography; Left-sided colorectal resection

Breve descrizione dei contenuti:

Background: Current evidence about intraoperative anastomotic testing after left-sided colorectal resections is still controversial. The aim of this study was to analyze the impact of Indocyanine Green fluorescent angiography (ICG-FA) and air-leak test (ALT) over standard assessment on anastomotic leakage (AL) rates according to surgeon's perception of anastomosis perfusion and/or integrity in clinical practice. Methods: A database of 2061 patients who underwent left-sided colorectal resections was selected from patients enrolled in a prospective multicenter study. It was retrospectively analyzed through a multi-treatment machine-learning model considering standard visual assessment (NW; No. = 899; 43.6%) as the reference treatment arm, compared to ICG-FA alone (WP; No. = 409; 19.8%), ALT alone (WI; No. = 420; 20.4%) or both (WPI; No. = 333; 16.2%). Twenty-four covariates potentially affecting the outcomes were included and balanced into the model within the subgroups. The primary endpoint was AL, the secondary endpoints were overall morbidity (OM), major morbidity (MM), reoperation for AL, and mortality. All the results were reported as odds ratio (OR) with 95% confidence intervals (95%CI). Results: The WPI subgroup showed significantly higher AL risk (OR 1.91; 95% CI 1.02-3.59; p 0.043), MM risk (OR 2.35; 95% CI 1.39-3.97; p 0.001), and reoperation for AL risk (OR 2.44; 95% CI 1.12-5.31; p 0.025). No other significant differences were recorded. Conclusions: This study showed that the surgeons' perception of both anastomotic perfusion and integrity (WPI subgroup) was associated to a significantly higher risk of AL and related morbidity, notwithstanding the extensive use of both ICG-FA and ALT testing.

Id prodotto:

141611

Handle IRIS:

11562/1142126

ultima modifica:

8 maggio 2025

Citazione bibliografica:

Catarci, Marco; Guadagni, Stefano; Masedu, Francesco; Guercioni, Gianluca; Ruffo, Giacomo; Viola, Massimo Giuseppe; Borghi, Felice; Scatizzi, Marco; Patriti, Alberto; Baiocchi, Gian Luca; Italian ColoRectal Anastomotic Leakage (iCral) study, Group; Pedrazzani, Corrado, Intraoperative left-sided colorectal anastomotic testing in clinical practice: a multi-treatment machine-learning analysis of the iCral3 prospective cohort «UPDATES IN SURGERY» , vol. 76 , n. 5 , 2024 , pp. 1715-1727

Consulta la scheda completa presente nel repository istituzionale della Ricerca di Ateneo