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Intraoperative perfusion assessment of the proximal colon by a visual grading system for safe anastomosis after resection in left-sided colorectal cancer patients

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Abstract
We aimed to evaluate the clinical feasibility of a new visual grading system. We included 50 patients who underwent resection of primary colorectal cancer. Before anastomosis, the marginal vessel was cut and the perfusion status was assessed by a visual grading system. The visual grading system is comprised of five grades according to the bleeding from the marginal vessel and is categorized into 4 groups: good (grade A and B), moderate (grade C), poor (grade D) and none (grade E). Colorectal anastomosis was performed only in the good and moderate groups. We compared postoperative outcomes between the good and moderate groups and analysed the factors affecting the perfusion grade. Among the patients, 48% were grade A, 12% were grade B, and 40% were grade C. There was no anastomotic leakage. Only one patient with grade C showed ischemic colitis and needed reoperation. Age was the only factor correlated with perfusion grade in multivariate analysis (OR 1.080, 95% CI 1.006-1.159, p=0.034). The perfusion grades were significantly different between >65 and <65 year-old patients (>65, A 29.2% B 12.5% C 58.3% vs. <65, A 65.4% B 11.5% C 23.1%, p=0.006). Our intraoperative perfusion assessment that uses a cutting method and a visual grading system is simple and useful for performing a safe anastomosis after colorectal resection. If the perfusion grade is better than grade C, an anastomosis can be performed safely. Age was found to be an important factor affecting the perfusion grade.
Author(s)
김진천김찬욱박인자송인호유창식유효선윤용식이종률임석병최으뜸
Issued Date
2021
Type
Article
Keyword
AnastomosisAnastomotic leakAnatomyColitisColorectal cancerColorectal carcinomaGastroenterologyIschemiaMultivariate analysisPerfusionSigns and symptoms
DOI
10.1038/s41598-021-82486-9
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8533
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_doaj_primary_oai_doaj_org_article_d171a134713547a592e551c753589b74&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Intraoperative%20perfusion%20assessment%20of%20the%20proximal%20colon%20by%20a%20visual%20grading%20system%20for%20safe%20anastomosis%20after%20resection%20in%20left-sided%20colorectal%20cancer%20patients&amp;offset=0&amp;pcAvailability=true
Publisher
SCIENTIFIC REPORTS
Location
미국
Language
영어
ISSN
2045-2322
Citation Volume
11
Citation Number
1
Citation Start Page
2746
Citation End Page
2746
Appears in Collections:
Medicine > Medicine
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