Anastomotic leak rates after repair of mesenteric bucket-handle injuries: A multi-center retrospective cohort study

Chathurika S. Dhanasekara, Brianna Marschke, Erin Morris, Bryan S. Bashrum, Kripa Shrestha, Robyn Richmond, Sharmila Dissanaike*, Ara Ko, Lakshika Tennakoon, Eric M. Campion, Frank C. Wood, Maggie Brandt, Grace Ng, Justin Regner, Stacey L. Keith, Michelle K. Mcnutt, Heather Kregel, Rajesh Gandhi, Thomas Schroeppel, Daniel R. MarguliesYassar Hashim, Joseph Herrold, Mallory Goetz, Le Rone Simpson, Doan Xuan-Lan

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

Background: Primary aim was to assess the relative risk (RR) of anastomotic leak (AL) in intestinal bucket-handle (BH) compared to non-BH injury. Methods: Multi-center study comparing AL in BH from blunt trauma 2010–2021 compared to non-BH intestinal injuries. RR was calculated for small bowel and colonic injury using R. Results: AL occurred in 20/385 (5.2%) of BH vs. 4/225 (1.8%) of non-BH small intestine injury. AL was diagnosed 11.6 ± 5.6 days from index operation in small intestine BH and 9.7 ± 4.3 days in colonic BH. Adjusted RR for AL was 2.32 [0.77–6.95] for small intestinal and 4.83 [1.47–15.89] for colonic injuries. AL increased infections, ventilator days, ICU & total length of stay, reoperation, and readmission rates, although mortality was unchanged. Conclusion: BH carries a significantly higher risk of AL, particularly in the colon, than other blunt intestinal injuries.

Original languageEnglish (US)
Pages (from-to)770-775
Number of pages6
JournalAmerican journal of surgery
Volume226
Issue number6
DOIs
StatePublished - Dec 2023

Keywords

  • Anastomotic leak
  • Blunt abdominal trauma
  • Bucket-handle injury
  • Devascularizing mesenteric injury
  • Intestinal trauma
  • Primary anastomosis

ASJC Scopus subject areas

  • Surgery

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