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Second redo surgery after two consecutive failures of a colorectal or coloanal anastomosis: is it reasonable?

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Colorectal redo surgery is well known to be a difficult procedure, associated with a high risk of failure. The aim of this study was to look into patients presenting two consecutive failed colorectal (CRA) or coloanal (CAA) anastomosis who underwent a second redo surgery (i.e., third anastomosis).

Methods

A retrospective study based on a prospective database of second redo surgeries of CRA or CAA, in an expert center. Sixteen patients between 2005 and 2020 were analyzed.

Results

After a mean follow-up of 28 ± 26 months, success of surgery (defined as no stoma at the end of follow-up) was reported in 10/16 patients (63%). One patient with chronic anastomotic leakage and another with early colonic ischemia had no defunctioning stoma reversal. In the remaining four patients with a failed second redo surgery, a definitive stoma was ultimately created for fistula recurrence (n = 1), poor functional results (n = 2), or local cancer recurrence (n = 1). Two risk factors for failure of this second redo surgery were significantly found in a univariate analysis: (1) nature of the primary anastomosis: 3/13 s redo surgeries failed (23%) if a CRA was first made and 3/3 (100%) if it was a CAA (p = 0.036); (2) age: patients with a failed second redo surgery were older (p = 0.04).

Conclusion

A 63% rate of success of second redo surgery was observed after two failed CRA or CAA. Although a demanding procedure, it can be proposed to carefully selected and motivated patients.

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Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Pôle Des Maladies de L’Appareil Digestif (PMAD), Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University of Paris, 100 Boulevard du Général Leclerc, 92110, Clichy, France

    Camélia Labiad, Marie Monsinjon, Massimo Giacca & Yves Panis

  2. Sorbonne Université, 15-21 rue de l’Ecole de Médecine, 75006, Paris, France

    Camélia Labiad

Authors
  1. Camélia Labiad
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  2. Marie Monsinjon
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  3. Massimo Giacca
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  4. Yves Panis
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Corresponding author

Correspondence to Yves Panis.

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The authors declare no competing interests.

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Labiad, C., Monsinjon, M., Giacca, M. et al. Second redo surgery after two consecutive failures of a colorectal or coloanal anastomosis: is it reasonable?. Int J Colorectal Dis 36, 2057–2060 (2021). https://doi.org/10.1007/s00384-021-03982-y

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  • DOI: https://doi.org/10.1007/s00384-021-03982-y

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