Multiple robotic stapler firings to transect the rectum are not associated with anastomotic leakage

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Hauptverfasser: Stefano Cardelli, Luca Stocchi, Amit Merchea, Dorin T. Colibaseanu, Michelle F. DeLeon, Nitin Mishra, Kevin J. Hancock, David W. Larson
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Veröffentlicht: Wiley 2025
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author Stefano Cardelli
Luca Stocchi
Amit Merchea
Dorin T. Colibaseanu
Michelle F. DeLeon
Nitin Mishra
Kevin J. Hancock
David W. Larson
author_facet Stefano Cardelli
Luca Stocchi
Amit Merchea
Dorin T. Colibaseanu
Michelle F. DeLeon
Nitin Mishra
Kevin J. Hancock
David W. Larson
Stefano Cardelli
Luca Stocchi
Amit Merchea
Dorin T. Colibaseanu
Michelle F. DeLeon
Nitin Mishra
Kevin J. Hancock
David W. Larson
collection Wiley Open Access
contents Multiple robotic stapler firings to transect the rectum are not associated with anastomotic leakage Stefano Cardelli Luca Stocchi Amit Merchea Dorin T. Colibaseanu Michelle F. DeLeon Nitin Mishra Kevin J. Hancock David W. Larson Colorectal Disease AbstractAimThe relationship between the number of stapler firings (SFs) during robotic rectal transection and the risk of colorectal/coloanal anastomotic leakage (AL) is controversial. This study investigates whether the number of robotic SFs is associated with an increased risk of AL.MethodRetrospective review of adult patients who underwent robotic total mesorectal excision (TME) and partial mesorectal excision (PME) with double‐stapled colorectal or coloanal anastomosis for both benign and malignant colorectal diseases between 2015 and 2023 across three enterprise‐wide hospitals. Primary outcome: the effect of multiple SFs on postoperative AL rate among patients who underwent one, two, or three or more SFs. Secondary outcome: the effects of other potential risk factors on postoperative AL.ResultsOf 503 patients who underwent robotic colorectal resection with a double‐stapled anastomosis, 56 (11%) developed a postoperative AL. The number of SFs was not associated with the AL rate (p = 0.51): the univariable and multivariate analyses found no correlation between the AL rate and the increasing number of SFs required, compared with one SF as the reference (adjusted two SFs, OR = 1.1, 95% CI: 0.6–2.2, p = 0.77 vs. adjusted three or more SFs, OR = 0.98, 95% CI: 0.4–2.3, p = 0.96). On multivariate analysis, AL was strongly associated with male gender (OR = 2.5, 95% CI: 1.3–4.9, p = 0.005) and with TME versus PME (OR = 2.8, 95% CI: 1.5–5.5, p = 0.002).ConclusionThe number of robotic SFs for rectal transection is not correlated with postoperative AL. 10.1111/codi.70094 http://onlinelibrary.wiley.com/termsAndConditions#vor
doi_str_mv 10.1111/codi.70094
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institution Wiley Open Access
license_str_mv http://onlinelibrary.wiley.com/termsAndConditions#vor
publishDate 2025
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spellingShingle Multiple robotic stapler firings to transect the rectum are not associated with anastomotic leakage
Stefano Cardelli
Luca Stocchi
Amit Merchea
Dorin T. Colibaseanu
Michelle F. DeLeon
Nitin Mishra
Kevin J. Hancock
David W. Larson
Colorectal Disease
Multiple robotic stapler firings to transect the rectum are not associated with anastomotic leakage Stefano Cardelli Luca Stocchi Amit Merchea Dorin T. Colibaseanu Michelle F. DeLeon Nitin Mishra Kevin J. Hancock David W. Larson Colorectal Disease AbstractAimThe relationship between the number of stapler firings (SFs) during robotic rectal transection and the risk of colorectal/coloanal anastomotic leakage (AL) is controversial. This study investigates whether the number of robotic SFs is associated with an increased risk of AL.MethodRetrospective review of adult patients who underwent robotic total mesorectal excision (TME) and partial mesorectal excision (PME) with double‐stapled colorectal or coloanal anastomosis for both benign and malignant colorectal diseases between 2015 and 2023 across three enterprise‐wide hospitals. Primary outcome: the effect of multiple SFs on postoperative AL rate among patients who underwent one, two, or three or more SFs. Secondary outcome: the effects of other potential risk factors on postoperative AL.ResultsOf 503 patients who underwent robotic colorectal resection with a double‐stapled anastomosis, 56 (11%) developed a postoperative AL. The number of SFs was not associated with the AL rate (p = 0.51): the univariable and multivariate analyses found no correlation between the AL rate and the increasing number of SFs required, compared with one SF as the reference (adjusted two SFs, OR = 1.1, 95% CI: 0.6–2.2, p = 0.77 vs. adjusted three or more SFs, OR = 0.98, 95% CI: 0.4–2.3, p = 0.96). On multivariate analysis, AL was strongly associated with male gender (OR = 2.5, 95% CI: 1.3–4.9, p = 0.005) and with TME versus PME (OR = 2.8, 95% CI: 1.5–5.5, p = 0.002).ConclusionThe number of robotic SFs for rectal transection is not correlated with postoperative AL. 10.1111/codi.70094 http://onlinelibrary.wiley.com/termsAndConditions#vor
title Multiple robotic stapler firings to transect the rectum are not associated with anastomotic leakage
topic Colorectal Disease
url https://onlinelibrary.wiley.com/doi/10.1111/codi.70094