{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:48:06Z","timestamp":1789433286464,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,7,11]],"date-time":"2018-07-11T00:00:00Z","timestamp":1531267200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Reports detailing the morbidity\u2013mortality after left colectomy are sparse and do not allow definitive conclusions to be drawn. We aimed to identify risk factors for anastomotic leakage, perioperative mortality and complications following left colectomy for colonic malignancies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We undertook a<jats:styled-content style=\"fixed-case\">STROBE<\/jats:styled-content>\u2010compliant analysis of left colectomies included in a national prospective online database. Forty\u2010two variables were analysed as potential independent risk factors for anastomotic leakage, postoperative morbidity and mortality. Variables were selected using the \u2018least absolute shrinkage and selection operator\u2019 (<jats:styled-content style=\"fixed-case\">LASSO<\/jats:styled-content>) method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We analysed 1111 patients. Eight per cent of patients had a leakage and in 80% of them reoperation or surgical drainage was needed. A quarter of patients (24.9%) experienced at least one minor complication. Perioperative mortality was 2%, leakage being responsible for 47.6% of deaths. Obesity (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>2.8, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.00\u20137.05,<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.04) and total parenteral nutrition (<jats:styled-content style=\"fixed-case\">TPN<\/jats:styled-content>) (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>3.7, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.58\u20138.51,<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002) were associated with increased risk of leakage, whereas female patients had a lower risk (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>0.36, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>0.18\u20130.67,<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002). Corticosteroids (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.03) and oral anticoagulants (<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.01) doubled the risk of complications, which was lower with hyperlipidaemia (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>0.3,<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.02). Patients on<jats:styled-content style=\"fixed-case\">TPN<\/jats:styled-content>had more complications (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>4.02, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>2.03\u20138.07,<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.04) and higher mortality (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>8.7, 95%<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>1.8\u201340.9,<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.006). Liver disease and advanced age impaired survival, corticosteroids being the strongest predictor of mortality (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>21.5,<jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Requirement for<jats:styled-content style=\"fixed-case\">TPN<\/jats:styled-content>was associated with more leaks, complications and mortality. Leakage was presumably responsible for almost half of deaths. Hyperlipidaemia and female gender were associated with lower rates of complications. These findings warrant a better understanding of metabolic status on perioperative outcome after left colectomy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.14309","type":"journal-article","created":{"date-parts":[[2018,6,19]],"date-time":"2018-06-19T18:50:15Z","timestamp":1529434215000},"page":"986-995","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Predictors of complications and mortality following left colectomy with primary stapled anastomosis for cancer: results of a multicentric study with 1111 patients"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8322-6421","authenticated-orcid":false,"given":"G.","family":"Pellino","sequence":"first","affiliation":[{"name":"Colorectal Unit Hospital Universitario y Politecnico La Fe University of Valencia Valencia Spain"},{"name":"Department of Medical, Surgical, Neurological, Metabolic and Ageing Sciences Universit\u00e0 della Campania \u2018Luigi Vanvitelli\u2019 Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Frasson","sequence":"additional","affiliation":[{"name":"Colorectal Unit Hospital Universitario y Politecnico La Fe University of Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Garc\u00eda\u2010Granero","sequence":"additional","affiliation":[{"name":"Colorectal Unit Hospital Universitario y Politecnico La Fe University of Valencia Valencia Spain"},{"name":"Human Anatomy and Embryology Department University of Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Granero\u2010Castro","sequence":"additional","affiliation":[{"name":"Colorectal Unit Hospital Universitario y Politecnico La Fe University of Valencia Valencia Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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