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Safety and Feasibility Colorectal Anastomosis Protocol Implementation: Results from the CASPI Single-Arm Pilot Study.
Ernesto Barzola1,2, Lidia Cornejo3, Judith Luquín1
1Colorectal Surgery Unit, Department of General and Digestive Surgery, University Hospital of Girona, 17007 Girona, Spain.
A new colorectal anastomosis assessment protocol (CASPI) shows high feasibility and safety in colorectal cancer surgery. This multimodal approach, including ICG perfusion and endoscopy, warrants further study for preventing anastomotic leakage.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Gastrointestinal Endoscopy
Background:
- Anastomotic leakage (AL) is a significant complication following colorectal surgery.
- Current strategies to prevent AL have limitations.
- A novel multimodal protocol, CASPI, was developed to assess colorectal anastomoses.
Purpose of the Study:
- To evaluate the feasibility, safety, and adherence of the colorectal anastomosis assessment protocol (CASPI).
- To assess the protocol's utility in patients undergoing colorectal cancer surgery.
Main Methods:
- A prospective, single-arm pilot study involving 34 patients with colorectal cancer.
- The CASPI protocol included indocyanine green (ICG) perfusion, doughnut integrity check, air leak test, intraoperative endoscopy, and postoperative sigmoidoscopy.
Main Results:
- 100% intraoperative and 88.2% postoperative adherence to the CASPI protocol.
- 94.1% adequate perfusion by ICG and 100% intact anastomotic doughnuts.
- No complications related to the CASPI protocol were observed.
Conclusions:
- The CASPI protocol demonstrated excellent feasibility, high adherence, and safety in colorectal cancer surgery.
- Findings support further investigation in larger, controlled trials to assess clinical effectiveness in reducing anastomotic complications.
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