Table 3.
Utilization of purported fistula mitigation strategies, stratified by region
| Variable | Asia/Australia | Europe/Africa/Middle East | North America | South/Central America | Overall | P-value |
|---|---|---|---|---|---|---|
| Surgeons, n (%) | 209 (23.5%) | 273 (30.6%) | 282 (31.6%) | 127 (14.3%) | 891 | – |
| Trans-anastomotic stents | ||||||
| Never | 37 (18.0%) | 82 (30.1%) | 73 (26.2%) | 42 (33.1%) | 234 (26.5%) | <0.001 |
| Occasionally (1–25%) | 39 (18.9%) | 74 (27.2%) | 73 (26.2%) | 41 (32.3%) | 227 (25.7%) | |
| Sometimes (26–75%) | 23 (11.2%) | 38 (14.0%) | 32 (11.5%) | 12 (9.4%) | 105 (11.9%) | |
| Frequently (76–99%) | 40 (19.4%) | 48 (17.6%) | 67 (24.0%) | 20 (15.7%) | 175 (19.8%) | |
| Always | 67 (32.5%) | 30 (11.0%) | 34 (12.2%) | 12 (9.4%) | 143 (16.2%) | |
| Type of stent used | ||||||
| Internal | 112 (67.5%) | 135 (71.8%) | 156 (75.7%) | 56 (65.9%) | 459 (71.2%) | 0.064 |
| External | 34 (20.5%) | 42 (22.3%) | 27 (13.1%) | 17 (20.0%) | 120 (18.6%) | |
| Depends on the case | 20 (12.0%) | 11 (5.9%) | 23 (11.2%) | 12 (14.1%) | 66 (10.2%) | |
| Biological sealants | ||||||
| Never | 140 (68.0%) | 174 (64.0%) | 176 (63.3%) | 84 (66.7%) | 574 (65.1%) | 0.007 |
| Occasionally (1–25%) | 32 (15.5%) | 62 (22.8%) | 62 (22.3%) | 27 (21.4%) | 183 (20.7%) | |
| Sometimes (26–75%) | 7 (3.4%) | 16 (5.9%) | 15 (5.4%) | 10 (7.9%) | 48 (5.4%) | |
| Frequently (76–99%) | 9 (4.4%) | 12 (4.4%) | 17 (6.1%) | 5 (4.0%) | 43 (4.9%) | |
| Always | 18 (8.7%) | 8 (2.9%) | 8 (2.9%) | 0 | 34 (3.9%) | |
| Autologous tissue patches | ||||||
| Never | 134 (64.4%) | 172 (64.2%) | 147 (53.1%) | 89 (71.2%) | 542 (61.7%) | 0.001 |
| Occasionally (1–25%) | 34 (16.3%) | 51 (19.0%) | 52 (18.8%) | 21 (16.8%) | 158 (18.0%) | |
| Sometimes (26–75%) | 18 (8.7%) | 18 (6.7%) | 20 (7.2%) | 5 (4.0%) | 61 (6.9%) | |
| Frequently (76–99%) | 10 (4.8%) | 12 (4.5%) | 38 (13.7%) | 7 (5.6%) | 67 (7.6%) | |
| Always | 12 (5.8%) | 15 (5.6%) | 20 (7.2%) | 3 (2.4%) | 50 (5.7%) | |
| Prophylactic, intraperitoneal drainage | ||||||
| Never | 26 (12.6%) | 47 (17.2%) | 41 (14.7%) | 9 (7.2%) | 123 (13.9%) | 0.003 |
| Occasionally (1–25%) | 25 (12.1%) | 19 (7.0%) | 26 (9.3%) | 14 (11.2%) | 84 (9.5%) | |
| Sometimes (26–75%) | 8 (3.9%) | 11 (4.0%) | 18 (6.5%) | 2 (1.6%) | 39 (4.4%) | |
| Frequently (76–99%) | 28 (13.5%) | 27 (9.9%) | 49 (17.6%) | 11 (8.8%) | 115 (13.0%) | |
| Always | 120 (58.0%) | 169 (61.9%) | 145 (52.0%) | 89 (71.2%) | 523 (59.2%) | |
| Type of drain(s) regularly used | ||||||
| Jackson–Pratt | 65 (36.7%) | 74 (33.5%) | 134 (56.5%) | 21 (18.3%) | 294 (39.2%) | <0.001 |
| Blake | 53 (29.9%) | 61 (27.6%) | 94 (39.7%) | 58 (50.4%) | 266 (35.5%) | |
| Penrose | 21 (11.9%) | 36 (16.3%) | 1 (0.4%) | 21 (18.3%) | 79 (10.5%) | |
| Other | 37 (20.9%) | 50 (22.6%) | 3 (1.3%) | 12 (10.4%) | 102 (13.6%) | |
| Number of drain(s) regularly used | ||||||
| 1 | 35 (19.6%) | 56 (25.8%) | 101 (43.5%) | 28 (24.3%) | 220 (29.6%) | <0.001 |
| 2 | 119 (66.5%) | 131 (60.4%) | 121 (52.2%) | 80 (69.6%) | 451 (60.7%) | |
| ≥3 | 18 (10.1%) | 22 (10.1%) | 5 (2.2%) | 5 (4.3%) | 50 (6.7%) | |
| Varies each case | 7 (3.9%) | 8 (3.7%) | 5 (2.2%) | 2 (1.7%) | 22 (3.0%) | |
| Remove drains based on early (PoD ≤3) drain amylase values | ||||||
| No | 84 (46.4%) | 112 (49.6%) | 160 (68.4%) | 56 (49.1%) | 412 (54.6%) | <0.001 |
| Yes | 97 (53.6%) | 114 (50.4%) | 74 (31.6%) | 58 (50.9%) | 343 (45.4%) | |
| Preferred PoD drain removal, median (IQR) | 5 (5–7) | 5 (4–7) | 5 (4–6) | 7 (5–8) | 5 (4–7) | <0.001 |
| Prophylactic somatostatin analogues | ||||||
| Never | 63 (30.3%) | 78 (28.7%) | 152 (54.7%) | 65 (51.2%) | 358 (40.5%) | <0.001 |
| Occasionally (1–25%) | 42 (20.2%) | 54 (19.9%) | 72 (25.9%) | 31 (24.4%) | 199 (22.5%) | |
| Sometimes (26–75%) | 26 (12.5%) | 48 (17.6%) | 23 (8.3%) | 15 (11.8%) | 112 (12.7%) | |
| Frequently (76–99%) | 30 (14.4%) | 37 (13.6%) | 17 (6.1%) | 12 (9.4%) | 96 (10.8%) | |
| Always | 47 (22.6%) | 55 (20.2%) | 14 (5.0%) | 4 (3.1%) | 120 (13.6%) | |