Colorectal surgery in Italy: a snapshot from the iCral study group

The Italian ColoRectal Anastomotic Leakage (iCral) study group, Marco Catarci, Giacomo Ruffo, Felice Borghi, Alberto Patriti, Paolo Delrio, Marco Scatizzi, Stefano Mancini, Gianluca Garulli, Alessandro Carrara, Felice Pirozzi, Stefano Scabini, Andrea Liverani, Gianluca Baiocchi, Roberto Campagnacci, Andrea Muratore, Graziano Longo, Marco Caricato, Raffaele Macarone Palmieri, Nereo VettorettoMarcello Ceccaroni, Paolo Ciano, Elisa Bertocchi, Desirée Cianflocca, Margherita Lambertini, Ugo Pace, Maddalena Baraghini, Lorenzo Pandolfini, Riccardo Angeloni, Andrea Lucchi, Giuseppe Tirone, Michele Motter, Antonio Sciuto, Antonio Martino, Andrea Pierre Luzzi, Tatiana di Cesare, Sarah Molfino, Angela Maurizi, Patrizia Marsanic, Federico Tomassini, Simone Santoni, Gabriella Teresa Capolupo, Pietro Amodio, Elisa Arici, Benedetta Ruggeri, Gianluca Guercioni

Research output: Contribution to journalArticlepeer-review


During a recent prospective trial on early diagnosis of anastomotic leakage (AL) after colorectal surgery, we gathered a large database on more than 1500 procedures performed in 19 surgical centers in Italy over a 12-month period. Main purpose of the present paper is to show the epidemiological data about colorectal procedures and anastomotic leakage. Prospective enrollment for all elective colorectal resections with anastomosis (September 2017–September 2018). Primary endpoint was AL; secondary endpoints were morbidity and mortality rates, readmission and reoperation rates, and length of post-operative hospital stay (; Identifier: NCT03560180). There were 1546 enrolled cases (56.9% of 2717 total resected cases). The rate of minimally invasive resections was 83.5%. Overall AL rate was 4.92% (76 cases; range per center 0-12.12%). Mean ± SD time to AL diagnosis was 5.95 ± 4.78 days (median 5, range 1-31). Overall morbidity rate was 30.20%, mortality 1.29% (20 cases; range per center 0-3.27), readmission 0.90%, and reoperation 6.92%. Mean ± SD post-operative LOS was 7.89 ± 5.97 days (median 6; range 1-120). AL significantly influenced all other secondary endpoints. This study offers a good snapshot of colorectal resections in Italy. There was a high rate of laparoscopic resections, reflecting the special interest in this kind of surgery by the participating centers. AL, morbidity, mortality, readmission and reoperation rates are compared to those reported in previous population-based studies. Compared to series dealing with open colorectal resections, the time to diagnosis of AL was shortened by several days.
Original languageEnglish
Pages (from-to)339-347
Number of pages9
JournalUpdates in Surgery
Issue number2
Publication statusPublished - Jun 1 2019


  • Anastomotic leakage
  • Colorectal surgery
  • Multicenter study
  • Prospective observational study


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