Anastomotic leaks in gastrointestinal surgery and their prevention

Abstract

Anastomotic leak in the gastrointestinal tract is one of the most important complications of resection. They are the main cause of reoperation, their occurrence worsens the prognosis of the patient, increasing the proportion of direct mortality, as well as being a significant risk factor for recurrence of cancer. The risk of leaks within the gastrointestinal tract is greatly varied, depending on the location and extent of the resection, but also on patient, disease or a surgical procedure, including surgeon. To determine the potential risk of leakage can be significant for introduction some prophylactic actions. Some of them have the character of general recommendations, as proper nutrition of the patient in the perioperative period, while another part is directly connected to the surgical procedure. The second group includes protective stoma, the use of tissue glues, insertion transrectal drain for rectal anastomosis decompression, the use of stents or the use of collagen matrix coated with fibrinogen and thrombin. Important to reduce the proportion of leaks can be more precise and targeted prophylactic recommendations, based on the individualized determination of risk factors leaks. Further research for this purpose are necessary for this purpose, the big hope can be associated with data obtained through mobile applications.

Dehiscence of colorectal anastomosis treated with noninvasive procedures.

“…It is due to the limitation of the minimal diameter of a catheter as well as foam compression limitations [ 34 ]. Hemostatic clips, tissue adhesives, and cellular growth stimulant are in turn most suitable for the healing of a small, persistent fissure such as a perirectal sinus remaining after EVT treatment [ 35 , 36 ]. An intra-luminal EVT inserted at the level of the anastomosis is the only solution either in the case of a dehiscence smaller than the diameter of a catheter, i.e.…”