Identifying Important Predictors for Anastomotic Leak After Colon and Rectal Resection

Abstract

Multiple risk factors exist that predispose patients to ALs. These risk factors should be considered before and during the surgical care of colorectal patients.

A novel powered circular stapler designed for creating secure anastomoses

“…Among complications, anastomotic leaks are a dominant surgical concern due to their high morbidity and mortality risks. Post-operative anastomotic leaks occur in up to 1%-4% of gastrectomies [13,14], 8%-11% of esophagectomies [15,16], and 6%-14% of colorectal resections, with mortality in the latter reported between 2% and 12% [17][18][19][20]. Post-operative anastomotic leak may result in 65%-81% higher total hospital costs and 56%-100% longer length of hospital stay [19,20].…”

Benefit of extraperitonization to prevent septic intraabdominal complications after distal rectal cancer surgery

“…7,8 Risk factors for anastomosis leakage like male sex, advanced age, overweight, low rectal cancer (10 cm from ano-rectal line), 3≥ Charlson index, high ligation of superior mesenteric artery, sepsis, neo-adjuvant chemotherapy, smoking, high American Society of Anesthesiologist (ASA) score, longer operative time (1.9), can be stratified by colon leakage score. 9,10 Intraoperative anastomosis check, good blood supply, tension free and meticulous operative technique are pre-requisites for better anastomosis healing. Protective ileostomy in low anterior rectum resection (ARR) has more advocates than oponents.…”

Endoscopic Deployment of MatriStem for Treatment of a Colorectal Anastomotic Leak

“…To avoid the hazards of reoperation, minimally invasive endoscopic techniques have been recently proposed as an alternative for salvaging colorectal anastomotic leaks. [2][3][4] One such extracellular matrix scaffold is urinary bladder matrix (UBM), which is composed of the epithelial basement membrane and tunica propria of the porcine urinary bladder and is decellularized, disinfected, dried, and sterilized. It is commercially available under the trade name MatriStem (ACell, Columbia, Maryland).…”