Novel technique for anastomotic salvage using transanal minimally invasive surgery: A case report

Olavarria, Oscar A.; Kress, Robert; Shah, Shinil K.; Agarwal, Amit Kumar

doi:10.4240/wjgs.v11.i5.271

Cited by 8 publications

(11 citation statements)

References 26 publications

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“…The transanal endoscopic techniques can be used to access and divide the septum overlying more proximal sinus tracts. This procedure may need to be performed several times over several weeks to months to get the tract to heal in fully [75]. Fibrin glue injection into these sinus tracts has been described and can be done directly via a transanal approach if the opening is distal enough, or endoscopically if it is more proximal [76,77].…”

Section: Management Of Anastomotic Leakmentioning

confidence: 99%

Anastomotic Complications

Friel

Kin

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Mechanical bowel prep and oral antibiotics prior to colon resection are associated with a lower risk of anastomotic leak.• A significant proportion of anastomotic leaks present after the immediate postoperative period, especially if there is a history of pelvic radiation. • Most early anastomotic bleeds are self-limited; late bleeds may be a sign of anastomotic leak. • Anastomotic stricture after cancer resection should undergo endoscopic biopsy and imaging to rule out recurrent cancer. • Benign anastomotic strictures may be amenable to endoscopic management, but some will require surgical revision or completion proctectomy with permanent colostomy if the strictured anastomosis is in the pelvis. • Anastomotic complications often lead to significant detriments to quality of life with regard to pain, defecatory function, sexual function, and urinary function. Discussion of these issues with patients is critical for surgical decision-making. Anastomotic LeakThe unfortunate reality faced by every surgeon who performs bowel resections is the occurrence of anastomotic leaks. The incidence of anastomotic leak after bowel anastomosis ranges from 2% to 21% and is associated with significant risk of short-and long-term morbidity [1][2][3][4][5]. This complication can be a devastating event that sets off a cascade of other unfortunate events, resulting in significant det-riments to quality of life, increased pain, prolonged disability, and sometimes death. Anastomotic leaks are associated with significantly higher healthcare resource utilization and cost, as patients with this complication are more likely to require additional diagnostic tests, procedures or reoperations, hospital days, outpatient care, and readmissions [6,7]. Perhaps the most frustrating aspect of anastomotic leaks in colorectal surgery is the fact that leaks and their severe consequences still occur despite the adoption of evidence-based perioperative guidelines, efforts to optimize patient risk factors, and adherence to surgical principles. Although important progress has been made toward reducing the risk of anastomotic leak, there is still much work to be done to increase our understanding of the pathophysiology of anastomotic leak, and effective strategies for prevention.

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Section: Management Of Anastomotic Leakmentioning

confidence: 99%

Anastomotic Complications

Friel

Kin

2021

The ASCRS Textbook of Colon and Rectal Surgery

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“…Patients, in whom the anastomotic leak was detected early (within five days), did not require conversion to laparotomy and were able to be discharged promptly. Olavarria et al [42] reported a case managing presacral abscess post anastomotic leak through three sessions of septotomies and debridement through TAMIS before successfully reversing the ileostomy. In a completely occluded anastomosis after a low anterior resection, Bong and Lim [43] managed to excise the fibrotic tissue at the stenotic site and regain the continuity of the canal.…”

Section: Tamis For Complication Of Low Rectal Anastomosismentioning

confidence: 99%

Transanal minimally invasive surgery: how can it help us?

Sriram¹,

Tzu-Liang²

2020

MIS

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Transanal surgery has evolved significantly in the past few decades. With the technological advancements of endoscopic systems, minimally invasive approaches in transanal surgeries are quickly increasing in popularity. Transanal endoscopic microsurgery was developed initially with subsequent transanal minimally invasive surgery (TAMIS) being introduced as an alternative in 2009. Over the past decade, more and more papers have been published on TAMIS, regarding the management of benign/malignant rectal lesions as well as repair of anastomotic leaks, anastomotic strictures, rectovaginal/rectourethral fistula, etc. This review details the progress of transanal surgery and the use of TAMIS in different scenarios.

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“…Recently, there has been an increase in options for surgeons to visualize and intervene in anastomotic colorectal leaks. These include endoscopic approaches as well as transanal minimally invasive surgery (TAMIS) [ 6 - 8 ]. Research of these techniques for anastomotic salvage has been limited to case reports and small series.…”

Section: Introductionmentioning

confidence: 99%

Transanal Minimally Invasive Surgery for Marsupialization of Chronic Abscess Cavity After Colorectal Anastomosis

McMahon¹,

Ma²

2023

Cureus

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Anastomotic leaks are one of the most feared and morbid complications after colorectal anastomosis. Management of leaks depends on the severity of the leak and focuses on controlling sepsis and saving the anastomosis. The lower the anastomosis, the more amenable it is to transanal approaches for salvage. However, when a complication exists higher up in the rectum, the surgeon is more limited in the ability to visualize and intervene. With the advent of transanal minimally invasive surgery (TAMIS) and the advancement of endoscopic procedures, there are now more options for surgeons to visualize and intervene in anastomotic colorectal leaks. Prior reports have described the use of TAMIS for the management of anastomotic leaks in the acute phase. However, this same approach can be useful in the management of chronic leaks. This report highlights the benefit of TAMIS to allow visualization and marsupialization of a chronic abscess cavity following an anastomotic leak.

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Novel technique for anastomotic salvage using transanal minimally invasive surgery: A case report

Cited by 8 publications

References 26 publications

Anastomotic Complications

Anastomotic Complications

Transanal minimally invasive surgery: how can it help us?

Transanal Minimally Invasive Surgery for Marsupialization of Chronic Abscess Cavity After Colorectal Anastomosis

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