Perioperative intrapelvic hyaluronate application as prophylaxis against complications following rectal anastomotic dehiscence: An experimental study

Páral, Jiří; Odlozilova, Sarka; Sirovy, Miroslav; Zajak, J; Kotek, Jiří; Lochman, Petr

doi:10.1016/j.asjsur.2021.09.006

Cited by 1 publication

(1 citation statement)

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“…Options include buttress with sutures, omentum, mesenteric flaps or synthetic materials ( 43 ). Fibrin and other associated sealants are purported to form a scaffold resistant to tension and compression while still remaining porous to cytokines and other immune cells essential for healing ( 44 - 47 ). Due to the questionable cost-benefit profile of these adjuncts, we do not utilise them in our routine practice.…”

Section: Discussionmentioning

confidence: 99%

Surgical considerations for the “perfect” colorectal anastomosis

Ong,

Tan,

Teo

et al. 2023

J Gastrointest Oncol

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A technically sound colorectal anastomosis is paramount in optimising outcomes and reducing complications such as anastomotic leak which can lead to prolonged hospital stay, repeated operations, stoma formation, anastomotic stricture formation and even mortality in patients. Therefore, thorough consideration should be given to all aspects of its construct, from its basic mechanical configuration to subsequent evaluation of anastomosis integrity and perfusion. Risk factors for anastomotic leakage are well established and are usually classified into modifiable and non-modifiable risk factors. In this review article, we will focus on and discuss the modifiable surgical risk factors and how the authors incorporate latest evidence and surgical principles in creating a “perfect” colorectal anastomosis. We review the latest evidence on the proper mechanical construct of a colorectal anastomosis, enhanced recovery after surgery (ERAS), high versus low ligation of inferior mesenteric artery (IMA), routine splenic flexure mobilisation (SFM), the use of indocyanine green (ICG), as well as methods used for the evaluation of the anastomosis integrity. New adjuncts described in the literature to reinforce anastomoses are also discussed. In summary, meticulous technique with nuanced refinements based on our understanding of surgical principles, together with the adoption of relevant new technologies, are essential in our strive towards the “perfect” colorectal anastomosis.

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Section: Discussionmentioning

confidence: 99%