Risk factors for colorectal anastomotic stenoses and their impact on quality of life: what are the lessons to learn?

“…36 Both physical and emotional components were affected in 2 studies. 40,41 One study showed that only symptom scores were affected instead of the physical or emotional component scores. 26 Multivariate analyses were performed in 17 studies.…”

Section: Effect Of Saes On Postoperative Qolmentioning

confidence: 99%

Systematic Review of the Impact of Surgical Harm on Quality of Life After General and Gastrointestinal Surgery

et al. 2014

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“…The etiology of this phenomenon after surgery has not been clarified. Opted theories are other conditions such as an irritable bowel syndrome, adhesions, stenosis, incomplete sigmoid resection or changed sympathetic innervation [31]. In accordance with these assumptions, the reported re-operation rates are low and range between 0 and 3% [3].…”

Section: Discussionmentioning

confidence: 86%

Recurrences and Ongoing Complaints of Diverticulitis; Results of a Survey among Gastroenterologists and Surgeons

Stam¹,

Draaisma²,

Consten³

et al. 2016

Hum Hered

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Objective: This study aims to investigate the current opinion of gastroenterologists and surgeons on treatment strategies for patients, with recurrences or ongoing complaints of diverticulitis. Background: Treatment of recurrences and ongoing complaints remains a point of debate. No randomized trials have been published yet and guidelines are not uniform in their advice. Design: A web-based survey was conducted among gastroenterologists and GE-surgeons. Questions were aimed at the treatment options for recurrent diverticulitis and ongoing complaints. Results: In total, 123 surveys were filled out. The number of patients with recurrent or ongoing diverticulitis who were seen at the outpatient clinic each year was 7 (0-30) and 5 (0-115) respectively. Surgeons see significantly more patients on an annual basis 20 vs. 15% (p = 0.00). Both surgeons and gastroenterologists preferred to treat patients in a conservative manner using pain medication and lifestyle advise (64.4 vs. 54.0, p = 0.27); however, gastroenterologists would treat patients with mesalazine medication, which is significantly more (28%, p = 0.04) than in the surgical group. Surgeons are inclined more towards surgery (31.5%, p = 0.02). Conclusions: Both surgeons and gastroenterologists prefer to treat recurrent diverticulitis and ongoing complaints in a conservative manner. Quality of life, the risk of complications and the viewpoint of the patient are considered important factors in the decision to resect the affected colon.

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“…Some of the identified risk factors for anastomotic leakage are male gender, nutritional status, high BMI, the location of anastomosis, diverting stoma, and history of radiation [10][11][12][13]. Men, because of the narrow pelvis, offer greater challenge during pelvic dissection, and hence increased risk of anastomotic leakage [14].…”

Section: Discussionmentioning

confidence: 99%

Analysis of Risk Factors and Management of Anastomotic Leakage After Rectal Cancer Surgery: An Indian Series

Jatal

Pai

Demenezes

et al. 2015

Indian J Surg Oncol

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The primary objective of this study was to determine whether sphincter preservation is possible among patients who develop anastomotic leakage after rectal cancer surgery. The secondary objective was to determine the factors that may contribute to anastomotic leakage. This is a retrospective review of a prospectively maintained database. All patients with rectal cancer who underwent restorative proctectomy over 1 year were included in the study. The parameters analyzed were age, preoperative hemoglobin and albumin, neoadjuvant therapy, type of surgery, level of ligation of inferior mesenteric pedicle, technique of anastomosis, and defunctioning proximal stoma. In this study, 176 cases of anterior resection were included,of which15 (8.5 %) had anastomotic leakage. None of the factors contributing to anastomotic leakage reached statistical significance on univariate analysis. Among the patients who had proximal defunctioning ileostomy (n = 9), five (56 %) required re-surgery whereas other four were managed with antibiotics and presacral drainage alone (44 %). Among the patients who didnot have proximal defunctioning ileostomy (n = 6), all (100 %) required re-surgery. Among the 12 eligible patients, stoma reversal was successful in eight (67 %) patients. This study highlights the importance of defunctioning proximal stoma in reducing the incidence and severity of anastomotic leakage as well as the need and extent of re-surgery for low rectal cancer. Sphincter preservation is possible in majority of patients who develop anastomotic leakage after rectal cancer surgery.

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Risk factors for colorectal anastomotic stenoses and their impact on quality of life: what are the lessons to learn?

Abstract: Since diverticulitis and mechanical anastomosis are risk factors for anastomotic stenosis, surgeons should take this into account when they are considering what type of anastomotic technique to utilize.

Cited by 88 publications

References 18 publications

Systematic Review of the Impact of Surgical Harm on Quality of Life After General and Gastrointestinal Surgery

Systematic Review of the Impact of Surgical Harm on Quality of Life After General and Gastrointestinal Surgery

Recurrences and Ongoing Complaints of Diverticulitis; Results of a Survey among Gastroenterologists and Surgeons

Analysis of Risk Factors and Management of Anastomotic Leakage After Rectal Cancer Surgery: An Indian Series

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