The Failed Anastomosis

Smallwood, Nathan; Mutch, Matthew G.; Fleshman, James W.

doi:10.1007/978-1-4614-9022-7_18

Cited by 3 publications

(3 citation statements)

References 159 publications

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“…Anastomotic leaks located within the peritoneal cavity more often present with diffuse contamination, peritonitis, and sepsis. 12 Extraperitoneal leaks may present in a less obvious fashion as a fistula, rectal drainage, pain, or urinary symptoms. 13,14 Asymptomatic leaks are usually identified during an evaluation prior to diverting ileostomy takedown, for example, endoscopy, CT scan with or without contrast (►Fig.…”

Section: Categorizationmentioning

confidence: 99%

“…As previously mentioned, ileocolic anastomoses are considered to have the lowest incidence of leaks, ranging from 1 to 3%, 4,34,35 yet when leaks occur, peritonitis and sepsis are more common compared with extraperitoneal leaks. 12 Patients with Crohn's disease (CD) are at a higher risk for an anastomotic leak 36 which can have significant impact on disease recurrence. 37 On retrospective review of a national registry, leak rates ranged from 1.6 to 14.3% by the number of risk factors for ileocolectomy for CD.…”

Section: Ileocolic Anastomotic Leakmentioning

confidence: 99%

“…These patients warrant an evaluated for an anastomotic leak. 12 On average, patients with an anastomotic leak compared with those without a leak spend almost a week longer in the hospital. 57,58 The median time to diagnosis has a reported range between 12 and 17 days from the time of surgery, at which point patients may have been discharged from the hospital.…”

Section: Short-term Outcomesmentioning

confidence: 99%

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Defining Anastomotic Leak and the Clinical Relevance of Leaks

Ellis

Maykel

2021

Clin Colon Rectal Surg

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Surgeons universally dread gastrointestinal anastomotic leaks, yet the precise definition is not widely agreed on despite international consensus guidelines. Likewise, leaks are not uniformly reported which makes comparisons across studies flawed. Leak rates range from 1 to 3% for ileocolonic, 0.5 to 18% for colorectal, and 5 to 19% for coloanal anastomoses. The sequelae of an anastomotic leak vary but generally correlate with the need for a change in clinical management, from minimal changes to the need for reoperation. Short- and long-term outcomes can be life-altering or life-threatening. Temporary or permanent stomas may be necessary and low pelvic anastomotic leaks may affect bowel function. For cancer patients, leaks can delay treatment and negatively affect oncologic outcomes. In Crohn's patients, leaks are associated with higher recurrence rates. In essence, the lack of agreement on the definition of an anastomotic leak inhibits meaningful understand of its epidemiology, prevention, and treatment.

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Section: Categorizationmentioning

confidence: 99%

Section: Ileocolic Anastomotic Leakmentioning

confidence: 99%

Section: Short-term Outcomesmentioning

confidence: 99%

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Defining Anastomotic Leak and the Clinical Relevance of Leaks

Ellis

Maykel

2021

Clin Colon Rectal Surg

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Rectal Stump Perforation Stump While Passing an End-to-End Anastomotic Stapler

Lee

2019

Colorectal Surgery Consultation

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Predictive factors of anastomotic leakage in laparoscopic colorectal surgery

Castor Siqueira Freire Viana,

Carballo

2023

SCT Proceedings in Interdisciplinary Insights and Innovations

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Background: Anastomotic leakage represent one of the most alarming complications after any gastrointestinal anastomosis. According to the predictive factors analyzed, the postoperative morbidity and mortality suffered by patients are long-lasting consequences on functional and oncological results. Its incidence is 3%-6%, even in experienced hands. There is a lack of consensus regarding its definition, with a variety of options for prevention and treatment. Various risk factors have been found to be associated with the development of an anastomotic dehiscence and have inspired the development of various preventive measures and technologies. AIM: determine the most relevant predictors of anastomotic dehiscence available in the current literature. Material and methods: For the development of the research protocol, the PRISMA statement has been followed by systematically, observationally, analytically, and retrospectively reviewing the literature. Articles and studies that address the risk factors for AL during laparoscopic colorectal surgery have been selected, as well as all the current knowledge on its management and post-surgical repair. A bibliographic search was carried out in electronic databases (PubMed, MEDLInE, EMBASE). Results: 16 articles were selected that coincided in their analyzes describing the following risk factors: smoking, advanced age, surgical technique and material used, prolonged operating time and late diagnosis. They are configured as a risk for the occurrence of anastomotic dehiscence, in addition to also recognizing the negative conditions that derive from this complication, such as increased hospitalization time, hospital expenses, and increased morbidity and mortality rates due to AD. Conclusion: prevention is the best way to avoid anastomotic leakage as a post-surgical complication, for this we must highlight the importance of analyzing the risk factors of each patient individually at an early stage such as male sex, a low anastomosis, a BMI greater than 30 and others. In order to adapt a personalized therapeutic plan and thereby reduce morbidity and mortality rates

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The Failed Anastomosis

Cited by 3 publications

References 159 publications

Defining Anastomotic Leak and the Clinical Relevance of Leaks

Defining Anastomotic Leak and the Clinical Relevance of Leaks

Rectal Stump Perforation Stump While Passing an End-to-End Anastomotic Stapler

Predictive factors of anastomotic leakage in laparoscopic colorectal surgery

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