Surgical management of anastomotic leak following colorectal surgery

2014 ◽  
Vol 25 (2) ◽  
pp. 58-66 ◽  
Author(s):  
Ron G. Landmann
Author(s):  
Richard T. Spence ◽  
Dhruvin H. Hirpara ◽  
Sachin Doshi ◽  
Fayez A. Quereshy ◽  
Sami A. Chadi

Author(s):  
Traci L. Hedrick ◽  
William Kane

AbstractManagement of the acute anastomotic leak is complex and patient-specific. Clinically stable patients often benefit from a nonoperative approach utilizing antibiotics with or without percutaneous drainage. Clinically unstable patients or nonresponders to conservative management require operative intervention. Surgical management is dictated by the degree of contamination and inflammation but includes drainage with proximal diversion, anastomotic resection with end-stoma creation, or reanastomosis with proximal diversion. Newer therapies, including colorectal stenting, vacuum-assisted rectal drainage, and endoscopic clipping, have also been described.


2021 ◽  
Vol 34 (06) ◽  
pp. 385-390
Author(s):  
Naomi M. Sell ◽  
Todd D. Francone

AbstractAnastomotic leak remains a critical and feared complication in colorectal surgery. The development of a leak can be catastrophic for a patient, resulting in overall increased morbidity and mortality. To help mitigate this risk, there are several ways to assess and potentially validate the integrity of a new anastomosis to give the patient the best chance of avoiding this postoperative complication. A majority of anastomoses will appear intact with no obvious sign of anastomotic dehiscence on gross examination. However, each anastomosis should be interrogated before the conclusion of an operation. The most common method to assess for an anastomotic leak is the air leak test (ALT). The ALT is a safe intraoperative method utilized to test the integrity of left-sided colon and rectal anastomoses and most importantly allows the ability to repair a failed test before concluding the operation. Additional troubleshooting is sometimes needed due to technical difficulties with the circular stapler. Problems, such as incomplete doughnuts and stapler misfiring, do occur and each surgeon should be prepared to address them.


2020 ◽  
Vol 219 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Vijaya T. Daniel ◽  
Karim Alavi ◽  
Jennifer S. Davids ◽  
Paul R. Sturrock ◽  
Cristina R. Harnsberger ◽  
...  

2019 ◽  
Vol 71 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Ahmad Alsaleh ◽  
Gianluca Pellino ◽  
Natasha Christodoulides ◽  
George Malietzis ◽  
Christos Kontovounisios

2020 ◽  
Vol 22 (10) ◽  
pp. 1451-1452
Author(s):  
D. J. Morrell ◽  
K. J. McKenna ◽  
E. Messaris ◽  
E. M. Pauli

2020 ◽  
Vol 72 (2) ◽  
pp. 463-468
Author(s):  
Cristian A. Angeramo ◽  
Nicolas H. Dreifuss ◽  
Francisco Schlottmann ◽  
Maximilano E. Bun ◽  
Nicolas A. Rotholtz

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