scholarly journals Anastomotic Leak after Colorectal Surgery. Our Experience in three Years.

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Kastriot Haxhirexha ◽  
Agron Dogjani ◽  
Lutfi Zylbehari ◽  
Nehat Baftiu ◽  
Ferizat Dika – Haxhirexha
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Anastomotic Leak ◽  
Intestinal Resection ◽  
Morbidity And Mortality ◽  
Multiple Risk Factors ◽  
Four Quadrant ◽  
Emergent Surgery ◽  
Large Bowel Resection

Background: One of the most severe complication after intestinal resection, often with catastrophic consequence for the patient is leakage from the anastomosis. The severity of complications after anastomotic leak may range from a small localized peritonitis or abscess formation without sepsis, to a development of a four quadrant peritonitis with septic shock. Until now despite the seriousness of this complications, the cause of anastomotic leakage are not yet definitively clear. Aim: The aim of this study is to submit our experience in treatment of patients with anastomotic leakage after intestinal resection and their outcome. Materials and Methods: The study included 63 patients with colorectal cancer operated in the Department of Surgery at the Clinical Hospital of Tetova. In all patients intestinal resection with end to end anastomosis was performed. Conclusions: Anastomotic leak after large bowel resection is a very serious complication with a great impact on patient’s morbidity and mortality.  Multiple risk factors are associated with occurrence of this complication whereas the more suspected are: preoperative anaemia, hypoalbuminemia, emergent surgery without adequate preparation of patient, intraoperative blood loss and blood transfusion during surgery etc. Early detection of AL is very important and helpful to improve the outcome of patients and to minimize postoperative rate of morbidity and mortality. Keywords: anastomotic leaks, colorectal surgery, risk factors  

scholarly journals Markers of Perioperative Bowel Complications in Colorectal Surgery Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Radomír Hyšpler ◽  
Alena Tichá ◽  
Milan Kaška ◽  
Lenka Žaloudková ◽  
Lenka Plíšková ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Intestinal Resection ◽  
Specific Marker ◽  
Exhaled Breath ◽  
Fatty Acid Binding ◽  
Gastrointestinal Complications ◽  
Reactive Protein ◽  
The Difference ◽  
Low Sensitivity

Colorectal cancer is a clinical condition whose treatment often involves intestinal resection. Such treatment frequently results in two major gastrointestinal complications after surgery: anastomotic leakage and prolonged ileus. Anastomotic leakage is a serious complication which, more often than not, is diagnosed late; to date, C-reactive protein is the only available diagnostic marker. A monocentric, prospective, open case-control study was performed in patients(n=117)undergoing colorectal surgery. Intestinal fatty acid binding protein (i-FABP), citrulline, D-lactate, exhaled hydrogen,Escherichia coligenomic DNA, and ischemia modified albumin (IMA) were determined preoperatively, postoperatively, and on the following four consecutive days. Bacterial DNA was not detected in any sample, and i-FABP and D-lactate lacked any distinct potential to detect postoperative bowel complications. Exhaled breath hydrogen content showed unacceptably low sensitivity. However, citrulline turned out to be a specific marker for prolonged ileus on postoperative days 3-4. Using a cut-off value of 20 μmol/L, a sensitivity and specificity of ~75% was achieved on postoperative day 4. IMA was found to be an efficient predictor of anastomosis leak by calculating the difference between preoperative and postoperative values. This test had 100% sensitivity and 80% specificity and 100% negative and 20% positive predictive value.

scholarly journals EVALUATION OF RISK FACTORS AFFECTING ANASTOMOTIC LEAKAGE AFTER REPAIR OF ESOPHAGEAL ATRESIA

2015 ◽  
Vol 28 (3) ◽  
pp. 161-162 ◽  
Author(s):  
Shahnam ASKARPOUR ◽  
Mehran PEYVASTEH ◽  
Hazhir JAVAHERIZADEH ◽  
Nasim ASKARI
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Anastomotic Leakage ◽  
Anastomotic Leak ◽  
Esophageal Atresia ◽  
Case Control Study ◽  
Case Control ◽  
Anastomotic Leaks ◽  
Factors Affecting ◽  
Control Study

Background: Anastomotic leak are reported among neonates who underwent esophageal atresia. Aim: To find risk factors of anastomotic leakage in patients underwent esophageal repair. Methods: All cases with esophageal atresia were included. In this case control study, patients were classified in two groups according to presence or absence of anastomotic leaks. Duration of study was 10 years. Results: Sixty-one cases were included. Mean±SD age at time of surgery in patients with leakage and without leakage was 9.50±7.25 and 8.83±6.93 respectively (p=.670). Blood transfusion and two layer anastomosis had significant correlation with anastomotic leakage. Conclusion: Blood transfusion and double layer anastomosis are associated with higher rate of anastomotic leakage.

scholarly journals Role of biomarkers in predicting anastomotic leakage following colorectal surgeries

2020 ◽  
Vol 8 (7) ◽  
pp. 2562
Author(s):  
Mumtaz Din Wani ◽  
Ferkhand Mohi Ud Din ◽  
Aabid Rasool Bhat ◽  
Irshad Ahmad Kumar ◽  
Ashiq Hussain Raina ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Anastomotic Leak ◽  
Sensitivity And Specificity ◽  
Peritoneal Fluid ◽  
Clinical Symptoms ◽  
Colorectal Disease ◽  
Total Leukocyte Count ◽  
Drain Fluid ◽  
The Mean

Background: Recovery after surgery for patients with colorectal disease has improved with the advent of minimal access surgery and standardized recovery protocols. Despite these advances, anastomotic leakage remains one of the most dreaded complications following colorectal surgery, with rates of 3-27 per cent depending on specific risk factors. The aim of the study was to assess sensitivity and specificity of systemic and peritoneal drain-fluid bio-markers in early prediction of anastomotic leak; and to co-relate rise in levels of biomarkers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Methods: The present study was a prospective observational study conducted on 60 patients in the Postgraduate Department of Surgery, Government Medical College, Srinagar after obtaining due ethical clearance over a period of two years.Results: The mean age was 54.87±11.901 years with 44 patients (73.3%) were males. Among systemic makers: the mean CRP level was 2.7800±0.500 mg/L, the mean total leukocyte count was 10.783±0.940 thousands and the mean serum procalcitonin level was 0.365±0.1385 ng/ml. Among peritoneal fluid drain bio-makers, the mean IL-6 level was 3551.066±1311.965 pg/ml, the mean IL-10 level was 628.533±460.358 pg/ml and the mean TNF-a level was 16.391±6.736 pg/ml. The anastomotic leak after colo-rectal surgery was noted in 16 patients (26.7%). In our study significant co-relation was noted between the rise in levels of peritoneal drain fluid biomarkers and severity of clinical symptoms but no significant co-relation was noted between the rise in levels of systemic markers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Conclusions: Systemic biomarkers are poor predictors of anastomotic leak after colorectal surgery. But sensitivity and specificity of peritoneal fluid drain biomarkers in predicting anastomotic leak was significantly high.

Smoking and alcohol misuse are major risk factors of anastomotic leakage in colorectal surgery

1998 ◽  
Vol 114 ◽  
pp. A43 ◽  
Author(s):  
L.T. Sørensen ◽  
L.T. Kirkeby ◽  
J. Skovdal ◽  
B. Vennits ◽  
P. Wille-Jørgensen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Alcohol Misuse

Risk Factors for Anastomotic Leak, Consideration for Proximal Diversion, and Appropriate Use of Drains

2021 ◽  
Vol 34 (06) ◽  
pp. 366-370
Author(s):  
Joanne Favuzza
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
High Risk ◽  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Anastomotic Leaks ◽  
Appropriate Use ◽  
Preoperative Optimization ◽  
Colorectal Surgeons ◽  
Drain Placement

AbstractAnastomotic leaks are a major source of morbidity after colorectal surgery. There is a myriad of risk factors that may contribute to anastomotic leaks. These risk factors can be categorized as modifiable, nonmodifiable, and intraoperative factors. Identification of these risk factors allows for preoperative optimization that may minimize the risk of anastomotic leak. Knowledge of such high-risk features may also affect intraoperative decision-making regarding the creation of an anastomosis, consideration for proximal diversion, or placement of a drain. A thorough understanding of the interplay between risk factors, indications for proximal diversion, and utility of drain placement is imperative for colorectal surgeons.

Morbidity and mortality after colorectal cancer surgery in patients with cirrhosis: A critical review of the literature.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 608-608
Author(s):  
Tarek Boussaha ◽  
Jean François Cadranel ◽  
Allaoua Smail ◽  
Hortensia Lison ◽  
Armand Garioud ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
Colorectal Surgery ◽  
Postoperative Morbidity ◽  
Cancer Surgery ◽  
Morbidity And Mortality ◽  
Colorectal Cancer Surgery ◽  
Increased Risk ◽  
Cirrhotic Patients ◽  
Independent Risk Factors

608 Background: Cirrhotic patients with localized colorectal cancer are potential candidates for tumor resection. The aim of this review was to evaluate the morbi-mortality after colorectal surgery. Methods: Comprehensive search was conducted using PUBMED, EMBASE, and the COCHRANE Library. Prospective and retrospective studies were selected. The study population included cirrhotic patients who underwent colorectal resection for non-metastatic colorectal cancer and patients with benign and other malignant disease. The postoperative morbi-mortality and independent risk factors were analysed. Results: Eight studies were identified. Among these, four studies compared the risk of colorectal surgery in patients with and without liver cirrhosis. The number of patients varied from 41 to 6,120. The severity of cirrhosis in most of the studies was classified with the Child-Pugh score. Class B and C were observed in 20% to 60% of the patients. Sepsis represented the main postoperative complication and occurred in 48% to 77% of patients. Mortality varied according to the Child-Pugh score, ranging from 11% to 41%, and was significantly higher for patients with cirrhosis in Child-Pugh Class C. Urgent surgical procedure had a negative impact on prognosis. The average length of hospital stay ranged from 9 to 18 days. Cirrhosis was associated with a 2-3 time and a 4-10 time increased risk of postoperative mortality in the absence and presence of portal hypertension, respectively compared with non-cirrhotic patients. The independent risk factors for postoperative morbidity and mortality were encephalopathy, ascites, low haemoglobin, prolonged prothrombin time, elevated bilirubin, hypoalbuminemia, postoperative infection, total colectomy, elective or non-elective surgery, the presence of co-morbidities and MELD score ≥ 15. Conclusions: Colorectal cancer surgery is associated with an increased risk of postoperative morbidity and mortality in cirrhosis patients. Studies evaluating exclusively the operative risk for colorectal cancer surgery in this patient’s population are rare. Prospective controlled trials to optimize the perioperative management of those patients are needed.

scholarly journals Risk Factors of Anastomotic Leakage and Long-Term Survival After Colorectal Surgery

Medicine ◽  
2016 ◽  
Vol 95 (8) ◽  
pp. e2890 ◽  
Author(s):  
Jong Seob Park ◽  
Jung Wook Huh ◽  
Yoon Ah Park ◽  
Yong Beom Cho ◽  
Seong Hyeon Yun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Term Survival ◽  
Long Term Survival

scholarly journals Colorectal Surgery in Cirrhotic Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jacqueline Paolino ◽  
Randolph M. Steinhagen
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Portal Hypertension ◽  
Colorectal Surgery ◽  
Postoperative Morbidity ◽  
Perioperative Management ◽  
Meld Score ◽  
Morbidity And Mortality ◽  
Stomal Complications ◽  
Cirrhotic Patients

Patients with cirrhosis have a greater risk of morbidity and mortality following colorectal surgery. Therefore, preoperative medical optimization and risk assessment using criteria such as the MELD score are vital in preventing complications. Some risk factors include age, urgency of surgery, and ASA score. Postoperative morbidity and mortality are related to portal hypertension, ascites, infection, and anastomotic and stomal complications. This review highlights the assessment of risk and perioperative management of cirrhotic patients undergoing colorectal surgery.

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