Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Anastomotic leakage (AL) after colorectal surgery is a significant concern, as it can lead to adverse functional and oncologic outcomes. Numerous studies have been conducted with the aim of identifying risk factors for AL and developing str...
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| Main Author: | |
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| Format: | Article |
| Language: | English |
| Published: |
Ewha Womans University College of Medicine
2023-12-01
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| Series: | The Ewha Medical Journal |
| Subjects: | |
| Online Access: | http://www.e-emj.org/archive/view_article?pid=emj-46-s1-29 |
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| Summary: | Anastomotic leakage (AL) after colorectal surgery is a significant concern, as it
can lead to adverse functional and oncologic outcomes. Numerous studies have
been conducted with the aim of identifying risk factors for AL and developing
strategies to prevent its occurrence, thereby reducing the severe morbidity
associated with AL. The intraoperative method for reducing AL includes a
mechanical assessment of AL, an assessment of bowel perfusion, drain placement,
and the creation of diverting stomas. The anastomosis technique is also
associated with AL, and the appropriate selection and accurate application of
anastomotic methods are crucial for preventing AL. Indocyanine green
fluorescence imaging has recently gained popularity as a method for assessing
bowel perfusion. While it is useful for detecting bowel perfusion, standardized
protocols and measurement methods need to be established to ensure its
reliability and effectiveness in clinical practice. The use of intraoperative
drains to reduce AL has produced inconsistent results, and the routine adoption
of this practice is not currently recommended. Diverting stomas can be used to
help reduce the morbidity associated with AL. However, it is important to
carefully consider the complications that can arise directly from the stoma
itself. It should be noted that while a stoma can reduce AL, it cannot
completely prevent it. This descriptive review examines various intraoperative
methods aimed at reducing AL, discussing their effectiveness in reducing AL. |
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| ISSN: | 2234-2591 |