Annals of Coloproctology

Original Articles

New double-stapling technique without staple-crossing line in laparoscopic low anterior resection: effort to reduce anastomotic leakage: Nam Seok Kim, Ji Hoon Kim, Yoon Suk Lee, In Kyu Lee, Won Kyung Kang; Received June 8, 2022 Accepted November 21, 2023 Published online November 22, 2024; DOI: https://doi.org/10.3393/ac.2022.00409.0058 [Epub ahead of print]

157 View
6 Download

Abstract PDF: Purpose
This study aimed to demonstrate the safety of new double-stapling technique (nDST), without a crossing line and dog ears, by comparing with conventional DST (cDST) in laparoscopic low anterior resection (LAR).
Methods
We retrospectively reviewed 98 consecutive patients who underwent laparoscopic LAR for rectal cancer from January 2018 to December 2020. The inclusion criterion was an anastomosis level below the peritoneal reflection and 4 cm above the anal verge. In the nDST group, the staple line of the linear cutter was sutured using barbed sutures to shorten the staple line before firing the circular stapler. Therefore, there were no crossing lines after firing the circular stapler. A 2:1 propensity score matching was performed between the cDST and nDST groups.
Results
After propensity score matching, 39 patients were in the cDST group and 20 were in the nDST group. There were no significant differences in patient demographics between the 2 groups. There was no difference in the total operation time between the cDST and nDST groups (124.0±26.2 minutes vs. 125.2±20.3 minutes, P=0.853). Morbidity rates were similar between the 2 groups (9 cases [23.1%] vs. 5 cases [25.0%], P=0.855). There was no significant difference in leakage rate (4 cases [10.3%] vs. 1 case [5.0%], P=0.847) and anastomotic bleeding rate (1 case [2.6%] vs. 3 cases [15.0%], P=0.211).
Conclusion
The nDST to eliminate the crossing line and dog ears in laparoscopic LAR is technically feasible and safe. However, more attention should be paid to anastomotic bleeding in such cases.

Colorectal cancer

Long-term clinical outcomes after high and low ligations with lymph node dissection around the root of the inferior mesenteric artery in patients with rectal cancer: Min Wan Lee, Sung Sil Park, Kiho You, Dong Eun Lee, Dong Woon Lee, Sung Chan Park, Kyung Su Han, Dae Kyung Sohn, Chang Won Hong, Bun Kim, Byung Chang Kim, Hee Jin Chang, Dae Yong Kim, Jae Hwan Oh; Ann Coloproctol. 2024;40(1):62-73. Published online February 26, 2024; DOI: https://doi.org/10.3393/ac.2023.00094.0013

2,610 View
198 Download
1 Citations

Graphical Abstract Abstract PDF

Purpose
This study aimed to evaluate the long-term clinical outcomes based on the ligation level of the inferior mesenteric artery (IMA) in patients with rectal cancer.
Methods
This was a retrospective analysis of a prospectively collected database that included all patients who underwent elective low anterior resection for rectal cancer between January 2013 and December 2019. The clinical outcomes included oncological outcomes, postoperative complications, and functional outcomes. The oncological outcomes included overall survival (OS) and relapse-free survival (RFS). The functional outcomes, including defecatory and urogenital functions, were analyzed using the Fecal Incontinence Severity Index, International Prostate Symptom Score, and International Index of Erectile Function questionnaires.
Results
In total, 545 patients were included in the analysis. Of these, 244 patients underwent high ligation (HL), whereas 301 underwent low ligation (LL). The tumor size was larger in the HL group than in the LL group. The number of harvested lymph nodes (LNs) was higher in the HL group than in the LL group. There were no significant differences in complication rates and recurrence patterns between the groups. There were no significant differences in 5-year RFS and OS between the groups. Cox regression analysis revealed that the ligation level (HL vs. LL) was not a significant risk factor for oncological outcomes. Regarding functional outcomes, the LL group showed a significant recovery in defecatory function 1 year postoperatively compared with the HL group.
Conclusion
LL with LNs dissection around the root of the IMA might not affect the oncologic outcomes comparing to HL; however, it has minimal benefit for defecatory function.

Citations

Citations to this article as recorded by

Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
Gyung Mo Son
Annals of Coloproctology.2024; 40(5): 415. CrossRef

Malignant disease, Rectal cancer, Functional outcomes,Colorectal cancer

The Effect of Anastomotic Leakage on the Incidence and Severity of Low Anterior Resection Syndrome in Patients Undergoing Proctectomy: A Propensity Score Matching Analysis: Sungjin Kim, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim; Ann Coloproctol. 2021;37(5):281-290. Published online June 7, 2021; DOI: https://doi.org/10.3393/ac.2021.03.15

3,700 View
69 Download
17 Web of Science
18 Citations

Abstract PDF

Purpose
Proctectomy for the treatment of rectal cancer results in inevitable changes to bowel habits. Symptoms such as fecal incontinence, constipation, and tenesmus are collectively referred to as low anterior resection syndrome (LARS). Among the several risk factors that cause LARS, anastomotic leakage (AL) is a strong risk factor for permanent stoma formation. Therefore, the purpose of this study was to investigate the relationship between the severity of LARS and AL in patients with rectal cancer based on the LARS score and the Memorial Sloan Kettering Cancer Center (MSKCC) defecation symptom questionnaires.
Methods
We retrospectively analyzed patients who underwent low anterior resection for rectal cancer since January 2010. Patients who completed the questionnaire were classified into the AL group and control group based on medical and imaging records. Major LARS and MSKCC scores were analyzed as primary endpoints.
Results
Among the 179 patients included in this study, 37 were classified into the AL group. After propensity score matching, there were significant differences in the ratio of major LARS and MSKCC scores of the control group and AL group (ratio of major LARS: 11.1% and 37.8%, P<0.001; MSKCC score: 67.29±10.4 and 56.49±7.2, respectively, P<0.001). Univariate and multivariate analyses revealed that AL was an independent factor for major LARS occurrence and MSKCC score.
Conclusion
This study showed that AL was a significant factor in the occurrence of major LARS and defecation symptoms after proctectomy.

Citations

Citations to this article as recorded by

The effect of robotic surgery on low anterior resection syndrome in patients with lower rectal cancer: a propensity score-matched analysis
Lei Zhang, Chenhao Hu, Jiamian Zhao, Chenxi Wu, Zhe Zhang, Ruizhe Li, Ruihan Liu, Junjun She, Feiyu Shi
Surgical Endoscopy.2024; 38(4): 1912. CrossRef
Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park
The World Journal of Men's Health.2024; 42(2): 304. CrossRef
Innovációk a colorectalis sebészetben
Balázs Bánky, András Fülöp, Viktória Bencze, Lóránd Lakatos, Petra Rozman, Attila Szijártó
Orvosi Hetilap.2024; 165(2): 43. CrossRef
Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein
Gyung Mo Son
Annals of Coloproctology.2024; 40(5): 415. CrossRef
Outcomes following anastomotic leak from rectal resections, including bowel function and quality of life
Angelina Di Re, Salam Tooza, Jason Diab, Charbel Karam, Mina Sarofim, Kevin Ooi, Catherine Turner, Daniel Kozman, David Blomberg, Matthew Morgan
Annals of Coloproctology.2023; 39(5): 395. CrossRef
The status of low anterior resection syndrome: data from a single-center in China
Jing Su, Qianhui Liu, Dagui Zhou, Xiaofeng Yang, Guiru Jia, Lijun Huang, Xiao Tang, Jiafeng Fang
BMC Surgery.2023;[Epub] CrossRef
Low anterior resection syndrome: is it predictable?
Dong Hyun Kang
Annals of Coloproctology.2023; 39(5): 373. CrossRef
Validation of low anterior resection syndrome score in Brazil with Portuguese
Kelly C.L.R. Buzatti, Andy Petroianu, Søren Laurberg, Rodrigo G. Silva, Beatriz D.S. Rodrigues, Peter Christensen, Antonio Lacerda-Filho, Therese Juul
Annals of Coloproctology.2023; 39(5): 402. CrossRef
Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son
Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef
How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han
The Ewha Medical Journal.2023;[Epub] CrossRef
Surgical Techniques for Transanal Local Excision for Early Rectal Cancer
Gyoung Tae Noh
The Ewha Medical Journal.2023;[Epub] CrossRef
Preventing Anastomotic Leakage, a Devastating Complication of Colorectal Surgery
Hyun Gu Lee
The Ewha Medical Journal.2023;[Epub] CrossRef
Early vs. standard reversal ileostomy: a systematic review and meta-analysis
N. J. O’Sullivan, H. C. Temperley, T. S. Nugent, E. Z. Low, D. O. Kavanagh, J. O. Larkin, B. J. Mehigan, P. H. McCormick, M. E. Kelly
Techniques in Coloproctology.2022; 26(11): 851. CrossRef
A predictive nomogram model for low anterior resection syndrome after rectal cancer resection
Mingfang Yan, Zhenmeng Lin, Zhiying Wu, Huizhe Zheng, Meiqin Shi
ANZ Journal of Surgery.2022; 92(12): 3224. CrossRef
Recycling of Iron Slag Waste in the Production of Ceramic Roof Tiles
M. M. Ahmed, K. A. M. El Naggar, M. F. Abadir, W. Abbas, E. M. Abdel Hamid, Ajaya Kumar Singh
Journal of Chemistry.2022; 2022: 1. CrossRef
Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management
Seung Mi Yeo, Gyung Mo Son
The Ewha Medical Journal.2022;[Epub] CrossRef
The watch-and-wait strategy versus radical resection for rectal cancer patients with a good response (≤ycT2) after neoadjuvant chemoradiotherapy
Chungyeop Lee, In Ja Park, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
Annals of Surgical Treatment and Research.2022; 103(6): 350. CrossRef
Functional outcomes after sphincter-preserving surgeries for low-lying rectal cancer: A review
Eun Jung Park, Seung Hyuk Baik
Precision and Future Medicine.2021; 5(4): 164. CrossRef

Original article

Defunctioning Protective Stoma Can Reduce the Rate of Anastomotic Leakage after Low Anterior Resection in Rectal Cancer Patients: Byoung Chul Lee, Seok-Byung Lim, Jong Lyul Lee, Chan Wook Kim, Yong Sik Yoon, In Ja Park, Chang Sik Yu, Jin Cheon Kim; Received October 22, 2019 Accepted November 19, 2019 Published online January 16, 2020; DOI: https://doi.org/10.3393/ac.2019.11.19.1

3,828 View
226 Download
16 Citations

Abstract PDF

PURPOSE
This study aimed to identify risk factors for anastomotic leakage and to evaluate the impact of protective stoma on the rate of anastomotic leakage and subsequent management.
METHODS
This retrospective study analyzed data from 4,282 patients who underwent low anterior resection between 2007 and 2014. Among these, 1,367 (31.9%) underwent surgery to create protective diverting stoma and 232 (5.4%) experienced anastomotic leakage. At 6-month timepoints, data were evaluated to identify any correlation between the presence of diverting stoma and the incidence of anastomotic leakage. In addition, clinicopathological parameters were investigated to identify risk factors for anastomotic leakage.
RESULTS
Diverting stomas significantly reduced the rate of anastomotic leakage [HR 0.334, 95% CI 0.212

Citations

Citations to this article as recorded by

Machine learning model for prediction of permanent stoma after anterior resection of rectal cancer: A multicenter study
Yang Su, Yanqi Li, Heng Zhang, Wangshuo Yang, Mengdie Liu, Xuelai Luo, Lu Liu
European Journal of Surgical Oncology.2024; 50(7): 108386. CrossRef
A nomogram of anastomotic stricture after rectal cancer: a retrospective cohort analysis
Yifan Cheng, Zhen Tian, Shuyang Gao, Shuai Zhao, Ruiqi Li, Jiajie Zhou, Qiannan Sun, Daorong Wang
Surgical Endoscopy.2024; 38(7): 3661. CrossRef
Factors associated with leakage after reversal of protective stoma in patients with locally advanced rectal cancer following curative resection and anastomosis
Miao-Ling Tsai, Ji-Shiang Hung, John Huang, Been-Ren Lin
European Journal of Surgical Oncology.2024; : 108698. CrossRef
Impact of diversion ileostomy on postoperative complications and recovery in the treatment of locally advanced upper-half rectal cancer
Yangyang Wang, Xiaojie Wang, Shenghui Huang, Heyuan Zhu, Ying Huang
Scientific Reports.2024;[Epub] CrossRef
The role of transanal drainage tube in preventing the anastomotic leakage in rectal cancer surgery without a defunctioning stoma: A meta-analysis
Yue-Xin Zhang, Tao Jin, Kun Yang
The Surgeon.2023; 21(4): e164. CrossRef
Sarcopenic Obesity Is a Risk Factor for Worse Oncological Long-Term Outcome in Locally Advanced Rectal Cancer Patients: A Retrospective Single-Center Cohort Study
Peter Tschann, Markus P. Weigl, Patrick Clemens, Philipp Szeverinski, Christian Attenberger, Matthias Kowatsch, Tarkan Jäger, Klaus Emmanuel, Thomas Brock, Ingmar Königsrainer
Nutrients.2023; 15(11): 2632. CrossRef
One Decade of Declining Use of Defunctioning Stomas After Rectal Cancer Surgery in the Netherlands: Are We on the Right Track?
Erik W. Ingwersen, Paulien J.K. van der Beek, Jan Willem T. Dekker, Susan van Dieren, Freek Daams
Diseases of the Colon & Rectum.2023; 66(7): 1003. CrossRef
Effects of Neoadjuvant Radiotherapy on Postoperative Complications in Rectal Cancer: A Meta-Analysis
Jianguo Yang, Yajun Luo, Tingting Tian, Peng Dong, Zhongxue Fu, Irena Ilic
Journal of Oncology.2022; 2022: 1. CrossRef
Tailored Management with Highly-Selective Diversion for Low Colorectal Anastomosis: Biochemical Postoperative Follow-Up and Long-Term Results from a Single-Institution Cohort
Philippe Rouanet, Marie Selvy, Marta Jarlier, Caroline Bugnon, Guillaume Carrier, Anne Mourregot, Pierre-Emmanuel Colombo, Christophe Taoum
Annals of Surgical Oncology.2022; 29(4): 2514. CrossRef
Are risk factors for anastomotic leakage influencing long-term oncological outcomes after low anterior resection of locally advanced rectal cancer with neoadjuvant therapy? A single-centre cohort study
Peter Tschann, Markus P. Weigl, Philipp Szeverinski, Daniel Lechner, Thomas Brock, Stephanie Rauch, Jana Rossner, Helmut Eiter, Paolo N. C. Girotti, Tarkan Jäger, Jaroslav Presl, Klaus Emmanuel, Alexander De Vries, Ingmar Königsrainer, Patrick Clemens
Langenbeck's Archives of Surgery.2022; 407(7): 2945. CrossRef
Analysis of Risk Factors for Anastomotic Leakage After Laparoscopic Anterior Resection of Rectal Cancer and Construction of a Nomogram Prediction Model
Keli Wang, Meijiao Li, Rui Liu, Yang Ji, Jin Yan
Cancer Management and Research.2022; Volume 14: 2243. CrossRef
Preoperative risk factors associated with anastomotic leakage after colectomy for colorectal cancer: a systematic review and meta-analysis
VINÍCIUS EVANGELISTA DIAS, PEDRO ALVES SOARES VAZ DE CASTRO, HOMERO TERRA PADILHA, LARA VICENTE PILLAR, LAURA BOTELHO RAMOS GODINHO, AUGUSTO CLAUDIO DE ALMEIDA TINOCO, RODRIGO DA COSTA AMIL, ALEIDA NAZARETH SOARES, GERALDO MAGELA GOMES DA CRUZ, JULIANA MA
Revista do Colégio Brasileiro de Cirurgiões.2022;[Epub] CrossRef
Fatores de risco pré-operatórios associados à fístula anastomótica após colectomia para câncer colorretal: revisão sistemática e metanálise
VINÍCIUS EVANGELISTA DIAS, PEDRO ALVES SOARES VAZ DE CASTRO, HOMERO TERRA PADILHA, LARA VICENTE PILLAR, LAURA BOTELHO RAMOS GODINHO, AUGUSTO CLAUDIO DE ALMEIDA TINOCO, RODRIGO DA COSTA AMIL, ALEIDA NAZARETH SOARES, GERALDO MAGELA GOMES DA CRUZ, JULIANA MA
Revista do Colégio Brasileiro de Cirurgiões.2022;[Epub] CrossRef
Risk Factors of Anastomotic Leakage After Anterior Resection for Rectal Cancer Patients
Xiang-nan Yu, Lu-ming Xu, Ya-wen Bin, Ye Yuan, Shao-bo Tian, Bo Cai, Kai-xiong Tao, Lin Wang, Guo-bin Wang, Zheng Wang
Current Medical Science.2022; 42(6): 1256. CrossRef
Effect of pelvic drain displacement on anastomotic leakage-related morbidity after rectal cancer surgery
Ho Yung Lee, Sung Il Kang, So Hyun Kim, Jae-Hwang Kim
Journal of Minimally Invasive Surgery.2021; 24(3): 158. CrossRef
Preoperative chemoradiotherapy versus surgery alone for advanced low rectal cancer: a large multicenter cohort study in Japan
Tomonori Akagi, Masafumi Inomata, Hajime Fujishima, Meiki Fukuda, Tsuyoshi Konishi, Shunsuke Tsukamoto, Fuminori Teraishi, Heita Ozawa, Keitaro Tanaka, Koya Hida, Yoshiharu Sakai, Masahiko Watanabe
Surgery Today.2020; 50(11): 1507. CrossRef

Original Articles

Anastomotic Sinus That Developed From Leakage After a Rectal Cancer Resection: Should We Wait for Closure of the Stoma Until the Complete Resolution of the Sinus?: Chris Tae-Young Chung, Se-Jin Baek, Jung-Myun Kwak, Jin Kim, Seon-Hahn Kim; Ann Coloproctol. 2019;35(1):30-35. Published online January 25, 2019; DOI: https://doi.org/10.3393/ac.2018.08.13

5,659 View
143 Download
5 Web of Science
5 Citations

Abstract PDF

Purpose
The aims of this study were to identify the clinical characteristics of an anastomotic sinus and to assess the validity of delaying stoma closure in patients until the complete resolution of an anastomotic sinus.
Methods
The subject patients are those who had undergone a resection of rectal cancer from 2011 to 2017, who had a diversion ileostomy protectively or therapeutically and who developed a sinus as a sequelae of anastomotic leakage. The primary outcomes that were measured were the incidence, management and outcomes of an anastomotic sinus.
Results
Of the 876 patients who had undergone a low anterior resection, 14 (1.6%) were found to have had an anastomotic sinus on sigmoidoscopy or a gastrografin enema before their ileostomy closure. In the 14 patients with a sinus, 7 underwent ileostomy closure as scheduled, with a mean closure time of 4.1 months. The remaining 7 patients underwent ileostomy repair, but it was delayed until after the follow-up for the widening of the sinus opening by using digital dilation, with a mean closure time of 6.9 months. Four of those remaining seven patients underwent stoma closure even though their sinus condition had not yet been completely resolved. No pelvic septic complications occurred after closure in any of the 14 patients with an anastomotic sinus, but 2 of the 14 needed a rediversion due to a severe anastomotic stricture.
Conclusion
Patients with an anastomotic sinus who had been carefully selected underwent successful ileostomy closure without delay.

Citations

Citations to this article as recorded by

Management of Low-Rectal Anastomotic Sinus With Transanal Minimally Invasive Septotomy
Nirvana B. Saraswat, Scott A. Brill, William E. Wise
The American Surgeon™.2023; 89(2): 322. CrossRef
The management of asymptomatic radiological anastomotic leakage following anterior resection
Mohamed Rabie, Laura Parry, Iannish Sadien, Sandeep Kapur, Adam Stearns, Irshad Shaikh
ANZ Journal of Surgery.2022; 92(4): 801. CrossRef
Chronische Anastomoseninsuffizienz nach tiefer Rektumresektion – ein ungelöstes Problem?
Peter Kienle, Jörn Richard Magdeburg
Der Chirurg.2021; 92(7): 605. CrossRef
Response to Dioscoridi et al.
G. I. Popivanov, V. M. Mutafchiyski, R. Cirocchi, S. D. Chipeva, V. V. Vasilev, K. T. Kjossev, M. S. Tabakov
Colorectal Disease.2020; 22(7): 841. CrossRef
Anastomotic Sinus Developed From Leakage in Rectal Cancer Resection: When Can We Reverse the Defunctioning Stoma?
Chang Hyun Kim
Annals of Coloproctology.2019; 35(1): 1. CrossRef

Transanal Tube Drainage as a Conservative Treatment for Anastomotic Leakage Following a Rectal Resection: Mostafa Shalaby, Waleed Thabet, Oreste Buonomo, Nicola Di Lorenzo, Mosaad Morshed, Giuseppe Petrella, Mohamed Farid, Pierpaolo Sileri; Ann Coloproctol. 2018;34(6):317-321. Published online December 20, 2018; DOI: https://doi.org/10.3393/ac.2017.10.18

5,601 View
176 Download
11 Web of Science
13 Citations

Abstract PDF

Purpose
We evaluate the role of transanal tube drainage (TD) as a conservative treatment for patients with anastomotic leakage (AL).
Methods
Patients treated for AL who had undergone a low or an ultralow anterior resection with colorectal or coloanal anastomosis for the treatment of rectal cancer between January 2013 and January 2017 were enrolled in this study. The data were collected prospectively and analyzed retrospectively. The primary outcomes were the diagnosis and the management of AL.
Results
Two hundred thirteen consecutive patients, 122 males and 91 females, were included. The mean age was 66.91 ± 11.15 years, and the median body mass index was 24 kg/m2 (range, 20–35 kg/m2 ). The median tumor distance from the anal verge was 8 cm (range, 4–12 cm). Ninety-three patients (44%) received neoadjuvant therapy for nodal disease and/or locally advanced rectal cancer. Only 13 patients (6%) developed AL. Six patients developed subclinical AL as they had a defunctioning ileostomy at the time of the initial procedure. They were treated conservatively with TD under endoscopic guidance in the endoscopy unit and received intravenous antibiotics. Six weeks after discharge, these 6 patients underwent follow-up flexible sigmoidoscopy which showed a completely healed anastomotic defect with no residual stenosis. Seven patients developed a clinically significant AL and required reoperation with pelvic abscess drainage and Hartmann colostomy formation.
Conclusion
These results suggest that TD for management of patients with AL is safe, cheap, and effective. Salvaging the anastomosis will help decrease the need for Hartmann colostomy formation. Proper patient selection is important.

Citations

Citations to this article as recorded by

Challenges in the interdisciplinary treatment of leakages after left-sided colorectal surgery: endoscopic negative pressure therapy, open-pore film drainage therapy and beyond
Pasquale Scognamiglio, Anja Seeger, Matthias Reeh, Nathaniel Melling, Karl F Karstens, Thomas Rösch, Jakob R Izbicki, Marcus Kantowski, Michael Tachezy
International Journal of Colorectal Disease.2023;[Epub] CrossRef
Significance of information obtained during transanal drainage tube placement after anterior resection of colorectal cancer
Yuki Okazaki, Masatsune Shibutani, Hisashi Nagahara, Tatsunari Fukuoka, Yasuhito Iseki, En Wang, Kiyoshi Maeda, Kosei Hirakawa, Masaichi Ohira, Zubing Mei
PLOS ONE.2022; 17(8): e0271496. CrossRef
The usefulness of transanal tube for reducing anastomotic leak in mid rectal cancer: compared to diverting stoma
Seok Hyeon Cho, In Kyu Lee, Yoon Suk Lee, Min Ki Kim
Annals of Surgical Treatment and Research.2021; 100(2): 100. CrossRef
Treatment Modalities for Anastomotic Leakage in Rectal Cancer Surgery
Deborah S. Keller, K. Talboom, C.P.M van Helsdingen, Roel Hompes
Clinics in Colon and Rectal Surgery.2021; 34(06): 431. CrossRef
Retrospective study of active drainage in the management of anastomotic leakage after anterior resection for rectal cancer
Xiaojie Tan, Mei Zhang, Lai Li, He Wang, Xiaodong Liu, Haitao Jiang
Journal of International Medical Research.2021;[Epub] CrossRef
Improved colorectal anastomotic leakage healing by transanal rinsing treatment after endoscopic vacuum therapy using a novel patient-applied rinsing catheter
Marcus Kantowski, Andreas Kunze, Eugen Bellon, Thomas Rösch, Utz Settmacher, Michael Tachezy
International Journal of Colorectal Disease.2020; 35(1): 109. CrossRef
Surgical complications in colorectal cancer patients
Haleh Pak, Leila Haji Maghsoudi, Ali Soltanian, Farshid Gholami
Annals of Medicine and Surgery.2020; 55: 13. CrossRef
Effect comparison of three different types of transanal drainage tubes after anterior resection for rectal cancer
Yun Luo, Chang-Kang Zhu, Ding-Quan Wu, Liang-Bi Zhou, Chong-Shu Wang
BMC Surgery.2020;[Epub] CrossRef
Percutaneous transesophageal gastro-tubing for the management of anastomotic leakage after upper GI surgery: a report of two clinical cases
Yutaka Tamamori, Katsunobu Sakurai, Naoshi Kubo, Ken Yonemitsu, Yasuhiro Fukui, Junya Nishimura, Kiyoshi Maeda, Yukio Nishiguchi
Surgical Case Reports.2020;[Epub] CrossRef
Long-Term Results after Anastomotic Leakage following Rectal Cancer Surgery: A Comparison of Treatment with Endo-Sponge and Transanal Irrigation
Alice Weréen, Martin Dahlberg, Göran Heinius, Emil Pieniowski, Deborah Saraste, Karolina Eklöv, Jonas Nygren, Klas Pekkari, Åsa H. Everhov
Digestive Surgery.2020; 37(6): 456. CrossRef
Preventive strategies for anastomotic leakage after colorectal resections: A review
Mostafa Shalaby, Waleed Thabet, Mosaad Morshed, Mohamed Farid, Pierpaolo Sileri
World Journal of Meta-Analysis.2019; 7(8): 389. CrossRef
Transanal surgery: A tool in colorectal anastomotic leakage
Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española (English Edition).2019; 97(10): 590. CrossRef
La cirugía transanal como herramienta en la dehiscencia de la anastomosis colorrectal
Pere Planellas Giné, Júlia Gil Garcia, Ramon Farrés Coll, Antoni Codina Cazador
Cirugía Española.2019; 97(10): 590. CrossRef

The Usefulness of Intraoperative Colonic Irrigation and Primary Anastomosis in Patients Requiring a Left Colon Resection: Youngki Hong, Soomin Nam, Jung Gu Kang; Ann Coloproctol. 2017;33(3):106-111. Published online June 30, 2017; DOI: https://doi.org/10.3393/ac.2017.33.3.106

4,248 View
58 Download
5 Web of Science
5 Citations

Abstract PDF

Purpose

The aim of this study is to assess the short-term outcome of intraoperative colonic irrigation and primary anastomosis and to suggest the usefulness of the procedure when a preoperative mechanical bowel preparation is inappropriate.

Methods

This retrospective study included 38 consecutive patients (19 male patients) who underwent intraoperative colonic irrigation and primary anastomosis for left colon disease between January 2010 and December 2016. The medical records of the patients were reviewed to evaluate the patients' characteristics, operative data, and postoperative short-term outcomes.

Results

Twenty-nine patients had colorectal cancer, 7 patients had perforated diverticulitis, and the remaining 2 patients included 1 with sigmoid volvulus and 1 with a perforated colon due to focal colonic ischemia. A diverting loop ileostomy was created in 4 patients who underwent a low anterior resection. Complications occurred in 15 patients (39.5%), and the majority was superficial surgical site infections (18.4%). Anastomotic leakage occurred in one patient (2.6%) who underwent an anterior resection due sigmoid colon cancer with obstruction. No significant difference in overall postoperative complications and superficial surgical site infections between patients with obstruction and those with peritonitis were noted. No mortality occurred during the first 30 postoperative days. The median hospital stay after surgery was 15 days (range, 8–39 days).

Conclusion

Intraoperative colonic irrigation and primary anastomosis seem safe and feasible in selected patients. This procedure may reduce the burden of colostomy in patients requiring a left colon resection with an inappropriate preoperative mechanical bowel preparation.

Citations

Citations to this article as recorded by

Emergency Colon and Rectal Surgery, What Every Surgeon Needs to Know
Brian Williams, Abhinav Gupta, Sarah D. Koller, Tanya JT Starr, Maximillian J.H. Star, Darcy D. Shaw, Ali H. Hakim, Jennifer Leinicke, Michael Visenio, Kenneth H. Perrone, Zachary H. Torgerson, Austin D. Person, Charles A. Ternent, Kevin A. Chen, Muneera
Current Problems in Surgery.2024; 61(1): 101427. CrossRef
Safety profile of a multimodal fail-safe model to minimize postoperative complications in oncologic colorectal resections—a cohort study
Shahram Khadem, Jonas Herzberg, Human Honarpisheh, Robert Maximilian Jenner, Salman Yousuf Guraya, Tim Strate
Perioperative Medicine.2023;[Epub] CrossRef
Intraoperative Colonic Irrigation for Low Rectal Resections With Primary Anastomosis: A Fail-Safe Surgical Model
Jonas Herzberg, Shahram Khadem, Salman Yousuf Guraya, Tim Strate, Human Honarpisheh
Frontiers in Surgery.2022;[Epub] CrossRef
Malignant Large Bowel Obstruction
Roberta L. Muldoon
Clinics in Colon and Rectal Surgery.2021; 34(04): 251. CrossRef
Mechanical Bowel Preparation, Do It or Not: When Crossing a River, What Do People Do?
Hungdai Kim
Annals of Coloproctology.2017; 33(3): 84. CrossRef

Risk Factors for Anastomotic Leakage after Laparoscopic Rectal Resection: Dong Hyun Choi, Jae Kwan Hwang, Yong Tak Ko, Han Jeong Jang, Hyeon Keun Shin, Young Chan Lee, Cheong Ho Lim, Seung Kyu Jeong, Hyung Kyu Yang; J Korean Soc Coloproctol. 2010;26(4):265-273. Published online August 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.4.265

5,022 View
56 Download
49 Citations

Abstract PDF

Purpose

The anastomotic leakage rate after rectal resection has been reported to be approximately 2.5-21 percent, but most results were associated with open surgery. The aim of this study was to identify risk factors and their relationship to the experience of the surgeon for anastomotic leakage after laparoscopic rectal resection.

Methods

Between March 2003 and December 2008, 156 patients underwent a laparoscopic rectal resection without a diverting ileostomy. The patients' characteristics, the details of treatment, the intraoperative results, and the postoperative results were recorded prospectively. Univariate and multivariate analyses were applied to identify risk factors for anastomotic leakage.

Results

The majority of operations were performed for malignant disease (n = 150; 96.2%), and 96 patients (61.5%) were males. Conversion to open surgery occurred in 1 case (0.6%). The anastomotic leak rate was 10.3% (16/156), and there were no mortalities. In the univariate analysis, tumor location, anastomotic level, intraoperative events, and operation time were associated with increased anastomotic leakage rate. In the multivariate analysis, anastomotic level (odds ratio [OR], 6.855; 95% confidence interval [CI], 1.271 to 36.964) and operation time (OR, 8.115; 95% CI, 1.982 to 33.222) were significantly associated with anastomotic leakage.

Conclusion

The important risk factors for anastomotic leakage after laparoscopic rectal resection without a diverting ileostomy were low anastomosis and long operation time. An additional procedure, such as diverting stoma, may reduce the anastomotic leakage if it is selectively applied in cases with these risk factors.

Citations

Citations to this article as recorded by

Colonic Anastomotic Leakage: Current State of the Problem and Prospects for Early Diagnosis
M. A. Chernykh, A. M. Belousov, K. G. Shostka
Innovative Medicine of Kuban.2024; (3): 131. CrossRef
Vorhersagbarkeit von Anastomoseninsuffizienzen in der Viszeralchirurgie
Jin-On Jung, Georg Dieplinger, Christiane Bruns
Die Chirurgie.2024; 95(11): 901. CrossRef
Anastomotic Leak Rate and Prolonged Postoperative Paralytic Ileus in Patients Undergoing Laparoscopic Surgery for Colo-Rectal Cancer After Placement of No-Coil Endoanal Tube
Michele Ammendola, Giorgio Ammerata, Francesco Filice, Rosalinda Filippo, Michele Ruggiero, Roberto Romano, Riccardo Memeo, Patrick Pessaux, Giuseppe Navarra, Severino Montemurro, Giuseppe Currò
Surgical Innovation.2023; 30(1): 20. CrossRef
Potential short-term outcome advantage of low vs. high ligation of inferior mesenteric artery for sigmoid and rectal cancer: propensity score matching analysis
Chia-Chen Hsu, Yu-Jen Hsu, Yih-Jong Chern, Bor-Kang Jong, Chun-Kai Liao, Pao-Shiu Hsieh, Wen-Sy Tsai, Jeng-Fu You
BMC Surgery.2023;[Epub] CrossRef
Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going?
Christos Tsalikidis, Athanasia Mitsala, Vasileios I. Mentonis, Konstantinos Romanidis, George Pappas-Gogos, Alexandra K. Tsaroucha, Michail Pitiakoudis
Current Oncology.2023; 30(3): 3111. CrossRef
Impact of anastomotic leakage on long-term prognosis after colorectal cancer surgery
Valeria Tonini, Manuel Zanni
World Journal of Gastrointestinal Surgery.2023; 15(5): 745. CrossRef
Efficacy and Safety of Transanal Drainage Tube for Prevention of Anastomotic Leakage after Surgery for Rectal Cancer
Tatsunosuke Harada, Yasuhiro Ishiyama, Yume Minagawa, Shingo Ito, Masataka Oneyama, Kazuhiro Narita
Nihon Daicho Komonbyo Gakkai Zasshi.2023; 76(6): 420. CrossRef
Preservation of the left colic artery in modified laparoscopic anterior rectal resections without auxiliary abdominal incisions for transanal specimen retrieval
Yulin Liu, Peng Yu, Han Li, Lijian Xia, Xiangmin Li, Meijuan Zhang, Zhonghui Cui, Jingbo Chen
BMC Surgery.2022;[Epub] CrossRef
The Role of Indocyanine Near-Infrared Fluorescence in Colorectal Surgery
Francesco Maione, Michele Manigrasso, Alessia Chini, Sara Vertaldi, Pietro Anoldo, Anna D’Amore, Alessandra Marello, Carmen Sorrentino, Grazia Cantore, Rosa Maione, Nicola Gennarelli, Salvatore D’Angelo, Nicola D’Alesio, Giuseppe De Simone, Giuseppe Servi
Frontiers in Surgery.2022;[Epub] CrossRef
Risk factors for colorectal anastomotic leakage and preventive measures: a retrospective cohort study
M. S. Lebedko, S. S. Gordeev, E. V. Alieva, M. D. Sivolob, Z. Z. Mamedli, S. G. Gaydarov, V. Yu. Kosyrev
Pelvic Surgery and Oncology.2022; 12(2): 17. CrossRef
Intracorporeal reinforcement with barbed suture is associated with low anastomotic leakage rates after laparoscopic low anterior resection for rectal cancer: a retrospective study
Haiping Lin, Minhao Yu, Guangyao Ye, Shaolan Qin, Hongsheng Fang, Ran Jing, Tingyue Gong, Yang Luo, Ming Zhong
BMC Surgery.2022;[Epub] CrossRef
Factors Contributing to Anastomotic Leakage Following Colorectal Surgery: Why, When, and Who Leaks?
Shravani Sripathi, Mashal I Khan, Naomi Patel, Roja T Meda, Surya P Nuguru, Sriker Rachakonda
Cureus.2022;[Epub] CrossRef
Anastomotic Leak in Ovarian Cancer Cytoreduction Surgery: A Systematic Review and Meta-Analysis
Massimiliano Fornasiero, Georgios Geropoulos, Konstantinos S. Kechagias, Kyriakos Psarras, Konstantinos Katsikas Triantafyllidis, Panagiotis Giannos, Georgios Koimtzis, Nikoletta A. Petrou, James Lucocq, Christos Kontovounisios, Dimitrios Giannis
Cancers.2022; 14(21): 5464. CrossRef
Association between circular stapler size and anastomotic leakage after laparoscopic low anterior resection for rectal cancer
Yugang Jiang, Hongyuan Chen, Meng Kong, Dong Sun, Hongguang Sheng
Journal of Cancer Research and Therapeutics.2022; 18(7): 1931. CrossRef
Preliminary surgical outcomes of laparoscopic right hemicolectomy with transrectal specimen extraction: a propensity score matching study of 120 cases (with video)
Mingguang Zhang, Zheng Liu, Peng Sun, Xiyue Hu, Haitao Zhou, Zheng Jiang, Jianqiang Tang, Qian Liu, Xishan Wang
Gastroenterology Report.2022;[Epub] CrossRef
Anastomotic Leak in Colorectal Surgery: Predictive Factors and Survival
Swetha Prabhakaran, Sowmya Prabhakaran, Wei Mou Lim, Glen Guerra, Alexander G. Heriot, Joseph C. Kong
Polish Journal of Surgery.2022; 95(5): 56. CrossRef
Anastomotic Leakage After Laparoscopic Colectomy: Who Will Require Emergency Fecal Diversion?
Alban Zarzavadjian Le Bian, Nicolas Tabchouri, Christine Denet, Théophile Guilbaud, Anaïs Laforest, Christophe Tresallet, Jean-Marc Ferraz, Brice Gayet, David Fuks
Journal of Laparoendoscopic & Advanced Surgical Techniques.2021; 31(9): 1040. CrossRef
Postoperative morbidity and mortality after anterior resection with preventive diverting loop ileostomy versus loop colostomy for rectal cancer: A updated systematic review and meta-analysis
Rui Du, Jiajie Zhou, Guifan Tong, Yue Chang, Dongliang Li, Feng Wang, Xu Ding, Qi Zhang, Wei Wang, Liuhua Wang, Daorong Wang
European Journal of Surgical Oncology.2021; 47(7): 1514. CrossRef
Risk factors of symptomatic anastomotic leakage and its impacts on a long-term survival after laparoscopic low anterior resection for rectal cancer: a retrospective single-center study
Xinyu Qi, Maoxing Liu, Kai Xu, Pin Gao, Fei Tan, Zhendan Yao, Nan Zhang, Hong Yang, Chenghai Zhang, Jiadi Xing, Ming Cui, Xiangqian Su
World Journal of Surgical Oncology.2021;[Epub] CrossRef
A Novel Nomogram for Prediction of Early Postoperative Complications of Total Gastrectomy for Gastric Cancer
Jiawen Zhang, Linhua Jiang, Xinguo Zhu
Cancer Management and Research.2021; Volume 13: 7579. CrossRef
A Retrospective Study of Risk Factors for Symptomatic Anastomotic Leakage after Laparoscopic Anterior Resection of the Rectal Cancer without a Diverting Stoma
Zhi-Jie Wang, Qian Liu
Gastroenterology Research and Practice.2020; 2020: 1. CrossRef
Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis
Z. Balciscueta, N. Uribe, L. Caubet, M. López, I. Torrijo, J. Tabet, M. C. Martín
Techniques in Coloproctology.2020; 24(9): 919. CrossRef
Computed tomography based cross-sectional anatomy of the pelvis predicts surgical outcome after rectal cancer surgery
Gyoung Tae Noh, Soon Sup Chung, Kwang Ho Kim, Ryung-Ah Lee
Annals of Surgical Treatment and Research.2020; 99(2): 90. CrossRef
Risk factors for anastomotic leakage and its impact on long-term survival in left-sided colorectal cancer surgery
Marius Kryzauskas, Augustinas Bausys, Austeja Elzbieta Degutyte, Vilius Abeciunas, Eligijus Poskus, Rimantas Bausys, Audrius Dulskas, Kestutis Strupas, Tomas Poskus
World Journal of Surgical Oncology.2020;[Epub] CrossRef
Analysis of risk factors for anastomotic leakage after lower rectal Cancer resection, including drain type: a retrospective single-center study
Tetsushi Kinugasa, Sachiko Nagasu, Kenta Murotani, Tomoaki Mizobe, Takafumi Ochi, Taro Isobe, Fumihiko Fujita, Yoshito Akagi
BMC Gastroenterology.2020;[Epub] CrossRef
Prediction model for anastomotic leakage after laparoscopic rectal cancer resection
Enesh Shiwakoti, Jianning Song, Jun Li, Shanshan Wu, Zhongtao Zhang
Journal of International Medical Research.2020;[Epub] CrossRef
Drainage smell and peritonitis are efficient indicators of anastomotic leakage after laparoscopic rectal cancer resection
Enesh Shiwakoti, Jianning Song, Jun Li, Shanshan Wu, Zhongtao Zhang
Journal of International Medical Research.2020;[Epub] CrossRef
Laparoscopic loop ileostomy reversal with intracorporeal anastomosis is associated with shorter length of stay without increased direct cost
Sarath Sujatha-Bhaskar, Matthew Whealon, Colette S. Inaba, Christina Y. Koh, Mehraneh D. Jafari, Steven Mills, Alessio Pigazzi, Michael J. Stamos, Joseph C. Carmichael
Surgical Endoscopy.2019; 33(2): 644. CrossRef
Risk and early predictive factors of anastomotic leakage in laparoscopic low anterior resection for rectal cancer
Masahiro Fukada, Nobuhisa Matsuhashi, Takao Takahashi, Hisashi Imai, Yoshihiro Tanaka, Kazuya Yamaguchi, Kazuhiro Yoshida
World Journal of Surgical Oncology.2019;[Epub] CrossRef
Male gender is associated with an increased risk of anastomotic leak in rectal cancer patients after total mesorectal excision
Chi Zhou, Xian-rui Wu, Xuan-hui Liu, Yu-feng Chen, Jia Ke, Xiao-wen He, Xiao-sheng He, Tuo Hu, Yi-feng Zou, Xiao-bin Zheng, Hua-shan Liu, Jian-cong Hu, Xiao-jian Wu, Jian-ping Wang, Ping Lan
Gastroenterology Report.2018; 6(2): 137. CrossRef
Predictive factors for anastomotic leakage after laparoscopic colorectal surgery
Antonio Sciuto, Giovanni Merola, Giovanni D De Palma, Maurizio Sodo, Felice Pirozzi, Umberto M Bracale, Umberto Bracale
World Journal of Gastroenterology.2018; 24(21): 2247. CrossRef
Predictive Factors for Small Intestinal and Colonic Anastomotic Leak: a Multivariate Analysis
Ahmad Sakr, Sameh Hany Emile, Emad Abdallah, Waleed Thabet, Wael Khafagy
Indian Journal of Surgery.2017; 79(6): 555. CrossRef
Smoking and tumor obstruction are risk factors for anastomotic leakage after laparoscopic anterior resection during rectal cancer treatment
Hiroyuki Matsuzaki, Soichiro Ishihara, Kazushige Kawai, Koji Murono, Kensuke Otani, Koji Yasuda, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Toshiaki Watanabe
Journal of the Anus, Rectum and Colon.2017; 1(1): 7. CrossRef
De Prefectos a Mandatarios de la Nación. La violencia en la política peruana (1829-1836)
Víctor Peralta Ruiz
Revista de Indias.2016; 76(266): 173. CrossRef
New technique of compression anastomosis in colorectal surgery – first results in 25 patients in Macedonia
Svetozar Antovic, Aleksandar Mitevski, Aleksandar Karagozov, Biljana Kuzmanovska, Nikola Jankulovski
PRILOZI.2016;[Epub] CrossRef
Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis
Kenji Kawada, Yoshiharu Sakai
World Journal of Gastroenterology.2016; 22(25): 5718. CrossRef
Clinical risk factors for anastomotic leakage after laparoscopic anterior resection for rectal cancer: a systematic review and meta-analysis
Hui Qu, Yao Liu, Dong-song Bi
Surgical Endoscopy.2015; 29(12): 3608. CrossRef
Safe anastomosis in laparoscopic and robotic low anterior resection for rectal cancer: A narrative review and outcomes study from an expert tertiary center
S. AL Asari, M.S. Cho, N.K. Kim
European Journal of Surgical Oncology (EJSO).2015; 41(2): 175. CrossRef
Preoperative risk factors for anastomotic leakage after resection for colorectal cancer: a systematic review and meta‐analysis
H.‐C. Pommergaard, B. Gessler, J. Burcharth, E. Angenete, E. Haglind, J. Rosenberg
Colorectal Disease.2014; 16(9): 662. CrossRef
Incidence and Mortality of Anastomotic Dehiscence Requiring Reoperation After Rectal Carcinoma Resection
Zhi-jie Cong, Liang-hao Hu, Jun-jie Xing, Zheng-qian Bian, Chuan-gang Fu, En-da Yu, Zhao-shen Li, Ming Zhong
International Surgery.2014; 99(2): 112. CrossRef
Anastomotic leakage as an outcome measure for quality of colorectal cancer surgery
H S Snijders, D Henneman, N L van Leersum, M ten Berge, M Fiocco, T M Karsten, K Havenga, T Wiggers, J W Dekker, R A E M Tollenaar, M W J M Wouters
BMJ Quality & Safety.2013; 22(9): 759. CrossRef
Systematic review of perioperative selective decontamination of the digestive tract in elective gastrointestinal surgery
D Roos, L M Dijksman, J G Tijssen, D J Gouma, M F Gerhards, H M Oudemans-van Straaten
British Journal of Surgery.2013; 100(12): 1579. CrossRef
Systematic Review of Anastomotic Leakage Rate According to an International Grading System Following Anterior Resection for Rectal Cancer
Zhi-Jie Cong, Liang-Hao Hu, Zheng-Qian Bian, Guang-Yao Ye, Min-Hao Yu, Yun-He Gao, Zhao-Shen Li, En-Da Yu, Ming Zhong, Georgina L Hold
PLoS ONE.2013; 8(9): e75519. CrossRef
A systematic review of outcome reporting in colorectal cancer surgery
R. N. Whistance, R. O. Forsythe, A. G. K. McNair, S. T. Brookes, K. N. L. Avery, A. M. Pullyblank, P. A. Sylvester, D. G. Jayne, J. E. Jones, J. Brown, M. G. Coleman, S. J. Dutton, R. Hackett, R. Huxtable, R. H. Kennedy, D. Morton, A. Oliver, A. Russell,
Colorectal Disease.2013;[Epub] CrossRef
Compression anastomosis ring device in colorectal anastomosis: a review of 1,180 patients
Hossein Masoomi, Ruihong Luo, Steven Mills, Joseph C. Carmichael, Anthony J. Senagore, Michael J. Stamos
The American Journal of Surgery.2013; 205(4): 447. CrossRef
Spontaneous Healing of a Rectovaginal Fistula Developing after Laparoscopic Segmental Bowel Resection for Intestinal Deep Infiltrating Endometriosis
William Kondo, Reitan Ribeiro, Carlos Henrique Trippia, Monica Tessmann Zomer
Case Reports in Obstetrics and Gynecology.2013; 2013: 1. CrossRef
A Novel Rodent Model Modifying Perioperative Temperature and Humidity during Bowel Surgery and Mimicking Laparoscopic Conditions
Torben Glatz, Gabriel Seifert, Philipp A. Holzner, S. Chikhladze, Birte Kulemann, Olivia Sick, Jens Höppner, Ulrich Theodor Hopt, Goran Marjanovic
Surgical Science.2012; 03(07): 353. CrossRef
Randomized clinical trial of perioperative selective decontamination of the digestive tract versus placebo in elective gastrointestinal surgery
D Roos, L M Dijksman, H M Oudemans-van Straaten, L T de Wit, D J Gouma, M F Gerhards
British Journal of Surgery.2011; 98(10): 1365. CrossRef
Ghost Ileostomy with or without abdominal parietal split
Michele Cerroni, Roberto Cirocchi, Umberto Morelli, Stefano Trastulli, Jacopo Desiderio, Mario Mezzacapo, Chiara Listorti, Luigi Esperti, Diego Milani, Nicola Avenia, Nino Gullà, Giuseppe Noya, Carlo Boselli
World Journal of Surgical Oncology.2011;[Epub] CrossRef

Analysis of Anastomotic Leakage after an Anterior Resection for Rectal Cancer.: Park, Hey Won , Kim, Chang Nam , Park, Jin Seok , Kang, Yoon Jung , Cho, Byung Sun , Lee, Min Koo , Choi, Young Jin , Park, Joo Seung; J Korean Soc Coloproctol. 2009;25(5):340-346.; DOI: https://doi.org/10.3393/jksc.2009.25.5.340

1,626 View
12 Download
1 Citations

Abstract PDF

PURPOSE
The aim of our study was to identify risk factors associated with anastomotic leakage (AL) after an anterior resection (high anterior resection+low anterior resection) for rectal cancer.
METHODS
Between January 1998 and December 2007, 356 patients underwent an anterior resection for rectal cancer. Early anastomotic leakage (EAL) was defined as leakage identified during hospitalization. Late anastomotic leakage (LAL) was defined as leakage identified in outpatients.
RESULTS
AL (EAL+LAL) occurred in 30 patients (8.4%, mean time: 15.4 days). Among of them, EAL occurred in 20 patients (5.6%, mean time: 5.1 days), and LAL occurred in 10 patients (2.8%, mean time: 36.0 days). In the univariate analysis, the size of the tumor, the tumor level from the anal verge, and the level of anastomosis were significantly associated with AL. In EAL, the size of the tumor, the tumor level from the anal verge, the level of anastomosis, the operation type, and the value of serum albumin on day 3 after the operation were risk factors. In LAL, the tumor level from the anal verge and the level of anastomosis were risk factors. In the multivariate analysis, tumor size >7 cm (AL: P<0.001, EAL: P<0.001) and tumor level from the anal verge < or =8 cm (AL: P=0.014, EAL: P=0.001) were independent risk factors.
CONCLUSION
AL and EAL after an anterior resection for rectal cancer were related to the size of the tumor and the level of the tumor from the anal verge.

Citations

Citations to this article as recorded by

Distribution of Lymph Node Metastases Is an Independent Predictor of Survival for Sigmoid Colon and Rectal Cancer
Jung Wook Huh, Young Jin Kim, Hyeong Rok Kim
Annals of Surgery.2012; 255(1): 70. CrossRef

Analysis of Results after Percutaneous Catheter Drainage for Anastomotic Leakage.: Hwang, Sang Il , Kim, Hungdai , Han, Won Kon; J Korean Soc Coloproctol. 2008;24(4):260-264.; DOI: https://doi.org/10.3393/jksc.2008.24.4.260

1,535 View
6 Download

Abstract PDF: PURPOSE
Anastomotic leakage is a serious and life- threatening complication after colorectal surgery. The management of clinical anastomotic leakage remains largely operative. The aim of this study was to analyze the clinical characteristics and the natural history of percutaneous catheter drainage (PCD) for anastomotic leakage after colorectal surgery.
METHODS
Twenty patients who were managed by PCD after anastomotic leakage between January 2002 and December 2006 were studied. Charts were reviewed for information on clinical characteristics and biolologic finding prePCD and postPCD.
RESULTS
Anastomotic leakage was managed by using only PCD in 16 of 20 patients (80%), and twenty percent of patients (4/20) were managed by using a loop ileostomy after PCD. Nine patients (45%) had peritoneal drains left in place at diagnosis. Before PCD, the mean of the peak white blood cell (WBC) was 12,800/mm3, and the mean period of fever (>38degrees C) was 3.4 (2~5) days. After PCD, the mean time until the body temperature dropped below 37oC was 3.1 (1~5) days, the mean time until the WBC count dropped below 10,000/mm3 was 3.2 (0~6) days, the mean duration of ileus and diarrhea was 3.3 (0~6) days, the mean total amount of drainage during 6 days was 880 cc, and the mean length of stay after PCD was 14.9 days.
CONCLUSIONS
PCD is a safe and effective method for treating anastomtic leakage in patients without sepsis or diffuse peritonitis and with CT scans that reveal no diffuse fluid collection.

Anastomosis Protection with Mallecot in Low Rectal Anastomosis.: Jang, Young Soo , Lim, Kyoung Hoon , Kang, Byung Mo , Choi, Gyu Seog , Jun, Soo Han; J Korean Soc Coloproctol. 2007;23(6):420-423.; DOI: https://doi.org/10.3393/jksc.2007.23.6.420

1,855 View
16 Download
1 Citations

Abstract PDF

PURPOSE
Anastomotic leakage following surgery is one of the most significant causes of morbidity and mortality. Therefore, prevention of anastomotic leakage is crucial for safe rectal surgery. The aim of this study is to determine the effect of Mallecot(R) insertion on the prevention of anastomotic leakage after low rectal anastomosis.
METHODS
From January 2002 to December 2006, 264 rectal cancer surgeries were performed in one center and by one surgeon. Among them, 110 cases whose anastomosis was located below 6 cm from the anal verge were collected and reviewed retrospectively. We made a diverting stoma on 6 out of 20 patients with high risk of anastomotic leakage, and inserted Mallecot(R) on the remaining 14 patients transanally. Removal of Mallecot(R) was done at the 7th postoperative day after a digital rectal examination to identify the completeness of anastomosis had been performed.
RESULTS
Totally, anastomotic leakage occurred in 8 of 110 patients (73%). Among the 90 patients without any preventive measures, 7 incidents of anastomotic leakage were observed; on the other hand, 1 of 14 patients with Mallecot(R) insertion suffered anastomotic leakage. In two of the patients with leakage, including 1 in the Mallecot(R) group, the leakage was resolved via percutaneous drainage; in the other 6 patients were reoperated.
CONCLUSIONS
The importance of preventing an anastomotic leakage after low rectal surgery cannot be overemphasized to reduce morbidity and to improve the prognosis. In addition, Mallecot(R) insertion may be an alternative method for diverting stoma formation.

Citations

Citations to this article as recorded by

Transanal tube placement for prevention of anastomotic leakage following low anterior resection for rectal cancer: a systematic review and meta-analysis
Gi Won Ha, Hyun Jung Kim, Min Ro Lee
Annals of Surgical Treatment and Research.2015; 89(6): 313. CrossRef

Risk Factors for Anastomotic Leakage after a Low Anterior Resection for Rectal Cancer.: Yoon, Seok jun , Kim, Jin soo , Min, Byung so , Kim, Nam Kyu , Baik, Seung Hyuk , Lee, Kang Young , Sohn, Seung Kook , Cho, Jang Hwan; J Korean Soc Coloproctol. 2007;23(5):365-373.; DOI: https://doi.org/10.3393/jksc.2007.23.5.365

1,872 View
16 Download
4 Citations

Abstract PDF

PURPOSE
Clinical anastomotic leakage remains a major problem after a low anterior resection for rectal cancer, so indentifing risk factors influencing anastomotic leakage is important. The aim of this study was to assess the association between risk factors and anastomotic leakage.
RESULTS
One thousand two hundred eight patients underwent a primary resection for rectal cancer from June 1993 to March 2007. We used hospital records and the colorectal cancer registry to analyze retrospectively the case histories of those patients. The operations were performed using a low anterior resection with the double stapling method. All patients underwent a tumor-specific mesorectal excision. Of the total, thirty-eight patients showed anastomotic leakage. Univariate and multivariate analyses were performed to assess the risk factors affecting to the anastomotic leakage.
RESULTS
The rate of anastomotic leakage was 3.2% (38 of 1,208 patients) with a mortality rate of 7.9% (3 of 38 patients). The overall mortality rate was 0.3% (3 of 1,208 patients). Males accounted for 28 of the 38 patients with leakage, and female accounted for the the account for the remnant 10. The mean age was 53.7 years (33~74 years). The mean leakage day was 11.8th day (3~37th day) after the operation, and the mean hospital day was 39.2 days (7~131 days). The mean body mass index (BMI) was 22.7 kg/m2 (15.7~30.8 kg/m2). The mean operation time was 230.5 minutes (90~425 minutes), and the mean bleeding loss was 519.5 cc (0~3,500 cc).
CONCLUSIONS
Significant risk factors for anastomotic leakage after primary resection for rectal cancer were the transfusion amount during surgery, a preliminary colostomy, and nodal stage.

Citations

Citations to this article as recorded by

Cyanoacrylate in Colorectal Surgery: Is It Safe?
Anna D’Amore, Pietro Anoldo, Michele Manigrasso, Giovanni Aprea, Giovanni Domenico De Palma, Marco Milone
Journal of Clinical Medicine.2023; 12(15): 5152. CrossRef
New Hope for Wound Healing after Bowel Resection
Ryung-Ah Lee
Journal of the Korean Society of Coloproctology.2012; 28(3): 117. CrossRef
Risk Factors for Anastomotic Leakage after Laparoscopic Rectal Resection
Dong Hyun Choi, Jae Kwan Hwang, Yong Tak Ko, Han Jeong Jang, Hyeon Keun Shin, Young Chan Lee, Cheong Ho Lim, Seung Kyu Jeong, Hyung Kyu Yang
Journal of the Korean Society of Coloproctology.2010; 26(4): 265. CrossRef
Cyanoacrylate for colonic anastomosis; is it safe?
Ki-Beom Bae, Sun-Hee Kim, Soo-Jin Jung, Kwan-Hee Hong
International Journal of Colorectal Disease.2010; 25(5): 601. CrossRef

Anastomotic Leakage after Laparoscopic versus Open Resection for Rectal Cancer: A Retrospective Study.: Lee, Doo Seok , Youk, Eui Gon , Choi, Sung Il , Lee, Doo Han , Kim, Do Sun , Moon, Hong Young; J Korean Soc Coloproctol. 2007;23(5):350-357.; DOI: https://doi.org/10.3393/jksc.2007.23.5.350

1,644 View
10 Download
5 Citations

Abstract PDF

PURPOSE
This study is to compare the rate and pattern of anastomotic leakage (AL) for rectal cancer after laparoscopic vs. conventional open surgery at high and low rectal anastomosis and to evaluate whether the number of linear staples used for distal rectal resection is related to AL in laparoscopic group.
RESULTS
One hundred ninety-seven patients who underwent a curative resection for rectal cancer between March 2002 and February 2006 were studied retrospectively (107 laparoscopic, 90 open). The proportions of patients with anastomosis above vs. below 5 cm from AV were not different between the laparoscopic and the open groups; (above/below: 54/53 and 41/49, respectively, P=0.57). The protective stoma rate, the overall rate of AL, the rate of AL according to the height of the anastomosis, and the number of distal linear staples were evaluated for both groups.
RESULTS
Clinical AL occurred in 11 of 107 patients (10.3%) for the laparoscopic group and in 5 of 90 patients (5.6%) for the open group. The rates of AL in patients without protective stoma were not significantly different for high rectal anastomosis (6.0% for laparoscopic vs. 2.6% for open, P= 0.63) and for low rectal anastomosis (25.8% for laparoscopic vs. 12.1% for open, P=0.21). The risk of AL was 4.9 times higher when 3 linear staples were used than when 2 linear staples were used in the laparoscopic group.
CONCLUSIONS
There was no statistical difference in AL between the laparoscopic group and the open group. The rate of AL could be reduced by using fewer linear staples for distal rectal resection in the laparoscopic group.

Citations

Citations to this article as recorded by

OF RECONSTRUCTIVE SURGERY IN PATIENTS WITH COLOSTOMY
V. V. Boyko, D. O. Yevtushenko, S. O. Nemenko, I. G. Fursov
Kharkiv Surgical School.2022; (2): 75. CrossRef
PREVENTION OF COLORECTAL ANASTOMOTIC LEAK
Andrii Klymenko, Igor Kononenko
Kharkiv Surgical School.2019; (5-6): 21. CrossRef
Safe anastomosis in laparoscopic and robotic low anterior resection for rectal cancer: A narrative review and outcomes study from an expert tertiary center
S. AL Asari, M.S. Cho, N.K. Kim
European Journal of Surgical Oncology (EJSO).2015; 41(2): 175. CrossRef
Risk Factors for Anastomotic Leakage after Laparoscopic Rectal Resection
Dong Hyun Choi, Jae Kwan Hwang, Yong Tak Ko, Han Jeong Jang, Hyeon Keun Shin, Young Chan Lee, Cheong Ho Lim, Seung Kyu Jeong, Hyung Kyu Yang
Journal of the Korean Society of Coloproctology.2010; 26(4): 265. CrossRef
Risk Factors for Anastomotic Leakage after Laparoscopic Intracorporeal Colorectal Anastomosis with a Double Stapling Technique
Jin Soo Kim, Sun Yeon Cho, Byung Soh Min, Nam Kyu Kim
Journal of the American College of Surgeons.2009; 209(6): 694. CrossRef

Risk Factors for Anastomotic Leakage after Laparoscopic Rectal Resection in Rectal Cancer: Does Laparoscopic Rectal Resection Increase Anastomotic Leakage Rate?.: Lee, Ho Suk , Kim, Min Ghwon , Park, Chang Kyun , Cho, Yoo Jin , Hwang, Duk Won , Noh, Sang Ik; J Korean Soc Coloproctol. 2007;23(2):101-109.; DOI: https://doi.org/10.3393/jksc.2007.23.2.101

1,471 View
8 Download

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the risk factors for clinical anastomotic leakage after laparoscopic resection for rectal cancer.
METHODS
From March 2001 and February 2006 in Seoul Veterans' Hospital, the prospective laparoscopic colorectal resection database identified 101 patients who a had laparoscopic rectal resection with colorectal or coloanal anastomosis. The associations between clinical anastomotic leakage and patient-, tumor-, surgery- and laparoscopic-related variables were studied.
RESULTS
The rate of clinical anastomotic leakage was 4 percent (4 of 101). The patient-related variable significantly associated with clinical anastomotic leakage was preoperative radiotherapy. The surgery-related factor that turned out to be significant was anastomosis situated less than 5 cm from the anal verge. No tumor- or laparoscopic-related variables were significantly associated with clinical anastomotic leakage. CONSLUSIONS: A protective ileostomy should be considered after a laparoscopic rectal resection for an rectal cancer for anastomosis situated less than 5 cm from the anal verge, particularly when preoperative radiotherapy is being used.

Risk Factors and Oncologic Impact of Anastomotic Leakage after Rectal Cancer Surgery.: Jung, Sang Hun , Yu, Chang Sik , Choi, Pyong Wha , Kim, Dae Dong , Hong, Dong Hyun , Kim, Hee Cheol , Kim, Jin Cheon; J Korean Soc Coloproctol. 2006;22(6):371-379.

981 View
13 Download

Abstract PDF: PURPOSE
Anastomotic leakage (AL) is a serious and life-threatening complication following rectal cancer surgery. The impact on long-term oncologic outcome in patients with AL is not clear. The aim of this retrospective study was to evaluate the risk factors of AL and its impact on long-term prognosis after rectal cancer surgery.
METHODS
We investigated 1,391 patients who underwent primary resection and anastomosis for rectal cancer between January 1997 and August 2003. Operations were performed as follows: AR (n=164), LAR (n=898), uLAR (n=329). Standard procedures in our clinic were mesorectal excision according to tumor location and autonomic nerve preservation. Median follow-up period was 40.1 months (2~96 months).
RESULTS
AL rate was 2.5% (n=35). Gender (male), age (>60 years) and uLAR were independent risk factors in multivariate analysis (HR: 3.03, 95% CI: 1.18~7.22; HR: 2.42, 95% CI: 1.12~7.83; HR: 2.68, 95% CI: 1.08~7.09, respectively). Local recurrence in the AL group was significantly higher than that in the non-AL group (P<0.05), but there was no significant difference in multivariate analysis (P=0.14). Systemic recurrence between both groups was not statistically different. The 5-year overall survival rate was significantly lower in the AL group than in the non-AL group (55.1% vs 74.1%, P<0.05) and the cancer- specific survival rate was lower in the AL group than in the non-AL group (63.0% vs 78.3%, P=0.05).
CONCLUSIONS
Age, gender, and anastomotic level were risk factors for AL after rectal cancer surgery and anastomotic leakage was associated with a poor survival.

First
Prev
Page of 1
Next
Last

Search