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International Journal of Colorectal Disease

, Volume 28, Issue 4, pp 437–445 | Cite as

Systematic review on the value of CT scanning in the diagnosis of anastomotic leakage after colorectal surgery

  • Verena N. N. Kornmann
  • Nikki Treskes
  • Lilian H. F. Hoonhout
  • Thomas L. Bollen
  • Bert van Ramshorst
  • Djamila Boerma
Review

Abstract

Background

Timely diagnosis of anastomotic leakage after colorectal surgery and adequate treatment is important to reduce morbidity and mortality. Abdominal computed tomography (CT) scanning is the diagnostic tool of preference, but its value may be questionable in the early postoperative period. The accuracy of CT scanning for the detection of anastomotic leakage and its role in timing of intervention was evaluated.

Methods

A systematic literature search was performed. Relevant publications were identified from four electronic databases between 1990 and 2011. Inclusion criteria were human studies, studies published in English or Dutch, colorectal surgery with primary anastomosis, and abdominal CT scan with reported outcome for the detection of anastomotic leakage. Exclusion criteria were cohort of fewer than five patients, other gastrointestinal surgery, no anastomosis, and radiological imaging other than CT.

Results

Eight studies, including 221 abdominal CT scans, fulfilled the inclusion criteria. Overall, the methodological quality of the studies was poor. The overall sensitivity of CT scanning to diagnose leakage was 0.68 (95 % confidence interval 0.59–0.75) for colonic resection. Data on the sequelae of false-negative CT scanning was not available.

Conclusion

There is limited good-quality evidence to determine the value of CT scans in the detection of anastomotic leakage. To prevent delay in diagnosis and appropriate treatment of anastomotic leakage, the relatively low sensitivity of CT scanning must be taken into account.

Keywords

Colorectal Surgery Anastomotic leakage Abdominal computed tomography 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • Verena N. N. Kornmann
    • 1
  • Nikki Treskes
    • 1
  • Lilian H. F. Hoonhout
    • 2
  • Thomas L. Bollen
    • 3
  • Bert van Ramshorst
    • 1
  • Djamila Boerma
    • 1
  1. 1.Department of SurgerySt. Antonius HospitalNieuwegeinThe Netherlands
  2. 2.Department of Quality and SafetySt. Antonius HospitalNieuwegeinThe Netherlands
  3. 3.Department of RadiologySt. Antonius HospitalNieuwegeinThe Netherlands

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