Advertisement

Postoperative Anastomotic Leak After Low Anterior Resection

  • Matthew M. Philp
  • Howard M. RossEmail author
Chapter

Abstract

The management of an anastomotic leak after low anterior resection is complex but must be mastered by surgeon operating on the rectum. Immediate management varies depending on the clinical situation when the leak is discovered. Long-term successful outcomes are possible via many different techniques. The management of anastomotic strictures and sinuses is discussed.

Keywords

Low anterior resection Anastomotic leak Anastomotic sinus Anastomotic stricture Diverting colostomy Anastomotic leak test 

Suggested Reading

  1. 1.
    Blumetti J, Abcarian H. Management of low colorectal anastomotic leak: preserving the anastomosis. World J Gastrointest Surg. 2015;7(12):378–83.CrossRefGoogle Scholar
  2. 2.
    Blumetti J, Chaudhry V, Prasad L, Abcarian H. Delayed transanal repair of persistent coloanal anastomotic leak in diverted patients after resection for rectal cancer. Colorectal Dis Off J Assoc Coloproctol G B Irel. 2012;14(10):1238–41.Google Scholar
  3. 3.
    Chadi SA, Fingerhut A, Berho M, DeMeester SR, Fleshman JW, Hyman NH, et al. Emerging trends in the etiology, prevention, and treatment of gastrointestinal anastomotic leakage. J Gastrointest Surg. 2016;20(12):2035–51.CrossRefGoogle Scholar
  4. 4.
    Dapri G, Guta D, Grozdev K, Antolino L, Bachir N, Jottard K, et al. Colorectal anastomotic leakage corrected by transanal laparoscopy. Colorectal Dis Off J Assoc Coloproctol G B Irel. 2016;18(6):O210–3.Google Scholar
  5. 5.
    Güenaga KF, Lustosa SAS, Saad SS, Saconato H, Matos D. Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Cochrane Database Syst Rev. 2007;(1):CD004647.Google Scholar
  6. 6.
    Hain E, Maggiori L, Manceau G, Zappa M, Prost à la Denise J, Panis Y. Persistent asymptomatic anastomotic leakage after laparoscopic sphincter-saving surgery for rectal cancer: can diverting stoma be reversed safely at 6 months? Dis Colon Rectum. 2016;59(5):369–76.CrossRefGoogle Scholar
  7. 7.
    Haito-Chavez Y, Law JK, Kratt T, Arezzo A, Verra M, Morino M, et al. International multicenter experience with an over-the-scope clipping device for endoscopic management of GI defects (with video). Gastrointest Endosc. 2014;80(4):610–22.CrossRefGoogle Scholar
  8. 8.
    Matthiessen P, Hallböök O, Rutegård J, Simert G, Sjödahl R. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial. Ann Surg. 2007;246(2):207–14.CrossRefGoogle Scholar
  9. 9.
    Sirois-Giguère E, Boulanger-Gobeil C, Bouchard A, Gagné J-P, Grégoire RC, Thibault C, et al. Transanal drainage to treat anastomotic leaks after low anterior resection for rectal cancer: a valuable option. Dis Colon Rectum. 2013;56(5):586–92.CrossRefGoogle Scholar
  10. 10.
    Stewart BT, Stitz RW. Marsupialization of presacral collections with use of an endoscopic stapler. Dis Colon Rectum. 1999;42(2):264–5.CrossRefGoogle Scholar
  11. 11.
    van Koperen PJ, van Berge Henegouwen MI, Rosman C, Bakker CM, Heres P, Slors JFM, et al. The Dutch multicenter experience of the Endo-Sponge treatment for anastomotic leakage after colorectal surgery. Surg Endosc. 2009;23(6):1379–83.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Division of Colon and Rectal SurgeryTemple University School of MedicinePhiladelphiaUSA
  2. 2.Division of Colon and Rectal SurgeryLewis Katz School of Medicine at Temple University and the Temple University Health SystemPhiladelphiaUSA

Personalised recommendations