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Postoperative Complications

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Rectal Cancer

Part of the book series: Updates in Surgery ((UPDATESSURG))

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Abstract

In this chapter we classify the complications of rectal surgery into early and late, according to the moment when they usually occur. For all the complications we have indicated the therapy, in some cases more than one, recently reported in literature. Late complications connected to lesions of the nerve plexus are treated in the dedicated chapter.

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References

  1. Martinez-Serrano MA, Parés D, Pera M et al (2009) Management of lower gastrointestinal bleeding after colorectal resection and stapled anastomosis. Tech Coloproctol 13:49–53

    Article  PubMed  Google Scholar 

  2. Hedberg SE, Helmy AH (1984) Experience with gastrointestinal stapling at the Massachussetts General Hospital. Surg Clin North Am 64:511–528

    PubMed  CAS  Google Scholar 

  3. Cirocco WC, Golub RW (1995) Endoscopic treatment of postoperative hemorrhage from a stapled colorectal anastomosis. Am Surg 61:460–463

    PubMed  CAS  Google Scholar 

  4. Lustosa SA, Matos D, Atallah AN et al (2001) Stapled versus hand-sewn methods for colorectal anastomosis surgery. Cochrane Database Syst Rev CD003144

    Google Scholar 

  5. Ishihara S, Watanabe T, Nagawa H et al (2008) Intraoperative Colonoscopy for stapled anastomosis in colorectal surgery. Surg Today 38:1063–1065

    Article  PubMed  Google Scholar 

  6. Perez RO, Sousa AJr, Bresciani C et al (2007) Endoscopic management of postoperative stapled colorectal anastomosis hemorrhage. Tec Coloproctol 11:64–66

    Article  CAS  Google Scholar 

  7. Weldon DT, Burke SJ, Sun S et al (2008) Interventional management of lower gastrointestinal bleeding. European Radiology 18:857–867

    Article  PubMed  Google Scholar 

  8. Jander HP, Russinovich NA (1980) Transcatheter gelfoam embolization in abdominal, retroperitoneal, and pelvic hemorrhage. Radiology136:337–344

    PubMed  CAS  Google Scholar 

  9. Montedori A, Cirocchi R, Farinella E et al (2010) Coverying ileo- or colostomy in anterior resection for rectal carcinoma (Review). Cochrane Database Syst Rev (5):CD006878

    PubMed  Google Scholar 

  10. Rahbari NN, Weitz J, Hohenberger W et al (2010) Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the international study group of rectal cancer 147:339–351

    Google Scholar 

  11. Matthiessen P, Hallböök O, Rutegård J et al (2007) Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial 246:207–214

    Google Scholar 

  12. Lipska MA, Bissett IP, Parry BR et al (2006) Anastomotic leakage after lower gastrointestinal anastomosis: men are at a higher risk. ANZ J Surg 76:579–585

    Article  PubMed  Google Scholar 

  13. Buchs NC, Gervaz P, Secic M et al (2008) Incidence, consequences, and risk factors for anastomotic dehiscence after colorectal surgery: a prospective monocentric study. Int J Colorectal Dis 23:265–270

    Article  PubMed  Google Scholar 

  14. Lee WS, Yun SH, Roh YN et al (2008) Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer. World J Surg 32:1124–1129

    Article  PubMed  Google Scholar 

  15. Ye F, Wang D, Xu X et al (2008) Use of intracolonic bypass secured by a biodegradable anastomotic ring to protect the low rectal anastomosis. Dis Colon Rectum 51:109–115

    Article  PubMed  Google Scholar 

  16. Guillou PJ, Quirke P, Thorpe H et al (2005) Short term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726

    Article  PubMed  Google Scholar 

  17. Bruce J, Krukowski ZH, Al-Khairy G et al (2001) Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg 88:1157–1168

    Article  PubMed  CAS  Google Scholar 

  18. Rullier E, Laurent C, Garrelon JL et al (1998) Risk factors for anastomotic leakage after resection of rectal cancer. Br J Surg 85:355–358

    Article  PubMed  CAS  Google Scholar 

  19. Hotta T, Yamaue H (2011) Laparoscopic surgery for rectal cancer : review of published literature 2000–2009. Surg Today 41:1583–1591

    Article  PubMed  Google Scholar 

  20. Matthiessen P, Hallböök O, Andersson M et al (2004) Risk factors for anastomotic leakage after anterior resection of the rectum. Colorectal Dis 6:462–469

    Article  PubMed  CAS  Google Scholar 

  21. Jones OM, John SK, Horseman N et al (2007) Low anastomotic leak rate after colorectal surgery: a single-centre study. Colorectal Dis 9:740–744

    Article  PubMed  CAS  Google Scholar 

  22. Harris LJ, Phillips BR, Maxwell PJ et al (2010) Outcomes of low anterior resection anastomotic leak after preoperative chemoradiation therapy for rectal cancer. Am Surg 76:747–751

    PubMed  Google Scholar 

  23. Zhu QL, Feng B, Lu AG et al (2010) Laparoscopic low anterior resection for rectal carcinoma: complication and management in 132 consecutive patients. World J Gastroenterol 16:4605–4610

    Article  PubMed  Google Scholar 

  24. Kim JS, Cho SY, Min BS, Kim NK (2009) Risk factors for anastomotic leakage after laparoscopic intracorporeal colorectal anastomosis with a double stapling technique. J Am Coll Surg. 209:694–701

    Article  PubMed  Google Scholar 

  25. Ito M, Sugito M, Kobayashi A et al (2008) Relationship between multiple numbers of stapler firings during rectal division and anastomotic leakage after laparoscopic rectal resection. Int J Colorectal Dis 23:703–707

    Article  PubMed  Google Scholar 

  26. Vignali A, Fazio VW, Lavery IC et al (1997) Factors associated with the occurence of leaks in stapled rectal anastomoses : a review of 1014 patients. J Am Coll Surg 185:105–113

    PubMed  CAS  Google Scholar 

  27. Do L, Syed N, Puthawala A et al (2011) Low-lying rectal cancer with anal canal involvement: abdominoperineal or low anterior resection after neoadjuvant chemoradiotherapy. Gastrointest Cancer Res 4:90–95

    PubMed  Google Scholar 

  28. Arumainayagam N, Chadwick M, Roe A (2009) The fate of anastomotic sinuses after total mesorectal excision for rectal cancer. Colorectal Disease 11:288–290

    Article  PubMed  CAS  Google Scholar 

  29. Hüser N, Michalski CW, Erkan M et al (2008) Systematic review and meta-analysis of the role of defunctioning stoma in low rectal cancer surgery. Annals of Surgery 248:52–60

    Article  PubMed  Google Scholar 

  30. Marusch F, Koch A, Schmidt U et al (2002) Value of a protective stoma in low anterior resection for rectal cancer. Dis Colon Rectum 45:1164–1171

    Article  PubMed  Google Scholar 

  31. Gastinger I, Marusch F, Steinert R et al (2005) Protective defunctioning stoma in low anterior resection for rectal carcinoma. Br J Surg 92:1137–1142

    Article  PubMed  CAS  Google Scholar 

  32. Wong NY, Eu KW (2005) A defunctioning ileostomy does not prevent clinical anastomotic leak after a low anterior resection: a prospective, comparative study. Dis of Col Rect 48:2076–2079

    Article  CAS  Google Scholar 

  33. Lipska MA, Bissett IP, Parry BR et al (2006) Anastomotic leakage after lower gastrointestinal anastomosis: men are at a higher risk. ANZ J Surg 76:579–585

    Article  PubMed  Google Scholar 

  34. Gingold BS, Jagelman DG (1982) Value of pelvic suction-irrigation in reducing morbidity of low anterior resection of the rectum a ten year experience. Surgery 91:394–398

    PubMed  CAS  Google Scholar 

  35. Urbach DR, Kennedy ED, Cohen MM (1999) Colon and rectal anastomoses do not require routine drainage: a systematic review and meta-analysis. Ann Surg 229:174–180

    Article  PubMed  CAS  Google Scholar 

  36. Yeh CY, Changchien CR, Wang JY et al (2005) Pelvic drainage and other risk factors for leakage after elective anterior resection in rectal cancer patients: a prospective study of 978 patients. Annals of surg 241:9–13

    Google Scholar 

  37. Chopra SS, Mrak K, Hünerbein M (2009) The effect of endoscopic treatment on healthing of anastomotic leaks after anterior resection of rectal cancer. Surgery 145:182–188

    Article  PubMed  Google Scholar 

  38. Scileppi T, Li JJ, Iswara K et al (2005) The use of a Polyflex coated esophageal stent to assist in the closure of a colonic anastomotic leak. Gastrointest Endosc 62:643–645

    Article  PubMed  Google Scholar 

  39. Hünerbein M, Krause M, Moesta KT et al (2005) Palliation of malignant rectal obstruction with self-expanding metal stents. Surgery 137:42–47

    Article  PubMed  Google Scholar 

  40. Trovato C, Fiori G, Ravizza D et al (2006) Delayed colonic perforation after metal stent placement for malignant colorectal obstruction. Endoscopy 38:E96

    Article  PubMed  Google Scholar 

  41. Mees ST, Palmes D, Mennigen R et al (2008) Endo-vacuum assisted closure treatment for rectal anastomotic insufficiency. Dis Colon Rectum 51:404–410

    Article  PubMed  Google Scholar 

  42. Arezzo A, Miegge A, Garbarini A, Morino M (2010) Endoluminal vacuum therapy for anastomotic leaks after rectal surgery. Tech Coloproctol 14:279–281

    Article  PubMed  CAS  Google Scholar 

  43. Morykwas MJ, Argenta LC, Shelton-Brown EI et al (1997) Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation. Ann Plast Surg 38:553–562

    Article  PubMed  CAS  Google Scholar 

  44. Parodi A, Manta R, Pedroni A et al (2011) Trattamento di fistole e perforazioni del tratto gas-troenterico. Giorn Ital End Dig 34:47–52

    Google Scholar 

  45. Poon JT, Law W, Wong IW et al (2009) Impact of laparoscopic colorectal resection on surgical site infection. Ann Surg 249:77–81

    Article  PubMed  Google Scholar 

  46. Ho VP, Stein SL et al (2011) Differing risk factors for incisional and organ/space surgical site infections following abdominal colorectal surgery. Dis Colon Rectum 54:818–825

    Article  PubMed  Google Scholar 

  47. Serra-Aracil X, Garcia-Domingo MI et al (2011) Surgical site infection in elective operations for colorectal cancer after the application of preventive measures. Arch Surg 146:606–612

    Article  PubMed  Google Scholar 

  48. Ho VP, Barie PS (2011) Antibiotic regimen and the timing of prophylaxis are important for reducing surgical site infection after elective abdominal colorectal surgery. Surg Inf 12:255–260

    Article  Google Scholar 

  49. Nguyen N, Yegiyants S, Kaloostian C et al (2008) The Surgical Care Improvement project (SCIP) initiative to reduce infection in elective colorectal surgery: which performance measures affect outcome? Am Surg 74:1012–1016

    PubMed  Google Scholar 

  50. Rosenberger LH, Politano AD, Sawyer RG (2011) The surgical care improvement project and prevention of post-operative infection, including surgical site infection. Surg Infect 12:163–168

    Article  Google Scholar 

  51. Alexander JW, Solomkin JS, Edwards MJ (2011) Updated recommendations for control of surgical site infections. Ann Surg 253:1082–1093

    Article  PubMed  Google Scholar 

  52. Edmiston CE, Spencer M, Lewis BD (2011) Reducing the risk of surgical site infections: did we really think SCIP was going to lead us to the promised land? Surg Infect 12:169–177

    Article  Google Scholar 

  53. Rosenberger LH, Politano AD, Sawyer RG (2011) The surgical care improvement project and prevention of post-operative infection, including surgical site infection. Surg Infect 12:163–168

    Article  Google Scholar 

  54. Hawn MT, Vick CC, Richman J et al (2011) Surgical site infection prevention: time to move beyond the surgical care improvement program. Ann Surg 254:494–499

    Article  PubMed  Google Scholar 

  55. Bannura GC, Cumsille MA, Barrera AE et al (2004) Predictive factors of stenosis after stapled colorectal anastomosis: prospective analysis of 179 consecutive patients. World J Surg 28:921–925

    Article  PubMed  Google Scholar 

  56. Curcio G, Spada M, di Francesco F et al (2010) Completely obstructed colorectal anastomosis: a new non-electrosurgical endoscopic approach before balloon dilatation. World J Gastroenterol 16:4751–4714

    Article  PubMed  Google Scholar 

  57. Nguyen-Tang T, Huber O, Gervaz P, Dumonceau JM (2008) Long-term quality of life after endoscopic dilation of strictured colorectal or colocolonic anastomoses. Surg Endosc 22:1660–1666

    Article  PubMed  CAS  Google Scholar 

  58. Xinopoulos D, Kypreos D, Bassioukas SP et al (2011) Comparative study of balloon and metal olive dilators for endoscopic management of benign anastomotic rectal strictures: clinical and cost-effectiveness outcomes. Surg Endosc 25:756–763

    Article  PubMed  Google Scholar 

  59. Lustosa SA, Matos D, Atallah AN, Castro AA (2002) Stapled versus handsewn methods for colorectal anastomosis surgery: a systematic review of randomized controlled trials. Sao Paulo Med J 120:132–136

    Article  PubMed  Google Scholar 

  60. Docherty JG, McGregor JR, Akyol AM et al (1995) Comparison of manually constructed and stapled anastomoses in colorectal surgery. West of Scotland and Highland Anastomosis Study Group. Ann Surg 221:176–184

    Article  PubMed  CAS  Google Scholar 

  61. Polese L, Vecchiato M, Frigo AC et al (2012) Risk factors for colorectal anastomotic stenoses and their impact on quality of life: what are the lessons to learn? Colorectal Dis 14:e124–e128

    Article  PubMed  CAS  Google Scholar 

  62. Marchena Gómez J, Ruiz de la Cuesta E, Gómez Guerra G et al (1997) Anastomotic stricture with the EEA-Stapler after colorectal anastomosis. Rev Esp Enferm Dig 89:835–842

    Google Scholar 

  63. Ambrosetti P, Francis K, De Peyer R, Frossard JL (2008) Colorectal anastomotic stenosis after elective laparoscopic sigmoidectomy for diverticular disease: a prospective evaluation of 68 patients. Dis Colon Rectum 51:1345–1349

    Article  PubMed  Google Scholar 

  64. Nguyen-Tang T, Huber O, Gervaz P et al (2008) Long- term quality of life after endoscopc dilatation of strictured colorectal or colocolonic anastomoses. Surg Endosc 22:1660–1666

    Article  PubMed  CAS  Google Scholar 

  65. Andicoechea Agorría A, Quintela Baizán I, Del Casar Lizcano JM et al (2011) Combined endoscopic ballon dilation and intralesional corticosteroid treatment of colorectal anastomotic stenosis refractary to dilatation alone. Cir Esp [Epub ahead of print]

    Google Scholar 

  66. Mukai M, Kishima K, Iizuka S et al (2009) Endoscopic hook knife cutting before balloon dilatation of a severe anastomotic stricture after rectal cancer resection. Endoscopy 41:e193–e194

    Article  PubMed  Google Scholar 

  67. Wang JT, Zhao HY, Liu YL (2005) Portal vein thrombosis. Hepatobiliary Pancreat Dis Int 4:515–518

    PubMed  Google Scholar 

  68. Abdelrazeq AS, Dwaik MA, Aldoori MI et al (2006) Laparoscopy-associated portal vein thrombosis :description of an envolving clinical syndrome. J Laparoendosc Adv Surg Tech A 16:9–14

    Article  PubMed  Google Scholar 

  69. Ishizaki Y, Bandai Y, Shimomura K et al (1993) Changes in splanchnic blood flow and cardiovascular effects following peritoneal insufflation of carbon dioxide. Surg End 7:420–423

    Article  CAS  Google Scholar 

  70. Epstein RM, Wheeller Ho, Frumin MJ et al (1961) The effect of hypercapnia on estimeted hepatic blood flow, circulating splanchinic blood volume and hepatic sulfobromophthalein cleaance during general anesthesia in man. J Clin Invest 40:592–598

    Article  PubMed  CAS  Google Scholar 

  71. James AW, Rabl C, Westphalen AC et al (2009) Portomesenteric Venous Thrombosis after Laparoscopic Surgery. Arch Surg144 : 520–526

    Article  PubMed  Google Scholar 

  72. Vadalà S, Cinardi N, Li Volti G et al (2008) Portal vein thrombosis following laparoscopic total mesorectal excision: case report. Tech Coloproctol 12:259–261

    Article  PubMed  Google Scholar 

  73. Macpherson A (1984) Portal hypertension doe to extrahepatic portal venous obstruction: a review of 40 cases. J R Coll Surg Edinb 29:4–10

    PubMed  CAS  Google Scholar 

  74. Bradbury MS, Kavanagh PV, Bechtold RE et al (2002) Mesenteric venous thrombosis: diagnosis and non invasive imaging. Radiographics 22:527–541

    PubMed  Google Scholar 

  75. Hidajat N, Stobbe H, Griesshaber V et al (2005) Imaging and radiological interventions of portal vein thrombosis. Acta Radiol 46:336–343

    Article  PubMed  CAS  Google Scholar 

  76. Condat B, Pessione F, Helene Denninger M et al (2000) Recent portal or mesenteric venous thrombosis: increased recognition and frequent recanalization on anticoagulant therapy. Hepatology 32:466–470

    Article  PubMed  CAS  Google Scholar 

  77. Aytekin C, Boyvat F, Kurt A et al (2001) Catheter-directed thrombolysis with transjugular access in portal vein thrombosis secondary to pancreatitis. Eur J Radiol 39:80–82

    Article  PubMed  CAS  Google Scholar 

  78. Sze DY, O’Sullivan GJ, Johnson DL et al (2000) Mesenteric and portal venous thrombosis treated by transjugular mechanical thrombolysis. AJR 175:732–734

    PubMed  CAS  Google Scholar 

  79. Davies M, Satyadas T, Akle CA (2002) Spontaneous resolution of a superior mesenteric vein thrombosis after laparoscopic Nissen fundoplication. Ann R Coll Surg Engl 84:177–180

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Surgery and Health Sciences, General Surgery Unit, Cattinara University Hospital, Trieste, Italy

    Michela Giuricin

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  1. Michela Giuricin
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  2. Greta Giacomel
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  3. Alessandra Lucchetta
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  4. Nicolò de Manzini
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Correspondence to Michela Giuricin .

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  1. Department of Medicine, Surgery and Health Sciences, General Surgery Unit, Cattinara University Hospital, Trieste, Italy

    Nicolò de Manzini

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Giuricin, M., Giacomel, G., Lucchetta, A., de Manzini, N. (2013). Postoperative Complications. In: de Manzini, N. (eds) Rectal Cancer. Updates in Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-2670-4_12

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  • DOI: https://doi.org/10.1007/978-88-470-2670-4_12

  • Publisher Name: Springer, Milano

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