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Intraoperative anastomotic dye test significantly decreases incidence of anastomotic leaks in patients undergoing resection for rectal cancer

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Abstract

Background

Anastomotic leakage is still a major complication in colorectal surgery. Prompt recognition and immediate treatment of anastomotic leak during surgery may reduce postoperative morbidity and mortality. Various types of intraoperative anastomotic test have been proposed to reduce the incidence of this complication. The aim of this study was to assess our experience with intraoperative dye test in rectal cancer surgery.

Methods

Between 2006 and 2009, a retrospective review of a single general surgeon’s practice identified 76 patients who underwent the intraoperative dye test in rectal cancer surgery. Seventy-three of these 76 patients underwent elective surgery without creation of a diverting stoma. Diluted dye was routinely introduced into the rectal lumen to test anastomotic integrity. Intraoperative leak was repaired prior to the completion of the procedure. No routine radiological survey assessed anastomotic integrity postoperatively.

Results

In 11 (14.5 %) out of 76 patients, anastomotic leaks were found and treated intraoperatively. None of the 65 patients without intraoperative leaks developed clinical leaks during the follow-up period. Postoperative leakage only occurred in one patient (1.3 %). He developed pelvic abscess evidenced by abdominal computed tomography scan and was treated non-operatively.

Conclusions

The favorable results allow the authors to recommend the routine use of the intraoperative dye test for colorectal anastomoses.

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Acknowledgments

This work was supported by grants from the Excellence for Cancer Research Center Grant through the funding by Department of Health, Executive Yuan, Taiwan, Republic of China (DOH101-TD-C-111-002).

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Division of Traumatology, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    C.-W. Chen & Y.-S. Yeh

  2. Graduate Institute of Injury Prevention and Control, College of Public Health and Nutrition, Taipei Medical University, Taipei, Taiwan

    C.-W. Chen

  3. Department of Surgery, Chi-Mei Medical Center, Tainan, Taiwan

    M.-J. Chen

  4. Division of General Surgery Medicine, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan

    H.-L. Tsai

  5. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan

    H.-L. Tsai

  6. Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    C.-W. Chen, Y.-T. Chang & J.-Y. Wang

  7. Division of Paediatric Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Y.-T. Chang

  8. Division of Gastrointestinal and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    J.-Y. Wang

  9. Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    J.-Y. Wang

  10. Department of Medical Genetics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    J.-Y. Wang

  11. Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan

    J.-Y. Wang

Authors
  1. C.-W. Chen
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  2. M.-J. Chen
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  3. Y.-S. Yeh
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  4. H.-L. Tsai
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  5. Y.-T. Chang
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  6. J.-Y. Wang
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Corresponding author

Correspondence to J.-Y. Wang.

Additional information

Chao-Wen Chen and Ming-Jenn Chen contributed equally to this work.

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Chen, CW., Chen, MJ., Yeh, YS. et al. Intraoperative anastomotic dye test significantly decreases incidence of anastomotic leaks in patients undergoing resection for rectal cancer. Tech Coloproctol 17, 579–583 (2013). https://doi.org/10.1007/s10151-012-0910-x

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  • DOI: https://doi.org/10.1007/s10151-012-0910-x

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