Prevention and control of postoperative anastomotic leak after colorectal anastomosis / 中华胃肠外科杂志
Chinese Journal of Gastrointestinal Surgery
;
(12): 379-382, 2016.
Article
in Chinese
| WPRIM
| ID: wpr-341522
ABSTRACT
Anastomotic leak is a major complication after colorectal resection. Risk factors for anastomotic leak include patient and disease related factors, preoperative factors(e.g. use of neoadjuvant chemoradiation and mechanical bowel preparation), intraoperative factors(e.g. anastomotic techniques, performing of water injection test, preventive colostomy, and surgical procedures, etc; postoperative factors, such as postoperative medication use, etc. Early diagnosis of anastomotic fistula is crucial, which can be made by combining laboratory examination with imaging examination or take the prediction and diagnosis model as reference. Once diagnosed, anastomotic leak should be managed immediately according to individual status and severity of disease. As for intraperitoneal anastomosis, no matter whether the bowel lack of blood supply or not, original anastomosis should be removed and terminal loop ileumstomy should be created. As for extraperitoneal anastomosis(mainly low rectal anastomosis), adequate drainage and terminal loop ileumstomy can be considered when anastomosis is slightly cracked or invisible due to adhesion. When anastomosis is severely cracked or blood supply is too limited, however, we must disconnect the original anastomotic and create a proximal colostomy.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Postoperative Complications
/
Postoperative Period
/
Rectum
/
General Surgery
/
Digestive System Surgical Procedures
/
Anastomosis, Surgical
/
Colostomy
/
Ileostomy
/
Drainage
/
Retrospective Studies
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Humans
Language:
Chinese
Journal:
Chinese Journal of Gastrointestinal Surgery
Year:
2016
Type:
Article
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