A novel multi-modal approach for prevention and treatment of anastomotic leakage after low anterior resection in rectal cancer patients

Wang, Zhun; Yang, Yu-Shen; Zhao, Xue-Feng

doi:10.1016/j.asjsur.2021.09.008

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…It is preferred to keep surgery as a last resort. Obviously this attitude is related to the presentation of the patient and the timing of the AL[ 16 - 18 ]. In agreement with Vignali and De Nardi[ 1 ], we believe that saving the anastomosis through the use of conservative treatments represents a valid therapeutic option to be used especially in clinically stable patients or in the presence of a small defect.…”

Section: To the Editormentioning

confidence: 99%

Endoluminal vacuum-assisted therapy as a treatment for anastomotic leakage in colorectal surgery

Chiarello¹,

Bianchi²,

Fransvea³

et al. 2022

WJG

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Anastomotic leakage (AL) has a wide range of clinical features ranging from radiological only findings to peritonitis and sepsis with multiorgan failure. An early diagnosis of AL is essential in order to establish the most appropriate treatment for this complication. Despite AL continues to be a dreadful compli-cation after colorectal surgery, there has been no consensus on its management. However, based on patient’s presentation and timing of the AL, there has been a gradual shift to a more conservative management, keeping surgery as the last option Reoperation for sepsis control is rarely necessary especially in those patients who already have a diverting stoma at the time of the leak. A nonoperative management is usually preferred in these patients. There are several treatment options, also for patients without a stoma who do not require a reoperation for a contained pelvic leak, including recently developed endoscopic procedures, such as clip placement or endoluminal vacuum-assisted therapy. More conservative treatments could be an option in patients who are clinically stable or in presence of a small defect.

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Section: To the Editormentioning

confidence: 99%