Postoperative and Long-term Outcomes After Redo Surgery for Failed Colorectal or Coloanal Anastomosis

Abstract

Redo surgery for failed colorectal or coloanal anastomosis is a valuable surgical option which allows avoidance of a permanent stoma in nearly 90% of patients. It remains a major undertaking with high intraoperative and postoperative morbidity.

Low anterior resection combined with a covering stoma in the treatment of rectal cancer reduces the risk of permanent anastomotic failure

“…Their 33 % failure rate in new handsewn coloanal anastomosis was markedly higher than the 5 % rate in new stapled colorectal anastomosis, as well. The even better results of another study on redo surgery after failed colorectal or coloanal anastomosis are not comparable with our or Levefre's results [28], because 42 % of the primary operations were performed for an indication other than rectal cancer, and the median height of the primary anastomosis was 9 cm from the anal verge [29]. Thus, since the results of redo surgery after low colorectal or coloanal anastomoses are far from encouraging, redo anastomosis should be attempted only in selected cases.…”

Long-term results of endoscopic balloon dilation for treatment of colorectal anastomotic stenosis

“…But those operations are associated with a considerable morbidity and mortality. Hence, major complications were reported in up to 18 % of surgical procedures performed for anastomotic strictures [11][12][13].…”

Right and Wrong Approaches To Colorectal Anastomotic Strictures: When? Which Technique?

“…[3,15] The rate of stapler-induced anastomotic stenosis was significantly greater than for manual anastomosis. [14] Male gender, the use of staples, and divergent stoma have been reported as prognostic factors in the development of anastomotic stricture. [16,17] In some studies, it has been said that anastomoses under the peritoneal reflection are associated with a greater risk of stenosis.…”

“…However, these procedures have serious morbidity and mortality rates, and major complications of up to 18% have been reported. [14] In our study, we evaluated the success of early and late endoscopic balloon and bougie dilatation techniques applied to anastomotic strictures in patients with a low anterior resection (LAR) with a diversion ileostomy due to colorectal cancer. Between July 2014 and December 2017, 167 patients underwent LAR with a diversion ileostomy in our clinic due to a rectal tumor.…”