Risk Factors for Anastomotic Leakage After Anterior Resection for Rectal Cancer

Kang, Celeste Y.; Halabi, Wissam J.; Chaudhry, Obaid; Nguyen, Vinh; Pigazzi, Alessio; Carmichael, Joseph C.; Mills, Steven; Stamos, Michael J.

doi:10.1001/2013.jamasurg.2

Cited by 342 publications

(281 citation statements)

References 46 publications

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“…4,[17][18][19] Studies evaluating nutritional supplementation tend to evaluate overall complications (including anastomotic leak), but few break out anastomotic leak alone. In addition, we must strongly consider the type (parenteral vs enteral) and timing (preoperative or postoperative) of nutritional supplementation.…”

Section: Modifying Patient Factors To Reduce Anastomotic Leaks Nutritionmentioning

confidence: 99%

Reducing gastrointestinal anastomotic leak rates: review of challenges and solutions

Phillips¹

2016

OAS

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Various techniques and interventions have been developed in an effort to obviate gastrointestinal anastomotic leaks. This review is intended to delineate potential modifications that can be made to reduce the risk of anastomotic leaks following gastrointestinal surgery. It may also serve to aid in identifying patients who are at increased risk of anastomotic leak. Modifiable risk factors for leak discussed include malnutrition, smoking, steroid use, bowel preparation, chemotherapy, duration of surgery, use of pressors, intravenous fluid administration, blood transfusion, and surgical anastomotic technique. Based upon literature review, operative techniques should include minimizing operative time, reducing ischemia, and utilizing stapled anastomoses. Buttressing of anastomoses with omentum has proven utility for esophageal surgery. Further recommendations include 5-7 days of immune-modifying nutritional supplementation for malnourished patients, discontinuation of smoking in the perioperative period, limiting steroid use, utilization of oral antibiotic preparation for colorectal surgery, avoidance of early operations (,4 weeks) following chemotherapy, limiting pressor use, and the utilization of goal-directed fluid management.

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Section: Modifying Patient Factors To Reduce Anastomotic Leaks Nutritionmentioning

confidence: 99%

Reducing gastrointestinal anastomotic leak rates: review of challenges and solutions

Phillips¹

2016

OAS

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“…), степень ком-пенсации сопутствующих заболеваний, приводящих к ангиопатии и гипоксии тканей (распространенный атеросклероз, сердечная недостаточность, сахарный диабет и др.) [1,[3][4][5][6][7]. Достаточное кровоснабжение дистальной части низводимой ободочной кишки и от-сутствие натяжения кишки при формировании пер-вичного анастомоза являются основными интраопе-рационными факторами, уменьшающими долю несостоятельностей анастомозов, на которые может повлиять хирург в процессе выполнения вмешатель-ства [2,[8][9][10].…”

Section: результатыunclassified

“…Частота возник-новения несостоятельности первичного анастомоза варьирует в различных исследованиях и может дости-гать 20 % [5][6][7]. По современным данным, регист-рируется снижение частоты несостоятельностей до 1-4 % на фоне выполненной интраоперационной флуоресцентной визуализации адекватности крово-снабжения анастомозируемых участков кишки [34,36].…”

Section: результатыunclassified

Intraoperative fluorescence angiography in objectification of relegated colon perfusion in oncocoloproctology: first Russian experience and review of the literature

Кочатков¹,

Lyadov²,

Пивень³

et al. 2016

Onkol. koloproktol.

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“…Post-operative anastomotic leaks occur in up to 1%-4% of gastrectomies [13,14], 8%-11% of esophagectomies [15,16], and 6%-14% of colorectal resections, with mortality in the latter reported between 2% and 12% [17][18][19][20]. Post-operative anastomotic leak may result in 65%-81% higher total hospital costs and 56%-100% longer length of hospital stay [19,20]. Patients who had post-operative anastomotic leaks incurred an additional hospital cost of $28,600 [19].…”

Section: Introductionmentioning

confidence: 99%