The failed intraperitoneal colon anastomosis after colon resection

Kanellos, Ioannis; Blouhos, Konstantinos; Demetriades, H.; Pramateftakis, Manousos-Georgios; Mantzoros, Ioannis; Zacharakis, Emmanouil; Betsis, D.

doi:10.1007/s10151-004-0111-3

Cited by 43 publications

(39 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other groups, too, report a high early mortality associated with AL [2,3]; furthermore, the removal of an anastomosis following an anastomotic leak often results in a 'permanent' stoma [4].…”

Section: Long-term Oncological Outcome -Follow Upmentioning

confidence: 99%

See 1 more Smart Citation

Anastomotic leakage after colon cancer surgery: A predictor of significant morbidity and hospital mortality, and diminished tumour-free survival

Kube

Mroczkowski

Granowski

et al. 2010

European Journal of Surgical Oncology (EJSO)

148

View full text Add to dashboard Cite

AimThe objective of this study was to find out the effects of anastomotic leakage (AL) following resection of colon cancer upon perioperative outcome and long-term oncological result. Patients and methodsUsing the data base of a country-wide quality assurance study "Quality Assurance in PrimaryColorectal Carcinoma" we analysed the data from the complete sub-population of 844 patients who had AL after resection of colon cancer. These were compared with corresponding data from 27 427 similar patients without AL. Hospital mortality, ALassociated post-operative morbidity and long-term outcome were investigated. ResultsHospital mortality after AL was 18.6%, compared with 2.6% for patients without AI. ALrelated secondary complications occurred in 62.7% cases, while patients without AL had a corresponding rate of 19.9%. Those with AL had a poorer long-term oncological result, with a five-year survival rate of 51.0% (p < 0.001) and a five-year tumour-free survival rate of 63.0% (compare 74.6% without AL; p < 0.001). ConclusionsPost-operative AL after resection of colon cancer is associated with significant morbidity and hospital mortality rates and a greater risk of a poor oncological outcome.

show abstract

Section: Long-term Oncological Outcome -Follow Upmentioning

confidence: 99%

“…It is encountered frequently in routine surgical practice, and it is associated with an increase in early post-operative mortality [1,2,3,4]. For colorectal cancer, there are indications that AL worsens the long-term oncological result [5,6,7].…”

Section: Introductionmentioning

confidence: 99%

Anastomotic leakage after colon cancer surgery: A predictor of significant morbidity and hospital mortality, and diminished tumour-free survival

Kube

Mroczkowski

Granowski

et al. 2010

European Journal of Surgical Oncology (EJSO)

148

View full text Add to dashboard Cite

show abstract

“…In large series, it has been reported to be associated with 25-37% of deaths. [1] Intraabdominal hemorrhage is the other complication that can develop during and/or after the operation. Its effects on hemodynamics and tissue perfusion are well known and appropriately struggled with.…”

Section: Resultsmentioning

confidence: 99%

Effects of hemoperitoneum on wound healing and fibrinolytic activity in colonic anastomosis

Köksal¹,

Uzun²,

Özkan³

et al. 2012

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

“…Because of the high morbidity and mortality associated with anastomosis leakage after colon surgery, many studies have been undertaken to prevent anastomotic leakage using various materials and methods in animal models [1,2,3,4,5,6,7]. However, the results of these studies have been controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Leaking colon anastomoses are responsible for numerous complications and account for as much as one third of postoperative deaths associated with colonic operations [1,2,3]. Furthermore, the use of chemotherapeutic agents like 5-fluorouracil (5-FU) to destroy cancer cells that might have been disseminated during operation [4] has an adverse effect on the healing of colonic anastomoses [5,6,7].…”

Section: Introductionmentioning

confidence: 99%

The Use of Collagen Content as Determined by Spectral Domain Polarization-Sensitive Optical Coherence Tomography to Assess Colon Anastomosis Healing in a Rat Model

Son

Jeong²,

Jung

et al. 2014

Eur Surg Res

View full text Add to dashboard Cite

Background/Purpose: Many studies have been undertaken to prevent anastomosis leakage of the colon, and several methods have been used to assess anastomosis healing, such as measurement of bursting pressure or hydroxyproline (a marker of collagen) content at the anastomosis site. However, these methods are inappropriate for comparing anastomosis healing at two time points in the same animals. In the present study, we measured the collagen level by spectral domain polarization-sensitive optical coherence tomography (SD-PS-OCT) to assess anastomosis healing. Methods: Sprague-Dawley rats were divided into groups C (saline-administered controls; study group) and M [a 5-fluorouracil (5-FU)-administered experimental group]. Immediately after end-to-end anastomosis of the colon, SD-PS-OCT images of anastomoses were taken (baseline). Animals were administered saline or 5-FU for 7 days. On the 7th postoperative day, SD-PS-OCT images were acquired, a histopathologic exam was performed, and hydroxyproline levels as well as mRNA expressions of collagen-1 and collagen-3 were measured at the anastomosis site. Results: Fibroblast proliferation and inflammatory cell infiltration were greater in group C than in group M. The mRNA expressions of collagen-1 and collagen-3 were substantially higher in group C. Hydroxyproline levels were higher in group M than in group C. Though collagen levels measured by SD-PS-OCT at 7 days were elevated compared with baseline in group C, no such changes were observed for group M. Conclusion: Collagen levels at the colon anastomosis site, measured with SD-PS-OCT, were not increased at 7 days postoperatively versus baseline when 5-FU was injected, but were increased in saline-treated controls. The measurement of collagen content by SD-PS-OCT was found to provide a good means of assessing anastomosis healing, because it allows in situ assessment of collagen contents at baseline and during the postoperative period.

show abstract

The failed intraperitoneal colon anastomosis after colon resection

Abstract: Even though the rate of anastomotic leakage in patients with intraperitoneal anastomosis after colon resection for colorectal cancer is low, it remains a significant complication and a major cause of postoperative morbidity and mortality.

Cited by 43 publications

References 6 publications

Anastomotic leakage after colon cancer surgery: A predictor of significant morbidity and hospital mortality, and diminished tumour-free survival

Anastomotic leakage after colon cancer surgery: A predictor of significant morbidity and hospital mortality, and diminished tumour-free survival

Effects of hemoperitoneum on wound healing and fibrinolytic activity in colonic anastomosis

The Use of Collagen Content as Determined by Spectral Domain Polarization-Sensitive Optical Coherence Tomography to Assess Colon Anastomosis Healing in a Rat Model

Contact Info

Product

Resources

About