Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature review
Abstract Background Anastomotic leakage (AL) is one of the most dreadful postoperative complications because it can result in increased morbidity and mortality as well as poorer long-term prognosis. Although most studies of AL limited their investigation time to a period of 30 days postoperatively,...
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| Format: | Article |
| Language: | English |
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BMC
2017-08-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | http://link.springer.com/article/10.1186/s12957-017-1208-2 |
| _version_ | 1819260989668851712 |
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| author | Masayoshi Iwamoto Kenji Kawada Koya Hida Suguru Hasegawa Yoshiharu Sakai |
| author_facet | Masayoshi Iwamoto Kenji Kawada Koya Hida Suguru Hasegawa Yoshiharu Sakai |
| author_sort | Masayoshi Iwamoto |
| collection | DOAJ |
| description | Abstract Background Anastomotic leakage (AL) is one of the most dreadful postoperative complications because it can result in increased morbidity and mortality as well as poorer long-term prognosis. Although most studies of AL limited their investigation time to a period of 30 days postoperatively, only a few studies have shown that AL can occur after that period. Here, we report four patients of rectal cancer with delayed AL following laparoscopic intersphincteric resection (ISR) and conduct a literature review on delayed AL. Case presentation Case 1 was a 67-year-old male who underwent laparoscopic partial ISR in July 2009. Although the patient was asymptomatic, an anastomotic-urethral fistula was observed 57 months after ISR. Case 2 was a 44-year-old female who underwent laparoscopic partial ISR in July 2008. She presented with discharge of gas and feces from her vagina, and an anastomotic-vaginal fistula was observed 14 months after ISR. Case 3 was a 74-year-old man who underwent laparoscopic partial ISR in August 2007. He presented with pneumaturia and fecaluria, and an anastomotic-urethral fistula was observed 4 months after ISR. Case 4 was a 68-year-old woman who underwent laparoscopic subtotal ISR for rectal cancer in February 2013 and partial hepatic resection for liver metastases in March 2013. She presented with anal pain and purulent perineal discharge, and an anastomotic-perineal fistula was observed 9 months after ISR. All four cases presented with fistula formation and required reoperation (establishment of a diverting ileostomy). Conclusions Since delayed AL is not a rare postoperative complication, surgeons need to provide long-term follow-up and remain alert to the possible development of delayed AL. |
| first_indexed | 2024-12-23T19:34:40Z |
| format | Article |
| id | doaj.art-8a5b00fd4e434647b648ffc1620d7313 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-23T19:34:40Z |
| publishDate | 2017-08-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-8a5b00fd4e434647b648ffc1620d73132022-12-21T17:33:49ZengBMCWorld Journal of Surgical Oncology1477-78192017-08-011511610.1186/s12957-017-1208-2Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature reviewMasayoshi Iwamoto0Kenji Kawada1Koya Hida2Suguru Hasegawa3Yoshiharu Sakai4Department of Surgery, Kyoto University Graduate School of MedicineDepartment of Surgery, Kyoto University Graduate School of MedicineDepartment of Surgery, Kyoto University Graduate School of MedicineDepartment of Gastroenterological Surgery, Faculty of Medicine, Fukuoka UniversityDepartment of Surgery, Kyoto University Graduate School of MedicineAbstract Background Anastomotic leakage (AL) is one of the most dreadful postoperative complications because it can result in increased morbidity and mortality as well as poorer long-term prognosis. Although most studies of AL limited their investigation time to a period of 30 days postoperatively, only a few studies have shown that AL can occur after that period. Here, we report four patients of rectal cancer with delayed AL following laparoscopic intersphincteric resection (ISR) and conduct a literature review on delayed AL. Case presentation Case 1 was a 67-year-old male who underwent laparoscopic partial ISR in July 2009. Although the patient was asymptomatic, an anastomotic-urethral fistula was observed 57 months after ISR. Case 2 was a 44-year-old female who underwent laparoscopic partial ISR in July 2008. She presented with discharge of gas and feces from her vagina, and an anastomotic-vaginal fistula was observed 14 months after ISR. Case 3 was a 74-year-old man who underwent laparoscopic partial ISR in August 2007. He presented with pneumaturia and fecaluria, and an anastomotic-urethral fistula was observed 4 months after ISR. Case 4 was a 68-year-old woman who underwent laparoscopic subtotal ISR for rectal cancer in February 2013 and partial hepatic resection for liver metastases in March 2013. She presented with anal pain and purulent perineal discharge, and an anastomotic-perineal fistula was observed 9 months after ISR. All four cases presented with fistula formation and required reoperation (establishment of a diverting ileostomy). Conclusions Since delayed AL is not a rare postoperative complication, surgeons need to provide long-term follow-up and remain alert to the possible development of delayed AL.http://link.springer.com/article/10.1186/s12957-017-1208-2Delayed anastomotic leakageIntersphincteric resectionRectal cancerSurgery |
| spellingShingle | Masayoshi Iwamoto Kenji Kawada Koya Hida Suguru Hasegawa Yoshiharu Sakai Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature review World Journal of Surgical Oncology Delayed anastomotic leakage Intersphincteric resection Rectal cancer Surgery |
| title | Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature review |
| title_full | Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature review |
| title_fullStr | Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature review |
| title_full_unstemmed | Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature review |
| title_short | Delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer: report of four cases and literature review |
| title_sort | delayed anastomotic leakage following laparoscopic intersphincteric resection for lower rectal cancer report of four cases and literature review |
| topic | Delayed anastomotic leakage Intersphincteric resection Rectal cancer Surgery |
| url | http://link.springer.com/article/10.1186/s12957-017-1208-2 |
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