Transanal endoluminal repair for anastomotic leakage after low anterior resection
Abstract Background There is still no consensus on the management of colorectal anastomotic leakage after low anterior resection. The goal was to evaluate the outcomes of patients who underwent transanal endoluminal repair + laparoscopic drainage ± stoma vs. drainage only ± stoma. Methods Retrospect...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-01-01
|
| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-022-01484-4 |
| _version_ | 1819349852661743616 |
|---|---|
| author | Yi-Chang Chen Yuan-Yao Tsai Tao-Wei Ke Abe Fingerhut William Tzu-Liang Chen |
| author_facet | Yi-Chang Chen Yuan-Yao Tsai Tao-Wei Ke Abe Fingerhut William Tzu-Liang Chen |
| author_sort | Yi-Chang Chen |
| collection | DOAJ |
| description | Abstract Background There is still no consensus on the management of colorectal anastomotic leakage after low anterior resection. The goal was to evaluate the outcomes of patients who underwent transanal endoluminal repair + laparoscopic drainage ± stoma vs. drainage only ± stoma. Methods Retrospective chart review of patients sustaining anastomotic leakage after laparoscopic low anterior resection between January 2013 and September 2020 who required laparoscopic reoperation. Results Forty-nine patients were included, 22 patients underwent combined laparoscopy and transanal endoluminal repair and 27 patients had drainage with a stoma (n = 16) or drainage alone (n = 11), without direct anastomotic repair. The overall morbidity rate was 30.6% and the mortality rate was 2%. Combined laparoscopic lavage/drainage and transanal endoluminal repair of anastomotic leakage was associated with a lower complication rate (13.6% vs. 44.4%, p = 0.03) and fewer intraabdominal infections (4.5% vs. 29.6%, p = 0.03) compared with no repair. Conclusions Combined laparoscopic lavage/drainage and transanal endoluminal repair is effective in the management of colorectal anastomosis leakage and was associated with lower morbidity—in particular intraabdominal infection—compared with no repair. However, our results need to be confirmed in larger, and ideally randomized, studies. |
| first_indexed | 2024-12-24T19:07:07Z |
| format | Article |
| id | doaj.art-d63ee4cae2a443ec8e369b36ac2e49ab |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-24T19:07:07Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-d63ee4cae2a443ec8e369b36ac2e49ab2022-12-21T16:43:05ZengBMCBMC Surgery1471-24822022-01-012211910.1186/s12893-022-01484-4Transanal endoluminal repair for anastomotic leakage after low anterior resectionYi-Chang Chen0Yuan-Yao Tsai1Tao-Wei Ke2Abe Fingerhut3William Tzu-Liang Chen4Department of Colorectal Surgery, China Medical University HospitalDepartment of Colorectal Surgery, China Medical University HospitalDepartment of Colorectal Surgery, China Medical University HospitalDepartment of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Minimally Invasive Surgery CenterChina Medical University Hsinchu HospitalAbstract Background There is still no consensus on the management of colorectal anastomotic leakage after low anterior resection. The goal was to evaluate the outcomes of patients who underwent transanal endoluminal repair + laparoscopic drainage ± stoma vs. drainage only ± stoma. Methods Retrospective chart review of patients sustaining anastomotic leakage after laparoscopic low anterior resection between January 2013 and September 2020 who required laparoscopic reoperation. Results Forty-nine patients were included, 22 patients underwent combined laparoscopy and transanal endoluminal repair and 27 patients had drainage with a stoma (n = 16) or drainage alone (n = 11), without direct anastomotic repair. The overall morbidity rate was 30.6% and the mortality rate was 2%. Combined laparoscopic lavage/drainage and transanal endoluminal repair of anastomotic leakage was associated with a lower complication rate (13.6% vs. 44.4%, p = 0.03) and fewer intraabdominal infections (4.5% vs. 29.6%, p = 0.03) compared with no repair. Conclusions Combined laparoscopic lavage/drainage and transanal endoluminal repair is effective in the management of colorectal anastomosis leakage and was associated with lower morbidity—in particular intraabdominal infection—compared with no repair. However, our results need to be confirmed in larger, and ideally randomized, studies.https://doi.org/10.1186/s12893-022-01484-4Transanal endoluminal repairColorectal anastomosisAnastomosis leakageLow anterior resection |
| spellingShingle | Yi-Chang Chen Yuan-Yao Tsai Tao-Wei Ke Abe Fingerhut William Tzu-Liang Chen Transanal endoluminal repair for anastomotic leakage after low anterior resection BMC Surgery Transanal endoluminal repair Colorectal anastomosis Anastomosis leakage Low anterior resection |
| title | Transanal endoluminal repair for anastomotic leakage after low anterior resection |
| title_full | Transanal endoluminal repair for anastomotic leakage after low anterior resection |
| title_fullStr | Transanal endoluminal repair for anastomotic leakage after low anterior resection |
| title_full_unstemmed | Transanal endoluminal repair for anastomotic leakage after low anterior resection |
| title_short | Transanal endoluminal repair for anastomotic leakage after low anterior resection |
| title_sort | transanal endoluminal repair for anastomotic leakage after low anterior resection |
| topic | Transanal endoluminal repair Colorectal anastomosis Anastomosis leakage Low anterior resection |
| url | https://doi.org/10.1186/s12893-022-01484-4 |
| work_keys_str_mv | AT yichangchen transanalendoluminalrepairforanastomoticleakageafterlowanteriorresection AT yuanyaotsai transanalendoluminalrepairforanastomoticleakageafterlowanteriorresection AT taoweike transanalendoluminalrepairforanastomoticleakageafterlowanteriorresection AT abefingerhut transanalendoluminalrepairforanastomoticleakageafterlowanteriorresection AT williamtzuliangchen transanalendoluminalrepairforanastomoticleakageafterlowanteriorresection |