Endoscopic evaluation of clinical colorectal anastomotic leakage

Tetsuo Ikeda, Ryuichi Kumashiro, Kenji Taketani, Koji Ando, Yasue Kimura, Hiroshi Saeki, Eiji Oki, Masaru Morita, Tomohiko Akahoshi, Makoto Hashizume, Yoshihiko Maehara

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Background: Anastomotic leakage (AL) is a major complication after anterior resection. However, its therapeutic strategies and technical risk factors have not been well established. Therefore, we endoscopically evaluated anastomotic regions after laparoscopic colorectal anastomosis using a double-stapling technique (DST) for determination of treatment and investigation of technical factors. Methods: In total, 191 consecutive patients underwent laparoscopic anterior resection with a DST from September 2008-January 2013. Anastomotic regions were endoscopically evaluated in patients suspected to have AL after surgery. Results: Anastomotic dehiscence was observed in 19 patients, and AL was diagnosed in 18 (9.3%). Of the 19 patients, 12 were treated by creation of an intestinal stoma and 7 were treated conservatively based on their clinical status and endoscopic findings. Twentythree dehiscences were observed among 19 anastomotic regions; all 23 were observed on the circular stapler anastomosis lines. Of these 23 dehiscences, 13 (56.5%) were located at the point at which the anastomosis lines of the circular and linear staplers overlapped, and 10 (43.5%) were located on the circumferential aspect between the overlapping points. Conclusions: Endoscopic evaluation of anastomotic regions is safe and useful for the determination of therapeutic strategies. The DST anastomotic technique itself may be closely related to the development of AL.

Original languageEnglish
Pages (from-to)126-134
Number of pages9
JournalJournal of Surgical Research
Volume193
Issue number1
DOIs
Publication statusPublished - 2015

All Science Journal Classification (ASJC) codes

  • Surgery

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