High tie in anterior resection for rectal cancer confers no increased risk of anastomotic leakage

2012 ◽  
Vol 22 (1) ◽  
pp. 0-0
Author(s):  
Tufan Egeli ◽  
Aras Emre Canda
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
High Tie ◽  
Increased Risk

High tie in anterior resection for rectal cancer confers no increased risk of anastomotic leakage

2011 ◽  
Vol 99 (1) ◽  
pp. 127-132 ◽  
Author(s):  
M. Rutegård ◽  
O. Hemmingsson ◽  
P. Matthiessen ◽  
J. Rutegård
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
High Tie ◽  
Increased Risk

scholarly journals Ultralow anterior resection with implantation of gentamicin-collagen sponge and no defunctioning stoma: anastomotic leakage and local cancer relapse

2019 ◽  
Vol 53 (1) ◽  
pp. 77-84 ◽  
Author(s):  
Tomasz Michalik ◽  
Rafał Matkowski ◽  
Przemyslaw Biecek ◽  
Jozef Forgacz ◽  
Bartlomiej Szynglarewicz
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Local Relapse ◽  
Collagen Sponge ◽  
Safe Procedure ◽  
Defunctioning Stoma ◽  
Ultralow Anterior Resection ◽  
Increased Risk ◽  
Low Incidence

Abstract Background Anterior resection with total mesorectal excision (TME) of ultralow rectal cancer may result in the increased risk of the anastomotic leakage (AL). The aim of this study was to evaluate the usefulness of the gentamicin-collagen sponge (GCS) for the protection against symptomatic AL and investigate association between AL and local relapse (LR). Patients and methods A series of 158 patients with ultralow rectal cancer was studied. All the patients underwent R0 sphincter-saving TME with anastomosis wrapping using GCS. In none of the cases a temporary protective stoma was constructed. Results AL rate was 3.2% (5/158) while median time to AL diagnosis was 5 days following surgery (range 3-15). There was no postoperative and leakage-related mortality. Patient age > 75 years and smoking were independent risk factors related to significantly increased AL rate: 12.5% vs. 0.8% (P = 0.0004) and 5.7% vs. 0% P = 0.043), respectively. LR was observed in 12% of cases. It was highly significantly more common and developed earlier in patients who have had AL when compared with non-AL group: 80% vs. 9% (P = 0.00001) and 8.5 vs. 17 months (P = 0.014), respectively. Conclusions Anastomosis wrapping with GCS after anterior resection with TME is a safe procedure resulting in the low incidence of anastomotic leakage which may be also associated with decreased risk of local relapse.

scholarly journals Predicting the risk and diminishing the consequences of anastomotic leakage after anterior resection for rectal cancer

2010 ◽  
Vol 57 (3) ◽  
pp. 47-50 ◽  
Author(s):  
B.J. Moran
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Anal Verge ◽  
Intestinal Anastomosis ◽  
Defunctioning Stoma ◽  
Increased Risk ◽  
Diverting Stoma ◽  
Risk Of Cancer

INTRODUCTION: Anastomotic leakage is one of the most serious early complications of any intestinal anastomosis. The morbidity and mortality are high and patients may be at increased risk of cancer recurrence. In colorectal surgery the risks are particularly high following low anterior resection. Factors which increase and decrease the risks are discussed. METHODS: A review of the main published risk factors for anastomotic leakage after anterior resection for rectal cancer together with the authors personal experience is reported. A review of a recent large randomized trial of a defunctioning stoma versus no stoma is outlined. RESULTS: The main factor influencing anastomotic leakage is the height of the anastomosis above the anal verge with the lower the anastomosis the higher the risk. All anastomoses within 7 cm of the anal verge are at increased risk which includes all patients who have had a total mesorectal excision. Neoadjuvant therapy (in particular long course radiotherapy or chemoradiotherapy) increases the risk. Male sex, older age, smoking, alcohol in excess, short course radiotherapy, obesity, general fitness, immunosuppression have been reported in some series as increasing the risk. A temporary diverting stoma decreases the consequences of leakage and reduces the need for emergency re-operation. Anastomotic leakage is associated with an increased postoperative death rate, reoperative rates, need for a permanent stoma and possibly an increase in local recurrence and decreased cancer specific and overall survival. CONCLUSION: Anastomotic leakage is a serious early complication following surgery for rectal cancer. The height of the anastomosis and neoadjuvant therapy are the main predictors of an increased risk. A diverting stoma diminishes the consequences of risk and reduces the need for emergency re-operation.

High risk of permanent stoma after anastomotic leakage in anterior resection for rectal cancer

2018 ◽  
Vol 21 (2) ◽  
pp. 174-182 ◽  
Author(s):  
H. Jutesten ◽  
J. Draus ◽  
J. Frey ◽  
G. Neovius ◽  
G. Lindmark ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
High Risk ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Permanent Stoma

Effect of Left Colonic Artery Preservation on Anastomotic Leakage in Laparoscopic Anterior Resection for Middle and Low Rectal Cancer

2013 ◽  
Vol 37 (12) ◽  
pp. 2935-2943 ◽  
Author(s):  
Takao Hinoi ◽  
Masazumi Okajima ◽  
Manabu Shimomura ◽  
Hiroyuki Egi ◽  
Hideki Ohdan ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Low Rectal Cancer ◽  
Laparoscopic Anterior Resection
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