Limits...
Minimally invasive management of anastomotic leaks in colorectal surgery

View Article: PubMed Central - PubMed

ABSTRACT

Anastomotic leakage is an unfortunate complication of colorectal surgery. This distressing situation can cause severe morbidity and significantly affects the patient’s quality of life. Additional interventions may cause further morbidity and mortality. Parenteral nutrition and temporary diverting ostomy are the standard treatments of anastomotic leaks. However, technological developments in minimally invasive treatment modalities for anastomotic dehiscence have caused them to be used widely. These modalities include laparoscopic repair, endoscopic self-expandable metallic stents, endoscopic clips, over the scope clips, endoanal repair and endoanal sponges. The review aimed to provide an overview of the current knowledge on the minimally invasive management of anastomotic leaks.

No MeSH data available.


Related in: MedlinePlus

Endoscopic appearance of anastomotic leakage. A: Anastomotic leak with a cavity before endoscopic vacuum-assisted closure therapy; B: The same cavity covered with granulation tissue (black arrow) three weeks after vacuum therapy was initiated.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5037335&req=5

Figure 2: Endoscopic appearance of anastomotic leakage. A: Anastomotic leak with a cavity before endoscopic vacuum-assisted closure therapy; B: The same cavity covered with granulation tissue (black arrow) three weeks after vacuum therapy was initiated.

Mentions: The endo-sponge continuously removes secretions, improves microcirculation, and therefore induces granulation formation in the defect. It also aids closure of the pelvic cavity by the application of negative pressure of 125 mmHg[26] (Figure 2). One disadvantage of this method is the requirement to change the sponge every 2-4 d until the abscess cavity has regressed[25,28,29]. However, this treatment is more effective at shrinking cavities, especially when used within 6 wk after the AL[10,30]. It should be noted that generalized peritonitis is not an indication for endo-sponge therapy[12,25,29]; and the overall complication rates are around 20%, mainly comprising anastomosis stenosis, recidivate abscess and fistula[26].


Minimally invasive management of anastomotic leaks in colorectal surgery
Endoscopic appearance of anastomotic leakage. A: Anastomotic leak with a cavity before endoscopic vacuum-assisted closure therapy; B: The same cavity covered with granulation tissue (black arrow) three weeks after vacuum therapy was initiated.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037335&req=5

Figure 2: Endoscopic appearance of anastomotic leakage. A: Anastomotic leak with a cavity before endoscopic vacuum-assisted closure therapy; B: The same cavity covered with granulation tissue (black arrow) three weeks after vacuum therapy was initiated.
Mentions: The endo-sponge continuously removes secretions, improves microcirculation, and therefore induces granulation formation in the defect. It also aids closure of the pelvic cavity by the application of negative pressure of 125 mmHg[26] (Figure 2). One disadvantage of this method is the requirement to change the sponge every 2-4 d until the abscess cavity has regressed[25,28,29]. However, this treatment is more effective at shrinking cavities, especially when used within 6 wk after the AL[10,30]. It should be noted that generalized peritonitis is not an indication for endo-sponge therapy[12,25,29]; and the overall complication rates are around 20%, mainly comprising anastomosis stenosis, recidivate abscess and fistula[26].

View Article: PubMed Central - PubMed

ABSTRACT

Anastomotic leakage is an unfortunate complication of colorectal surgery. This distressing situation can cause severe morbidity and significantly affects the patient’s quality of life. Additional interventions may cause further morbidity and mortality. Parenteral nutrition and temporary diverting ostomy are the standard treatments of anastomotic leaks. However, technological developments in minimally invasive treatment modalities for anastomotic dehiscence have caused them to be used widely. These modalities include laparoscopic repair, endoscopic self-expandable metallic stents, endoscopic clips, over the scope clips, endoanal repair and endoanal sponges. The review aimed to provide an overview of the current knowledge on the minimally invasive management of anastomotic leaks.

No MeSH data available.


Related in: MedlinePlus