Transanal endoluminal repair for anastomotic leakage after low anterior resection

BMC Surgery

William Tzu-Liang Chen¹  Yuan-Yao Tsai²  Yi-Chang Chen²  Tao-Wei Ke²  Abe Fingerhut³ 

[1] China Medical University Hsinchu Hospital;Department of Colorectal Surgery, China Medical University Hospital;Department of General Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Minimally Invasive Surgery Center;

关键词: Transanal endoluminal repair;    Colorectal anastomosis;    Anastomosis leakage;    Low anterior resection;   

DOI  :  10.1186/s12893-022-01484-4

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown