Management of colorectal anastomotic leakage: differences between salvage and anastomotic takedown - 08/11/12
, Jose Saez, M.D., Monica Millan, M.D., Esther Kreisler, M.D., Thomas Golda, M.D., Ricardo Frago, M.D., Bernat Miguel, M.A.
Corresponding author: Tel.: +34-93-260-7485; fax: +34-93-260-7485Abstract |
Background |
The aim of this study was to evaluate and compare the morbidity associated with 2 strategies of treatment of colorectal anastomotic leakage: surgical drainage of anastomosis with loop ileostomy versus anastomotic takedown.
Methods |
An observational study of patients operated on for ileocolic or colorectal anastomotic leakage between 2001 and 2009. Patients were classified into 2 groups: group 1, salvage of the anastomosis, and group 2, anastomotic takedown. Mortality and morbidity were assessed. Morbidity and mortality of bowel restoration were also evaluated.
Results |
Thirty-nine patients were included into group 1 and 54 into group 2. Mortality was 15% for group 1 and 37% for group 2 (P = .022). The rate of patients suitable for stoma reversal was 91% for loop ileostomy and 38% for end stoma (P < .001). Morbidity was 18% after loop ileostomy closure and 71% after end stoma reversal (P = .021). Hospitalization was 10 days and 21 days, respectively (P = .009). There was no mortality.
Conclusions |
Salvage of anastomosis with loop ileostomy is an effective strategy to control peritoneal sepsis for colorectal anastomotic leakage.
Le texte complet de cet article est disponible en PDF.Keywords : Colorectal anastomosis, Leakage, Anastomotic takedown, Salvage, Bowel restoration
Plan
Vol 204 - N° 5
P. 671-676 - novembre 2012 Retour au numéro
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