Review
Gastroenterology & Hepatology
Andrea Vignali, Paola De Nardi
Summary: Endoluminal vacuum-assisted therapy is a new method for treating colorectal anastomotic leaks, which ensures continuous drainage of the abscess cavity and promotes the formation of granulation tissue. It is more effective in preserving the anastomosis compared to conventional treatments. However, there is still a lack of standardization in the indications, inclusion criteria, and definitions of success, and the long-term and functional results are poorly reported.
WORLD JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Gastroenterology & Hepatology
Fengming Xu, Haoze Li, Ce Guo, Zhengyang Yang, Jiale Gao, Xiao Zhang, Qi Wei, Cong Meng, Liting Sun, Guocong Wu, Hongwei Yao, Zhongtao Zhang
Summary: This study aimed to determine the incidence of postoperative surgical complications and anastomotic leakage following taTME and identify their associated risk factors. The study found that surgical complications occurred in 35.1% of patients within the first 30 days following surgery, and the incidence of anastomotic leakage was 15.8%. Multivariate analysis revealed that preoperative T3-4, American Society of Anesthesiology score > 3, and incomplete total mesorectal excision specimens were independent risk factors for surgical complications and anastomotic leakage.
JOURNAL OF GASTROINTESTINAL SURGERY
(2023)
Article
Oncology
V. T. Hoek, S. Buettner, C. L. Sparreboom, R. Detering, A. G. Menon, G. J. Kleinrensink, M. W. J. M. Wouters, J. F. Lange, J. K. Wiggers
Summary: This study aimed to develop a robust preoperative prediction model for anastomotic leakage after surgical resection for rectal cancer. Significant risk factors were identified and included in the prediction model, which can be used for patient counselling and risk-stratification before undergoing rectal resection for cancer.
Article
Surgery
Kevin Talboom, Nynke G. Greijdanus, Cyriel Y. Ponsioen, Pieter J. Tanis, Wilhelmus A. Bemelman, Roel Hompes
Summary: Early initiation of EVASC for anastomotic leakage after rectal cancer resection yields high rates of healed and functional anastomosis. EVASC shows increasing success with the implementation of highly selective diversion and early diagnosis of the leak.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Gastroenterology & Hepatology
Kevin Talboom, Nynke G. Greijdanus, Frans van Workum, Sander Ubels, Camiel Rosman, Roel Hompes, Johannes H. W. de Wilt, Pieter J. Tanis
Summary: This study investigated the preferred treatment for anastomotic leakage after low anterior resection for rectal cancer by expert colorectal surgeons worldwide. The results showed that early leaks in septic patients were treated preferentially by major salvage surgery, while early leaks in non-septic patients were treated with drainage and fecal diversion. Late leaks had a wide range of treatment options, with minimal influence of symptoms on the proposed strategy. Treatment strategies for leaks of the blind loop and rectovaginal fistulae varied greatly.
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
(2022)
Article
Surgery
Zhao-liang Yu, Xuan-hui Liu, Hua-shan Liu, Jia Ke, Yi-feng Zou, Wu-teng Cao, Jian Xiao, Zhi-yang Zhou, Ping Lan, Xiao-jian Wu, Xian-rui Wu
Summary: The study evaluated the impact of pelvic dimensions on the risk of anastomotic leak in rectal cancer patients. The results showed that pelvic inlet and intertuberous distance were independent predictors for postoperative anastomotic leak. The incorporation of pelvic dimensions with other factors in the nomogram may provide a clinical tool for predicting anastomotic leak.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Gastroenterology & Hepatology
Frans van Workum, Kevin Talboom, Gerjon Hannink, Albert Wolthuis, Borja F. de Lacy, Jeremie H. Lefevre, Michael Solomon, Matteo Frasson, Nicolas Rotholtz, Quentin Denost, Rodrigo Oliva Perez, Tsuyoshi Konishi, Yves Panis, Camiel Rosman, Roel Hompes, Pieter J. Tanis, Johannes H. W. de Wilt
Summary: This study aims to investigate the factors contributing to the severity of anastomotic leakage after low anterior resection for rectal cancer, create a severity score, and evaluate the effects of different treatment approaches on outcome parameters. The international multicentre retrospective cohort study, TENTACLE-Rectum, will provide valuable evidence-based recommendations for improving outcomes in patients with severe treatment-related morbidity.
COLORECTAL DISEASE
(2021)
Article
Surgery
Vladimir Bencurik, Matej Skrovina, Lubomir Martinek, Jiri Bartos, Maria Machackova, Michal Dosoudil, Erika Stepanova, Lenka Pribylova, Radim Bris, Katherine Vomackova
Summary: The study showed that using ICG to visualize tissue perfusion in low rectal resections for cancer can significantly reduce the incidence of AL. Diabetes and the application of a transanal drain (NoCoil) were identified as additional risk factors for AL.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2021)
Article
Gastroenterology & Hepatology
Chenchen Guo, Zhiwen Fu, Xin Qing, Mengen Deng
Summary: The study aimed to evaluate the efficacy of transanal drainage tube (TDT) placement for preventing anastomotic leakage after low anterior resection for rectal cancer. The results showed that in randomized controlled trials, TDT was not associated with a significant difference in anastomotic leakage but increased the risk of anastomotic bleeding. In observational studies, TDT was significantly associated with a reduction in anastomotic leakage and no significant difference in anastomotic bleeding. Both types of studies demonstrated a comparable reduction in reoperation rate with TDT. These findings suggest that TDTs may not have superiority and highlight the differences between randomized controlled trials and observational data.
COLORECTAL DISEASE
(2022)
Article
Multidisciplinary Sciences
Tingzhen Li, Jianglong Huang, Purun Lei, Xiaofeng Yang, Zehong Chen, Peng Chen, Jiancheng Zhai, Xuefeng Guo, Hongbo Wei
Summary: This study aimed to identify the risk factors and develop a prediction model for anastomotic leakage in rectal cancer patients. The results showed that preoperative bowel obstruction and early first defecation after surgery were independent risk factors. The nomogram prediction model had good predictive ability, which could guide treatment and surgical decision-making.
Article
Surgery
Nynke G. Greijdanus, Kiedo Wienholts, Sander Ubels, Kevin Talboom, Gerjon Hannink, Albert Wolthuis, Francisco B. de Lacy, Jeremie H. Lefevre, Michael Solomon, Matteo Frasson, Nicolas Rotholtz, Quentin Denost, Rodrigo O. Perez, Tsuyoshi Konishi, Yves Panis, Martin Rutegard, Roel Hompes, Camiel Rosman, Frans van Workum, Pieter J. Tanis, Johannes H. W. de Wilt
Summary: The study developed a prediction model for 1-year stoma-free survival in rectal cancer patients with anastomotic leakage. The model, consisting of 18 clinically relevant factors, showed good discrimination and calibration, providing guidance for patient counseling and future treatment strategies analysis.
Article
Surgery
Carly N. Bisset, Eamonn Ferguson, Ewan MacDermid, Sharon L. Stein, Nuha Yassin, Nicola Dames, Deborah S. Keller, Raymond Oliphant, Simon H. Parson, Jennifer Cleland, Susan J. Moug
Summary: This international study shows that the personality of surgeons is an independent factor that affects variation in surgical practice. Colorectal surgeons possess different personality traits compared to the general population, and certain traits are associated with anastomotic decision-making in specific scenarios.
BRITISH JOURNAL OF SURGERY
(2022)
Article
Surgery
Thomas W. A. Koedam, Boukje T. Bootsma, Charlotte L. Deijen, Tim van de Brug, Geert Kazemier, Miguel A. Cuesta, Alois Furst, Antonio M. Lacy, Eva Haglind, Jurriaan B. Tuynman, Freek Daams, Hendrik J. Bonjer
Summary: Anastomotic leakage after rectal cancer surgery negatively affects long-term oncological outcomes, leading to increased local recurrences and decreased disease-free survival. However, its impact on outcomes after colon cancer surgery remains inconclusive.
Article
Oncology
Chuangkun Li, Weiwen Liang, Lili Chu, Yingqi Wei, Xiusen Qin, Zifeng Yang, Wentai Guo, Hui Wang, Huaiming Wane, Rongkang Huang
Summary: The main risk factors for anastomotic leakage in elderly rectal cancer patients after surgery include American Society of Anesthesiologists score >= 3, male sex, and neoadjuvant radiotherapy. Combining these factors can accurately predict the occurrence of anastomotic leakage. The nomogram developed in this study has a moderate predictive ability.
CANCER MANAGEMENT AND RESEARCH
(2021)
Article
Cell Biology
Jiajun Luo, Hongxue Wu, Yu Yang, Yue Jiang, Jingwen Yuan, Qiang Tong
Summary: Detecting oxidative stress levels (MDA) is significantly helpful in diagnosing anastomotic leakage after rectal surgery, with MDA showing similar diagnostic accuracy to CRP and serving as a useful biomarker for early diagnosis.
MEDIATORS OF INFLAMMATION
(2021)