Review
Gastroenterology & Hepatology
Simon Lindner, Steffen Eitelbuss, Svetlana Hetjens, Joshua Gawlitza, Julia Hardt, Steffen Seyfried, Christian Galata, Christoph Reissfelder, Flavius Sandra-Petrescu, Florian Herrle
Summary: Endoscopy and digital rectal examination appear to be the best diagnostic tests for assessing the integrity of the colorectal anastomosis prior to ileostomy reversal. Studies with lower methodological quality overestimated the accuracy of contrast enema. Omission of contrast enema in favor of endoscopic and clinical assessment is justified based on existing evidence and risk-benefit considerations.
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
(2021)
Article
Cardiac & Cardiovascular Systems
Irmina A. Elliott, Mark F. Berry, Winston Trope, Natalie S. Lui, Brandon A. Guenthart, Douglas Z. Liou, Richard I. Whyte, Leah M. Backhus, Joseph B. Shrager
Summary: This study demonstrates that the sensitivity of fluoroscopic esophagography with oral administration of contrast material to exclude anastomotic leak after esophagectomy is not well established, and the consequences of missing a leak in this setting have not been previously described. Therefore, a high index of suspicion must be maintained even after a normal esophagram result, and the common practice of using this test to triage patients for diet advancement is questioned.
ANNALS OF THORACIC SURGERY
(2023)
Article
Cardiac & Cardiovascular Systems
Philip A. Linden, Christopher W. Towe, Stephanie G. Worrell, Boxiang Jiang, Vanessa P. Ho, Luis Argote-Greene, Katelynn Bachman, Yaron Perry
Summary: Drain amylase is a versatile method for early detection of anastomotic leaks, and its accuracy is unaffected by various factors except for smoking.
ANNALS OF THORACIC SURGERY
(2022)
Article
Gastroenterology & Hepatology
N. Moreno-Lopez, S. Mvouama, A. Bourredjem, I Fournel, T. Perrin, A. Flaris, P. Rat, O. Facy
Summary: This study assessed the benefit of rectal contrast enema CT scan (RCE-CT) for early diagnosis of anastomotic leaks (AL) following colorectal surgery. The results showed that RCE-CT had increased negative predictive value, sensitivity, and lower false-negative rate compared to regular CT scan.
TECHNIQUES IN COLOPROCTOLOGY
(2023)
Article
Surgery
Mateusz Jagielski, Jacek Piatkowski, Grzegorz Jarczyk, Marek Jackowski
Summary: The study found that endoscopic rectal drainage using vacuum-assisted therapy is an effective and safe minimally invasive treatment for patients with intestinal anastomotic leaks following resection procedures within the middle and distal rectum.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(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
Carla Christine Maria Marres, Esmee W. M. Engelmann, Chistianne J. Buskens, Hester Eline Haak, Willem A. Bemelman, Anthony Willem Hendrik van de Ven
Summary: The study found that the use of rectal contrast significantly increased the predictive value of CT scanning for anastomotic leakage after colorectal surgery, especially when the contrast reached the anastomosis.
COLORECTAL DISEASE
(2021)
Article
Gastroenterology & Hepatology
N. Nimalan A. Jeganathan, Walter A. Koltun
Summary: Rates of anastomotic leak following intestinal resections in inflammatory bowel disease are significantly influenced by clinical characteristics such as low serum albumin, preoperative abscess, reoperative abdominal surgery, and steroid use. While the literature may be conflicting, common themes suggest factors like biologic therapy, immunomodulator use, and method of anastomosis do not increase anastomotic-related complications. Attention to identifying, optimizing, and reducing known risks is crucial in achieving a low rate of anastomotic leakage in colorectal surgery.
CLINICS IN COLON AND RECTAL SURGERY
(2021)
Article
Emergency Medicine
David R. Gilley, Gurpal S. Virdi, Arya W. Namin, Laura M. Dooley
Summary: The study aimed to investigate the impact of CT on treatment decisions for patients with sore throat in the emergency department. The results showed a higher rate of successful drainage procedures in patients with palatal bulge. CT scans could be avoided in patients without physical exam findings suggestive of deep neck space abscesses.
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2021)
Article
Oncology
Yoshitaka Ishikawa, Katsunori Nishikawa, Keita Takahashi, Takanori Kurogochi, Masami Yuda, Yujiro Tanaka, Akira Matsumoto, Yuichiro Tanishima, Fumiaki Yano, Ken Eto, Rishindra M. Reddy
Summary: This study evaluated the impact of additional microvascular anastomosis on anastomotic leaks after esophagectomy and gastric conduit reconstruction. The study found that additional microvascular anastomosis significantly reduced the occurrence of anastomotic leaks and provided AVI criteria for AMA application, helping guide surgeons in deciding when to perform AMA surgery.
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Clinical Neurology
S. J. Huls, D. P. Shlapak, D. K. Kim, S. Leng, C. M. Carr
Summary: This study demonstrates the novel use of dual-energy CT in diagnosing difficult CSF leaks. Virtual monoenergetic images can enhance contrast and accurately locate the leakage site.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2022)
Article
Surgery
Jonathan Nguyen, K. Aviva Bashan, Cecilia Jiang, Mung Lin, Yasmin Tootla, Kahdi Udobi, Keneeshia N. Williams, Rondi Gelbard, Crystal T. Nguyen, Richard Sola, Randi N. Smith, Jason D. Sciarretta, Caroline Butler, Bryan C. Morse, April A. Grant, Peter Rhee
Summary: This meta-analysis aimed to evaluate the efficacy of rectal contrast CT in identifying colorectal injuries in victims of penetrating injuries. The results showed that rectal contrast had poor sensitivity and may be unnecessary. Other subtle clues can be used as indicators of injury in the absence of rectal contrast.
Review
Surgery
Uzair M. Jogiat, Warren Y. L. Sun, Jerry T. Dang, Valentin Mocanu, Janice Y. Kung, Shahzeer Karmali, Simon R. Turner, Noah J. Switzer
Summary: This study found that gastric ischemic conditioning (GIC) can reduce the incidence of anastomotic leaks and strictures following esophagectomy, with no significant impact on overall survival. Further research is needed to determine the optimal patient population, timing, and techniques for implementing GIC in esophagectomy.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
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)
Review
Biology
Laurent Monino, Tom G. G. Moreels
Summary: Anastomotic leaks after gastrointestinal surgery can have severe consequences, but endoscopic vacuum therapy (EVT) is recognized as an effective and safe treatment option. However, the technique may be challenging and may discourage endoscopists from using it. This review provides practical solutions and tips to facilitate the use of EVT for better patient outcomes.
