Reducing anastomotic leak in colorectal surgery: The old dogmas and the new challenges.
Anastomosis, Surgical
/ adverse effects
Anastomotic Leak
/ epidemiology
Anti-Bacterial Agents
/ administration & dosage
Cathartics
/ administration & dosage
Colon
/ diagnostic imaging
Enema
Fluorescein Angiography
Gastrointestinal Microbiome
/ drug effects
Humans
Incidence
Preoperative Care
/ adverse effects
Rectum
/ diagnostic imaging
Surgical Wound Infection
/ etiology
Treatment Outcome
Anastomosis
Anastomotic leakage
Colic surgery
Complication
Prevention
Rectal surgery
Surgical site infection
Journal
World journal of gastroenterology
ISSN: 2219-2840
Titre abrégé: World J Gastroenterol
Pays: United States
ID NLM: 100883448
Informations de publication
Date de publication:
14 Sep 2019
14 Sep 2019
Historique:
received:
19
03
2019
revised:
09
08
2019
accepted:
19
08
2019
entrez:
28
9
2019
pubmed:
29
9
2019
medline:
27
2
2020
Statut:
ppublish
Résumé
Anastomotic leak (AL) constitutes a significant issue in colorectal surgery, and its incidence has remained stable over the last years. The use of intra-abdominal drain or the use of mechanical bowel preparation alone have been proven to be useless in preventing AL and should be abandoned. The role or oral antibiotics preparation regimens should be clarified and compared to other routes of administration, such as the intravenous route or enema. In parallel, preoperative antibiotherapy should aim at targeting collagenase-inducing pathogens, as identified by the microbiome analysis. AL can be further reduced by fluorescence angiography, which leads to significant intraoperative changes in surgical strategies. Implementation of fluorescence angiography should be encouraged. Progress made in AL comprehension and prevention might probably allow reducing the rate of diverting stoma and conduct to a revision of its indications.
Identifiants
pubmed: 31558854
doi: 10.3748/wjg.v25.i34.5017
pmc: PMC6747296
doi:
Substances chimiques
Anti-Bacterial Agents
0
Cathartics
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
5017-5025Déclaration de conflit d'intérêts
Conflict-of-interest statement: The authors have no conflict of interest to declare.
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