Percutaneous Drainage vs. Surgery as Definitive Treatment for Anastomotic Leak after Intestinal Resection in Patients with Crohn's Disease.
Crohn’s disease
anastomotic leak
bowel resection
ileostomy
image-guide drainage
intra-abdominal abscess
percutaneous drainage
perianastomotic collection
Journal
Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588
Informations de publication
Date de publication:
09 Feb 2023
09 Feb 2023
Historique:
received:
31
12
2022
revised:
06
02
2023
accepted:
07
02
2023
entrez:
25
2
2023
pubmed:
26
2
2023
medline:
26
2
2023
Statut:
epublish
Résumé
Anastomotic leak (AL) remains one of the most relevant complications after intestinal resection for Crohn's disease (CD). While surgery has always been considered the standard treatment for perianastomotic collection, percutaneous drainage (PD) has been proposed as a potential alternative. Retrospective study in consecutive patients treated with either PD or surgery for AL after intestinal resection for CD between 2004 and 2022. AL was defined as a perianastomotic fluid collection confirmed by radiological findings. Patients with generalized peritonitis or clinical instability were excluded. To compare the success rate of PD vs. surgery. Secondary aims: To compare the outcomes at 90 days after the procedures; to identify the variables associated with the indication for PD. A total of 47 patients were included, of which 25 (53%) underwent PD and 22 (47%) surgery. The success rate was 84% in the PD and 95% in the surgery group ( The present study suggests that PD is a safe and effective procedure to treat anastomotic leak and perianastomotic collection in CD patients. PD should be indicated in all eligible patients as an effective alternative to surgery.
Sections du résumé
BACKGROUND
BACKGROUND
Anastomotic leak (AL) remains one of the most relevant complications after intestinal resection for Crohn's disease (CD). While surgery has always been considered the standard treatment for perianastomotic collection, percutaneous drainage (PD) has been proposed as a potential alternative.
METHODS
METHODS
Retrospective study in consecutive patients treated with either PD or surgery for AL after intestinal resection for CD between 2004 and 2022. AL was defined as a perianastomotic fluid collection confirmed by radiological findings. Patients with generalized peritonitis or clinical instability were excluded.
PRIMARY AIM
OBJECTIVE
To compare the success rate of PD vs. surgery. Secondary aims: To compare the outcomes at 90 days after the procedures; to identify the variables associated with the indication for PD.
RESULTS
RESULTS
A total of 47 patients were included, of which 25 (53%) underwent PD and 22 (47%) surgery. The success rate was 84% in the PD and 95% in the surgery group (
CONCLUSION
CONCLUSIONS
The present study suggests that PD is a safe and effective procedure to treat anastomotic leak and perianastomotic collection in CD patients. PD should be indicated in all eligible patients as an effective alternative to surgery.
Identifiants
pubmed: 36835926
pii: jcm12041392
doi: 10.3390/jcm12041392
pmc: PMC9961459
pii:
doi:
Types de publication
Journal Article
Langues
eng
Références
J Biomed Inform. 2009 Apr;42(2):377-81
pubmed: 18929686
Updates Surg. 2019 Sep;71(3):533-537
pubmed: 30196474
J Clin Gastroenterol. 2001 May-Jun;32(5):409-12
pubmed: 11319312
Int J Colorectal Dis. 2008 Dec;23(12):1167-74
pubmed: 18690466
Updates Surg. 2021 Feb;73(1):149-156
pubmed: 33409848
Clin Gastroenterol Hepatol. 2019 Sep;17(10):2042-2049.e4
pubmed: 30583051
Tech Coloproctol. 2020 Aug;24(8):903
pubmed: 32562151
Ann Surg. 1991 Jan;213(1):37-42
pubmed: 1985536
BJS Open. 2021 Sep 6;5(5):
pubmed: 34518869
Int J Colorectal Dis. 2021 Nov;36(11):2419-2426
pubmed: 33876296
J Crohns Colitis. 2016 Jan;10(1):38-42
pubmed: 26417048
Clin Colon Rectal Surg. 2021 Oct 01;34(6):400-405
pubmed: 34853561
Ann Surg. 2010 Aug;252(2):307-12
pubmed: 20585239
Surgery. 2010 Mar;147(3):339-51
pubmed: 20004450
J Gastroenterol. 2004;39(5):441-8
pubmed: 15175942
World J Gastrointest Surg. 2016 Mar 27;8(3):274-83
pubmed: 27022455
Dis Colon Rectum. 2013 Mar;56(3):275-80
pubmed: 23392139
Tech Coloproctol. 2020 Jul;24(7):711-720
pubmed: 32306308
Int J Colorectal Dis. 2022 Jun;37(6):1421-1428
pubmed: 35599268
Clin Colon Rectal Surg. 2021 Oct 01;34(6):359-365
pubmed: 34853555
J Crohns Colitis. 2010 Feb;4(1):28-62
pubmed: 21122489
Int J Colorectal Dis. 2021 Oct;36(10):2119-2125
pubmed: 33929586
Am J Surg. 2014 Jul;208(1):58-64
pubmed: 24476970
Aliment Pharmacol Ther. 2012 Mar;35(6):625-33
pubmed: 22313322
J Crohns Colitis. 2020 Feb 10;14(2):155-168
pubmed: 31742338
J Crohns Colitis. 2016 Feb;10(2):202-8
pubmed: 26512133