Miscellaneous

Do we really know why colorectal anastomosis leak?

by Editor

Contents

Do we really know why colorectal anastomosis leak?

Although surgical technique has evolved over the past several decades with the advent of newer surgical staplers, laparoscopy, and robotics, we have not witnessed a decrease in the incidence of colorectal anastomotic leaks suggesting that the fundamental pathogenesis of anastomotic leak remains unknown.

How often do bowel resections leak?

Anastomotic leakage (AL) is still one of the most serious complications for colorectal surgery. The incidence is reported about 2.8~8.4% as all1,2, of which 75% occurs for rectal anastomosis resulting in a mortality rate of 1.7~16.4%1,3.

How is anastomotic leakage treated?

Management of Anastomotic Leak

  1. Antibiotics.
  2. Drainage.
  3. Stenting.
  4. Vacuum Therapy/Endo-Sponge.
  5. Surgical Intervention.
  6. Minimally Invasive Techniques.

When do anastomotic leaks happen?

The lowest leak rates are found with ileocolic anastomoses (1 to 3 percent) and the highest occur with coloanal anastomosis (10 to 20 percent). Leaks usually become apparent between five and seven days postoperatively.

What is a Riche Cannieu anastomosis in the evaluation of?

Another anomaly that can complicate diagnostic studies is the Riche-Cannieu anastomosis (see the image below). Riche-Cannieu anastomosis is communication between recurrent branch of median nerve and deep branch of ulnar nerve in hand.

Is the berretini anastomosis a normal structure?

Ulnar to Median nerve (between the common digital nerves arising from them)- aka ramus communicans or superficial communicating branch. Since many investigators found its incidence to be over 80%, the Berretini anastomosis should be considered a normal structure rather than an anatomic variation. It has no age, sex or race predilections.

What are the symptoms of anastomoses between the median?

Due to altered innervation patterns, musculoskeletal disorders of the forearm and hand may present with misleading symptoms. Additionally, existence of an anastomosis may require an alteration of surgical methods or be a source of iatrogenic injury.