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Reducing anastomotic leak in colorectal surgery: the old dogmas and the new challenges

Published inWorld Journal of Gastroenterology, vol. 25, no. 34, p. 5017-5025
Publication date2019
Abstract

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.

Keywords
  • Anastomotic leakage
  • Rectal surgery
  • Colic surgery
  • Prevention
  • Surgical site infection
  • Anastomosis
  • Complication
Citation (ISO format)
MEYER, Jérémy et al. Reducing anastomotic leak in colorectal surgery: the old dogmas and the new challenges. In: World Journal of Gastroenterology, 2019, vol. 25, n° 34, p. 5017–5025. doi: 10.3748/wjg.v25.i34.5017
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ISSN of the journal1007-9327
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Creation09/30/2019 12:51:00 PM
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