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|Title:||Standardized pelvic drainage of anastomotic leaks following anterior resection without diversional stomas|
Low anterior resection
|Citation:||Peng, J., Xu, Y., Guan, Z., Wang, M., Cai, G., Cai, S., Lu, J. (2010). Standardized pelvic drainage of anastomotic leaks following anterior resection without diversional stomas. American Journal of Surgery 199 (6) : 753-758. ScholarBank@NUS Repository. https://doi.org/10.1016/j.amjsurg.2009.03.026|
|Abstract:||Background: Anastomotic leakage is a serious complication in rectal cancer surgery. More than one third of rectal cancer patients with low anterior resection (LAR) will receive defunctional stomas during primary operation. Methods: Six hundred thirty-nine consecutive rectal cancer patients, whose tumors were located 5 to 12 cm from the anal verge, were treated with LAR. A standardized pelvic drainage for all these patients and selective irrigation for patients with leakage were conducted, and defunctional stoma was used as a salvage modality. All the anastomoses were all extraperitonealized during primary operations. Results: The anastomotic leakage rate was 7.04%. Male gender and location of tumor were found to be risk factors for leakage in patients with LAR. The overall stoma rate was 1.88%. Nearly 75% of leakage could be cured by irrigation-suction without surgical intervention. Severe complications, such as peritonitis, fistula, and obstruction, were strong predictors of irrigation failure. Conclusions: Extraperitonealized anastomosis and pelvic drainage obtained a very low rate of defunctional stoma for LAR. Pelvic irrigation-suction was an effective modality to resolve anastomotic leakage. © 2010 Elsevier Inc. All rights reserved.|
|Source Title:||American Journal of Surgery|
|Appears in Collections:||Staff Publications|
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