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Title: Standardized pelvic drainage of anastomotic leaks following anterior resection without diversional stomas
Authors: Peng, J.
Xu, Y.
Guan, Z.
Wang, M.
Cai, G.
Cai, S.
Lu, J. 
Keywords: Anastomotic leakage
Defunctional stoma
Low anterior resection
Pelvic drainage
Rectal cancer
Issue Date: 2010
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.
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
ISSN: 00029610
DOI: 10.1016/j.amjsurg.2009.03.026
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