Original CommunicationThe effect of endoscopic treatment on healing of anastomotic leaks after anterior resection of rectal cancer
Section snippets
Materials and methods
Our retrospective analysis included 274 patients with rectal carcinoma who underwent anterior rectal resection with colorectal anastomosis from January 2000 to December 2005. Among these patients we observed 29 symptomatic anastomotic leaks (10.6%). The mean age of the patients was 65 years (range, 33–83); there were 17 men and 12 women.
In 16 patients in the leakage group (n = 29) preoperative (neoadjuvant) therapy consisting of short-term radiation (n = 6), long-term radiochemotherapy (n = 7),
Results
The short-term outcome revealed no fatalities in all patients with anastomotic leakage; septic complications were observed in 5 of 13 patients (39%) in the endoscopic group and in 3 of 7 patients (42%) in the operative group. The median duration of intensive care stay was 11 days (range, 1–42) for endoscopy and 13 days (range, 3–24) for an operative approach. Average time of hospitalization was 25 days (range, 12–49) with endoscopy and 26 days (range, 12–32) with operative therapy. Secondary
Discussion
Anastomotic leakage is a major complication after rectal operations. Conventional operative treatment, including relaparotomy lavage and stoma creation, can effectively reduce the hazardous complications of anastomotic leaks, including peritonitis and sepsis.11 A potential drawback of this approach is the general morbidity of diverting stomas of up to 30% and the reduced reversal rate of <50% in patients with anastomotic leakage.16, 17
Through technological advances, alternative treatment
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