Prevention and treatment of anastomotic leakage after anterior resection for patients with rectal cancer

doi:10.3877/cma.j.issn.1674-3946.2021.05.033

Abstract

Abstract:

Anastomotic leakage is a common serious complication after anterior resection of rectal cancer. And it is still one of the most challenging problems to colorectal cancer surgeons. Anastomotic leakage would result in prolonged hospitalization, local recurrence, poor overall survival and even increased perioperative death. Therefore, the prevention and treatment of anastomotic leakage should be the most important perioperative management for patients with rectal cancer. This article aims to summarize and analyze the prevention and treatment measures of anastomotic leakage.

Key words: Anastomotic leak, Rectal neoplasms, Prevention, Treatment

Xiangnan Yu, Daan Fu, Zheng Dai, Junhua Chen, Ming Cai, Peng Zhang, Kailin Cai, Kaixiong Tao, Zheng Wang, Guobin Wang. Prevention and treatment of anastomotic leakage after anterior resection for patients with rectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(05): 587-590.

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References 54

[1]	王锡山. 中美结直肠癌流行病学特征对比及防控策略分析[J/CD]. 中华结直肠疾病电子杂志，2019，8(1)：1-5.
[2]	汪建平. 重视结直肠癌流行病学研究[J]. 中国实用外科杂志，2013，33(8)：622-624.
[3]	Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: A proposal by the International Study Group of Rectal Cancer[J]. Surgery，2010，147(3)：339-351.
[4]	McDermott FD, Heeney A, Kelly ME, et al. Systematic review of preoperative, intraoperative and postoperative risk factors for colorectal anastomotic leaks[J]. Br J Surg，2015，102(5)：462-479.
[5]	李俊，安勇博，吴国聪，等. 直肠癌前切除术后吻合口漏的发生率以及影响因素分析[J]. 中华胃肠外科杂志，2018，21(4)：413-418.
[6]	邓凯，张建立，江秀丽，等. 直肠癌前切除术后吻合口漏风险因素分析[J]. 中华胃肠外科杂志，2018，21(4)：425-430.
[7]	吴舟桥，石晋瑶，李子禹，等. 对当前结直肠术后吻合口漏研究的思考[J]. 中华胃肠外科杂志，2018，21(4)：372-377.
[8]	Ha GW, Kim JH, Lee MR. Oncologic Impact of Anastomotic Leakage Following Colorectal Cancer Surgery: A Systematic Review and Meta-Analysis[J]. Ann Surg Oncol，2017，24(11)：3289-3299.
[9]	Mirnezami A, Mirnezami R, Chandrakumaran K, et al. Increased local recurrence and reduced survival from colorectal cancer following anastomotic leak: systematic review and meta-analysis[J]. Ann Surg，2011，253(5)：890-899.
[10]	Kawada K, Sakai Y. Preoperative, intraoperative and postoperative risk factors for anastomotic leakage after laparoscopic low anterior resection with double stapling technique anastomosis[J]. World J Gastroenterol，2016，22(25)：5718-5727.
[11]	Lee SY, Jung MR, Kim CH, et al. Nutritional risk screening score is an independent predictive factor of anastomotic leakage after rectal cancer surgery[J]. Eur J Clin Nutr，2018，72(4)：489-495.
[12]	尚作宏，王再兴，张建新，等. 结直肠术后吻合口漏的术前预测模型的构建[J]. 中华实验外科杂志，2019，36(11)：2085-2089.
[13]	Xu H, Kong F. Malnutrition-Related Factors Increased the Risk of Anastomotic Leak for Rectal Cancer Patients Undergoing Surgery[J]. Biomed Res Int, 2020，2020：5059670.
[14]	Weimann A, Braga M, Carli F, et al. ESPEN guideline: Clinical nutrition in surgery[J]. Clin Nutr，2017，36(3)：623-650.
[15]	范朝刚，陈军. 结直肠手术肠道准备作用评估[J]. 中国实用外科杂志，2016，36(2)：178-181.
[16]	张颖毅，潘吉勇，樊哲，等. 抗生素配合机械肠道准备预防腹腔镜结直肠手术并发症的价值研究[J]. 现代消化及介入诊疗，2019，24(7)：784-787.
[17]	Roos D, Dijksman LM, Tijssen JG, et al. Systematic review of perioperative selective decontamination of the digestive tract in elective gastrointestinal surgery[J]. Br J Surg，2013，100(12)：1579-1588.
[18]	叶颖江，高志冬，祝丽宇. 结直肠癌急性肠梗阻一期切除吻合的共识与争议[J]. 中国实用外科杂志，2019，39(12)：1283-1287.
[19]	Pickard C, Thomas R, Robertson I, et al. Ostomy Creation for Palliative Care of Patients With Nonresectable Colorectal Cancer and Bowel Obstruction[J]. J Wound Ostomy Continence Nurs，2018，45(3)：239-241.
[20]	Pisano M, Zorcolo L, Merli C, et al. 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation[J]. World J Emerg Surg，2018, 13：36.
[21]	Park JS, Choi G-S, Kim SH, et al. Multicenter analysis of risk factors for anastomotic leakage after laparoscopic rectal cancer excision: the Korean laparoscopic colorectal surgery study group[J]. Ann Surg，2013，257(4): 665-671.
[22]	Matthiessen P, Hallbook O, Rutegard J, et al. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial[J]. Ann Surg，2007，246(2)：207-214.
[23]	方方，王晓岚，徐亚香. 低位直肠癌腹腔镜下根治保肛术中改良襻式单一切口末端回肠造口定位的研究[J]. 实用临床医药杂志，2015，19(8)：88-90.
[24]	王鹏飞，周锋，黄瀚章，等. 肠造口还纳手术中意外情况及术后并发症的防治[J]. 中华普通外科杂志，2018，33(8)：696-697.
[25]	Zhang L, Zheng W, Cui J, et al. Risk factors for nonclosure of defunctioning stoma and stoma-related complications among low rectal cancer patients after sphincter-preserving surgery[J]. Chronic Dis Transl Med，2020，6(3)：188-197.
[26]	Liu XH, Wu XR, , Zhou C, et al. Conversion is a risk factor for postoperative anastomotic leak in rectal cancer patients - A retrospective cohort study[J]. Int J Surg，2018，53：298-303.
[27]	Nishigori H, Ito M, Nishizawa Y. A novel transanal tube designed to prevent anastomotic leakage after rectal cancer surgery: the WING DRAIN[J]. Surg Today，2016，47(4)：513-520.
[28]	Klein P, Immler F, Sterk P, et al. [Secure anastomoses of the large intestine (especially with transanal drainage][J]. Zentralbl Chir，1997，122(7)：528-532.
[29]	Hidaka E, Ishida F, Mukai S, et al. Efficacy of transanal tube for prevention of anastomotic leakage following laparoscopic low anterior resection for rectal cancers: a retrospective cohort study in a single institution[J]. Surg Endosc，2015，29(4)：863-867.
[30]	Yang C-S, Choi G-S, Park JS, et al. Rectal tube drainage reduces major anastomotic leakage after minimally invasive rectal cancer surgery[J]. Colorectal Dis，2016，18(12)：O445-O452.
[31]	Dunn CJ, Goa KL. Fibrin sealant: A review of its use in surgery and endoscopy[J]. Drugs，1999，58(5)：863-886.
[32]	Wenger FA, Szucsik E, Hoinoiu BF, et al. Is Circular Fibrin Sealing of Low Rectal Anastomosis Able to Prevent Leakage in 21-Day Follow-up? Randomized Experimental Trial in Pigs[J]. Surg Innov，2019，26(4)：408-419.
[33]	Kim HJ, Huh JW, Kim HR, et al. Oncologic impact of anastomotic leakage in rectal cancer surgery according to the use of fibrin glue: case-control study using propensity score matching method[J]. Am J Surg，2014，207(6)：840-846.
[34]	Kim HJ, , Huh JW, , Kim HR , et al. Oncologic impact of anastomotic leakage in rectal cancer surgery according to the use of fibrin glue: case-control study using propensity score matching method[J]. Am J Surg，2014，207(6)：840-846.
[35]	臧潞，马君俊，郑民华. 直肠癌根治术中保留左结肠动脉对吻合口瘘及手术时间的影响[J]. 中华胃肠外科杂志，2016，19(4)：386-387.
[36]	沈荐，李敏哲，杜燕夫，等. 保留左结肠动脉的腹腔镜直肠癌低位前切除术的长期疗效分析[J]. 中华胃肠外科杂志，2017，20(6)：660-664.
[37]	Komen N, Slieker J, de Kort P, et al. High tie versus low tie in rectal surgery: comparison of anastomotic perfusion[J]. Int J Colorectal Dis，2011，26(8)：1075-1078.
[38]	Guo Y, Wang D, He L, et al. Marginal artery stump pressure in left colic artery-preserving rectal cancer surgery: a clinical trial[J]. ANZ J Surg，2017，87(7-8)：576-581.
[39]	Alsuhaimi MA, Yang SY, Kang JH, et al. Operative safety and oncologic outcomes in rectal cancer based on the level of inferior mesenteric artery ligation: a stratified analysis of a large Korean cohort[J]. Ann Surg Treat Res，2019，97(5)：254-260.
[40]	Fujii S, Ishibe A, Ota M, et al. Randomized clinical trial of high versus low inferior mesenteric artery ligation during anterior resection for rectal cancer[J]. BJS Open，2018，2(4)：195-202.
[41]	Karliczek A, Jesus EC, Matos D, et al. Drainage or non-drainage in elective colorectal anastomosis: a systematic review and meta-analysis[J]. Colorectal Dis，2006，8(4)：259-265.
[42]	赵旭鹏，李英杰，王墨飞，等. 恒温下持续双套管冲洗引流对结直肠癌术后肠瘘患者感染控制效果的影响[J/CD]. 中华普外科手术学杂志(电子版), 2019, 13(6)：625-627.
[43]	张建新，蔡逊，金炜东，等. 中低位直肠癌切除术后吻合口漏的引流新思路[J]. 腹部外科，2016，29(6)：463-466.
[44]	Schiffmann L, Wedermann N, Schwander F, et al. Neoadjuvant radio-chemotherapy prolongs healing of anastomotic leakage after rectal resection treated with endoscopic vacuum therapy[J]. Therap Adv Gastroenterol，2019，12：1756284819877606.
[45]	Tsereteli Z, Sporn E, Geiger TM, et al. Placement of a covered polyester stent prevents complications from a colorectal anastomotic leak and supports healing: randomized controlled trial in a large animal model[J]. Surgery，2008，144(5): 786-792.
[46]	余卫中，余琼，张刚. 直肠覆膜支架置入治疗直肠癌术后吻合口漏28例分析[J]. 西南国防医药，2017，27(3)：277-279.
[47]	彭学，谢霞，樊超强，等. OTSC金属夹系统在消化道内镜治疗中的应用[J]. 局解手术学杂志，2017，26(1)：26-29.
[48]	Mennigen R, Colombo-Benkmann M, Senninger N, et al. Endoscopic Closure of Postoperative Gastrointestinal Leakages and Fistulas with the Over-the-Scope Clip (OTSC)[J]. J Gastrointest Surg，2013，17(6)：1058-1065.
[49]	张娟娟，汪志明，刁艳青，等. 经内镜OTSC吻合夹闭合消化道瘘的临床研究[J]. 医学研究生学报，2018，31(10)：1054-1056.
[50]	Raithel M, Albrecht H, Scheppach W, et al. Outcome, comorbidity, hospitalization and 30-day mortality after closure of acute perforations and postoperative anastomotic leaks by the over-the-scope clip (OTSC) in an unselected cohort of patients[J]. Surg Endosc，2017，31(6)：2411-2425.
[51]	Sevim Y, Celik SU, Yavarifar H, et al. Minimally invasive management of anastomotic leaks in colorectal surgery[J]. World J Gastrointest Surg，2016，8(9)：621-626.
[52]	刘荫华. 低位直肠癌吻合口漏和直肠阴道瘘的预防与处理[J]. 中国实用外科杂志，2007，27(6)：448-450.
[53]	池畔，黄胜辉. 直肠癌术后吻合口漏的分类和治疗策略[J]. 中华胃肠外科杂志，2018，21(4)：365-371.
[54]	中华医学会外科学分会结直肠外科学组. 中国直肠癌手术吻合口漏诊断、预防及处理专家共识[J]. 中华胃肠外科杂志，2019，22(3)：201-206.

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