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Assessing Anastomotic Integrity and Perfusion

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Abstract

Anastomotic leak after colorectal resection is a major cause of morbidity and probably occurs early in the postoperative period. A positive intraoperative air-leak test is associated with increased risk of anastomotic leak (OR 2.65) despite revision, as are incomplete “doughnuts.” Routine evaluation with endoscopy may lead to anastomotic revision in 10% of patients. Intraoperative assessment of microperfusion using indocyanine green is a promising technique, with meta-analyses showing anastomotic leak rate can be reduced from 7.6% to 3.8%. Lastly, postoperative biomarker techniques, while currently experimental, may offer opportunities to detect anastomotic leak in the early postoperative period before clinically evident.

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Authors and Affiliations

  1. Department of Surgery, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, Norfolk, UK

    Adam T. Stearns

  2. Department of Surgery, St. Marks Hospital, London, UK

    John T. Jenkins

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Correspondence to Adam T. Stearns .

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Editors and Affiliations

  1. London Health Sciences Centre, University Hospital, London, Ontario, Canada

    Christopher M. Schlachta

  2. Mount Sinai School of Medicine, New York, New York, USA

    Patricia Sylla

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Stearns, A.T., Jenkins, J.T. (2018). Assessing Anastomotic Integrity and Perfusion. In: Schlachta, C., Sylla, P. (eds) Current Common Dilemmas in Colorectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-70117-2_31

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  • DOI: https://doi.org/10.1007/978-3-319-70117-2_31

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