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Anastomotic Leak

MedGen UID:
183077
•Concept ID:
C0919691
•
Pathologic Function
Synonyms: Anastomotic Leakage; Anastomotic Leakages; Anastomotic Leaks; Leak, Anastomotic; Leakage, Anastomotic; Leakages, Anastomotic; Leaks, Anastomotic

Definition

Breakdown of the connection and subsequent leakage of effluent (fluids, secretions, air) from a SURGICAL ANASTOMOSIS of the digestive, respiratory, genitourinary, and cardiovascular systems. Most common leakages are from the breakdown of suture lines in gastrointestinal or bowel anastomosis. [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVAnastomotic Leak

Professional guidelines

PubMed

Diagnosis, assessment, and management of surgical complications following esophagectomy.
Grimminger PP, Goense L, Gockel I, Bergeat D, Bertheuil N, Chandramohan SM, Chen KN, Chon SH, Denis C, Goh KL, Gronnier C, Liu JF, Meunier B, Nafteux P, Pirchi ED, Schiesser M, Thieme R, Wu A, Wu PC, Buttar N, Chang AC
Ann N Y Acad Sci 2018 Dec;1434(1):254-273. Epub 2018 Jul 8 doi: 10.1111/nyas.13920. PMID: 29984413
Emerging Trends in the Etiology, Prevention, and Treatment of Gastrointestinal Anastomotic Leakage.
Chadi SA, Fingerhut A, Berho M, DeMeester SR, Fleshman JW, Hyman NH, Margolin DA, Martz JE, McLemore EC, Molena D, Newman MI, Rafferty JF, Safar B, Senagore AJ, Zmora O, Wexner SD
J Gastrointest Surg 2016 Dec;20(12):2035-2051. Epub 2016 Sep 16 doi: 10.1007/s11605-016-3255-3. PMID: 27638764
Update on clinical impact, documentation, and management of complications associated with esophagectomy.
Low DE, Bodnar A
Thorac Surg Clin 2013 Nov;23(4):535-50. doi: 10.1016/j.thorsurg.2013.07.003. PMID: 24199703

Recent clinical studies

Etiology

Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going?
Tsalikidis C, Mitsala A, Mentonis VI, Romanidis K, Pappas-Gogos G, Tsaroucha AK, Pitiakoudis M
Curr Oncol 2023 Mar 7;30(3):3111-3137. doi: 10.3390/curroncol30030236. PMID: 36975449Free PMC Article
C-reactive Protein and Procalcitonin Levels to Predict Anastomotic Leak After Colorectal Surgery: Systematic Review and Meta-analysis.
Bona D, Danelli P, Sozzi A, Sanzi M, Cayre L, Lombardo F, Bonitta G, Cavalli M, Campanelli G, Aiolfi A
J Gastrointest Surg 2023 Jan;27(1):166-179. Epub 2022 Sep 29 doi: 10.1007/s11605-022-05473-z. PMID: 36175720
Risk factors for anastomotic leakage after anterior resection for rectal cancer (RALAR study): A nationwide retrospective study of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group.
Degiuli M, Elmore U, De Luca R, De Nardi P, Tomatis M, Biondi A, Persiani R, Solaini L, Rizzo G, Soriero D, Cianflocca D, Milone M, Turri G, Rega D, Delrio P, Pedrazzani C, De Palma GD, Borghi F, Scabini S, Coco C, Cavaliere D, Simone M, Rosati R, Reddavid R; collaborators from the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group
Colorectal Dis 2022 Mar;24(3):264-276. Epub 2021 Dec 6 doi: 10.1111/codi.15997. PMID: 34816571Free PMC Article
Anastomotic leakage after esophagectomy for esophageal cancer: definitions, diagnostics, and treatment.
Fabbi M, Hagens ERC, van Berge Henegouwen MI, Gisbertz SS
Dis Esophagus 2021 Jan 11;34(1) doi: 10.1093/dote/doaa039. PMID: 32476017Free PMC Article
Management of Complications After Esophagectomy.
Yeung JC
Thorac Surg Clin 2020 Aug;30(3):359-366. Epub 2020 May 22 doi: 10.1016/j.thorsurg.2020.04.002. PMID: 32593368

Diagnosis

Predictive Factors for Anastomotic Leakage Following Colorectal Cancer Surgery: Where Are We and Where Are We Going?
Tsalikidis C, Mitsala A, Mentonis VI, Romanidis K, Pappas-Gogos G, Tsaroucha AK, Pitiakoudis M
Curr Oncol 2023 Mar 7;30(3):3111-3137. doi: 10.3390/curroncol30030236. PMID: 36975449Free PMC Article
C-reactive Protein and Procalcitonin Levels to Predict Anastomotic Leak After Colorectal Surgery: Systematic Review and Meta-analysis.
Bona D, Danelli P, Sozzi A, Sanzi M, Cayre L, Lombardo F, Bonitta G, Cavalli M, Campanelli G, Aiolfi A
J Gastrointest Surg 2023 Jan;27(1):166-179. Epub 2022 Sep 29 doi: 10.1007/s11605-022-05473-z. PMID: 36175720
Anastomotic leakage in colorectal cancer surgery.
Chiarello MM, Fransvea P, Cariati M, Adams NJ, Bianchi V, Brisinda G
Surg Oncol 2022 Mar;40:101708. Epub 2022 Jan 24 doi: 10.1016/j.suronc.2022.101708. PMID: 35092916
C-reactive protein can predict anastomotic leak in colorectal surgery: a systematic review and meta-analysis.
Yeung DE, Peterknecht E, Hajibandeh S, Hajibandeh S, Torrance AW
Int J Colorectal Dis 2021 Jun;36(6):1147-1162. Epub 2021 Feb 8 doi: 10.1007/s00384-021-03854-5. PMID: 33555423
Anastomotic leakage after esophagectomy for esophageal cancer: definitions, diagnostics, and treatment.
Fabbi M, Hagens ERC, van Berge Henegouwen MI, Gisbertz SS
Dis Esophagus 2021 Jan 11;34(1) doi: 10.1093/dote/doaa039. PMID: 32476017Free PMC Article

Therapy

Effect of noninvasive respiratory support after extubation on postoperative pulmonary complications in obese patients: A systematic review and network meta-analysis.
Li R, Liu L, Wei K, Zheng X, Zeng J, Chen Q
J Clin Anesth 2023 Dec;91:111280. Epub 2023 Oct 4 doi: 10.1016/j.jclinane.2023.111280. PMID: 37801822
Blood Perfusion Assessment by Indocyanine Green Fluorescence Imaging for Minimally Invasive Rectal Cancer Surgery (EssentiAL trial): A Randomized Clinical Trial.
Watanabe J, Takemasa I, Kotake M, Noura S, Kimura K, Suwa H, Tei M, Takano Y, Munakata K, Matoba S, Yamagishi S, Yasui M, Kato T, Ishibe A, Shiozawa M, Ishii Y, Yabuno T, Nitta T, Saito S, Saigusa Y, Watanabe M; EssentiAL Trial Group
Ann Surg 2023 Oct 1;278(4):e688-e694. Epub 2023 May 23 doi: 10.1097/SLA.0000000000005907. PMID: 37218517Free PMC Article
C-reactive Protein and Procalcitonin Levels to Predict Anastomotic Leak After Colorectal Surgery: Systematic Review and Meta-analysis.
Bona D, Danelli P, Sozzi A, Sanzi M, Cayre L, Lombardo F, Bonitta G, Cavalli M, Campanelli G, Aiolfi A
J Gastrointest Surg 2023 Jan;27(1):166-179. Epub 2022 Sep 29 doi: 10.1007/s11605-022-05473-z. PMID: 36175720
Neoadjuvant chemotherapy in locally advanced colon cancer: a systematic review and meta-analysis.
Gosavi R, Chia C, Michael M, Heriot AG, Warrier SK, Kong JC
Int J Colorectal Dis 2021 Oct;36(10):2063-2070. Epub 2021 May 4 doi: 10.1007/s00384-021-03945-3. PMID: 33945007
The role of Kono-S anastomosis and mesenteric resection in reducing recurrence after surgery for Crohn's disease: a systematic review.
Alshantti A, Hind D, Hancock L, Brown SR
Colorectal Dis 2021 Jan;23(1):7-17. Epub 2020 Jun 11 doi: 10.1111/codi.15136. PMID: 32418300

Prognosis

Anastomotic leak in colorectal cancer patients: New insights and perspectives.
Foppa C, Ng SC, Montorsi M, Spinelli A
Eur J Surg Oncol 2020 Jun;46(6):943-954. Epub 2020 Feb 24 doi: 10.1016/j.ejso.2020.02.027. PMID: 32139117
Esophagojejunal anastomotic leakage following gastrectomy for gastric cancer.
Makuuchi R, Irino T, Tanizawa Y, Bando E, Kawamura T, Terashima M
Surg Today 2019 Mar;49(3):187-196. Epub 2018 Oct 13 doi: 10.1007/s00595-018-1726-8. PMID: 30317492
Predictive factors for anastomotic leakage after laparoscopic colorectal surgery.
Sciuto A, Merola G, De Palma GD, Sodo M, Pirozzi F, Bracale UM, Bracale U
World J Gastroenterol 2018 Jun 7;24(21):2247-2260. doi: 10.3748/wjg.v24.i21.2247. PMID: 29881234Free PMC Article
Complications of pancreato-duodenectomy.
Kapoor VK
Rozhl Chir 2016 Feb;95(2):53-9. PMID: 27008166
Diverting ileostomy in colorectal surgery: when is it necessary?
Hanna MH, Vinci A, Pigazzi A
Langenbecks Arch Surg 2015 Feb;400(2):145-52. Epub 2015 Jan 30 doi: 10.1007/s00423-015-1275-1. PMID: 25633276

Clinical prediction guides

Score prediction of anastomotic leak in colorectal surgery: a systematic review.
Litchinko A, Buchs N, Balaphas A, Toso C, Liot E, Meurette G, Ris F, Meyer J
Surg Endosc 2024 Apr;38(4):1723-1730. Epub 2024 Feb 28 doi: 10.1007/s00464-024-10705-1. PMID: 38418633Free PMC Article
Systematic review of preoperative and intraoperative colorectal Anastomotic Leak Prediction Scores (ALPS).
Venn ML, Hooper RL, Pampiglione T, Morton DG, Nepogodiev D, Knowles CH
BMJ Open 2023 Jul 18;13(7):e073085. doi: 10.1136/bmjopen-2023-073085. PMID: 37463818Free PMC Article
Early and late anastomotic leak after colorectal surgery: A systematic review of the literature.
Škrabec CG, Carné AV, Pérez MC, Corral J, Pujol AF, Cuadrado M, Troya J, Ibáñez JJ, Parés D
Cir Esp (Engl Ed) 2023 Jan;101(1):3-11. Epub 2022 Jul 23 doi: 10.1016/j.cireng.2022.07.011. PMID: 35882311
Risk factors for anastomotic leakage after anterior resection for rectal cancer (RALAR study): A nationwide retrospective study of the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group.
Degiuli M, Elmore U, De Luca R, De Nardi P, Tomatis M, Biondi A, Persiani R, Solaini L, Rizzo G, Soriero D, Cianflocca D, Milone M, Turri G, Rega D, Delrio P, Pedrazzani C, De Palma GD, Borghi F, Scabini S, Coco C, Cavaliere D, Simone M, Rosati R, Reddavid R; collaborators from the Italian Society of Surgical Oncology Colorectal Cancer Network Collaborative Group
Colorectal Dis 2022 Mar;24(3):264-276. Epub 2021 Dec 6 doi: 10.1111/codi.15997. PMID: 34816571Free PMC Article
Prediction of anastomotic leak and its prognosis in digestive surgery.
Haga Y, Wada Y, Takeuchi H, Ikejiri K, Ikenaga M
World J Surg 2011 Apr;35(4):716-22. doi: 10.1007/s00268-010-0922-5. PMID: 21184072

Recent systematic reviews

Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective colorectal surgery.
Willis MA, Toews I, Soltau SL, Kalff JC, Meerpohl JJ, Vilz TO
Cochrane Database Syst Rev 2023 Feb 7;2(2):CD014909. doi: 10.1002/14651858.CD014909.pub2. PMID: 36748942Free PMC Article
C-reactive Protein and Procalcitonin Levels to Predict Anastomotic Leak After Colorectal Surgery: Systematic Review and Meta-analysis.
Bona D, Danelli P, Sozzi A, Sanzi M, Cayre L, Lombardo F, Bonitta G, Cavalli M, Campanelli G, Aiolfi A
J Gastrointest Surg 2023 Jan;27(1):166-179. Epub 2022 Sep 29 doi: 10.1007/s11605-022-05473-z. PMID: 36175720
Neoadjuvant chemotherapy in locally advanced colon cancer: a systematic review and meta-analysis.
Gosavi R, Chia C, Michael M, Heriot AG, Warrier SK, Kong JC
Int J Colorectal Dis 2021 Oct;36(10):2063-2070. Epub 2021 May 4 doi: 10.1007/s00384-021-03945-3. PMID: 33945007
C-reactive protein can predict anastomotic leak in colorectal surgery: a systematic review and meta-analysis.
Yeung DE, Peterknecht E, Hajibandeh S, Hajibandeh S, Torrance AW
Int J Colorectal Dis 2021 Jun;36(6):1147-1162. Epub 2021 Feb 8 doi: 10.1007/s00384-021-03854-5. PMID: 33555423
Reporting of complications after laparoscopic cholecystectomy: a systematic review.
Alexander HC, Bartlett AS, Wells CI, Hannam JA, Moore MR, Poole GH, Merry AF
HPB (Oxford) 2018 Sep;20(9):786-794. Epub 2018 Apr 9 doi: 10.1016/j.hpb.2018.03.004. PMID: 29650299

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