Leakage problems following surgery for rectal cancer can be managed with a minimally invasive approach
About 1 in 10 patients who undergo surgery for rectal cancer face the complication of anastomotic leakage, whether they undergo open or laparoscopic surgery. This leakage occurs when the suture line breaks down between the newly joined sections of rectum and waste seeps into the body. Life-threatening inflammation (peritonitis) can occur in the worst cases. Fortunately, the majority of patients who suffer anastomotic leakage can be managed with a minimally invasive approach, suggests a new study.
Of 307 patients who had minimally invasive (laparoscopic) surgery for rectal cancer between 2001 and 2006, 29 patients experienced anastomotic leakage. Nearly 35 percent of leakage victims were successfully managed with conservative treatment (antibiotics and closed suction drainage). Another 60 percent of the patients were treated with additional laparoscopic surgery. This minimally invasive surgery can be used to manage leakages if they are detected early, note the authors. They recommend that surgeons first explore the abdomen with laparoscopy, because anastomotic leakages often can be treated with irrigation and an ileostomy, a procedure in which surgeons create an opening in the abdominal wall to let waste exit the body. Risk factors for experiencing leakage after laparoscopic procedures included being male, being younger (54 vs. 58 years old), having a surgery site in the lower rectum, and operation times longer than 3 1/2 hours. This study was funded in part by the Agency for Healthcare Research and Quality (HS00059).
See "Anastomotic leakage after laparoscopic protectomy can be managed by a minimally invasive approach," by Yong-Geul Joh, M.D., Seon-Hahn Kim, M.D., Koo-Yong Hahn, M.D., and others in the January 2009 Diseases of the Colon and Rectum 52(1), pp. 91-96.
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