Anastomotic leakage in rectal surgery: Where are we and where do we go from here?

Abstract

Anastomotic leak in colorectal surgery is a significant complication which is feared by surgeons and has considerable consequences for patients. It affects up to 17% of rectal resections and although there is significant knowledge regarding its detection and treatment, there are still no reliable methods for its prevention. We proposed the routine use of intra-operative endoscopy as a method of reducing the risk of anastomotic leak. This thesis explores current knowledge regarding anastomotic leaks, including the causes, prevention and management. We also present the findings from a feasibility trial into intra-operative endoscopy as a method for reducing anastomotic leak rate. We found that the prevention of anastomotic leak is multi-faceted. Current methods cannot prevent it entirely but intra-operative endoscopy is a safe and potentially beneficial method of identifying leaks and preventing complications but further large-scale trials are required. If it cannot be prevented, early diagnosis and treatment is important to reduce further complications.

Date of Award	2023
Original language	English
Awarding Institution	University of Plymouth
Supervisor	Mark Coleman (Other Supervisor)