Transanal surgery: A tool in the colorectal anastomotic leakage

Cir Esp (Engl Ed). 2019 Dec;97(10):590-593. doi: 10.1016/j.ciresp.2019.04.015.
[Article in English, Spanish]

Abstract

The treatment of anastomotic leakage after oncological surgery for rectal cancer is a surgical challenge. The goal of this study is to show how transanal surgery combined with the abdominal approach is a very useful tool to decide on individualized treatment depending on the degree of dehiscence and to assist us in its local management. We present three cases of patients with colorectal anastomotic dehiscence. In two, we demonstrate the treatment of acute colorectal leakage and how transanal surgery allows us to confirm its viability and rule out any underlying ischemia. Furthermore, it facilitates good drainage of the adjacent collection as well as the placement of a vacuum system, if necessary, and its subsequent replacements. The last case is a delayed dehiscence with chronic presacral sinus, and its treatment by transanal access for fenestration.

Keywords: Anastomotic leakage; Cirugía transanal; Cáncer de recto; Dehiscencia anastomótica; Rectal cancer; Transanal surgery.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / surgery*
  • Aged
  • Anal Canal / surgery
  • Anastomosis, Surgical / adverse effects*
  • Anastomotic Leak / diagnostic imaging
  • Anastomotic Leak / etiology
  • Anastomotic Leak / surgery*
  • Drainage / methods
  • Humans
  • Ileostomy / methods
  • Laparoscopy / methods
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Rectal Neoplasms / pathology
  • Transanal Endoscopic Surgery / methods*