Reducing anastomotic leak in colorectal surgery: The old dogmas and the new challenges  

作　　者：Jeremy Meyer Surennaidoo Naiken Niki Christou Emilie Liot Christian Toso Nicolas Christian Buchs Frédéric Ris 

机构地区：[1]Division of Digestive Surgery, University Hospitals of Geneva

出　　处：《World Journal of Gastroenterology》2019年第34期5017-5025,共9页世界胃肠病学杂志（英文版）

摘　　要：Anastomotic leak(AL)constitutes a significant issue in colorectal surgery,and its incidence has remained stable over the last years.The use of intra-abdominal drain or the use of mechanical bowel preparation alone have been proven to be useless in preventing AL and should be abandoned.The role or oral antibiotics preparation regimens should be clarified and compared to other routes of administration,such as the intravenous route or enema.In parallel,preoperative antibiotherapy should aim at targeting collagenase-inducing pathogens,as identified by the microbiome analysis.AL can be further reduced by fluorescence angiography,which leads to significant intraoperative changes in surgical strategies.Implementation of fluorescence angiography should be encouraged.Progress made in AL comprehension and prevention might probably allow reducing the rate of diverting stoma and conduct to a revision of its indications.Anastomotic leak(AL) constitutes a significant issue in colorectal surgery, and its incidence has remained stable over the last years. The use of intra-abdominal drain or the use of mechanical bowel preparation alone have been proven to be useless in preventing AL and should be abandoned. The role or oral antibiotics preparation regimens should be clarified and compared to other routes of administration, such as the intravenous route or enema. In parallel, preoperative antibiotherapy should aim at targeting collagenase-inducing pathogens, as identified by the microbiome analysis. AL can be further reduced by fluorescence angiography, which leads to significant intraoperative changes in surgical strategies. Implementation of fluorescence angiography should be encouraged.Progress made in AL comprehension and prevention might probably allow reducing the rate of diverting stoma and conduct to a revision of its indications.

关 键 词：Anastomotic LEAKAGE RECTAL SURGERY COLIC SURGERY Prevention Surgical site infection ANASTOMOSIS COMPLICATION 

分 类 号：R[医药卫生]