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Management and results of complications after anterior resection with colonic pouch reconstruction for rectal cancer
Author(s) -
Kruschewski M.,
Gröne J.,
Vogel N.,
Zimmermann M.,
Buhr H. J.
Publication year - 2011
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2009.02140.x
Subject(s) - medicine , pouch , surgery , anastomosis , colorectal cancer , abscess , coloanal anastomosis , cancer
Aim Colonic J‐pouch reconstruction is widely carried out during low anterior resection. The aim of this observational study was to describe the complications and evaluate the results of adverse event management. Method A total of 128 patients underwent an elective anterior resection with colorectal or coloanal J‐pouch reconstruction for primary rectal cancer between January 1997 and December 2008. Results The overall mortality was 1.6%. Three (2.3%) patients developed pouch necrosis, one of whom died. The rate of anastomotic leakage was 11.7%. Other major complications included intra‐abdominal abscess (3.1%), haemorrhage (0.8%) and abdominal dihiscence (0.8%). In all cases of anastomotic leakage, the pouch was salvaged, with 80% of patients undergoing surgical revision with relaparotomy and transanal suture. Patients with pouch necrosis underwent relaparotomy with removal of the pouch and a terminal colostomy. In all cases of intra‐abdominal abscess without anastomotic leakage, radiologically controlled percutaneous drainage was carried out. Conclusion Anal function can usually be saved after anastomotic leakage by salvage surgery without increase in mortality.