|Table of Contents|

Review of challenges and solutions in reducing gastrointestinal anastomotic leak

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2017 02
Page:
331-334
Research Field:
Publishing date:

Info

Title:
Review of challenges and solutions in reducing gastrointestinal anastomotic leak
Author(s):
Meng Hui1; Cao Huihui1; Xiao Xi1; Wang Yunjie2
1.Department of Thoracic Surgery,Lanzhou General Hospital,Gansu Lanzhou 730050,China;2.Department of Thoracic Surgery,Tangdu Hospital，the Fourth Military University,Shaanxi Xi'an 710038,China.
Keywords:
anastomosis; anastomotic; leak; gastrointestinal; complications
PACS:
R730.6
DOI:
10.3969/j.issn.1672-4992.2017.02.046
Abstract:
In this review,we combined with our clinical experiences and the newest techniques and methods,to reduce incidence of anastomotic leaks following gastrointestinal surgery all over the world,to improve the cognition of the potential risk and high-risk patient of anastomotic leaks.Modifiable factors for anastomotic leak discussed malnutrition,smoking,steroid use,bowel preparation,chemotherapy,duration of surgery,use of pressors,intravenous fluid administration,blood transfusion,surgical anastomotic technique,minimizing operative time,reducing ischemia,and exact utilizing stapled anastomoses.Buttressing of anastomoses with omentum has proven multiple effects for esophageal surgery.Therefore,advocatings include 5~7 days of immune modifying nutritional supplementation for malnourished patients,discontinuation of smoking and limiting steroid use in the perioperative period,utilization of oral antibiotic preparation for colorectal surgery,avoidance of early operations（4 weeks) following chemotherapy,limiting pressor use,and the utilization of goal-directed fluid management,to reduce the risk of anastomotic leaks.

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Last Update: 2016-12-01