Fistulas after Low Anterior Resection with TME
- *Corresponding Author:
- Stefan Morarasu MD
2nd Department of Surgical Oncology
Regional Institute of Oncology Iasi 2-4
G-ral Berthelot Street 700483 Iasi, Romania
E-mail: [email protected]
Received date: December 13, 2016; Accepted date: December 27, 2016; Published date: January 02, 2017
Citation: Morarasu S, Frunza T, Rotundu A, Lunca S, Dimofte G. Fistulas after Low Anterior Resection with TME. Journal of Surgery [Jurnalul de chirurgie]. 2017; 13(1): 25-29 DOI: 10.7438/1584-9341-13-1-5
Copyright: © 2017 Morarasu S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Despite advances in modern anastomotic techniques for colorectal surgery, anastomotic fistulas are still considered a dreaded complication, with a reported rate varying from 2 to 25%. Although fistulas can appear after any bowel anastomosis, it seems that low colorectal anastomosis are the most prone to such complications. Herein we aim to provide a review on our own experience with postoperative anastomotic fistulas after low colorectal anastomosis. Between 1998 and 2016, 62 patients had a LAR procedure with TME and low colorectal anastomosis. The mean age was 62.29 years. Triple stapled side to end colorectal anastomosis was the preferred technique with protective ileostomy. We report a fistula rate of 9.67% (6 cases) after Low Anterior Resection including blind fistula seen on first month follow-up endoscopic evaluation. While blind fistulas generated little morbidity, clinically manifested fistulas posed significant management challenge. Nevertheless we report no mortality related to fistula. Indubitably, more research is needed to establish a proper prevention guideline for anastomotic leaks, a “golden-standard” anastomotic technique and ideal management criteria for fistulas.