alexa Abstract | Fistulas after Low Anterior Resection with TME
[Jurnalul de Chirurgie]
ISSN: 1584-9341

Journal of Surgery
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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.

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Author(s): Ștefan Morărașu, Tudor Frunză, Alexandru Rotundu, Sorinel Luncă, Gabriel Dimofte



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