Abstract
Four hundred five consecutive cases of low anterior colon resection were studied to determine the best treatment of anastomotic leak. The triad of fever, leukocytosis, and pelvic pain was present in 15 of the 16 cases with leaks. Four (25%) of the 16 patients died. Eleven were managed by proximal decompression and drainage; four died (36%). Three patients underwent takedown of the anastomosis, end colostomy, and distal closure or exteriorization; none died. Neither of the two patients who had drainage alone died. Anastomotic leakage accounted for two thirds of the deaths in this series. Recognition of the clinical triad of fever, leukocytosis, and pelvic pain could lead to earlier diagnosis and improved outcome. Our data suggest that a procedure that includes takedown of the anastomosis, end colostomy, and closure of the rectum is the most efficacious treatment of anastomotic leakage after low anterior colon resection.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 968-971 |
| Number of pages | 4 |
| Journal | Archives of Surgery |
| Volume | 123 |
| Issue number | 8 |
| State | Published - Aug 1988 |
| Externally published | Yes |
Fingerprint
ASJC Scopus subject areas
- Surgery
Cite this
Treatment of anastomotic leakage following low anterior colon resection. / Mileski, William; Joehl, R. J.; Rege, R. V.; Nahrwold, D. L.
In: Archives of Surgery, Vol. 123, No. 8, 08.1988, p. 968-971.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment of anastomotic leakage following low anterior colon resection.
AU - Mileski, William
AU - Joehl, R. J.
AU - Rege, R. V.
AU - Nahrwold, D. L.
PY - 1988/8
Y1 - 1988/8
N2 - Four hundred five consecutive cases of low anterior colon resection were studied to determine the best treatment of anastomotic leak. The triad of fever, leukocytosis, and pelvic pain was present in 15 of the 16 cases with leaks. Four (25%) of the 16 patients died. Eleven were managed by proximal decompression and drainage; four died (36%). Three patients underwent takedown of the anastomosis, end colostomy, and distal closure or exteriorization; none died. Neither of the two patients who had drainage alone died. Anastomotic leakage accounted for two thirds of the deaths in this series. Recognition of the clinical triad of fever, leukocytosis, and pelvic pain could lead to earlier diagnosis and improved outcome. Our data suggest that a procedure that includes takedown of the anastomosis, end colostomy, and closure of the rectum is the most efficacious treatment of anastomotic leakage after low anterior colon resection.
AB - Four hundred five consecutive cases of low anterior colon resection were studied to determine the best treatment of anastomotic leak. The triad of fever, leukocytosis, and pelvic pain was present in 15 of the 16 cases with leaks. Four (25%) of the 16 patients died. Eleven were managed by proximal decompression and drainage; four died (36%). Three patients underwent takedown of the anastomosis, end colostomy, and distal closure or exteriorization; none died. Neither of the two patients who had drainage alone died. Anastomotic leakage accounted for two thirds of the deaths in this series. Recognition of the clinical triad of fever, leukocytosis, and pelvic pain could lead to earlier diagnosis and improved outcome. Our data suggest that a procedure that includes takedown of the anastomosis, end colostomy, and closure of the rectum is the most efficacious treatment of anastomotic leakage after low anterior colon resection.
UR - http://www.scopus.com/inward/record.url?scp=0024058865&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0024058865&partnerID=8YFLogxK
M3 - Article
VL - 123
SP - 968
EP - 971
JO - JAMA Surgery
JF - JAMA Surgery
SN - 2168-6254
IS - 8
ER -