ArticleIn vivo (Athens, Greece)
The Effect of Multifaceted Anastomotic Leakage Prevention
Article in In vivo (Athens, Greece). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- The application of intraoperative strategies to reduce protective stoma in mid and low rectal cancer: a retrospective study utilizing indocyanine green and precise anatomical techniques.World journal of surgical oncology · 2026Article
- Clinical application of indocyanine green fluorescence imaging technology in laparoscopic rectal cancer surgery.Journal of gastrointestinal oncology · 2025Article
- Achieving the perfect end-to-end single-stapled anastomosis in low anterior resection for rectal cancer: technical aspects.Annals of coloproctology · 2025Article
- Use of Fluorescent Catheters to Prevent Urological Organ Injury in Minimally Invasive Colorectal Surgery: A Retrospective Study.In vivo (Athens, Greece)Observational
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Authors and funding
7 authors.
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Abstract
BACKGROUND/
aimIn rectal cancer surgery, anastomotic leakage (AL) is the most important complication and has a reported frequency of 11-15%. The causes of AL leakage are complex, and AL prevention should be performed in multiple directions. Thus, this study examined the usefulness of the comprehensive and multifaceted AL preventive measures. PATIENTS AND
methodsIn total, 164 rectal surgery patients who had low rectal staple anastomosis below the peritoneal reflection were enrolled. The patients were divided into two groups: (i) the multifaceted AL prevention group (MP group, n=34) and (ii) the insufficient AL prevention group (IP group, n=130). Multifaceted AL prevention was defined as intestinal blood flow evaluated via indocyanine green (ICG)-fluorescence imaging (FI), the use of a single-staple technique (SST) without intersecting stapling lines or "dog ears", the use of transanal suture reinforcement according to the air leakage test, and the use of a transanal tube for anatomical decompression and a diverting stoma for diverting the fecal stream. The AL rates were retrospectively compared between the two groups. The data are expressed as the median and interquartile range.
resultsThe rate of AL was significantly lower in the MP group (0%) than in the IP group (11.54%) (p=0.0423).
conclusionMultifaceted AL prevention, including ICG-FI and SST, achieved a zero incidence of AL. Multifaceted prevention significantly lessened AL more than inadequate prevention did. Therefore, if the weight of each preventive measure cannot be clearly identified, to avoid AL, it is important to take all preventive measures from multiple aspects.
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