Treatment of Anastomotic Leakage Following Low Anterior Colon Resection

W. J. Mileski, R. J. Joehl, Robert V Rege, D. L. Nahrwold

Research output: Contribution to journalArticle

77 Scopus citations

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 languageEnglish (US)
Pages (from-to)968-971
Number of pages4
JournalArchives of Surgery
Volume123
Issue number8
DOIs
StatePublished - Aug 1988

ASJC Scopus subject areas

  • Surgery

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