Editorial
Copyright ©2013 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 21, 2013; 19(15): 2293-2297
Published online Apr 21, 2013. doi: 10.3748/wjg.v19.i15.2293
Colorectal anastomotic leakage: Aspects of prevention, detection and treatment
Freek Daams, Misha Luyer, Johan F Lange
Freek Daams, Misha Luyer, Department of Surgery, Catharina Ziekenhuis, 5623 EJ Eindhoven, The Netherlands
Johan F Lange, Department of Surgery, Erasmus Medical Center, 3015 CE Rotterdam, The Netherlands
Author contributions: Daams F and Luyer M performed the review of literature and wrote the paper; Lange JF supervised the data collection and revised the paper
Correspondence to: Freek Daams, MD, Department of Surgery, Catharina Ziekenhuis, Michelangelolaan 2, 5623 EJ Eindhoven, The Netherlands. freekdaams@gmail.com
Telephone: +31-6-55688542  Fax: +31-40-2443370
Received: December 31, 2012
Revised: January 18, 2013
Accepted: February 5, 2013
Published online: April 21, 2013
Abstract

All colorectal surgeons are faced from time to time with anastomotic leakage after colorectal surgery. This complication has been studied extensively without a significant reduction of incidence over the last 30 years. New techniques of prevention, by innovative anastomotic techniques should improve results in the future, but standardization and “teachability” should be guaranteed. Risk scoring enables intra-operative decision-making whether to restore continuity or deviate. Early detection can lead to reduction in delay of diagnosis as long as a standard system is used. For treatment options, no firm evidence is available, but future studies could focus on repair and saving of the anastomosis on the one hand or anastomotical breakdown and definitive colostomy on the other hand.

Keywords: Colorectal surgery, Complications, Postoperative care, Anastomotic leakage, Prevention

Core tip: This editorial covers the past achievements and future challenges in the field of colorectal anastomotic leakage. New anastomotic techniques and risk scores should improve incidence numbers and early detection, whereas future research could focus on preservation of the anastomosis in case of leakage.