Nerstrøm M, Krarup PM, Jorgensen LN, Ågren MS. Therapeutic improvement of colonic anastomotic healing under complicated conditions: A systematic review. World J Gastrointest Surg 2016; 8(5): 389-401 [PMID: 27231518 DOI: 10.4240/wjgs.v8.i5.389]
Corresponding Author of This Article
Magnus S Ågren, Professor, Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark. magnus.agren@mail.dk
Research Domain of This Article
Surgery
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2016; 8(5): 389-401 Published online May 27, 2016. doi: 10.4240/wjgs.v8.i5.389
Therapeutic improvement of colonic anastomotic healing under complicated conditions: A systematic review
Malene Nerstrøm, Peter-Martin Krarup, Lars Nannestad Jorgensen, Magnus S Ågren
Malene Nerstrøm, Peter-Martin Krarup, Lars Nannestad Jorgensen, Magnus S Ågren, Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, DK-2400 Copenhagen NV, Denmark
Magnus S Ågren, Copenhagen Wound Healing Center, Bispebjerg Hospital, University of Copenhagen, DK-2400 Copenhagen NV, Denmark
Magnus S Ågren, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, DK-2200 Copenhagen, Denmark
Author contributions: Nerstrøm M performed the literature search, collected and analyzed the data and drafted the article; Krarup PM designed the study, performed the literature search and the statistical analyses; Jorgensen LN designed the study and edited the manuscript; Ågren MS designed the study and edited the manuscript.
Conflict-of-interest statement: There are no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Magnus S Ågren, Professor, Digestive Disease Center, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, DK-2400 Copenhagen NV, Denmark. magnus.agren@mail.dk
Telephone: +45-35316493 Fax: +45-35313911
Received: June 28, 2015 Peer-review started: July 5, 2015 First decision: September 17, 2015 Revised: February 8, 2016 Accepted: March 4, 2016 Article in press: March 9, 2016 Published online: May 27, 2016 Processing time: 323 Days and 23.6 Hours
Core Tip
Core tip: Anastomotic leakage is a challenging complication after colorectal surgery. Although many pharmaceutical compounds have the potential to improve anastomotic healing, none has reached the clinical setting. This study reviewed 65 experimental studies investigating 48 different therapeutic agents for the improvement of anastomotic healing under complicated conditions due to ischemia, ischemia/reperfusion, obstructive bowel, obstructive jaundice, peritonitis, chemotherapy or radiotherapy. Of the 31 agents reported to enhance anastomotic healing, one was subjected to a meta-analysis. Hyperbaric oxygen therapy significantly improved anastomotic healing in rat models complicated by bowel ischemia. Further exploration is needed to define agents that reduce AL in high-risk patients.
