COLONIC ANASTOMOSES LEAKAGE

Abstract

Colonic anastomoses leakage is still a serious problem in abdominal surgery with significant morbidity and mortality. Incidence of this complication ranges from 1,8 to 19,2%, and depends on various risk factors: male sex, age, low level of anastomosis, malignant nature of the disease, high level of ASA scores, long duration of surgery, emergency nature of the operation, preoperative radiation therapy and perioperative blood loss and / or transfusion of blood components. Observation data lead to the development of various algorithms and scales for predicting the failure of anastomoses (for example, the PROCOLE index). Preventive methods include correction of a patient's nutritional deficiency in the perioperative period, elimination of a preventive stoma, use of tissue adhesives, transrectal drainage for decompression of a rectal anastomosis, use of stents or a collagen matrix coated with fibrinogen and thrombin. Given the validity and legitimacy of additional (preventive) interventions during the formation of the anastomosis, it should be noted that at present there is no clearly defined standard for operation on the digestive tract when anastomoses are applied.