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CC BY-NC-ND 4.0 · Journal of Coloproctology 2021; 41(01): 042-046
DOI: 10.1055/s-0041-1724058
Original Article

Pull-Through in Patients after Pelvic Anastomosis Leak Following Proctectomy: A Cross-Sectional Study

Abaixamento em pacientes após vazamento de anastomose pélvica após proctectomia: Um estudo transversal
Hasan Davoodabadi
1   Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
,
Mohammad Aldraji 
2   Shahed Universtiy, Tehran, Iran
,
Abdolhosein Davoodabadi Farahani
3   Kashan University of Medical Sciences, Kashan, Iran
,
Parnian Soltani
4   Iran University of Medical Sciences, Tehran, Iran
,
Mehdi Alemrajabi
1   Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
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Abstract

Introduction Colorectal cancer is the second most common type of cancer and the third leading cause of mortality due to cancers. Anastomosis leak after proctectomy is a dangerous complication that must be managed carefully. The aim of the present study was to assess the procedure of resection and pull-through of the new rectum after anastomosis leak in patients after proctectomy.

Methods and Materials This was a cross-sectional study. Patients who visited the Firoozgar Hospital between 2015 and 2018 for rectal cancer surgery and had anastomosis leak entered the study. All patients underwent resection of the residue of rectum and pull-through of colon.

Results In the present study, out of the 110 cases who underwent proctectomy, 12 patients with postoperative anastomosis leak were reported. Five (41.7%) were male and 7 (58.3%) were female. The mean age of the patients was 41.5 ± 4.3 years (33–51). Resection of the new rectum and pull-through anastomosis were performed for these 12 patients. No major intraoperative complication occurred. Postoperative course was uneventful in all patients.

Discussion Resection of residue of rectum and pull-through in patients with anastomosis leak can be done after rectal cancer surgery. This method is superior to abdominopelvic resection in many aspects, especially regarding accessibility to the new rectum by rectal exam or endosonography to assess recurrence or a relative continence after closure of ostomy.

Resumo

Introdução O câncer colorretal é o segundo tipo de câncer mais comum, e a terceira principal causa de mortalidade por câncer. O vazamento da anastomose após a proctectomia é uma complicação perigosa, que deve ser tratada com cuidado. O objetivo do presente estudo foi avaliar o procedimento de ressecção e abaixamento do novo reto após vazamento de anastomose em pacientes submetidos à proctectomia.

Métodos e Materiais Este foi um estudo transversal que incluiu pacientes que compareceram ao Firoozgar Hospital entre 2015 e 2018 submetidos a cirurgia de câncer retal e com vazamento de anastomose. Todos os pacientes foram submetidos a ressecção do resíduo do reto e abaixamento do cólon.

Resultados No presente estudo, dos 110 casos submetidos a proctectomia, 12 pacientes tiveram vazamento de anastomose pós-operatório: 5 (41,7%) do sexo masculino e 7 (58,3%) do sexo feminino. A idade média dos pacientes foi de 41,5 ±  4,3 anos (gama: 33 a 51 anos). A ressecção do reto novo e a anastomose por abaixamento foram realizadas nesses 12 pacientes. Nenhuma complicação intraoperatória mais grave ocorreu. No pós-operatório, não houve intercorrências em nenhum dos pacientes.

Discussão A ressecção de resíduo retal e o abaixamento em pacientes com vazamento de anastomose pode ser feita após cirurgia de câncer retal. Este método é superior à ressecção abdominopélvica em muitos aspectos, especialmente quanto à acessibilidade ao novo reto por exame retal ou endossonografia para avaliar a recorrência ou uma continência relativa após o fechamento da ostomia.

Keywords

rectal cancer - anastomosis leak - proctectomy

Palavras-chave

câncer retal - vazamento de anastomose - protectomia

Authors' Contribution

All the authors contributed equally in the preparation of the present manuscript.




Publication History

Received: 05 July 2020

Accepted: 30 August 2020

Article published online:
19 March 2021

© 2021. Sociedade Brasileira de Coloproctologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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