Abstract
Leaks from anastomoses can be a serious complication of any gastrointestinal resection.
Leaks lead to increased morbidity, delayed postoperative recovery, and potential delays
in adjuvant treatment in cancer cases. Prevention of anastomotic leak has been an
area of ongoing research for decades. Methods of assessing bowel perfusion have been
developed that may provide forewarning of anastomotic compromise. Physical reinforcement
of the anastomosis with buttressing material is an available method employed with
the goal of preventing leaks. Liquid-based sealants have also been explored. Lastly,
interactions between the gut microbiome and anastomotic healing have been investigated
as a mean of manipulating the microenvironment to reduce leak rates. Though no single
technology has been successful in eliminating leaks, an understanding of these developing
fields will be important for all surgeons who operate on the gastrointestinal tract.
Keywords
anastomosis - colorectal surgery - anastomotic leak - bowel perfusion - endoscopy
