Published online Apr 21, 2013. doi: 10.3748/wjg.v19.i15.2293
Revised: January 18, 2013
Accepted: February 5, 2013
Published online: April 21, 2013
Processing time: 109 Days and 20.5 Hours
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.
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.