Minimally invasive management of anastomotic leaks in colorectal surgery

Abstract

Anastomotic leakage is an unfortunate complication of colorectal surgery. This distressing situation can cause severe morbidity and significantly affects the patient’s quality of life. Additional interventions may cause further morbidity and mortality. Parenteral nutrition and temporary diverting ostomy are the standard treatments of anastomotic leaks. However, technological developments in minimally invasive treatment modalities for anastomotic dehiscence have caused them to be used widely. These modalities include laparoscopic repair, endoscopic self-expandable metallic stents, endoscopic clips, over the scope clips, endoanal repair and endoanal sponges. The review aimed to provide an overview of the current knowledge on the minimally invasive management of anastomotic leaks.

Keywords: Minimally invasive surgery; Anastomotic leak; Colorectal surgery

Core tip: Anastomotic leakage is the most feared complication of colorectal surgery, leading to significant patient morbidity and mortality. Its incidence is 3%-6%, even in experienced hands. Despite the high prevalence of this condition, there is no consensus on the proper management of anastomotic leaks. In this review, we summarize and discuss the current knowledge on minimally invasive treatment strategies for anastomotic leakage after colorectal surgery.