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An anastomotic leak is a fault in the surgical connection between the two remaining sections of bowel after a resection is performed. This allows the bowel contents to leak into the abdomen. Anastomotic leaks may cause infection, abscess development, and organ failure if untreated. Surgical steps are taken to prevent leaks when possible.
A surgical anastomosis is a surgical technique used to make a new connection between two body structures that carry fluid, such as blood vessels or bowel. For example, an arterial anastomosis is used in vascular bypass and a colonic anastomosis is used to restore colonic continuity after the resection of colon cancer .
Contamination of the peritoneal cavity with fecal matter as a result of the anastomotic leak can lead to peritonitis, sepsis or death. In patients who underwent colectomy as a treatment for colorectal cancer, an anastomotic leak increases the risk of recurrence of cancer in the same area and reduces survival in the long term.
In medicine, the ileal pouch–anal anastomosis (IPAA), also known as restorative proctocolectomy (RPC), ileal-anal reservoir (IAR), an ileo-anal pouch, ileal-anal pullthrough, or sometimes referred to as a J-pouch, S-pouch, W-pouch, or a pelvic pouch, is an anastomosis of a reservoir pouch made from ileum (small intestine) to the anus, bypassing the former site of the colon in cases where the ...
Bowel obstruction may occur, or the anastomosis created by the surgery may leak. [1] The stoma may retract, or may prolapse. [1] Rarely, it may necrose. [1] Technique
Anastomosis can be performed by hand or with an anastomosis assist device. [6] Studies have been performed comparing various anastomosis approaches taking into account surgical "time and cost, postoperative anastomotic bleeding, leakage, and stricture". [7]
Cuffitis is inflammation at the anal transition zone or "cuff" created as a result of ileal pouch-anal anastomosis (IPAA). [1] It is considered a variant form of ulcerative colitis that occurs in the rectal cuff. [2] Cuffitis is a common complication of IPAA, particularly when a stapled anastomosis without mucosectomy procedure has been used. [2]
This procedure requires a temporary loop ileostomy to allow the anastomosis to heal. With lifestyle adjustments, those who have had this procedure for their Crohn's disease can resume normal bowel movements without artificial appliances. However, there is always the possibility of disease relapse, as Crohn's can affect mouth to anus. [13]