Emerging Trends in the Etiology, Prevention, and Treatment of Gastrointestinal Anastomotic Leakage

Sami A Chadi^{1

2

3}, Abe Fingerhut^{4

5}, Mariana Berho⁶, Steven R DeMeester⁷, James W Fleshman⁸, Neil H Hyman⁹, David A Margolin¹⁰, Joseph E Martz¹¹, Elisabeth C McLemore¹², Daniela Molena¹³, Martin I Newman¹⁴, Janice F Rafferty¹⁵, Bashar Safar¹⁶, Anthony J Senagore¹⁷, Oded Zmora¹⁸, Steven D Wexner¹⁹

Affiliations

¹ Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA.
² Division of General Surgery, University Health Network, Toronto, ON, Canada.
³ Department of Surgery, University of Toronto, Toronto, ON, Canada.
⁴ Section for Surgical Research, Department of Surgery, Medical University of Graz, Graz, Austria.
⁵ First Department of Surgery, Hippokration University Hospital, University of Athens, Athens, Greece.
⁶ Department of Pathology, Cleveland Clinic Florida, Weston, FL, USA.
⁷ Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁸ Department of Surgery, Baylor University Medical Center at Dallas, Dallas, TX, USA.
⁹ Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
¹⁰ Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA.
¹¹ Division of Colorectal Surgery, Mount Sinai Beth Israel, New York, NY, USA.
¹² Department of Surgery, Colorectal Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
¹³ Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
¹⁴ Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Weston, FL, USA.
¹⁵ Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
¹⁶ Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁷ Department of Surgery, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
¹⁸ Department of Surgery, Sackler School of Medicine, Sheba Medical Center, Tel Aviv, Israel.
¹⁹ Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA. wexners@ccf.org.

PMID: 27638764
DOI: 10.1007/s11605-016-3255-3

Review

Emerging Trends in the Etiology, Prevention, and Treatment of Gastrointestinal Anastomotic Leakage

Sami A Chadi et al. J Gastrointest Surg. 2016 Dec.

. 2016 Dec;20(12):2035-2051.

doi: 10.1007/s11605-016-3255-3. Epub 2016 Sep 16.

Authors

Affiliations

¹ Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA.
² Division of General Surgery, University Health Network, Toronto, ON, Canada.
³ Department of Surgery, University of Toronto, Toronto, ON, Canada.
⁴ Section for Surgical Research, Department of Surgery, Medical University of Graz, Graz, Austria.
⁵ First Department of Surgery, Hippokration University Hospital, University of Athens, Athens, Greece.
⁶ Department of Pathology, Cleveland Clinic Florida, Weston, FL, USA.
⁷ Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
⁸ Department of Surgery, Baylor University Medical Center at Dallas, Dallas, TX, USA.
⁹ Department of Surgery, University of Chicago Medicine, Chicago, IL, USA.
¹⁰ Department of Colon and Rectal Surgery, Ochsner Clinic Foundation, New Orleans, LA, USA.
¹¹ Division of Colorectal Surgery, Mount Sinai Beth Israel, New York, NY, USA.
¹² Department of Surgery, Colorectal Surgery, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA, USA.
¹³ Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University, Baltimore, MD, USA.
¹⁴ Department of Plastic and Reconstructive Surgery, Cleveland Clinic Florida, Weston, FL, USA.
¹⁵ Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
¹⁶ Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹⁷ Department of Surgery, School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
¹⁸ Department of Surgery, Sackler School of Medicine, Sheba Medical Center, Tel Aviv, Israel.
¹⁹ Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA. wexners@ccf.org.

PMID: 27638764
DOI: 10.1007/s11605-016-3255-3

Abstract

Anastomotic leaks represent one of the most alarming complications following any gastrointestinal anastomosis due to the substantial effects on post-operative morbidity and mortality of the patient with long-lasting effects on the functional and oncologic outcomes. There is a lack of consensus related to the definition of an anastomotic leak, with a variety of options for prevention and management. A number of patient-related and technical risk factors have been found to be associated with the development of an anastomotic leak and have inspired the development of various preventative measures and technologies. The International Multispecialty Anastomotic Leak Global Improvement Exchange group was convened to establish a consensus on the definition of an anastomotic leak as well as to discuss the various diagnostic, preventative, and management measures currently available.

Keywords: Consensus; Gastrointestinal anastomotic leakage; International Multispecialty Anastomotic Leak Global Improvement Exchange; Morbidity; Review.

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References

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Emerging Trends in the Etiology, Prevention, and Treatment of Gastrointestinal Anastomotic Leakage

Affiliations

Emerging Trends in the Etiology, Prevention, and Treatment of Gastrointestinal Anastomotic Leakage

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Affiliations

Abstract

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Medical