Veyrie et al identified risk factors for anastomotic leakage following colectomy for cancer. These can help identify patients who may benefit from interventions to reduce the risk. The authors are from multiple hospitals in France and Tunisia.
Colectomy
Risk Factor
Preventive Action
right
preoperative weight loss > 10%
preoperative nutritional support
left
poor colonic cleanliness
intra-operative colonic lavage; protective stoma if other risk factors present
left
palliative procedure
left
distal colorectal anastomosis
where:
• Palliative colectomy is considered equivalent to disseminated cancer or the presence of distant metastases.
• Intraoperative colonic lavage sounds like a mess.
A patient with one or more risk factors for leakage should be monitored closely after surgery for early signs of a leak.
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