New approaches towards risk assessment, diagnosis and prevention strategies of colorectal anastomotic leakage

Abstract

The most important and frustrating complication of colorectal surgery is colorectal anastomotic leakage (CAL). An anastomotic defect causes leakage of colonic content into the abdominal and/or pelvic space leading to peritonitis, abscess formation and sepsis that can be fatal. The incidence of CAL varies between 3 % and 19 % 1-4 and mortality rates due to CAL vary between 10 % and 20 % 5-7. Moreover, CAL is a risk factor for local recurrence of colorectal cancer and is reported to reduce long-term cancer specific survival 8. The pathological processes leading up to the occurrence of this defect are poorly understood. Even when all patient-, disease- and operation related factors favor proper anastomotic healing, CAL still may occur.