Definition and diagnostic criteria of anastomotic leakage after sphincter-preserving surgery for rectal cancer

Abstract

Anastomotic leakage is a common and severe postoperative complication foollowing sphincter-preserving surgery of rectal cancer. Many useful studies on anastomotic leakage were conducted both in our country and abroad. However, the lack of standardized and influential definition and diagnostic criteria is responsible for confusion in the literature. In this paper, the history of studies on the definition and diagnostic criteria of anastomotic leakage is reviewed, and the name evolution process of anastomotic leakage in domestic and foreign studies is introduced. We briefly describe the current situation of the coexistence of "leakage" and "fistula" in China. Based on the general definition and the word meaning of the interruption of anastomotic continuity, using "anastomotic leakage" instead of "anastomotic fistula" is necessary. The common diagnostic criteria are the Clavien-Dindo classification in 2004 and the ISREC definition and grading proposed by the International Study Group of Rectal Cancer in 2010. Both criteria have their own advantages and disadvantages. The standardized use of the definition and diagnostic criteria of postoperative anastomotic leakage of rectal cancer will help improve surgical safety assessment and facilitate academic communication. In view of the current situation of China, we still need to promote standardized definition and diagnostic criteria of anastomotic leakage.