FAILURE OF COLORECTAL ANASTOMOSIS. CLINICAL ANALYSIS

Abstract

Failure of colorectal anastomosis was found in 1 case after 30 stapler operations and in 6 cases after 60 manual anastomoses. All the anastomoses were formed by two rows of sutures and were subperitoneal. The diagnosis of failure was mad on the basis of clinical data. One patient died. The errors in diagnosis of colorectal anastomosis failure are discussed. Visualization of a failure area by means of contrast enema and CT is essential. From 2013 to 2017 in Chernivtsi Oncological Center 90 operations were performed for rectal cancer with colorectal anastomoses. The first row of sutures was applied from the inner part of mucosa. In 25 cases invagination technique was applied. Anastomoses were made by 5 surgeons with a high level of professional work. One failure occurred on 11 day after formation of stepler anastomosis, by means of manual anastomoses failure appeared on 5-9 days. Conservative therapy was given to 2 patients. Transversostomy was performed in 4 patients, and lparotomy with resection of anastomosis – in 1 patient. In all cases surgeons were not informed about the size of dehiscence and level of drainage of subperitoneal abscess. In such situation transversostomy may be dangerous and subperitoneal abscess leads to peritonitis.