Abstract
Anastomotic leakage following right colectomy for malignancy is a rare complication associated with high mortality and morbidity. The therapeutic dilemma is between the construction of an ileostomy and mucous fistula and the construction of a new ileo-colic anastomosis. The above mentioned choices have significant disadvantages, i.e quality of life issues and the need for a new laparotomy related to the first therapy and the danger of a new leakage can arise the latter. We present an alternative approach to this problem. We suggest, in cases of significant disruption of the anastomosis, the excision of the old anastomosis and the construction of a side-toside ileocolic anastomosis with the use of staplers, which is then brought out in the right abdomen wall as a stoma. The advantages to this approach are the avoidance of a new leak in the peritoneal cavity in the case of an insufficient anastomosis, and that reconstruction can be done without midline laparotomy via the stoma site.
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