Abstract
The conventional operative intervention for leaks following coloanal anastomoses has been proximal fecal diversion with or without take-down of anastomosis. A few of these cases are also amenable to percutaneous drainage. Ostomies created in this situation are often permanent, specifically in cases where coloanal anastomoses are taken down at the time of reoperation. We present two patients who developed perianastomotic pelvic abscesses that were treated with transanal large bore catheter drainage resulting in successful salvage of coloanal anastomoses without the need for a laparotomy or ostomy creation. We propose this to be an effective therapeutic approach to leaks involving low coloanal anastomoses in the absence of generalized peritonitis.
Highlights
Anastomotic leaks carry a reported mortality of 6 to 39% [1]
Abdominal wash out with stoma creation is the treatment of choice for an anastomotic dehiscence in presence of peritonitis
Many of these patients require a complete takedown of anastomosis [2]. e reported healing rates after diversion are widely variable, and this approach obviously subjects the patient to another abdominal surgery [3]
Summary
Anastomotic leaks carry a reported mortality of 6 to 39% [1]. Majority of these patients require a reoperation with complete take-down of anastomosis and fecal diversion. Take-down of coloanal anastomosis presents a unique challenge as pelvic scarring, and absence of distal bowel segment precludes restoration of bowel continuity at a later day. We present two patients managed with a transanal drainage following coloanal anastomotic dehiscence
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