Keywords:
Performed at one institution, Not applicable, Acute, Surgery, Screening, Complications, CT, Gastrointestinal tract, Colon, GI Tract
Authors:
A. Fernández Tamayo1, M. J. J. Adán Martín1, E. Diez1, J. Miranda Bautista2, C. Segura Escribano1, M. González Estévez1, A. Garcia1; 1Madrid/ES, 2Madrid, Madrid/ES
DOI:
10.26044/ecr2020/C-10294
Purpose
Anastomotic leak is one of the most severe complications in colorectal surgery, as it drastically impacts on morbidity and mortality rates and involves frequent reinterventions. Incidence rates range between 1.8 to 3% in most case series1,2, leading up to mortality rates from 7 to 39%.
Despite its severity, patients often remain asymptomatic until late stages, with an increase in complications occurrences such as peritonitis, intra-abdominal collections or loss of perianastomotic tissue viability, implying more aggressive surgical procedures.
It has been vastly demonstrated that an abdominal CT scan with an endorectal contrast agent is an optimal test for anastomotic leak detection, with a sensitivity of 74-85% and a specificity of 91-94%2,3. Endorectal contrast agent leak is the most accurate diagnostic finding and, if used routinely, shows high specificity values with great reliability4.
According to the previous information, we developed a screening protocol using an abdominal CT scan that allowed early detection of anastomotic leak in patients who underwent colorectal surgery, in order to improve patients’ forecast and morbimortality.