Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery

R. Phitayakorn; C. P. Delaney; H. L. Reynolds; B. J. Champagne; A. G. Heriot; P. Neary; A. J. Senagore; P. Ambrosetti; C. Bailey; R. P. Billingham; M. Braga; W. D. Buie; A. W. Darzi; P. R. Douglas; E. J. Dozois; N. S. Fearnhead; F. A. Frizelle; S. L. Gearhart; Q. H. Gonzalez; J. R. Haaga; G. J. Harris; A. F. Horgan; P. G. Horgan; H. Kehlet; S. H. Kim; A. M. Lacy; J. Leroy; F. López-Kostner; K. A. Ludwig; J. Marks; A. J. Megibow; J. I. Merlino; J. R. Monson; R. W. Motson; D. A. Nakamoto; G. L. Newstead; P. R. O'Connell; Y. Panis; F. Penninckx; A. Rajput; F. Seow Choen; M. J. Stamos; A. Vignali; S. D. Wexner; K. S. Wong

doi:10.1007/s00268-008-9468-1

Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery

R. Phitayakorn, C. P. Delaney, H. L. Reynolds, B. J. Champagne, A. G. Heriot, P. Neary, A. J. Senagore, P. Ambrosetti, C. Bailey, R. P. Billingham, M. Braga, W. D. Buie, A. W. Darzi, P. R. Douglas, E. J. Dozois, N. S. Fearnhead, F. A. Frizelle, S. L. Gearhart, Q. H. Gonzalez, J. R. HaagaG. J. Harris, A. F. Horgan, P. G. Horgan, H. Kehlet, S. H. Kim, A. M. Lacy, J. Leroy, F. López-Kostner, K. A. Ludwig, J. Marks, A. J. Megibow, J. I. Merlino, J. R. Monson, R. W. Motson, D. A. Nakamoto, G. L. Newstead, P. R. O'Connell, Y. Panis, F. Penninckx, A. Rajput, F. Seow Choen, M. J. Stamos, A. Vignali, S. D. Wexner, K. S. Wong

School of Medicine

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Abstract

Background: The risk factors and incidence of anastomotic leak following colorectal surgery are well reported in the literature. However, the management of the multiple clinical scenarios that may be encountered has not been standardized. Methods: The medical literature from 1973 to 2007 was reviewed using PubMed for papers relating to anastomotic leaks and abdominal abscess, with a specific emphasis on predisposing factors, prevention strategies, and treatment approaches. A six-round modified Delphi research method was utilized to find consensus among a group of expert colorectal surgeons and interventional radiologists regarding standardized management algorithms for anastomotic leaks. Results: Management scenarios were divided into those for intraperitoneal anastomoses, extraperitoneal (low pelvic) anastomoses, and anastomoses with proximal diverting stomas. Management options were then based on the clinical presentation and radiographic findings and organized into three interconnected algorithms. Conclusions: This process was a useful first step toward establishing guidelines for the management of anastomotic leak.

Original language	English (US)
Pages (from-to)	1147-1156
Number of pages	10
Journal	World journal of surgery
Volume	32
Issue number	6
DOIs	https://doi.org/10.1007/s00268-008-9468-1
State	Published - Jun 2008

ASJC Scopus subject areas

Surgery

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Phitayakorn, R., Delaney, C. P., Reynolds, H. L., Champagne, B. J., Heriot, A. G., Neary, P., Senagore, A. J., Ambrosetti, P., Bailey, C., Billingham, R. P., Braga, M., Buie, W. D., Darzi, A. W., Douglas, P. R., Dozois, E. J., Fearnhead, N. S., Frizelle, F. A., Gearhart, S. L., Gonzalez, Q. H., ... Wong, K. S. (2008). Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery. World journal of surgery, 32(6), 1147-1156. https://doi.org/10.1007/s00268-008-9468-1

Phitayakorn, R, Delaney, CP, Reynolds, HL, Champagne, BJ, Heriot, AG, Neary, P, Senagore, AJ, Ambrosetti, P, Bailey, C, Billingham, RP, Braga, M, Buie, WD, Darzi, AW, Douglas, PR, Dozois, EJ, Fearnhead, NS, Frizelle, FA, Gearhart, SL, Gonzalez, QH, Haaga, JR, Harris, GJ, Horgan, AF, Horgan, PG, Kehlet, H, Kim, SH, Lacy, AM, Leroy, J, López-Kostner, F, Ludwig, KA, Marks, J, Megibow, AJ, Merlino, JI, Monson, JR, Motson, RW, Nakamoto, DA, Newstead, GL, O'Connell, PR, Panis, Y, Penninckx, F, Rajput, A, Seow Choen, F, Stamos, MJ, Vignali, A, Wexner, SD & Wong, KS 2008, 'Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery', World journal of surgery, vol. 32, no. 6, pp. 1147-1156. https://doi.org/10.1007/s00268-008-9468-1

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title = "Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery",

abstract = "Background: The risk factors and incidence of anastomotic leak following colorectal surgery are well reported in the literature. However, the management of the multiple clinical scenarios that may be encountered has not been standardized. Methods: The medical literature from 1973 to 2007 was reviewed using PubMed for papers relating to anastomotic leaks and abdominal abscess, with a specific emphasis on predisposing factors, prevention strategies, and treatment approaches. A six-round modified Delphi research method was utilized to find consensus among a group of expert colorectal surgeons and interventional radiologists regarding standardized management algorithms for anastomotic leaks. Results: Management scenarios were divided into those for intraperitoneal anastomoses, extraperitoneal (low pelvic) anastomoses, and anastomoses with proximal diverting stomas. Management options were then based on the clinical presentation and radiographic findings and organized into three interconnected algorithms. Conclusions: This process was a useful first step toward establishing guidelines for the management of anastomotic leak.",

author = "R. Phitayakorn and Delaney, {C. P.} and Reynolds, {H. L.} and Champagne, {B. J.} and Heriot, {A. G.} and P. Neary and Senagore, {A. J.} and P. Ambrosetti and C. Bailey and Billingham, {R. P.} and M. Braga and Buie, {W. D.} and Darzi, {A. W.} and Douglas, {P. R.} and Dozois, {E. J.} and Fearnhead, {N. S.} and Frizelle, {F. A.} and Gearhart, {S. L.} and Gonzalez, {Q. H.} and Haaga, {J. R.} and Harris, {G. J.} and Horgan, {A. F.} and Horgan, {P. G.} and H. Kehlet and Kim, {S. H.} and Lacy, {A. M.} and J. Leroy and F. L{\'o}pez-Kostner and Ludwig, {K. A.} and J. Marks and Megibow, {A. J.} and Merlino, {J. I.} and Monson, {J. R.} and Motson, {R. W.} and Nakamoto, {D. A.} and Newstead, {G. L.} and O'Connell, {P. R.} and Y. Panis and F. Penninckx and A. Rajput and {Seow Choen}, F. and Stamos, {M. J.} and A. Vignali and Wexner, {S. D.} and Wong, {K. S.}",

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language = "English (US)",

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T1 - Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery

AU - Phitayakorn, R.

AU - Delaney, C. P.

AU - Reynolds, H. L.

AU - Champagne, B. J.

AU - Heriot, A. G.

AU - Neary, P.

AU - Senagore, A. J.

AU - Ambrosetti, P.

AU - Bailey, C.

AU - Billingham, R. P.

AU - Braga, M.

AU - Buie, W. D.

AU - Darzi, A. W.

AU - Douglas, P. R.

AU - Dozois, E. J.

AU - Fearnhead, N. S.

AU - Frizelle, F. A.

AU - Gearhart, S. L.

AU - Gonzalez, Q. H.

AU - Haaga, J. R.

AU - Harris, G. J.

AU - Horgan, A. F.

AU - Horgan, P. G.

AU - Kehlet, H.

AU - Kim, S. H.

AU - Lacy, A. M.

AU - Leroy, J.

AU - López-Kostner, F.

AU - Ludwig, K. A.

AU - Marks, J.

AU - Megibow, A. J.

AU - Merlino, J. I.

AU - Monson, J. R.

AU - Motson, R. W.

AU - Nakamoto, D. A.

AU - Newstead, G. L.

AU - O'Connell, P. R.

AU - Panis, Y.

AU - Penninckx, F.

AU - Rajput, A.

AU - Seow Choen, F.

AU - Stamos, M. J.

AU - Vignali, A.

AU - Wexner, S. D.

AU - Wong, K. S.

PY - 2008/6

Y1 - 2008/6

N2 - Background: The risk factors and incidence of anastomotic leak following colorectal surgery are well reported in the literature. However, the management of the multiple clinical scenarios that may be encountered has not been standardized. Methods: The medical literature from 1973 to 2007 was reviewed using PubMed for papers relating to anastomotic leaks and abdominal abscess, with a specific emphasis on predisposing factors, prevention strategies, and treatment approaches. A six-round modified Delphi research method was utilized to find consensus among a group of expert colorectal surgeons and interventional radiologists regarding standardized management algorithms for anastomotic leaks. Results: Management scenarios were divided into those for intraperitoneal anastomoses, extraperitoneal (low pelvic) anastomoses, and anastomoses with proximal diverting stomas. Management options were then based on the clinical presentation and radiographic findings and organized into three interconnected algorithms. Conclusions: This process was a useful first step toward establishing guidelines for the management of anastomotic leak.

AB - Background: The risk factors and incidence of anastomotic leak following colorectal surgery are well reported in the literature. However, the management of the multiple clinical scenarios that may be encountered has not been standardized. Methods: The medical literature from 1973 to 2007 was reviewed using PubMed for papers relating to anastomotic leaks and abdominal abscess, with a specific emphasis on predisposing factors, prevention strategies, and treatment approaches. A six-round modified Delphi research method was utilized to find consensus among a group of expert colorectal surgeons and interventional radiologists regarding standardized management algorithms for anastomotic leaks. Results: Management scenarios were divided into those for intraperitoneal anastomoses, extraperitoneal (low pelvic) anastomoses, and anastomoses with proximal diverting stomas. Management options were then based on the clinical presentation and radiographic findings and organized into three interconnected algorithms. Conclusions: This process was a useful first step toward establishing guidelines for the management of anastomotic leak.

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SP - 1147

EP - 1156

JO - World journal of surgery

JF - World journal of surgery

IS - 6

ER -

Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery

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