Hernandez Paul T, Paspulati Raj M, Shanmugan Skandan
Division of Colorectal Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania.
Department of Radiology, University Hospitals, Case Western Reserve University, Cleveland, Ohio.
Clin Colon Rectal Surg. 2021 Nov 23;34(6):391-399. doi: 10.1055/s-0041-1735270. eCollection 2021 Nov.
Anastomotic leaks after colorectal surgery is associated with increased morbidity and mortality. Understanding the impact of anastomotic leaks and their risk factors can help the surgeon avoid any modifiable pitfalls. The diagnosis of an anastomotic leak can be elusive but can be discerned by the patient's global clinical assessment, adjunctive laboratory data and radiological assessment. The use of inflammatory markers such as C-Reactive Protein and Procalcitonin have recently gained traction as harbingers for a leak. A CT scan and/or a water soluble contrast study can further elucidate the location and severity of a leak. Further intervention is then individualized on the spectrum of simple observation with resolution or surgical intervention.
结直肠手术后的吻合口漏与发病率和死亡率的增加相关。了解吻合口漏的影响及其危险因素有助于外科医生避免任何可改变的陷阱。吻合口漏的诊断可能难以捉摸，但可以通过患者的整体临床评估、辅助实验室数据和影像学评估来识别。使用炎症标志物如C反应蛋白和降钙素原作为漏出的预兆最近受到了关注。CT扫描和/或水溶性造影剂研究可以进一步阐明漏出的位置和严重程度。然后根据单纯观察至病情缓解或手术干预的范围进行个体化的进一步干预。
