Preoperative assessment of blood supply and its role in predicting anastomotic leak
Document Type
Article
Publication Date
7-1-2023
Abstract
Background: Anastomosis leak is one of the significant postoperative complications after colorectal sur-gery. The aim of this systematic review was to synthesize the evidence relative to the preoperative assessment of the colon and rectum blood supply and to investigate its role in predicting anastomosis leak. Method: This systematic review was conducted according to the recommendations of the Cochrane Handbook for Reviews of Interventions and reported according to Preferred Reporting Items for Sys-tematic Reviews and Meta-Analyses. PubMed, Embase, and the Cochrane Library were searched to identify eligible studies. The main outcome variable was the preoperative assessment of patterns of blood supply to the colon and the impact of these patterns on anastomosis leak. The quality of bias control in the studies was assessed using the Newcastle-Ottawa Scale. Due to the heterogeneous nature of the included studies, no meta-analysis was conducted. Results: Fourteen studies were included. The study covered a period from 1978 to 2021. A significant degree of variation in the arterial and/or venous supply of the colon and rectum might influence anastomosis leak rates. Calcification in great blood vessels can be assessed with a preoperative computed tomography scan, which may predict anastomosis leak rates. This is supported by many experimental studies that showed increased rates of anastomosis leak after preoperative ischemia, but the extent of this impact is not well established. Conclusion: Preoperative assessment of blood supply to the colon and rectum might help in planning the surgical intervention to reduce anastomosis leak rates. Calcium scoring of major arteries might predict anastomosis leak and thus play a crucial role in intraoperative decision-making. & COPY; 2023 Elsevier Inc. All rights reserved.
Divisions
fac_med
Publication Title
Surgery
Volume
174
Issue
1
Publisher
Mosby-Elsevier
Publisher Location
360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA