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Erschienen in: Journal of Gastrointestinal Surgery 7/2010

01.07.2010 | Review Article

Influence of Anastomotic Leakage on Oncological Outcome in Patients with Rectal Cancer

verfasst von: In Ja Park

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 7/2010

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Abstract

Introduction

Anastomotic leakages are one of the most serious complications of postoperative recovery among patients that undergo rectal cancer resection. Some investigators have suggested that anastomotic leakages have an impact on the oncological outcome; however, this is currently controversial.

Procedure

Considering the increase of sphincter-preserving procedures for rectal cancer, anastomotic leakage, and its impact on oncological outcomes has become an important issue.

Outcome

The rates of anastomotic leakage are reported to range between 0.6% and 17.4%, depending on the definitions used. Here, we review the available information on anastomotic leakage and its association with oncological outcome.
Literatur
1.
Zurück zum Zitat Khuri SF, Henderson WG, DePalma RG, Mosca C, Healey NA, Kumbhani DJ. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 2005;242:326–341.PubMed Khuri SF, Henderson WG, DePalma RG, Mosca C, Healey NA, Kumbhani DJ. Determinants of long-term survival after major surgery and the adverse effect of postoperative complications. Ann Surg 2005;242:326–341.PubMed
2.
Zurück zum Zitat Chapuis PH, Dent OF, Fisher R, Newland RC, Phelis MT, Smyth E, et al. A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer. Br J Surg. 1985;72:698–702.CrossRefPubMed Chapuis PH, Dent OF, Fisher R, Newland RC, Phelis MT, Smyth E, et al. A multivariate analysis of clinical and pathological variables in prognosis after resection of large bowel cancer. Br J Surg. 1985;72:698–702.CrossRefPubMed
3.
Zurück zum Zitat Newland RC, Dent OF, Chapuis PH, Bokey EL. Clinicopathologically diagnosed residual tumour after resection for colorectal cancer. A 20-year prospective study. Cancer. 1993;72:1536–1542.CrossRefPubMed Newland RC, Dent OF, Chapuis PH, Bokey EL. Clinicopathologically diagnosed residual tumour after resection for colorectal cancer. A 20-year prospective study. Cancer. 1993;72:1536–1542.CrossRefPubMed
4.
Zurück zum Zitat Newland RC, Dent OF, Lyttle MN, Chapuis PH, Bokey EL. Pathologic determinants of survival associated with colorectal cancer with lymph node metastases. Cancer 1994;73:2076–2082.CrossRefPubMed Newland RC, Dent OF, Lyttle MN, Chapuis PH, Bokey EL. Pathologic determinants of survival associated with colorectal cancer with lymph node metastases. Cancer 1994;73:2076–2082.CrossRefPubMed
5.
Zurück zum Zitat Fielding LP, Arsenault PA, Chapuis PH, Dent O, Gathright B, Hardcastle JD, et al. Clinicopathological staging for colorectal cancer: an international documentation system (IDS) and an international comprehensive anatomical terminology (ICAT). J Gastroenterol Hepatol 1991;6:325–344.CrossRefPubMed Fielding LP, Arsenault PA, Chapuis PH, Dent O, Gathright B, Hardcastle JD, et al. Clinicopathological staging for colorectal cancer: an international documentation system (IDS) and an international comprehensive anatomical terminology (ICAT). J Gastroenterol Hepatol 1991;6:325–344.CrossRefPubMed
6.
Zurück zum Zitat Akyol AM, McGregor JR, Galloway DJ, Murray GD, George WD. Anastomotic leaks in colorectal cancer surgery: a risk factor for recurrence? Int J Colorect Dis 1991;6:179–183.CrossRef Akyol AM, McGregor JR, Galloway DJ, Murray GD, George WD. Anastomotic leaks in colorectal cancer surgery: a risk factor for recurrence? Int J Colorect Dis 1991;6:179–183.CrossRef
7.
Zurück zum Zitat Docherty JG, McGregor JR, Akyol AM, Murray GD, Galloway DJ. Comparison of manually constructed and stapled anastomoses in colorectal surgery. West of Scotland and Highland Anastomosis Study Group. Ann Surg 1995;221:176–184.CrossRefPubMed Docherty JG, McGregor JR, Akyol AM, Murray GD, Galloway DJ. Comparison of manually constructed and stapled anastomoses in colorectal surgery. West of Scotland and Highland Anastomosis Study Group. Ann Surg 1995;221:176–184.CrossRefPubMed
8.
Zurück zum Zitat Fujita S, Teramoto T, Watanabe M, Kodaira S, Kitajima M. Anastomotic leakage after colorectal cancer surgery: a risk factor for recurrence and poor prognosis. Jpn J Clin Oncol 1993;23:299–302.PubMed Fujita S, Teramoto T, Watanabe M, Kodaira S, Kitajima M. Anastomotic leakage after colorectal cancer surgery: a risk factor for recurrence and poor prognosis. Jpn J Clin Oncol 1993;23:299–302.PubMed
9.
Zurück zum Zitat Peterson S, Freitag M, Hellmich G, Ludwig K. Anastomotic leakage: impact on local recurrence and survival in surgery of colorectal cancer. Int J Colorectal Dis 1998;13:160–163.CrossRef Peterson S, Freitag M, Hellmich G, Ludwig K. Anastomotic leakage: impact on local recurrence and survival in surgery of colorectal cancer. Int J Colorectal Dis 1998;13:160–163.CrossRef
10.
Zurück zum Zitat Lee WS, Yun SH, Roh YN, Yun HR, Lee WY, Cho YB, et al. Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer. World J Surg 2008;32:1124–1129.CrossRefPubMed Lee WS, Yun SH, Roh YN, Yun HR, Lee WY, Cho YB, et al. Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer. World J Surg 2008;32:1124–1129.CrossRefPubMed
11.
Zurück zum Zitat Bruce J, Krukowski ZH, Al-Khairy G, Russell EM, Park KG. Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg 2001;88:1157–1168.CrossRefPubMed Bruce J, Krukowski ZH, Al-Khairy G, Russell EM, Park KG. Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg 2001;88:1157–1168.CrossRefPubMed
12.
Zurück zum Zitat Lim M, Akhtar S, Sasapu K, Harris K, Burke D, Sagar P, et al. Clinical and subclinical leaks after low colorectal anastomosis; a clinical and radiologic study. Dis Colon Rectum 2006;49:1611–1619.CrossRefPubMed Lim M, Akhtar S, Sasapu K, Harris K, Burke D, Sagar P, et al. Clinical and subclinical leaks after low colorectal anastomosis; a clinical and radiologic study. Dis Colon Rectum 2006;49:1611–1619.CrossRefPubMed
13.
Zurück zum Zitat Karanjia ND, Corder AP, Bearn P, Heald RJ. Leakage from stapled anastomosis after total mesorectal excision for carcinoma of the rectum. Br J Surg 1994; 81: 1224–1226.CrossRefPubMed Karanjia ND, Corder AP, Bearn P, Heald RJ. Leakage from stapled anastomosis after total mesorectal excision for carcinoma of the rectum. Br J Surg 1994; 81: 1224–1226.CrossRefPubMed
14.
Zurück zum Zitat Law WL, Chu KW. Anterior resection for rectal cancer with mesorectal excision: a prospective evaluation of 622 patients. Ann Surg 2004;240:260–268.CrossRefPubMed Law WL, Chu KW. Anterior resection for rectal cancer with mesorectal excision: a prospective evaluation of 622 patients. Ann Surg 2004;240:260–268.CrossRefPubMed
15.
Zurück zum Zitat Kim NK, Kim YW, Min BS, Lee KY, Shon SK, Cho CH. Operative safety and oncologic outcomes of anal sphincter-preserving surgery with mesorectal excision for rectal cancer: 931 consecutive patients treated at a single institution. Ann Surg Oncol 2009;16:900–909.CrossRefPubMed Kim NK, Kim YW, Min BS, Lee KY, Shon SK, Cho CH. Operative safety and oncologic outcomes of anal sphincter-preserving surgery with mesorectal excision for rectal cancer: 931 consecutive patients treated at a single institution. Ann Surg Oncol 2009;16:900–909.CrossRefPubMed
16.
Zurück zum Zitat Anthuber M, Fuerst A, Elser F, Berger R, Jauch KW. Outcome of laparoscopic surgery for rectal cancer in 101 patients. Dis Colon Rectum 2003;46:1047–1053.CrossRefPubMed Anthuber M, Fuerst A, Elser F, Berger R, Jauch KW. Outcome of laparoscopic surgery for rectal cancer in 101 patients. Dis Colon Rectum 2003;46:1047–1053.CrossRefPubMed
17.
Zurück zum Zitat Jörgren F, Johansson R, Damber L, Lindmark G. Anastomotic leakage after surgery for rectal cancer: a risk factor of local recurrence, distant metastasis and reduced cancer-specific survival? Colorect Dis 2009. doi:10.1111/j.1463-1318.2009.02136.x Jörgren F, Johansson R, Damber L, Lindmark G. Anastomotic leakage after surgery for rectal cancer: a risk factor of local recurrence, distant metastasis and reduced cancer-specific survival? Colorect Dis 2009. doi:10.​1111/​j.​1463-1318.​2009.​02136.​x
18.
Zurück zum Zitat Eckmann C, Kujath P, Schiedeck TH, Shekarriz H, Bruch HP. Anastomotic leakage following low anterior resection: results of a standardized diagnostic and therapeutic approach. Int J Colorect Dis 2004; 19:128–133.CrossRef Eckmann C, Kujath P, Schiedeck TH, Shekarriz H, Bruch HP. Anastomotic leakage following low anterior resection: results of a standardized diagnostic and therapeutic approach. Int J Colorect Dis 2004; 19:128–133.CrossRef
19.
Zurück zum Zitat Averbach AM, Chang D, Koslowe P, Sugarbaker PH. Anastomotic leak after double-stapled low colorectal resection. Dis Colon Rectum 1996; 39:780–787.CrossRefPubMed Averbach AM, Chang D, Koslowe P, Sugarbaker PH. Anastomotic leak after double-stapled low colorectal resection. Dis Colon Rectum 1996; 39:780–787.CrossRefPubMed
20.
Zurück zum Zitat Ng NH, Ng DC, Cheung HY, Wong JC, Yau KK, Chung CC, et al. Laparoscopic resection for rectal cancers: lessons learned from 579 cases. Ann Surg 2009;249:82–86.CrossRefPubMed Ng NH, Ng DC, Cheung HY, Wong JC, Yau KK, Chung CC, et al. Laparoscopic resection for rectal cancers: lessons learned from 579 cases. Ann Surg 2009;249:82–86.CrossRefPubMed
21.
Zurück zum Zitat Mann B, Kleinschmidt S, Stremmel W. Prospective study of hand-sutured anastomosis after colorectal resection. Br J Surg 1996;83:29–31CrossRefPubMed Mann B, Kleinschmidt S, Stremmel W. Prospective study of hand-sutured anastomosis after colorectal resection. Br J Surg 1996;83:29–31CrossRefPubMed
22.
Zurück zum Zitat Scheidbach H, Schneider C, Konradt J, Bärlehner E, Köhler L, Wittekind Ch, et al. Laparoscopic abdominoperineal resection and anterior resection with curative intent for carcinoma of the rectum. Surg Endosc 2002;16:7–13.CrossRefPubMed Scheidbach H, Schneider C, Konradt J, Bärlehner E, Köhler L, Wittekind Ch, et al. Laparoscopic abdominoperineal resection and anterior resection with curative intent for carcinoma of the rectum. Surg Endosc 2002;16:7–13.CrossRefPubMed
23.
Zurück zum Zitat Eriksen MT, Wibe A, Norstein J, Haffner J, Wiig JN, Norwegian Rectal Cancer Group. Anastomotic leakage following routine mesorectal excision for rectal cancer in a national cohort of patients. Colorectal Dis 2005;7:51–57.CrossRefPubMed Eriksen MT, Wibe A, Norstein J, Haffner J, Wiig JN, Norwegian Rectal Cancer Group. Anastomotic leakage following routine mesorectal excision for rectal cancer in a national cohort of patients. Colorectal Dis 2005;7:51–57.CrossRefPubMed
24.
Zurück zum Zitat Kim JC, Takahashi K, Yu CS, Kim HC, Kim TW, Ryu MH, et al. Comparative outcomes between chemoradiotherapy and lateral pelvic lymph node dissection following total mesorectal excision in rectal cancer. Ann Surg 2007;246:754–762.CrossRefPubMed Kim JC, Takahashi K, Yu CS, Kim HC, Kim TW, Ryu MH, et al. Comparative outcomes between chemoradiotherapy and lateral pelvic lymph node dissection following total mesorectal excision in rectal cancer. Ann Surg 2007;246:754–762.CrossRefPubMed
25.
Zurück zum Zitat Chang SC, Lin JK, Yang SH, Jiang JK, Chen WC, Lin TC. Long-term outcome of anastomosis leakage after curative resection for mid and low rectal cancer. Hepatogastroenterology 2003;50:1898–1902.PubMed Chang SC, Lin JK, Yang SH, Jiang JK, Chen WC, Lin TC. Long-term outcome of anastomosis leakage after curative resection for mid and low rectal cancer. Hepatogastroenterology 2003;50:1898–1902.PubMed
26.
Zurück zum Zitat Law WL, Choi HK, Lee YM, Ho JW, Seto CL. Anastomotic leakage is associated with poor long-term outcome in patients after curative colorectal resection for malignancy. J Gastrointest Surg 2007;11:8–15.CrossRefPubMed Law WL, Choi HK, Lee YM, Ho JW, Seto CL. Anastomotic leakage is associated with poor long-term outcome in patients after curative colorectal resection for malignancy. J Gastrointest Surg 2007;11:8–15.CrossRefPubMed
27.
Zurück zum Zitat Bell SW, Walker KG, Rickard MJ, Sinclair G, Dent OF, Chapuis PH, et al. Anastomotic leakage after curative anterior resection results in a higher prevalence of local recurrence. Br J Surg 2003;90:1261–1266.CrossRefPubMed Bell SW, Walker KG, Rickard MJ, Sinclair G, Dent OF, Chapuis PH, et al. Anastomotic leakage after curative anterior resection results in a higher prevalence of local recurrence. Br J Surg 2003;90:1261–1266.CrossRefPubMed
28.
Zurück zum Zitat Jung SH, Yu CS, Choi PW, Kim DD, Park IJ, Kim HC, et al. Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery. Dis Colon Rectum 2008;51:902–908.CrossRefPubMed Jung SH, Yu CS, Choi PW, Kim DD, Park IJ, Kim HC, et al. Risk factors and oncologic impact of anastomotic leakage after rectal cancer surgery. Dis Colon Rectum 2008;51:902–908.CrossRefPubMed
29.
Zurück zum Zitat Ptok H, Marusch F, Meyer F, Schubert D, Gastinger I, Lippert H. Impact of anastomotic leakage on oncological outcome after rectal cancer resection. Br J Surg 2007;94:1548–1554.CrossRefPubMed Ptok H, Marusch F, Meyer F, Schubert D, Gastinger I, Lippert H. Impact of anastomotic leakage on oncological outcome after rectal cancer resection. Br J Surg 2007;94:1548–1554.CrossRefPubMed
30.
Zurück zum Zitat McArdle CS, McMillan DC, Hole DJ. Impact of anastomotic leakage on long-term survival of patients undergoing curative resection for colorectal cancer. Br J Surg 2005;92:1150–1154.CrossRefPubMed McArdle CS, McMillan DC, Hole DJ. Impact of anastomotic leakage on long-term survival of patients undergoing curative resection for colorectal cancer. Br J Surg 2005;92:1150–1154.CrossRefPubMed
31.
Zurück zum Zitat Walker KG, Bell SW, Rickard MJ, Mehanna D, Dent OF, Chapuis PH et al. Anastomotic leakage is predictive of diminished survival after potentially curative resection for colorectal cancer. Ann Surg 2004;240: 255–259.CrossRefPubMed Walker KG, Bell SW, Rickard MJ, Mehanna D, Dent OF, Chapuis PH et al. Anastomotic leakage is predictive of diminished survival after potentially curative resection for colorectal cancer. Ann Surg 2004;240: 255–259.CrossRefPubMed
32.
Zurück zum Zitat Law WL, Chu KW, Tung HM. Early outcomes of 100 patients with laparoscopic resection for rectal neoplasm. Surg Endosc 2004;18:1592–1596.PubMed Law WL, Chu KW, Tung HM. Early outcomes of 100 patients with laparoscopic resection for rectal neoplasm. Surg Endosc 2004;18:1592–1596.PubMed
33.
Zurück zum Zitat Bertelsen CA, Andreasen AH, Jørgensen T, Harling H; on behalf of the Danish Colorectal Cancer Group. Anastomotic leakage after curative anterior resection for rectal cancer. Colorect Dis 2009 (in press) Bertelsen CA, Andreasen AH, Jørgensen T, Harling H; on behalf of the Danish Colorectal Cancer Group. Anastomotic leakage after curative anterior resection for rectal cancer. Colorect Dis 2009 (in press)
34.
Zurück zum Zitat Branagan G, Finnis D, Wessex Colorectal Cancer Audit Working Group. Prognosis after anastomotic leakage in colorectal surgery. Dis Colon Rectum 2005;48:1021–1026.CrossRefPubMed Branagan G, Finnis D, Wessex Colorectal Cancer Audit Working Group. Prognosis after anastomotic leakage in colorectal surgery. Dis Colon Rectum 2005;48:1021–1026.CrossRefPubMed
35.
Zurück zum Zitat Merkel S, Wang WY, Schmidt O, Dworak O, Wittekind C, Hohenberger W, Hermanek P. Locoregional recurrence in patients with anastomotic leakage after anterior resection for rectal carcinoma. Colorectal Dis 2001;3:154–160.CrossRefPubMed Merkel S, Wang WY, Schmidt O, Dworak O, Wittekind C, Hohenberger W, Hermanek P. Locoregional recurrence in patients with anastomotic leakage after anterior resection for rectal carcinoma. Colorectal Dis 2001;3:154–160.CrossRefPubMed
36.
Zurück zum Zitat Eberhardt JM, Kiran RP, Lavery IC. The impact of anastomotic leak and intra-abdominal abscess on cancer-related outcomes after resection for colorectal cancer: a case control study. Dis Colon Rectum 2009;52:380–386.PubMed Eberhardt JM, Kiran RP, Lavery IC. The impact of anastomotic leak and intra-abdominal abscess on cancer-related outcomes after resection for colorectal cancer: a case control study. Dis Colon Rectum 2009;52:380–386.PubMed
37.
Zurück zum Zitat Law WL, Chu KW. Local recurrence following total mesorectal excision with double-stapling anastomosis for rectal cancers: analysis of risk factors. World J Surg 2002;26:1272–1276.CrossRefPubMed Law WL, Chu KW. Local recurrence following total mesorectal excision with double-stapling anastomosis for rectal cancers: analysis of risk factors. World J Surg 2002;26:1272–1276.CrossRefPubMed
38.
Zurück zum Zitat Kressner U, Graf W, Mahteme H, Pahlman L, Glimelius B. Septic complications and prognosis after surgery for rectal cancer. Dis Colon Rectum 2002;45:316–321.CrossRefPubMed Kressner U, Graf W, Mahteme H, Pahlman L, Glimelius B. Septic complications and prognosis after surgery for rectal cancer. Dis Colon Rectum 2002;45:316–321.CrossRefPubMed
39.
Zurück zum Zitat Fermor B, Umpleby HC, Lever JV, Symes MO, Williamson RC. Proliferative and metastatic potential of exfoliated colorectal cancer cells. J Natl Cancer Inst 1986;76:347–349.PubMed Fermor B, Umpleby HC, Lever JV, Symes MO, Williamson RC. Proliferative and metastatic potential of exfoliated colorectal cancer cells. J Natl Cancer Inst 1986;76:347–349.PubMed
40.
Zurück zum Zitat van den Tol PM, van Rossen EE, van Eijck CH, Bonthuis F, Marquet RL, Jeekel H. Reduction of peritoneal trauma by using nonsurgical gauze leads to less implantation metastasis of spilled tumor cells. Ann Surg 1998;227:242–248.CrossRefPubMed van den Tol PM, van Rossen EE, van Eijck CH, Bonthuis F, Marquet RL, Jeekel H. Reduction of peritoneal trauma by using nonsurgical gauze leads to less implantation metastasis of spilled tumor cells. Ann Surg 1998;227:242–248.CrossRefPubMed
41.
Zurück zum Zitat Umpleby HC, Fermor B, Symes MO, Williamson RC. Viability of exfoliated colorectal carcinoma cells. Br J Surg 1984;71:659–663.CrossRefPubMed Umpleby HC, Fermor B, Symes MO, Williamson RC. Viability of exfoliated colorectal carcinoma cells. Br J Surg 1984;71:659–663.CrossRefPubMed
42.
Zurück zum Zitat Slanetz CA Jr. The effect of inadvertent intraoperative perforation on survival and recurrence in colorectal cancer. Dis Colon Rectum 1984;27:792–797CrossRefPubMed Slanetz CA Jr. The effect of inadvertent intraoperative perforation on survival and recurrence in colorectal cancer. Dis Colon Rectum 1984;27:792–797CrossRefPubMed
43.
Zurück zum Zitat Finlay IG, McArdle CS. Occult hepatic metastases in colorectal carcinoma. Br J Surg 1986;73:732–735.CrossRefPubMed Finlay IG, McArdle CS. Occult hepatic metastases in colorectal carcinoma. Br J Surg 1986;73:732–735.CrossRefPubMed
44.
Zurück zum Zitat Denis MG, Lipart C, Leborgne J, LeHur PA, Galmiche JP, Denis M, et al. Detection of disseminated tumor cells in peripheral blood of colorectal cancer patients. Int J Cancer 1997;74:540–544.CrossRefPubMed Denis MG, Lipart C, Leborgne J, LeHur PA, Galmiche JP, Denis M, et al. Detection of disseminated tumor cells in peripheral blood of colorectal cancer patients. Int J Cancer 1997;74:540–544.CrossRefPubMed
45.
Zurück zum Zitat Molnar B, Ladanyi A, Tanko L, Sreter L, Tulassay Z. Circulating tumor cell clusters in the peripheral blood of colorectal cancer patients. Clin Cancer Res 2001;7:4080–4085.PubMed Molnar B, Ladanyi A, Tanko L, Sreter L, Tulassay Z. Circulating tumor cell clusters in the peripheral blood of colorectal cancer patients. Clin Cancer Res 2001;7:4080–4085.PubMed
46.
Zurück zum Zitat Nielsen HJ, Christensen IJ, Sorensen S, Moesgaard F, Brunner N. Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group. Ann Surg Oncol 2000;7:617–623.PubMed Nielsen HJ, Christensen IJ, Sorensen S, Moesgaard F, Brunner N. Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group. Ann Surg Oncol 2000;7:617–623.PubMed
47.
Zurück zum Zitat McMillan DC, Canna K, McArdle CS. Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 2003;90:215–219.CrossRefPubMed McMillan DC, Canna K, McArdle CS. Systemic inflammatory response predicts survival following curative resection of colorectal cancer. Br J Surg 2003;90:215–219.CrossRefPubMed
48.
Zurück zum Zitat Balkwill F, Mantovani A. Inflammation and cancer: Back to Virchow? Lancet 2001;357:539–545.CrossRefPubMed Balkwill F, Mantovani A. Inflammation and cancer: Back to Virchow? Lancet 2001;357:539–545.CrossRefPubMed
49.
Zurück zum Zitat Abramovitch R, Marikovsky M, Meir G, Neeman M. Stimulation of tumour growth by wound-derived growth factors. Br J Cancer 1999;79:1392–1398.CrossRefPubMed Abramovitch R, Marikovsky M, Meir G, Neeman M. Stimulation of tumour growth by wound-derived growth factors. Br J Cancer 1999;79:1392–1398.CrossRefPubMed
50.
Zurück zum Zitat Mynster T, Christensen IJ, Moesgaard F, Nielsen HJ. Effects of the combination of blood transfusion and postoperative infectious complications on prognosis after surgery for colorectal cancer. Danish RANX05 Colorectal Cancer Study Group. Br J Surg 2000;87:1553–1562.CrossRefPubMed Mynster T, Christensen IJ, Moesgaard F, Nielsen HJ. Effects of the combination of blood transfusion and postoperative infectious complications on prognosis after surgery for colorectal cancer. Danish RANX05 Colorectal Cancer Study Group. Br J Surg 2000;87:1553–1562.CrossRefPubMed
51.
Zurück zum Zitat Marusch F, Koch A, Schmidt U, Wenisch H, Ernst M, Manger T, et al. Early postoperative results of surgery for rectal carcinoma as a function of the distance of the tumor from the anal verge: results of a multicenter prospective evaluation. Langenbecks Arch Surg 2002; 387: 94–100.CrossRefPubMed Marusch F, Koch A, Schmidt U, Wenisch H, Ernst M, Manger T, et al. Early postoperative results of surgery for rectal carcinoma as a function of the distance of the tumor from the anal verge: results of a multicenter prospective evaluation. Langenbecks Arch Surg 2002; 387: 94–100.CrossRefPubMed
52.
53.
Zurück zum Zitat Kanellos I, Zacharakis E, Christoforidis E, Demetriades H, Betsis D. Low anterior resection without defunctioning stoma. Tech Coloproctol 2002;6:153–157.CrossRefPubMed Kanellos I, Zacharakis E, Christoforidis E, Demetriades H, Betsis D. Low anterior resection without defunctioning stoma. Tech Coloproctol 2002;6:153–157.CrossRefPubMed
54.
Zurück zum Zitat den Dulk M, Marijnen CA, Collette L, Putter H, Påhlman L, Folkesson J, et al. Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery. Br J Surg 2009;96:1066–1075.CrossRef den Dulk M, Marijnen CA, Collette L, Putter H, Påhlman L, Folkesson J, et al. Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery. Br J Surg 2009;96:1066–1075.CrossRef
55.
Zurück zum Zitat Matthiessen P, Hallbö-ök O, Rutegård J, Simert G, Sjöndahl R. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial. Ann Surg 2007;246:207–214.CrossRefPubMed Matthiessen P, Hallbö-ök O, Rutegård J, Simert G, Sjöndahl R. Defunctioning stoma reduces symptomatic anastomotic leakage after low anterior resection of the rectum for cancer: a randomized multicenter trial. Ann Surg 2007;246:207–214.CrossRefPubMed
56.
Zurück zum Zitat Marusch F, Koch A, Schmidt U, Geibetaler S, Dralle H, Saeger HD, et al. Value of a protective stoma in low anterior resections for rectal cancer. Dis Colon Rectum 2002; 45: 1164–71.CrossRefPubMed Marusch F, Koch A, Schmidt U, Geibetaler S, Dralle H, Saeger HD, et al. Value of a protective stoma in low anterior resections for rectal cancer. Dis Colon Rectum 2002; 45: 1164–71.CrossRefPubMed
57.
Zurück zum Zitat Graffner H, Fredlund P, Olsson SA, Oscarson J, Petersson BG. Protective colostomy in low anterior resection of the rectum using the EEA stapling instrument. A randomized study. Dis Colon Rectum 1983;26:87–90.CrossRefPubMed Graffner H, Fredlund P, Olsson SA, Oscarson J, Petersson BG. Protective colostomy in low anterior resection of the rectum using the EEA stapling instrument. A randomized study. Dis Colon Rectum 1983;26:87–90.CrossRefPubMed
58.
Zurück zum Zitat Gastinger I, Marusch F, Steinert R, Wolff S, Koeckerling F, Lippert H, Working Group Colon/Rectum Carcinoma. Protective defunctioning stoma in low anterior resection for rectal carcinoma. Br J Surg. 2005;92:1137–1142.CrossRefPubMed Gastinger I, Marusch F, Steinert R, Wolff S, Koeckerling F, Lippert H, Working Group Colon/Rectum Carcinoma. Protective defunctioning stoma in low anterior resection for rectal carcinoma. Br J Surg. 2005;92:1137–1142.CrossRefPubMed
59.
Zurück zum Zitat Peeters KC, Tollenaar RA, Marijnen CA, Klein Krnenbarg E, Steup WH, Wiggers T, et al. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer. Br J Surg. 2005;92:211–216.CrossRefPubMed Peeters KC, Tollenaar RA, Marijnen CA, Klein Krnenbarg E, Steup WH, Wiggers T, et al. Risk factors for anastomotic failure after total mesorectal excision of rectal cancer. Br J Surg. 2005;92:211–216.CrossRefPubMed
60.
Zurück zum Zitat Wong NY, Eu KW. A defunctioning ileostomy does not prevent clinical anastomotic leak after a low anterior resection: a prospective, comparative study. Dis Colon Rectum. 2005;48:2076 –2079.CrossRefPubMed Wong NY, Eu KW. A defunctioning ileostomy does not prevent clinical anastomotic leak after a low anterior resection: a prospective, comparative study. Dis Colon Rectum. 2005;48:2076 –2079.CrossRefPubMed
Metadaten
Titel
Influence of Anastomotic Leakage on Oncological Outcome in Patients with Rectal Cancer
verfasst von
In Ja Park
Publikationsdatum
01.07.2010
Verlag
Springer-Verlag
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 7/2010
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-009-1153-7

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Gesundheitsminister Lauterbach hat die vom Bundeskabinett beschlossene Klinikreform verteidigt. Kritik an den Plänen kommt vom Marburger Bund. Und in den Ländern wird über den Gang zum Vermittlungsausschuss spekuliert.

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S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.