Risk factors for failure of percutaneous drainage and need for reoperation following symptomatic gastrointestinal anastomotic leak.

Abstract:

BACKGROUND:Few studies have evaluated the role of computed tomography-guided percutaneous drainage (PD) in the management of gastrointestinal (GI) anastomotic leaks. METHODS:Ten-year review of an interventional radiology database identified patients with symptomatic GI anastomotic leaks. Clinical, laboratory, radiographic, and operative characteristics following a technically successful PD which then failed and required reoperation for anastomotic leak were compared with those successfully treated with PD. RESULTS:Sixty-one patients met study inclusion criteria. Fifty patients (82%) successfully underwent therapeutic PD of a perianastomotic fluid collection, with median follow-up of 16 months. Eleven patients (18%), at a median interval of 16 days, required reoperation following PD. A forward logistic regression showed cardiopulmonary disease (P = .03) and cancer surgery (P = .01) to be factors independently associated with the need for reoperation. The level of the anastomosis, initial fecal diversion/stoma, fluid collection size, and microbiology of aspirate did not predict failure of PD. CONCLUSIONS:Cardiopulmonary disease and cancer surgery appear to be independent predictors for failure of PD and need for reoperation following a symptomatic GI anastomotic leak.

journal_name

Am J Surg

authors

Felder SI,Barmparas G,Murrell Z,Fleshner P

doi

10.1016/j.amjsurg.2013.08.050

subject

Has Abstract

pub_date

2014-07-01 00:00:00

pages

58-64

issue

1

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(14)00011-7

journal_volume

208

pub_type

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