Anastomotic Leak

Breakdown of the connection and subsequent leakage of digestive system fluid from a SURGICAL ANASTOMOSIS of digestive system structures. Most common leakages are from breakdown of the sutured lines in gastrointestinal or bowel anastomosis.

Also Known As:

Networked: 1622 relevant articles (69 outcomes, 142 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Rectal Neoplasms (Rectal Cancer)
2.	Anastomotic Leak
3.	Fistula
4.	Pathologic Constriction (Stenosis)
5.	Hemorrhage

Experts

1.	Lange, Johan F: 12 articles (01/2016 - 07/2008)
2.	Nieuwenhuijzen, Grard A P: 6 articles (08/2015 - 04/2013)
3.	Luyer, Misha D P: 6 articles (08/2015 - 04/2013)
4.	Jeekel, Johannes: 6 articles (05/2015 - 05/2012)
5.	Kleinrensink, Gert-Jan: 6 articles (05/2015 - 07/2009)
6.	Shukla, Parul J: 6 articles (07/2011 - 12/2005)
7.	Matthiessen, P: 5 articles (11/2015 - 01/2008)
8.	Büchler, Markus W: 5 articles (02/2015 - 05/2002)
9.	Cirocchi, Roberto: 5 articles (01/2015 - 01/2011)
10.	Dubecz, Attila: 5 articles (08/2014 - 02/2011)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Anastomotic Leak:

1.	Fibrin Tissue Adhesive (Fibrin Sealant)IBA 01/01/2012 - "Adhesive film is more effective in reducing anastomotic leakage than fibrin glue." 02/01/1987 - "We conclude that fibrin glue is effective in lessening the incidence of esophagogastric anastomotic leaks as employed in this experimental model." 12/01/2004 - "The aims of this study were to (1) develop an iatrogenic leak model in swine, (2) examine the efficacy of fibrin sealant in sealing iatrogenic anastomotic leak, and (3) review our experience with the use of fibrin sealant in 66 patients who underwent laparoscopic GBP. " 01/01/2012 - "In this study, the ability of fibrin glue and adhesive film to repair anastomotic leaks in an experimental model was compared. " 06/01/2014 - "Multivariate analysis confirmed that anastomotic leakage was an independent prognostic factor of both local recurrence and disease-free survival, but the use of fibrin glue was not associated with the long-term outcomes when controlling for confounders. "
2.	Methylene Blue (Methylthioninium Chloride)FDA Link 10/01/2015 - "The aim of our study is to evaluate and compare whether methylene blue or upper gastrointestinal (UGI) study is more effective in detecting an anastomotic leak after RYGB. " 04/01/2012 - "Determining between chyle leak and anastomotic leak after esophageal reconstruction: the utility of methylene blue dye." 04/01/2001 - "Two of the six pigs had an intraoperative duodenoenterostomy anastomotic leak detected on methylene blue testing. " 01/01/2007 - "We sought to determine the efficacy of the methylene blue enema (MBE) as an intraoperative test for anastomotic leaks. " 07/01/2005 - "In the presence of anastomotic leaks or fistulas, methylene blue can be recovered in adjacent drains. "
3.	VancomycinFDA LinkGeneric 02/01/1997 - "Decontamination with polymyxin, tobramycin, vancomycin, and amphotericin B during anastomotic wound healing is safe and effective in the prevention of esophagojejunal anastomotic leakage after total gastrectomy." 04/01/1997 - "The results of a prospective double-blind placebo-controlled multicenter trial indicate that perioperative i.v. prophylaxis with cefotaxim and topical decontamination with polymyxin B, tobramycin, vancomycin and amphotericin B from the day before surgery until the 7th postoperative day is most effective in the prevention of esophagojejunal anastomotic leakage following total gastrectomy. "
4.	Tobramycin (Nebcin)FDA LinkGeneric 02/01/1997 - "Decontamination with polymyxin, tobramycin, vancomycin, and amphotericin B during anastomotic wound healing is safe and effective in the prevention of esophagojejunal anastomotic leakage after total gastrectomy." 04/01/1997 - "The results of a prospective double-blind placebo-controlled multicenter trial indicate that perioperative i.v. prophylaxis with cefotaxim and topical decontamination with polymyxin B, tobramycin, vancomycin and amphotericin B from the day before surgery until the 7th postoperative day is most effective in the prevention of esophagojejunal anastomotic leakage following total gastrectomy. "
5.	Amphotericin B (Amphotericin)FDA LinkGeneric 02/01/1997 - "Decontamination with polymyxin, tobramycin, vancomycin, and amphotericin B during anastomotic wound healing is safe and effective in the prevention of esophagojejunal anastomotic leakage after total gastrectomy." 04/01/1997 - "The results of a prospective double-blind placebo-controlled multicenter trial indicate that perioperative i.v. prophylaxis with cefotaxim and topical decontamination with polymyxin B, tobramycin, vancomycin and amphotericin B from the day before surgery until the 7th postoperative day is most effective in the prevention of esophagojejunal anastomotic leakage following total gastrectomy. "
6.	C-Reactive ProteinIBA 10/01/2013 - "The predictive value of C-reactive protein (CRP) as a marker of infective postoperative complications, particularly in the form of anastomotic leakage, has been investigated by several authors with promising results. " 10/01/2015 - "A recent study demonstrated significant correlations between anastomotic leak (AL) and numerical values of C-reactive protein (CRP), white cell count (WCC) and albumin measured on postoperative day (POD) 4. A predictive model comprising all three (NUn score >10) was found to be highly sensitive and discriminant in predicting AL and complications. " 03/01/2014 - "Several recent studies have investigated the role of C-reactive protein (CRP) as an early marker of anastomotic leakage following colorectal surgery. " 10/01/2013 - "The aim of this study was to evaluate the diagnostic accuracy of C-reactive protein in predicting anastomotic leakage. " 12/01/2012 - "The aim of the present study was to determine whether the levels of C-reactive protein (CRP) and white blood cell counts (WBC) have a role as early predictors of post-operative septic complications including anastomotic leakage in patients operated laparoscopically in a fast-track regimen. "
7.	FibrinIBA 12/01/2012 - "A multicentre, prospective, randomised, controlled, and simple blind clinical trial was started in January 2007, with the aim of demonstrating the efficacy of fibrin-based biological adhesives in the prevention of anastomotic leaks in the high risk digestive tract. " 12/01/2012 - "Our study demonstrates, significantly, that in the 104 patients in the study that fibrin based biological adhesives are capable of preventing anastomotic leaks in the high risk digestive tract, reducing the risk of leaks by 61% and a further surgeries. " 12/01/2012 - "[Use of fibrin based biological adhesives in the prevention of anastomotic leaks in the high risk digestive tract: preliminary results of the multicentre, prospective, randomised, controlled, and simple blind phase IV clinical trial: Protissucol001]." 04/01/2010 - "It disclosed a normal anastomosis in 11, fibrin deposits in 4, and a leak in 1. In comparison with CS only, CT at day 7 improves the sensitivity and negative predictive value for diagnosing an anastomotic leak. " 01/01/2004 - "There were no anastomotic leaks at the fibrin-sealed GJS sites. "
8.	PlasticsIBA 02/01/2005 - "The placement of self-expanding plastic stents is a highly effective treatment for esophageal anastomotic leaks. " 05/01/2014 - "A pooled analysis was performed and subgroup analysis was performed for plastic versus metallic stents and anastomotic leaks versus perforations separately. " 05/01/2011 - "Management of esophageal anastomotic leaks, perforations, and fistulae with self-expanding plastic stents." 02/01/2011 - "Anastomotic leaks after oesophagojejunostomy usually are treated by endoluminal stenting with self-expandable metal or plastic stents. " 01/01/2011 - "This review will consider the literature concerning the use of self-expanding plastic stents in the treatment of oesophageal anastomotic leakage and spontaneous perforations of the oesophagus."
9.	Polyethylene Glycols (Polyethylene Glycol)FDA LinkGeneric 09/01/2004 - "Subgroup analysis showed that anastomotic leakage was significantly greater after bowel preparation with polyethylene glycol (PEG) compared with no preparation, but not after other types of preparation. " 05/01/1999 - "There was no statistically significant difference found in the number of patients with postoperative infective complications (14.7% vs 17.7%) or anastomotic leakage (5.3% vs 5.7%) with senna and polyethylene glycol, respectively. " 04/01/2006 - "The aim of this clinical trial was to evaluate whether a single phosphate enema was as effective as oral polyethylene glycol (PEG) solution in preventing anastomotic leakage. " 08/01/2005 - "In the polyethylene glycol group there were a total of nine wound infections (7.2 percent) and seven anastomotic leaks (5.6 percent) compared with seven wound infections (5.6 percent) (P = 0.61) and six anastomotic leaks (4.8 percent) (P = 0.78) in the normal meal preoperatively group. " 05/01/2000 - "Anastomotic leaks occurred in 4 percent of the polyethylene glycol electrolyte solution patients and in 2 percent of the other cases, and other surgical site infections occurred in 6 and 5 percent, respectively. "
10.	Polyethylene Terephthalates (Polyethylene Terephthalate)IBA 04/01/2006 - "We present a patient with a melioidosis mycotic aneurysm of the descending aorta presenting with fever and right pleural effusion, managed successfully with initial Dacron graft repair with staged omental reinforcement, and subsequent endovascular stent grafting of a late anastomotic leak." 09/01/1982 - "While both the omentum and peritoneum proved not to be effective in preventing anastomotic leakage, Dacron velour did considerably lower this incidence to within reasonable limits but led to formation of low-grade lymphoma at the reinforcement site in two animals. " 01/01/2013 - "Here, we report the use of endograft implantation and prolonged intravenous antibiotics to successfully treat a life-threatening Dacron aortic tube graft infection and anastomotic leak. "

Therapies and Procedures

1.	Stents 08/01/2013 - "It is known that anastomotic leakages particularly situated in the chest can be successfully treated with endoscopically placed self-expanding stents with/without additional drainage. " 01/01/2008 - "Despite the limited number of patients, conservative management of intrathoracic anastomotic leaks with covered self-expandable metal stents performed under fluoroscopic guidance has proved to be rapid, safe, and effective in all cases of this series." 08/01/2001 - "The cohort treated without stents and H-2 blockade was at significantly greater risk for anastomotic leakage. " 08/01/2015 - "Esophageal stent for the treatment of a perforation or anastomotic leak has been shown to be effective and safe. " 03/01/2008 - "Stent placement can prove very useful in the management of post-oesophagectomy anastomotic leaks, but its contribution needs to be evaluated with caution in cases of oesophageal perforations or TEF. "
2.	Esophagectomy 10/01/2013 - "Endoscopic endoluminal vacuum therapy was the best treatment of anastomotic leakage in systemically ill patients after esophagectomy in this retrospective analysis. " 10/01/2013 - "Endoscopic endoluminal vacuum therapy is superior to other regimens in managing anastomotic leakage after esophagectomy: a comparative retrospective study." 01/01/2013 - "This study evaluated the safety and efficacy of endoscopy in diagnosing anastomotic leaks after esophagectomy. " 01/01/2014 - "The purpose of this study was to investigate the effectiveness of sternocleidomastoid (SCM) flap repair for anastomotic leakage after esophagectomy. " 01/01/2014 - "The aim of this study was to analyze our experience with management of intrathoracic anastomotic leak after esophagectomy. "
3.	Gastric Bypass (Roux-en-Y Gastric Bypass) 11/01/2005 - "Anastomotic leak after laparoscopic Roux-en-Y gastric bypass (LGB) is a major complication that must be recognized and treated early for best results. " 05/01/2014 - "The author of that study concluded that PE is indicated for anastomotic leak management after gastrojejunostomies. " 11/01/2015 - "Comment on: Technical factors associated with anastomotic leak after Roux-en-Y gastric bypass." 04/01/2015 - "Minimally invasive management of anastomotic leak after bariatric Roux-en-Y gastric bypass." 03/01/2015 - "Anastomotic leak is one of the most serious complications after Roux-en-Y gastric bypass (RYGB). "
4.	Transplants (Transplant) 01/01/2011 - "The comparisons of the main complications and mortality rates in walking children with esophageal substitutions performed in the first months of life showed that the incidences of cervical anastomotic leaks and graft failures were similar, but mortality rate in the first few months of life was significantly greater than that observed in our group of patients (P= 0.001). " 07/01/1991 - "Anastomotic leakages after Bentall's operation were found mostly at the bilateral coronary ostia, and incidence rate of the leakages experienced in the first 22 patients who had one lane coronary-graft anastomosis, reduced statistically significantly in patients who had two lane coronary-graft anastomosis, and also survival rate of these latter patients improved significantly than the former patients. " 01/01/2007 - "In this experimental study aimed at preventing anastomotic leakage and dehiscence, we used dehydrated, lyophilized human dura mater and free peritoneal graft for reinforcement of anastomotic region after primary repair in rats, and investigated whether they are superior to primary anastomosis. " 05/01/2014 - "The skin graft-covered pectoralis major muscle flap provides secure external coverage to prevent anastomotic leakage even in complicated cases. " 01/01/2007 - "To prevent anastomotic leakage, a number of drugs with different mechanisms of action were tested, and autogenic grafts and various synthetic materials were used for reinforcement of the anastomotic region. "
5.	Gastrectomy 08/01/2014 - "The study group included 32 patients from a prospectively maintained database of oesophageal leaks, with the majority being anastomotic leaks after minimally invasive oesophagectomy (n = 28), followed by laparoscopic cardiomyotomy (n = 3) and extended total gastrectomy (n = 1). " 03/01/2014 - "Between July 2002 and March 2013, 13 patients treated with SEMS and 14 patients treated with NSET for anastomotic leaks after total gastrectomy were enrolled onto the study. " 03/01/2014 - "The purpose of this study was to assess the clinical characteristics and therapeutic outcomes of SEMS and nonstent endoscopic therapy (NSET) for treatment of anastomotic leaks after total gastrectomy with the aim of assisting endoscopists in choosing a treatment method. " 09/01/1997 - "The purpose of this study was to investigate the incidence of esophagojejunal anastomotic leakage (EJAL) after total gastrectomy. " 03/01/1997 - "This study has shown conclusively that anastomotic leakage is the most important factor for prediction of postoperative hospital stay after total gastrectomy."