Treatment of chronic presacral sinus after low anterior resection
| Autor: | D. A. M. Sloothaak, W. A. Bemelman, Pieter J. Tanis, Christianne J. Buskens |
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| Přispěvatelé: | AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Colorectal cancer Fistula Anastomotic Leak Anastomosis Postoperative Complications Medicine Humans Rectal Fistula Sinus (anatomy) Aged Retrospective Studies Aged 80 and over Low Anterior Resection business.industry Rectal Neoplasms Sacrococcygeal Region Anastomosis Surgical Carcinoma Gastroenterology Rectum Retrospective cohort study Middle Aged medicine.disease Abscess Surgery medicine.anatomical_structure Rectal Diseases Treatment Outcome Radiological weapon Chronic Disease Female business Complication |
| Zdroj: | Colorectal disease, 15(6), 727-732. Wiley-Blackwell |
| ISSN: | 1462-8910 |
| Popis: | Aim The aim of this retrospective study was to determine patient and treatment characteristics with corresponding clinical outcome of symptomatic chronic presacral sinus after low anterior resection. Method Twenty-two patients were treated for a presacral sinus persisting for at least 12 months after low anterior resection for rectal carcinoma between January 2005 and March 2012. Patient charts were reviewed and analysed using descriptive statistics. Results Fistula formation was the most frequently observed secondary complication in 55% of patients. A median of 6 (1–44) surgical, endoscopic or radiological interventions related to the presacral sinus were performed. Overall, the chronic presacral sinus healed after multimodality treatment in nine (41%) patients at a median interval from primary surgery of 45 (24–93) months. If basic treatment principles were followed (anastomotic reconstruction or completion proctectomy with filling of the cavity), healing rate of the sinus was higher than where these principles were not adhered to (62% vs 11%). Conclusion Successful treatment of a chronic presacral sinus after low anterior resection appears to be achieved by salvage surgery with anastomotic reconstruction in highly selected patients or intersphincteric completion proctectomy and omentoplasty. |
| Databáze: | OpenAIRE |
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