Anastomosis leakage is a feared and critical complication of colorectal surgery, as it raises morbidity and death significantly. In some situations, such as emergency colorectal surgery, removal of low rectal tumours, the existence of underlying chronic colon pathology, immunodeficiency, and malnutrition, anastomotic leaking is common. Despite sufficient caution and superb surgical technique, some anastomotic leaks are unavoidable during colo-rectal resection. For individuals with a variety of risk factors for anastomotic safety, proximal diversion should be addressed. The purpose of this paper is to emphasise the significance of two specific risk factors in adult anastomotic healing and function: colonic and rectal neural malformations or innervation abnormalities, and reduced immunological defence. Intestinal innervation malformations may be linked to colonic motility abnormalities, whether or not they are accompanied by a megacolon, and they are rarely seen acutely. Histopathological investigation of full-thickness intestine samples is required for a definitive diagnosis, and treatment should be tailored to the severity and extent of the probable neuronal abnormality. Intestinal bacteria, on the other hand, have been linked to systemic infection when the host's defensive mechanisms are weakened, and they may play a crucial part in the pathophysiology of anastomotic leak. Surgeons must assess the risks in cases where there is a suspicion of immune system disruption and execute an ostomy rather than an anastomosis following colon resection.
Author(S) Details
Avgoustou Constantinos
Surgical Department, General Hospital of Nea Ionia ‘‘Constantopoulion-Aghia Olga-Patission’’ Address: 13, Ploutarchou Str, 15344 Gerakas Attikis, Athens, Greece.
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