J Korean Soc Coloproctol.  2008 Aug;24(4):260-264. 10.3393/jksc.2008.24.4.260.

Analysis of Results after Percutaneous Catheter Drainage for Anastomotic Leakage

• Hwang SI
• Kim H
• Han WK

• KMID: 2101457
• DOI: http://doi.org/10.3393/jksc.2008.24.4.260

Abstract

PURPOSE: Anastomotic leakage is a serious and life- threatening complication after colorectal surgery. The management of clinical anastomotic leakage remains largely operative. The aim of this study was to analyze the clinical characteristics and the natural history of percutaneous catheter drainage (PCD) for anastomotic leakage after colorectal surgery.
METHODS
Twenty patients who were managed by PCD after anastomotic leakage between January 2002 and December 2006 were studied. Charts were reviewed for information on clinical characteristics and biolologic finding prePCD and postPCD.
RESULTS
Anastomotic leakage was managed by using only PCD in 16 of 20 patients (80%), and twenty percent of patients (4/20) were managed by using a loop ileostomy after PCD. Nine patients (45%) had peritoneal drains left in place at diagnosis. Before PCD, the mean of the peak white blood cell (WBC) was 12,800/mm3, and the mean period of fever (>38degrees C) was 3.4 (2~5) days. After PCD, the mean time until the body temperature dropped below 37oC was 3.1 (1~5) days, the mean time until the WBC count dropped below 10,000/mm3 was 3.2 (0~6) days, the mean duration of ileus and diarrhea was 3.3 (0~6) days, the mean total amount of drainage during 6 days was 880 cc, and the mean length of stay after PCD was 14.9 days.
CONCLUSIONS
PCD is a safe and effective method for treating anastomtic leakage in patients without sepsis or diffuse peritonitis and with CT scans that reveal no diffuse fluid collection.

Keyword

Anastomotic leakage; Percutaneous catheter drainage (PCD); Loop ileostomy

MeSH Terms

Anastomotic Leak
Body Temperature
Catheters
Colorectal Surgery
Diarrhea
Drainage
Fever
Humans
Hypogonadism
Ileostomy
Ileus
Length of Stay
Leukocytes
Mitochondrial Diseases
Natural History
Ophthalmoplegia
Peritonitis
Sepsis
Hypogonadism
Mitochondrial Diseases
Ophthalmoplegia