Ann Surg Treat Res.  2023 Apr;104(4):214-221. 10.4174/astr.2023.104.4.214.

Efficacy of air leak test in detection of anastomotic leaks after rectal excision: a retrospective case-controlled study

• Song SH
• Park JS
• Choi GS
• Park SY
• Kim HJ
• Lee SM
• Na DH
• Jeong MH

• KMID: 2541147
• DOI: http://doi.org/10.4174/astr.2023.104.4.214

Abstract

Purpose
Although its efficacy is uncertain, an intraoperative air leak test (ALT) is commonly used to detect mechanical defects following bowel anastomosis. This study aimed to evaluate the efficacy of ALT to detect anastomotic leakage (AL) following rectal excision.
Methods
We reviewed our database for patients with rectal cancers who had undergone curative surgery between January 2012 and January 2018. Patients were grouped according to whether or not an ALT was performed. Propensity score analyses were performed to compare outcomes for groups in a 1:1 case-matched cohort.
Results
In total, 1,191 patients underwent rectal excision; 438 (219 in each group) formed the case-matched cohort for analysis. The protective stoma rate was 16.0% and 14.6% in the ALT and the no-ALT groups, respectively (P = 0.791). In the ALT group, 2 patients (0.9%) showed a positive result and were treated with rectal tube drainage, resulting in no leakage. There was no significant difference in postoperative AL rate between the groups (ALT group: 4.6% vs. no-ALT group: 4.1%, P > 0.999).
Conclusion
ALT played a minimal role in detecting AL following rectal excision. Further studies are warranted to validate our results and clarify whether AL can be prevented with ALT or alternative methods.

Keyword

Air leak test; Anastomotic leak; Laparoscopy; Rectal excision; Robotic surgical procedures

Figure

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  Fig. 1 Study flow diagram. KNUCH, Kyungpook National University Chilgok Hospital; ALT, air leak test.

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  Fig. 2 Diagram showing the categorization of the no air leak test group (no-ALT).

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