AIM: Despite improvements in anastomotic technique, anastomotic leakage is frequently encountered following anterior resection. This can eventually evolve into a presacral sinus. This study assessed the incidence, the natural course and the outcome of persisting presacral sinus. METHOD: Patients who underwent low anterior resection (LAR) for cancer or restorative proctocolectomy (RPC) for ulcerative colitis or familial polyposis were eligible. Patients with anastomotic leakage or a presacral abscess were included. Outcome parameters included a persistent presacral sinus, or its closure and average time to closure and the stoma closure rate. RESULTS: Twenty-five patients were identified with a sinus after LAR (n = 20) or RPC (n = 5). A persistent sinus was present in nine (1%) of 834 patients after LAR and two (0.9%) of 229 patients after RPC. Definitive resolution of the sinus occurred in 12 (52%) of 23 assessable patients. This was achieved at a median of 340 days (range 23-731 days). At final follow-up, nine of the 23 patients had permanent faecal diversion because of recurrent abscess or persistent sinus formation, seven after LAR and two after RPC. CONCLUSION: A significant proportion of patients with anastomotic leakage after rectal surgery develop a chronic sinus, of which only half heal over time. Persisting sinus is the main reason for a permanent stoma.
AIM: Despite improvements in anastomotic technique, anastomotic leakage is frequently encountered following anterior resection. This can eventually evolve into a presacral sinus. This study assessed the incidence, the natural course and the outcome of persisting presacral sinus. METHOD:Patients who underwent low anterior resection (LAR) for cancer or restorative proctocolectomy (RPC) for ulcerative colitis or familial polyposis were eligible. Patients with anastomotic leakage or a presacral abscess were included. Outcome parameters included a persistent presacral sinus, or its closure and average time to closure and the stoma closure rate. RESULTS: Twenty-five patients were identified with a sinus after LAR (n = 20) or RPC (n = 5). A persistent sinus was present in nine (1%) of 834 patients after LAR and two (0.9%) of 229 patients after RPC. Definitive resolution of the sinus occurred in 12 (52%) of 23 assessable patients. This was achieved at a median of 340 days (range 23-731 days). At final follow-up, nine of the 23 patients had permanent faecal diversion because of recurrent abscess or persistent sinus formation, seven after LAR and two after RPC. CONCLUSION: A significant proportion of patients with anastomotic leakage after rectal surgery develop a chronic sinus, of which only half heal over time. Persisting sinus is the main reason for a permanent stoma.
Authors: J F Huisman; H L van Westreenen; E J van der Wouden; H F A Vasen; E J R de Graaf; P G Doornebosch; T J Tang; I Schot; R M Brohet; W H de Vos Tot Nederveen Cappel; M Vermaas Journal: Tech Coloproctol Date: 2019-07-23 Impact factor: 3.781
Authors: W A A Borstlap; G D Musters; L P S Stassen; H L van Westreenen; D Hess; S van Dieren; S Festen; E J van der Zaag; P J Tanis; W A Bemelman Journal: Surg Endosc Date: 2017-06-29 Impact factor: 4.584
Authors: Emma Westerduin; Gijsbert D Musters; Anna A W van Geloven; Marinke Westerterp; Erwin van der Harst; Willem A Bemelman; Pieter J Tanis Journal: Int J Colorectal Dis Date: 2017-08-11 Impact factor: 2.571