Несостоятельность толстокишечного анастомоза: современное состояние проблемы и перспективы ранней диагностики
https://doi.org/10.35401/2541-9897-2024-9-3-131-138
Аннотация
Статья посвящена актуальной проблеме несостоятельности толстокишечных анастомозов у пациентов, перенесших резекционные вмешательства по поводу колоректального рака. Описаны факторы риска развития несостоятельности толстокишечных анастомозов, а также подходы к ее диагностике. Особое внимание уделено неинвазивной лабораторной ранней диагностике несостоятельности анастомоза с использованием специфических биохимических маркеров.
Об авторах
М. А. Черных
Санкт-Петербургский государственный университет
Россия
Россия
Черных Максим Александрович, врач-онколог онкологического отделения № 2
199034, Санкт-Петербург, Университетская набережная, д. 7/9
А. М. Белоусов
Санкт-Петербургский государственный университет
Россия
Россия
Белоусов Александр Михайлович, к. м. н., заместитель директора по медицинской части (хирургия и онкология), врач-хирург, онколог
К. Г. Шостка
Санкт-Петербургский государственный университет
Россия
Россия
Шостка Кирилл Георгиевич, к. м. н., заведующий онкологическим отделением № 2, врач-онколог
Список литературы
1. Siegel RL, Wagle NS, Cercek A, Smith RA, Jemal A. Colorectal cancer statistics, 2023. CA Cancer J Clin. 2023;73(3):233–254. PMID: 36856579. https://doi.org/10.3322/caac.21772
2. Ueno A, Yokota M, Ueno M, Kawamoto K. Colorectal cancer in adolescent and young adults: epidemiology in Japan and narrative review. J Gastrointest Oncol. 2023;14(4):1856– 1868. PMID: 37720434. PMCID: PMC10502560. https://doi.org/10.21037/jgo-23-98
3. Общероссийская общественная организация «Российское общество клинической онкологии», Российское общество специалистов по колоректальному раку, Общероссийская общественная организация «Ассоциация колопроктологов России», Ассоциация онкологов России. Клинические рекомендации «Рак прямой кишки». Министерство здравоохранения Российской Федерации; 2022.
4. Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986;1(8496):1479–1482. PMID: 2425199. https://doi.org/10.1016/s0140-6736(86)91510-2
5. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation--technical notes and outcome. Colorectal Dis. 2009;11(4):354–365. PMID: 19016817. https://doi.org/10.1111/j.1463-1318.2008.01735.x
6. Chude GG, Rayate NV, Patris V, et al. Defunctioning loop ileostomy with low anterior resection for distal rectal cancer: should we make an ileostomy as a routine procedure? A prospective randomized study. Hepatogastroenterology. 2008;55(86–87):1562– 1567. PMID: 19102343.
7. Fleshman J, Sargent DJ, Green E, et al; Clinical Outcomes of Surgical Therapy Study Group. Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg. 2007;246(4):655–664. PMID: 17893502. https://doi.org/10.1097/SLA.0b013e318155a762
8. Bonjer HJ, Deijen CL, Haglind E; COLOR II Study Group. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015;373(2):194. PMID: 26154803. https://doi.org/10.1056/NEJMc1505367
9. Color II Study Group, Buunen M, Bonjer HJ, et al. COLOR II. A randomized clinical trial comparing laparoscopic and open surgery for rectal cancer. Dan Med Bull. 2009;56(2):89–91. PMID: 19486621.
10. Pucci MJ, Beekley AC. Use of robotics in colon and rectal surgery. Clin Colon Rectal Surg. 2013;26(1):39–46. PMID: 24436647. PMCID: PMC3699138. https://doi.org/10.1055/s-0033-1333660
11. Sciuto A, Merola G, De Palma GD, et al. Predictive factors for anastomotic leakage after laparoscopic colorectal surgery. World J Gastroenterol. 2018;24(21):2247–2260. PMID: 29881234. PMCID: PMC5989239. https://doi.org/10.3748/wjg.v24.i21.2247
12. Nagaya M, Kato J, Niimi N, Tanaka S, Iio K. Proposal of a novel method to evaluate anastomotic tension in esophageal atresia with a distal tracheoesophageal fistula. Pediatr Surg Int. 2005;21(10):780–785. PMID: 16177921. https://doi.org/10.1007/s00383-005-1540-4
13. Kye BH, Rookkachart T, Kim JH, et al. Safety of laparoscopic oncologic resection in elderly patients with colorectal cancer: a multicenter retrospective study based on perioperative short-term outcomes. J Laparoendosc Adv Surg Tech A. 2019;29(8):1016–1022. PMID: 31188061. https://doi.org/10.1089/lap.2019.0049
14. Degerli MS, Canturk AO, Bozkurt H, et al. Systematic assessment of complications after laparoscopic colorectal surgery for advanced colorectal cancer: a retrospective study using Clavien-Dindo classification, 5-year experience. Malawi Med J. 2022;34(1):49–52. PMID: 37265825. PMCID: PMC10230576. https://doi.org/10.4314/mmj.v34i1.9
15. Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum: a proposal by the International Study Group of Rectal Cancer. Surgery. 2010;147(3):339–351. PMID: 20004450. https://doi.org/10.1016/j.surg.2009.10.012
16. Chadi SA, Fingerhut A, Berho M, et al. Emerging trends in the etiology, prevention, and treatment of gastrointestinal anastomotic leakage. J Gastrointest Surg. 2016;20(12):2035–2051. PMID: 27638764. https://doi.org/10.1007/s11605-016-3255-3
17. Cong ZJ, Hu LH, Bian ZQ, et al. Systematic review of anastomotic leakage rate according to an international grading system following anterior resection for rectal cancer. PloS One. 2013;8(9):e75519. PMID: 24086552. PMCID: PMC3783382. https://doi.org/10.1371/journal.pone.0075519
18. Sparreboom CL, van Groningen JT, Lingsma HF, et al; Dutch ColoRectal Audit group. Different risk factors for early and late colorectal anastomotic leakage in a nationwide audit. Dis Colon Rectum. 2018;61(11):1258–1266. PMID: 30239395. https://doi.org/10.1097/DCR.0000000000001202
19. Ellis CT, Maykel JA. Defining Anastomotic leak and the clinical relevance of leaks. Clin Colon Rectal Surg. 2021;34(6):359–365. PMID: 34853555. PMCID: PMC8610631. https://doi.org/10.1055/s-0041-1735265
20. Matthiessen P, Hallböök O, Andersson M, Rutegård J, Sjödahl R. Risk factors for anastomotic leakage after anterior resection of the rectum. Colorectal Dis. 2004;6(6):462–469. PMID: 15521937. https://doi.org/10.1111/j.1463-1318.2004.00657.x
21. Park JS, Huh JW, Park YA, et al. Risk factors of anastomotic leakage and long-term survival after colorectal surgery. Medicine (Baltimore). 2016;95(8):e2890. PMID: 26937928. PMCID: PMC4779025. https://doi.org/10.1097/MD.0000000000002890
22. Zarnescu EC, Zarnescu NO, Costea R. Updates of risk factors for anastomotic leakage after colorectal surgery. Diagnostics (Basel). 2021;11(12):2382. PMID: 34943616. PMCID: PMC8700187. https://doi.org/10.3390/diagnostics11122382
23. Vennix S, Pelzers L, Bouvy N, et al. Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev. 2014;2014(4):CD005200. PMID: 24737031. PMCID: PMC10875406. https://doi.org/10.1002/14651858.CD005200.pub3
24. Zhu QL, Feng B, Lu AG, et al. Laparoscopic low anterior resection for rectal carcinoma: complications and management in 132consecutive patients. World JGastroenterol. 2010;16(36):4605– 4610. PMID: 20857534. PMCID: PMC2945495. https://doi.org/10.3748/wjg.v16.i36.4605
25. Choi DH, Hwang JK, Ko YT, et al. Risk factors for anastomotic leakage after laparoscopic rectal resection. J Korean Soc Coloproctology. 2010;26(4):265–273. PMID: 21152228. PMCID: PMC2998006. https://doi.org/10.3393/jksc.2010.26.4.265
26. Hamabe A, Ito M, Nishigori H, Nishizawa Y, Sasaki T. Preventive effect of diverting stoma on anastomotic leakage after laparoscopic low anterior resection with double stapling technique reconstruction applied based on risk stratification. Asian J Endosc Surg. 2018;11(3):220–226. PMID: 29230964. https://doi.org/10.1111/ases.12439
27. Slesser AA, Pellino G, Shariq O, et al. Compression versus hand-sewn and stapled anastomosis in colorectal surgery: a systematic review and meta-analysis of randomized controlled trials. Tech Coloproctology. 2016;20(10):667–676. PMID: 27554096. https://doi.org/10.1007/s10151-016-1521-8
28. Yang SI, Lee SH, Lee SH. Outcomes of intracorporeal versus extracorporeal anastomosis in laparoscopic colectomy surgery. J Minim Invasive Surg. 2021;24(4):208–214. PMID: 35602863. PMCID: PMC8965989. https://doi.org/10.7602/jmis.2021.24.4.208
29. den Dulk M, Marijnen CA, Collette L, et al. Multicentre analysis of oncological and survival outcomes following anastomotic leakage after rectal cancer surgery. Br J Surg. 2009;96(9):1066– 1075. PMID: 19672927. https://doi.org/10.1002/bjs.6694
30. Güenaga KF, Lustosa SA, Saad SS, Saconato H, Matos D. Ileostomy or colostomy for temporary decompression of colorectal anastomosis. Cochrane Database Syst Rev. 2007;2007(1):CD004647. PMID: 17253517. PMCID: PMC8842962. https://doi.org/10.1002/14651858.CD004647.pub2
31. Suwanabol PA, Hardiman KM. Prevention and management of colostomy complications: retraction and stenosis. Dis Colon Rectum. 2018;61(12):1344–1347. PMID: 30399047. https://doi.org/10.1097/DCR.0000000000001246
32. Alves A, Panis Y, Trancart D, Regimbeau JM, Pocard M, Valleur P. Factors associated with clinically significant anastomotic leakage after large bowel resection: multivariate analysis of 707 patients. World J Surg. 2002;26(4):499–502. PMID: 11910487. https://doi.org/10.1007/s00268-001-0256-4
33. Ha GW, Kim JH, Lee MR. Oncologic impact of anastomotic leakage following colorectal cancer surgery: a systematic review and meta-analysis. Ann Surg Oncol. 2017;24(11):3289–3299. PMID: 28608118. https://doi.org/10.1245/s10434-017-5881-8
34. Erb L, Hyman NH, Osler T. Abnormal vital signs are common after bowel resection and do not predict anastomotic leak. J Am Coll Surg. 2014;218(6):1195–1199. PMID: 24680576. https://doi.org/10.1016/j.jamcollsurg.2013.12.059
35. An V, Chandra R, Lawrence M. Anastomotic failure in colorectal surgery: where are we at?. Indian J Surg. 2018;80(2):163–170. PMID: 29915483. PMCID: PMC5991011. https://doi.org/10.1007/s12262-018-1745-0
36. Hyman N, Manchester TL, Osler T, Burns B, Cataldo PA. Anastomotic leaks after intestinal anastomosis: it’s later than you think. Ann Surg. 2007;245(2):254–258. PMID: 17245179. PMCID: PMC1876987. https://doi.org/10.1097/01.sla.0000225083.27182.85
37. Leslie DB, Dorman RB, Anderson J, et al. Routine upper gastrointestinal imaging is superior to clinical signs for detecting gastrojejunal leak after laparoscopic Roux-en-Y gastric bypass. J Am Coll Surg. 2012;214(2):208–213. PMID: 22265221. https://doi.org/10.1016/j.jamcollsurg.2011.10.021
38. Habib K, Gupta A, White D, Mazari FA, Wilson TR. Utility of contrast enema to assess anastomotic integrity and the natural history of radiological leaks after low rectal surgery: systematic review and meta-analysis. Int J Colorectal Dis. 2015;30(8):1007–1014. PMID: 25922145. https://doi.org/10.1007/s00384-015-2225-7
39. Gessler B, Eriksson O, Angenete E. Diagnosis, treatment, and consequences of anastomotic leakage in colorectal surgery. Int J Colorectal Dis. 2017;32(4):549–556. PMID: 28070659. PMCID: PMC5355508. https://doi.org/10.1007/s00384-016-2744-x
40. Rencuzogullari A, Benlice C, Valente M, Abbas MA, Remzi FH, Gorgun E. Predictors of anastomotic leak in elderly patients after colectomy: nomogram-based assessment from the American College of Surgeons National Surgical Quality Program procedure-targeted cohort. Dis Colon Rectum. 2017;60(5):527–536. PMID: 28383453. https://doi.org/10.1097/DCR.0000000000000789
41. Wright EC, Connolly P, Vella M, Moug S. Peritoneal fluid biomarkers in the detection of colorectal anastomotic leaks: a systematic review. Int J Colorectal Dis. 2017;32(7):935–945. PMID: 28401350. https://doi.org/10.1007/s00384-017-2799-3
42. Wierdak M, Pisarska M, Kuśnierz-Cabala B, et al. Use of inflammatory markers in the early detection of infectious complications after laparoscopic colorectal cancer surgery with the ERAS protocol. Wideochir Inne Tech Maloinwazyjne. 2018;13(3):315– 325. PMID: 30302144. PMCID: PMC6174169. https://doi.org/10.5114/wiitm.2018.75846
43. Singh PP, Zeng IS, Srinivasa S, Lemanu DP, Connolly AB, Hill AG. Systematic review and meta-analysis of use of serum Creactive protein levels to predict anastomotic leak after colorectal surgery. Br J Surg. 2014;101(4):339–346. PMID: 24311257. https://doi.org/10.1002/bjs.9354
44. Hayati F, Mohd Azman ZA, Nasuruddin DN, Mazlan L, Zakaria AD, Sagap I. Serum procalcitonin predicts anastomotic leaks in colorectal surgery. Asian Pac J Cancer Prev. 2017;18(7):1821–1825. PMID: 28749112. PMCID: PMC5648385. https://doi.org/10.22034/APJCP.2017.18.7.1821
45. Bilgin IA, Hatipoglu E, Aghayeva A, et al. Predicting value of serum procalcitonin, C-reactive protein, drain fluid culture, drain fluid interleukin-6, and tumor necrosis factor-α levels in anastomotic leakage after rectal resection. Surg Infect (Larchmt). 2017;18(3):350–356. PMID: 28394749. https://doi.org/10.1089/sur.2016.222
46. Malibary N, Saleem A, Almuttawa A, et al. Evaluating Dutch Leakage Scores in diagnosing anastomotic leak in colorectal surgery. Surgical Practice. 2021;25(3):152–157. https://doi.org/10.1111/1744-1633.12509
47. Nakahara H, Song J, Sugimoto M, et al. Anti-interleukin-6 receptor antibody therapy reduces vascular endothelial growth factor production in rheumatoid arthritis. Arthritis Rheum. 2003;48(6):1521– 1529. PMID: 12794819. https://doi.org/10.1002/art.11143
48. Zielińska-Borkowska U, Dib N, Tarnowski W, Skirecki T. Monitoring of procalcitonin but not interleukin-6 is useful for the early prediction of anastomotic leakage after colorectal surgery. Clin Chem Lab Med. 2017;55(7):1053–1059. PMID: 27930362. https://doi.org/10.1515/cclm-2016-0736
49. Sammour T, Singh PP, Zargar-Shoshtari K, Su’a B, Hill AG. Peritoneal cytokine levels can predict anastomotic leak on the first postoperative day. Dis Colon Rectum. 2016;59(6):551–556. PMID: 27145313. https://doi.org/10.1097/DCR.0000000000000598
50. Ladika Davidovic B, Muzina Misic D, Samija I. Peritoneal interleukin-6 and tumor necrosis factor-alpha as markers for early detection of anastomotic dehiscence following surgery for colorectal cancer. Molecular and Experimental Biology in Medicine. 2019;2(2):28–32. https://doi.org/10.33602/mebm.2.2.5
51. Su’a B, Milne T, Jaung R, et al. Detection of anastomotic leakage following elective colonic surgery: results of the prospective Biomarkers and Anastomotic Leakage (BALL) study. J Surg Res. 2022;273:85–92. PMID: 35033821. https://doi.org/10.1016/j.jss.2021.12.019
52. Qi XY, Tan F, Liu MX, et al. Serum and peritoneal biomarkers for the early prediction of symptomatic anastomotic leakage in patients following laparoscopic low anterior resection: a single-center prospective cohort study. Cancer Rep (Hoboken). 2023;6(4):e1781. PMID: 36718787. PMCID: PMC10075299. https://doi.org/10.1002/cnr2.1781
53. Sparreboom CL, Wu Z, Dereci A, et al. Cytokines as early markers of colorectal anastomotic leakage: a systematic review and meta-analysis. Gastroenterol Res Pract. 2016;2016:3786418. PMID: 27051416. PMCID: PMC4804081. https://doi.org/10.1155/2016/3786418
54. Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: Enhanced Recovery After Surgery (ERAS®) Society recommendations: 2018. World J Surg. 2019;43(3):659–695. PMID: 30426190. https://doi.org/10.1007/s00268-018-4844-y
Рецензия
Для цитирования:
Черных М.А., Белоусов А.М., Шостка К.Г. Несостоятельность толстокишечного анастомоза: современное состояние проблемы и перспективы ранней диагностики. Инновационная медицина Кубани. 2024;(3):131-138. https://doi.org/10.35401/2541-9897-2024-9-3-131-138
For citation:
Chernykh M.A., Belousov A.M., Shostka K.G. Colonic Anastomotic Leakage: Current State of the Problem and Prospects for Early Diagnosis. Innovative Medicine of Kuban. 2024;(3):131-138. (In Russ.) https://doi.org/10.35401/2541-9897-2024-9-3-131-138
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