Transanal Drainage for Anastomotic Leakage after Laparoscopic Low Anterior Resection of Rectum

Yuuki Masano, Suguru Hasegawa, Masato Naito, Hiroaki Furuyama, Tsunehiro Yoshimura, Akinari Nomura*, Junichiro Kawamura*, Satoshi Nagayama* and Yoshiharu Sakai*

Department of Surgery, Tenri Hospital
Department of Surgery, Kyoto University*

In seven cases of anastomotic leakage causing pelvic abscess after laparoscopic low anterior resction treated by transanal drainage, anastomotic leakage was diagnosed by enema, the fistula was dilated by forefinger, and abscess cavities were drained into the rectum, avoiding surgical intervention including percutaneous drainage and/or laparotomy and/or diverting ileostomy. In one case, transanal drainage was ineffective and diverting ileostomy was performed. The patient's general condition must be good, however, and the abscess limited to within the presacral space not expanded into the abdominal cavity. Cases of peritonitis and septicemia due to leakage should be excluded. Transanal drainage can be one of the therapeutic options for the anastomotic leakage following laparoscopic low anterior resection.

Key words
anastomotic failure or leakage, therapy, laparoscopic anterior resection

Reprint requests
Yuki Masano Department of Surgery, Tenri Hospital
200 Mishimacho, Tenri, 632-8552 JAPAN

Accepted
November 18, 2009

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