Definition and grading of anastomotic leakage following anterior resection of the rectum: A proposal by the International Study Group of Rectal Cancer
Definition and grading of anastomotic leakage following anterior resection of the rectum: A proposal by the International Study Group of Rectal Cancer
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DOI：
10.1016/j.surg.2009.10.012
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发表时间：
2010-03-01
期刊：
影响因子：
3.8
通讯作者：
Buechler, Markus W.
中科院分区：
文献类型：
--
作者：
Rahbari, Nuh N.;Weitz, Juergen;Buechler, Markus W.
背景资料。吻合口漏是直肠前切除术后的主要并发症。吻合口漏的发生率在临床研究中差异很大，部分原因是缺乏对这种并发症的标准化定义。本文的目的是提出直肠前切除术后吻合口漏的定义和严重程度分级。经过文献回顾，直肠癌国际研究小组制定了吻合口漏的共识定义和严重程度分级。吻合口漏应被定义为吻合口肠壁的缺陷(包括新直肠储罐的缝合线和吻合线)，导致管腔内腔和管外间隙的连通。吻合口漏的严重程度应根据对临床治疗的影响进行分级。A级吻合口漏不会改变患者的处理，而B级吻合口漏需要积极的治疗干预，但无需再次剖腹手术即可处理。C级吻合口瘘需再次开腹手术。所提出的定义和临床分级很容易应用于临床研究的设置。它应在今后的报告中应用，以便于对不同研究的结果进行有效比较。(《外科手术2010》；147：339-51。)
Background. Anastomotic leakage represents a major complication after anterior resection of the rectum. The incidence of anastomotic leakage varies considerably among clinical studies in part owing to the lack of a standardized definition of this complication. The aim of the present article was to propose a definition and severity grading of anastomotic leakage after anterior rectal resection.Methods. After a literature review a consensus definition, and severity grading of anastomotic leakage was developed within the International Study Group of Rectal CancerResults. Anastomotic leakage should, be defined as a defect of the intestinal wall at the anastomotic site (including suture and staple lines of neorectal reservoirs) leading to a communication between the intra- and extraluminal compartments. Severity of anastomotic leakage should be graded according to the impact on clinical management. Grade A anastomotic leakage results in no change in patients' management, whereas grade B leakage requires active therapeutic intervention but is manageable without re-laparotomy. Grade C anastomotic leakage requires re-laparotomy.Conclusion. The proposed definition and clinical grading is applicable easily in the setting of clinical studies. It should be applied in future reports to facilitate valid comparison, of the results of different studies. (Surgery 2010;147:339-51.)