PDF(Pubmed)
Abstract：
UNASSIGNED: Anastomotic leaks (ALs) are a significant and feared postoperative complication, with incidence of up to 30% despite advances in surgical techniques. With implications such as additional interventions, prolonged hospital stays, and hospital readmission, ALs have important impacts at the level of individual patients and healthcare providers, as well as healthcare systems as a whole. Challenges in developing unified definitions and grading systems for leaks have proved problematic, despite acknowledgement that colorectal AL is a critical issue in intestinal surgery with serious consequences. The aim of this study was to construct a narrative review of literature surrounding definitions and grading systems for ALs, and consequences of this postoperative complication.
UNASSIGNED: A literature review was conducted by examining databases including PubMed, Web of Science, OVID Embase, Google Scholar, and Cochrane library databases. Searches were performed with the following keywords: anastomosis, anastomotic leak, colorectal, surgery, grading system, complications, risk factors, and consequences. Publications that were retrieved underwent further assessment to ensure other relevant publications were identified and included.
UNASSIGNED: A universally accepted definition and grading system for ALs continues to be lacking, leading to variability in reported incidence in the literature. Additional factors add to variability in estimates, including differences in the anastomotic site and institutional/individual differences in operative technique. Various groups have worked to publish guidelines for defining and grading AL, with the International Study Group of Rectal Cancer (ISGRC/ISREC) definition the current most recommended universal definition for colorectal AL. The burden of AL on patients, healthcare providers, and hospitals is well documented in evidence from leak consequences, such as increased morbidity and mortality, higher reoperation rates, and increased readmission rates, among others.
UNASSIGNED: Colorectal AL remains a significant challenge in intestinal surgery, despite medical advancements. Understanding the progress made in defining and grading leaks, as well as the range of negative outcomes that arise from AL, is crucial in improving patient care, reduce surgical mortality, and drive further advancements in earlier detection and treatment of AL.
UNASSIGNED: A literature review was conducted by examining databases including PubMed, Web of Science, OVID Embase, Google Scholar, and Cochrane library databases. Searches were performed with the following keywords: anastomosis, anastomotic leak, colorectal, surgery, grading system, complications, risk factors, and consequences. Publications that were retrieved underwent further assessment to ensure other relevant publications were identified and included.
UNASSIGNED: A universally accepted definition and grading system for ALs continues to be lacking, leading to variability in reported incidence in the literature. Additional factors add to variability in estimates, including differences in the anastomotic site and institutional/individual differences in operative technique. Various groups have worked to publish guidelines for defining and grading AL, with the International Study Group of Rectal Cancer (ISGRC/ISREC) definition the current most recommended universal definition for colorectal AL. The burden of AL on patients, healthcare providers, and hospitals is well documented in evidence from leak consequences, such as increased morbidity and mortality, higher reoperation rates, and increased readmission rates, among others.
UNASSIGNED: Colorectal AL remains a significant challenge in intestinal surgery, despite medical advancements. Understanding the progress made in defining and grading leaks, as well as the range of negative outcomes that arise from AL, is crucial in improving patient care, reduce surgical mortality, and drive further advancements in earlier detection and treatment of AL.
摘要：
■吻合口漏（AL）是一种严重且令人恐惧的术后并发症，尽管外科技术取得了进步，但发病率高达30%。随着额外干预等影响，住院时间延长,再入院,AL对个体患者和医疗保健提供者的水平具有重要影响，以及整个医疗系统。事实证明，在开发统一的泄漏定义和分级系统方面的挑战是有问题的，尽管承认结直肠AL是肠道手术中的关键问题，但后果严重。本研究的目的是对围绕AL的定义和分级系统的文献进行叙述性回顾，以及这种术后并发症的后果。
■通过检查包括PubMed，WebofScience,OVIDEmbase,谷歌学者，和Cochrane图书馆数据库。使用以下关键词进行搜索：吻合，吻合口漏,结直肠,手术,分级系统，并发症,危险因素，和后果。对检索到的出版物进行进一步评估，以确保确定并包括其他相关出版物。
■仍然缺乏普遍接受的AL定义和评分系统，导致文献中报告的发病率变化。其他因素增加了估计的可变性，包括吻合部位的差异和手术技术的机构/个体差异。各种小组都在努力发布定义和分级AL的指南，国际直肠癌研究小组（ISGRC/ISREC）的定义是目前最推荐的结直肠AL通用定义。AL对患者的负担，医疗保健提供者，医院有很好的证据证明泄漏的后果，如发病率和死亡率增加，更高的再手术率，再入院率提高，在其他人中。
■结直肠AL仍然是肠道外科的重大挑战，尽管医学进步。了解在定义和分级泄漏方面取得的进展，以及AL产生的一系列负面结果，对改善病人护理至关重要，降低手术死亡率，并推动AL早期检测和治疗的进一步发展。
■通过检查包括PubMed，WebofScience,OVIDEmbase,谷歌学者，和Cochrane图书馆数据库。使用以下关键词进行搜索：吻合，吻合口漏,结直肠,手术,分级系统，并发症,危险因素，和后果。对检索到的出版物进行进一步评估，以确保确定并包括其他相关出版物。
■仍然缺乏普遍接受的AL定义和评分系统，导致文献中报告的发病率变化。其他因素增加了估计的可变性，包括吻合部位的差异和手术技术的机构/个体差异。各种小组都在努力发布定义和分级AL的指南，国际直肠癌研究小组（ISGRC/ISREC）的定义是目前最推荐的结直肠AL通用定义。AL对患者的负担，医疗保健提供者，医院有很好的证据证明泄漏的后果，如发病率和死亡率增加，更高的再手术率，再入院率提高，在其他人中。
■结直肠AL仍然是肠道外科的重大挑战，尽管医学进步。了解在定义和分级泄漏方面取得的进展，以及AL产生的一系列负面结果，对改善病人护理至关重要，降低手术死亡率，并推动AL早期检测和治疗的进一步发展。
