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Clin Colon Rectal Surg 2022; 35(02): 155-164
DOI: 10.1055/s-0041-1742117
Review Article

Dealing with Complications of Colorectal Surgery Using the Transanal Approach—When and How?

K. Talboom
1   Department of Surgery, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
,
P. J. Tanis
2   Department of Surgery, Amsterdam UMC, location VUMC, Amsterdam, The Netherlands
3   Department of Surgical Oncology and Gastrointestinal Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
4   Cancer Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
,
W. A. Bemelman
1   Department of Surgery, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
4   Cancer Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
,
R. Hompes
1   Department of Surgery, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
4   Cancer Centre Amsterdam, University of Amsterdam, Amsterdam, The Netherlands
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Abstract

The transanal approach is a new and exciting addition to the surgeons' repertoire to deal with complications after colorectal surgery. Improved exposure, accessibility, and visibility greatly facilitate adequate dissection of the affected area with potential increase in effectiveness and reduced morbidity. An essential component in salvaging anastomotic leaks of low colorectal, coloanal, or ileoanal anastomoses is early diagnosis and early treatment, especially when starting with endoscopic vacuum therapy, followed by early surgical closure (endoscopic vacuum-assisted surgical closure). Redo surgery using a transanal minimally invasive surgery platform for chronic leaks after total mesorectal excision surgery or surgical causes of pouch failure successfully mitigates limited visibility and exposure by using a bottom-up approach.

Keywords

transanal minimally invasive surgery - complications - anastomotic leakage - colorectal surgery


Publikationsverlauf

Artikel online veröffentlicht:
28. Februar 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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