In for the long haul: Managing the consequences of anastomotic leak

Abstract

After the initial period of source control and treating sepsis, the pervasive long-term effects of anastomotic failure become clear. Most of these produce some form of debility, require prolonged treatment with multiple procedures and operations and for some, even shorten survival. Regardless of the complication, it is imperative that the surgeon remain patient and create a treatment plan that is measured and safe. This may involve as little as a single operation for reversal of diverting stoma, the time-consuming and labor-intensive management of enterocutaneous fistulas (ECFs), serial dilations of an anastomotic stricture or managing and guiding patients through poor functional and oncologic outcomes.