Can anastomotic leaks be prevented?

Can anastomotic leaks be prevented?

Many variables contribute to anastomotic leaks, and many of them can’t be controlled, including the health status of the people being treated, the difficulty of the particular operation and what happens during the healing process. However, surgeons can screen for leaks that may have occurred at the time of surgery.

Screening

Tests to screen for leaks following anastomosis include:

• Air test. Fill your body cavity with saline and introduce air into your body channel. If bubbles appear in the fluid, there’s a leak in the connection. Usually, these leaks are addressed by either redoing the connection or sewing over the connection.
• Fluid test. Introduce an antiseptic solution to your body channel to see if it leaks.
• Contrast test. In the case of intestinal surgery, your surgeon can check for leaks using a CT scan with contrast dye. The contrast is injected into your rectum near the anastomosis to see if it leaks out of the connection.

Screening at the time of surgery won’t prevent all leaks, but it can reduce their number and can highlight people who may be more at risk of a recurring leak.

Preventative stoma

In the case of intestinal surgery, surgeons may be able to prevent the worst effects of a bowel leak by keeping poop out of your bowels during healing. They can do this by creating a temporary colostomy or ileostomy to divert bowel contents away from the connection and into a bag. This won’t prevent an anastomotic leak, but it will prevent bowel contents from infecting your abdominal cavity.

Ostomies create a new, artificial opening for poop to come out, called a stoma. This allows your bowels to rest and heal without the irritation of poop passing through. Surgeons create temporary, preventative ostomies under certain conditions. Temporary ostomy surgery is recommended as a preventative measure when people are at higher risk of leaking.