1Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Review purpose: The aim is to review historical and prospective studies results of anastomotic leaks (AL) after right hemicolectomy (RH) and ileocolic anastomosis.
Methods: Detailed literature review of articles published in 2002-2019 was performed using PubMed, Cochrane database and Google Scholar search system. Keywords used in the search: right colectomy, right hemicolectomy ileocolic anastomosis, leak, dehiscence, abscess, peritonitis.
Results: The historical studies state, that RH is considered a safe operation with low anastomotic leak rates up to 2-4%. Recent studies suggest AL after RH range from 8% to 9%. Studies have shown a higher chance of AL after stapled anastomosis (5,4 – 8,5%) versus hand sewn anastomosis (2,4 – 7,4%). Other risk factors such as Crohn’s disease, side-to-side versus end-to-end anastomosis, single layer versus double layer anastomosis, intraabdominal versus extra-abdominal anastomosis should be considered. Intraoperative testing reduces the rate of postoperative leakage.
Conclusions: AL rate after RH is high, and this surgery is not as safe as it seemed to be. Patient comorbidities and underlying pathologies should be taken into consideration before performing RH. Intraoperative AL identification should be used to reduce the complication rate.
Keywords: Anastomosis leak, right hemicolectomy, ileocolic anastomosis.