Transrectal Vacuum Assisted Drainage: A NEW METHOD OF TREATING ANASTOMOTIC LEAKAGE AFTER RECTAL RESECTION. A Prospective Randomized Multicenter Study in Cooperation With "The Danish Colorectal Cancer Group"
Inclusion Criteria:
- Patients with clinically significant* anastomotic leakage after intended curative
rectal resection (LAR) for rectal cancer with primary anastomosis.
- Patients whose operation did not include ileostomy must have surgery to create a
stoma within two days after beginning of the vacuum therapy and before randomization.
Anastomotic leakage must have been diagnosed within 21 days of the primary
operation.
- Patients with and without preoperative radiation therapy may participate.
- Groups will be formed accordingly, because patients who had preoperative radiation
therapy heal more slowly.
- Patients with anastomotic leakage (diagnosed by endoscopic or radiology techniques)
and clinical signs and symptoms indicating a health impairment (fever, pain, elevated
creatinine levels).
- Anastomotic leakage after rectal cancer surgery
Exclusion Criteria:
- Informed consent
- Age < 18 years
- Acute surgery
- Leakage diagnosed more than 21 days after the primary operation
- Patient does not consent to temporary ileostomy
- Anastomosis technically inaccessible for vacuum-assisted drainage
- Small intestine visible in abscess cavity
- Residual cancer tissue in the pelvic cavity
- Suspicion of fistulation between the abscess cavity and internal genitalia, urinary
tract system, or small intestines.