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World J Gastroenterol. Sep 21, 2014; 20(35): 12445-12457
Published online Sep 21, 2014. doi: 10.3748/wjg.v20.i35.12445
Published online Sep 21, 2014. doi: 10.3748/wjg.v20.i35.12445
Improving the outcomes in oncological colorectal surgery
Jeroen LA van Vugt, Djamila Boerma, Department of Surgery, St Antonius Hospital, 3430 EM Nieuwegein, The Netherlands
Kostan W Reisinger, Joep PM Derikx, Department of Surgery, Maastricht University Medical Center and Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht University, 6200 MD Maastricht, The Netherlands
Jan HMB Stoot, Department of Surgery, Orbis Medical Center, 6162 BG Sittard, The Netherlands
Jan HMB Stoot, Department of Surgery, Atrium Medical Center, 6401 CX Heerlen, The Netherlands
Author contributions: van Vugt JLA and Reisinger KW contributed equally to this work, they performed the review of literature and wrote and revised the paper; Derikx JPM and Boerma D provided support and knowledge and revised the paper; Stoot JHMB designed the review, provided support and knowledge and revised the paper.
Correspondence to: Kostan W Reisinger, MD, Department of Surgery, Maastricht University Medical Center and Nutrim School for Nutrition, Toxicology and Metabolism, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. k.reisinger@maastrichtuniversity.nl
Telephone: +31-43-3881494 Fax: +31-43-3884154
Received: December 28, 2013
Revised: March 18, 2014
Accepted: June 14, 2014
Published online: September 21, 2014
Revised: March 18, 2014
Accepted: June 14, 2014
Published online: September 21, 2014
Core Tip
Core tip: Laparoscopic surgery is a fundamental improvement in oncological colorectal surgery, associated with better short-term outcomes. However, anastomotic leakage still presents a major challenge in the postoperative course. Future research should therefore aim at the prevention, timely recognition and treatment of this complication. Correction of nutritional compromise, frailty and muscle loss, optimization of fluid and microcirculatory status, implementation of clinical and laboratory diagnostic markers, and the use of clinical audits may all contribute to a reduction of anastomotic leakage.