Prevention of anastomotic leakage in colorectal surgery

Anastomotic leakage is a major cause of mortality in colorectal surgery. So me variables associated with a high-risk level for anastomotic leakage have been identified, including denutrition, obesity, smoking, level of the ana stomoses, qualification of the surgeon. Several methods have been evaluated in order to prevent anastomotic leakage. Prophylactic antibiotic therapy h as been recommended, but has no effect on the rate of anastomotic leakage. Optimal preoperative colonic preparation appears to be obtained with povido ne iodine enemas associated with a low residue diet. Stapling gives better results than sutures only for difficult anastomoses. Colostomy does not pre vent leakage but minimizes its consequences. Omentoplasty, peritoneal drain age, gastric tube, biofragmentable anastomotic ring, and Coloshield have de monstrated their efficacy.