EP567 - Endoscopic Rescue of Colorectal Anastomotic Leak: A Five Years’ Experience

Sunday, May 11, 2025

4:11 PM – 4:16 PM PT

Location: Monitor 4, Sails Pavilion, Upper Level

Author(s)

EA

Edgardo G. Arcia Guerra, Colorectal Surgeon, Vice President of the Panamanian Association of Coloproctology

Colorectal Surgeon
FACS, member ASCRS, member ESCP, international fellow SAGES
Panama, Panama, Panama

Disclosure information not submitted.
JL

JOSE ISAAC LATORRACA, FACS

Colorectal Surgeon
FACS
Panama, Panama, Panama

Disclosure information not submitted.
Felix H. Bonilla, MD (he/him/his)

Coloproctology fellow
HCIC Brazil
Panama, Panama, Panama

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

Senior Author(s)

IB

Ivan Beitia Jurado, Colorectal Surgeon

Colorectal Surgeon
Member ASCRS
Panama, Panama, Panama

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

ePoster Presenter(s)

Sarah M. De Maya, General Surgery Resident (she/her/hers)

General Surgery Resident
Hospital Regional de Veraguas
Panama, Panama, Panama

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.

Felix H. Bonilla, MD: This individual has no financial relationships with ineligible companies.

Ivan Beitia Jurado, Colorectal Surgeon: This individual has no financial relationships with ineligible companies.

Sarah M. De Maya, General Surgery Resident: This individual has no financial relationships with ineligible companies.

Image or Table (Do Not add text here):

Purpose/Background: Anastomotic leaks (AL) are one of the most serious complications of colorectal surgery and still carry certain probability.

The over-the-scope clip (OTSC) system was developed as a GI wall full-thickness suturing device that bridges the gap between conventional medical treatment and surgical procedures and it has proved to be useful in endoscopic management of colorectal AL.1

The use of covered self-expandable esophageal metal stents (SEMS) has been described in the management of leaks, perforations, and fistulae of the upper GI tract but has proved useful in colorectal surgery in anastomotic leak scenarios.2

Methods/Interventions: We reviewed a total of 298 cases of colorectal anastomosis from 2019 to 2024

Results/Outcomes: We account for 12 cases of anastomotic leak, being 10 of them from a laparoscopic approach and 2 from open approach. 75% were colorectal anastomosis, 8.3% ileal pouch anal anastomosis, 8.3% ileorectal anastomosis and 8.3% colo-colonic anastomosis.

In all the 298 cases reviewed, bowel preparation, endoscopic examination, pneumatic testing, use of indocyanine green and placement of abdominal drainage were performed.

Success rate was seen in 83% of cases with OTSC. In 17% of the cases, where OTSC failed, anastomotic rescue could be accomplished with mixed endoscopic therapy (STENT, TAMIS, E-VAC)

The average hospital stay was 17.4 days.

Conclusion/Discussion: Early identification of anastomotic leaks is the key to providing less invasive treatment.

OTSC and STENT proved to be successfully useful in management of anastomotic leaks, reducing reinterventions and permanent stomas.