Special Considerations of Anastomotic Leaks in Crohn's Disease

Clin Colon Rectal Surg. 2021 Oct 1;34(6):412-416. doi: 10.1055/s-0041-1735273. eCollection 2021 Nov.

Abstract

Rates of anastomotic leak following intestinal resections in the setting of inflammatory bowel disease are significantly influenced by clinical characteristics. While the literature can be contradictory due to significant heterogeneity in the published data, several common themes appear to consistently arise. With respect to Crohn's disease, low serum albumin, preoperative abscess, reoperative abdominal surgery, and steroid use are associated with an increased risk of postoperative intra-abdominal septic complications. On the contrary, biologic therapy, immunomodulator use, and method of anastomosis appear not to confer increased anastomotic-related complications. Undoubtedly, a low rate of anastomotic leakage is inherent to procedures within colorectal surgery but diligent attention must be paid to identify, optimize, and, therefore, reduce known risks.

Keywords: Crohn's disease; anastomotic leak; biologics; hypoalbuminemia; intra-abdominal abscess; steroids.

Publication types

  • Review

Grants and funding

Funding This work was supported by the Peter and Marshia Carlino Early Career Professorship Award for Inflammatory Bowel Disease Research.