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- 저자 : ( Ayan Banerjea ) (검색결과 1 건)
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( Ahmed Ahmed ),( Ayan Banerjea ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Early diagnosis of anastomotic leakage after colorectal surgery and adequate treatment is crucial to reduce both morbidity and mortality. Computed tomography(CT) scanning is the diagnostic investigation of preference, but its role is questionable in the early postoperative days. The accuracy of CT scanning in the early postoperative period within the fi rst few days after surgery may even be lower when compared to a CT scan more than a week after surgery. Methods: 185 patients underwent 1 or more bowel anastomosis during the period of 6 months. A prospective data sheet was updated regularly with post op morbidity and mortality. The type of anastomosis, timing of postoperative CT scan, diagnosis of leakage and accuracy of the CT scan in detecting it were all recorded. Results: 54 patients (29%) had CT scans post operatively, of whom 48 happened during the same admission with a mean time of 5±3 days postoperatively.A total of 9 patients had their fi rst CT scan onday 3 or earlier postoperatively with one leak detected on that. The mean time for diagnosing a leak was 14±8 days. Conclusions: Timely and correct diagnosis and treatment of anastomotic leakage after bowel surgery remains to be a major challenge.Clinical decision remains of utmost importance in the individual patient and should therefore not depend on one specifi c clinical or additional diagnostic factor.
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