CT scan for early diagnosis of anastomotic leak after colorectal surgery: is rectal contrast useful?

Background Computed tomography ( CT) scan with rectal contrast enema (RCE-CT) could increase the detection rate of anastomotic leaks (AL) in the early postoperative period following colorectal surgery, compared to CT scan without RCE. The aim of this study was to assess the benefit of RCE-CT for the...

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Published in:Techniques in coloproctology 2023-08, Vol.27 (8), p.639-645
Main Authors: Moreno-Lopez, N., Mvouama, S., Bourredjem, A., Fournel, I., Perrin, T., Flaris, A., Rat, P., Facy, O.
Format: Article
Language:English
Subjects:
Abdominal Surgery
Colorectal Surgery
Gastroenterology
Medical imaging
Medicine
Medicine & Public Health
Original Article
Postoperative period
Proctology
Surgery
Surgical anastomosis
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Summary:Background Computed tomography ( CT) scan with rectal contrast enema (RCE-CT) could increase the detection rate of anastomotic leaks (AL) in the early postoperative period following colorectal surgery, compared to CT scan without RCE. The aim of this study was to assess the benefit of RCE-CT for the early diagnosis of AL following colorectal surgery. Methods Patients who had a RCE-CT for suspected AL in the early postoperative period following colorectal surgery with anastomosis between January 2012 and July 2019 at the Dijon University Hospital were retrospectively included. All images were reviewed by two independent observers who were blinded to the original report. The reviewers reported for each patient whether an AL was present or not in each imaging modality (CT scan, then RCE-CT). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were then calculated to determine the diagnostic performance of each modality. Results One hundred and thirty-nine patients were included. RCE-CT had an increased NPV compared to CT scan (82% vs 77% ( p  = 0.02) and 84% vs 68% ( p  
ISSN:1123-6337
1128-045X
DOI:10.1007/s10151-022-02716-8