Skip to main content

Advertisement

Log in

Salvage repair of anastomotic dehiscence following colon surgery using an expanded polytetrafluoroethylene graft

  • Case Report
  • Published:
Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Anastomotic dehiscence is a serious complication of colorectal surgery that causes death in up to 40% of cases in which it occurs. Edema and inflammation due to abdominal sepsis can prevent the use of standard management (i.e., colostomy, ileostomy or Hartmann’s procedure), in which case alternative salvage repair methods are required. The present report describes the treatment of a 73-year-old female patient at high risk of mortality because of intraabdominal sepsis due to suture dehiscence following a right hemicolectomy and ileo-transversostomy. Several surgical repair procedures were tried, but all failed. We then used an expanded polytetrafluoroethylene (ePTFE) graft in salvage repair, and this approach proved successful. This is the first report to describe clinical, macroscopic and histopathological findings, following use of an ePTFE graft in colorectal repair in humans.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Choi HK, Law WL, Ho JW (2006) Leakage after resection and intraperitoneal anastomosis for colorectal malignancy: analysis of risk factors. Dis Colon Rectum 49:1719–1725

    Article  PubMed  Google Scholar 

  2. Golub R, Golub RW, Cantu R Jr, Stein HD (1997) A multivariate analysis of factors contributing to leakage of intestinal anastomoses. J Am Coll Surg 184:364–372

    PubMed  CAS  Google Scholar 

  3. Parc Y, Frileux P, Schmitt G, Dehni N, Ollivier JM, Parc R (2000) Management of postoperative peritonitis after anterior resection: experience from a referral intensive care unit. Dis Colon Rectum 43:579–587 (discussion 587–589)

    Google Scholar 

  4. Wittmann DH, Schein M, Condon RE (1996) Management of secondary peritonitis. Ann Surg 224:10–18

    Article  PubMed  CAS  Google Scholar 

  5. Cağa T, Gürer F (1993) Polytetrafluoroethylene patch grafting for closure of stomach defects in the rat. Br J Surg 80:1013–1014

    Article  PubMed  Google Scholar 

  6. Ozlem N, Erdogan B, Gültekin S, Dedeoglu S, Aydin A (1999) Repairing great duodenal defects in rabbits by ePTFE patch. Acta Chir Belg 99:17–21

    PubMed  CAS  Google Scholar 

  7. Astarcioğlu H, Koçdor MA, Sökmen S, Karademir S, Ozer E, Bora S (2001) Comparison of different surgical repairs in the treatment of experimental duodenal injuries. Am J Surg 181:309–312

    Article  PubMed  Google Scholar 

  8. Oh DS, Manning MM, Emmanuel J, Broyles SE, Stone HH (2002) Repair of full-thickness defects in alimentary tract wall with patches of expanded polytetrafluoroethylene. Ann Surg 235:708–711 (discussion 711–712)

    Google Scholar 

  9. Nikeghbalian S, Atefi S, Kazemi K et al (2008) Repairing large duodenal injuries in dogs by expanded polytetrafluoroethylene patch. J Surg Res 144:17–21

    Article  PubMed  CAS  Google Scholar 

  10. Bellón JM, Buján J, Contreras LA, Hernando A, Jurado F (1996) Similarity in behavior of polytetrafluoroethylene (ePTFE) prostheses implanted into different interfaces. Biomed Mater Res 31:1–9

    Article  Google Scholar 

  11. Jenkins SD, Klamer TW, Parteka JJ, Condon RE (1983) A comparison of prosthetic materials used to repair abdominal wall defects. Surgery 94:392–398

    PubMed  CAS  Google Scholar 

  12. Pairolero PC, Arnold PG (1986) Thoracic wall defects: surgical management of 205 consecutive patients. Mayo Clin Proc 61:557–563

    PubMed  CAS  Google Scholar 

  13. Revuelta JM, Garcia-Rinaldi R, Val F, Crego R, Duran CM (1985) Expanded polytetrafluoroethylene surgical membrane for pericardial closure. An experimental study. J Thorac Cardiovasc Surg 89:451–455

    PubMed  CAS  Google Scholar 

  14. Fulton RL, Dickson M (1990) A useful technique for closure of pulmonary lacerations. Ann Thorac Surg 50:149–150

    Article  PubMed  CAS  Google Scholar 

  15. Martin JN Jr, Brewer DW, Rush LV Jr, Martin RW, Hess LW, Morrison JC (1990) Successful pregnancy outcome following mid-gestational uterine rupture and repair using gore-tex soft tissue patch. Obstet Gynecol 75:518–521

    PubMed  Google Scholar 

  16. Brown GL, Richardson JD, Malangoni MA, Tobin GR, Ackerman D, Polk HC Jr (1985) Comparison of prosthetic materials for abdominal wall reconstruction in the presence of contamination and infection. Ann Surg 201:705–711

    Article  PubMed  CAS  Google Scholar 

  17. van der Lei B, Bleichrodt RP, Simmermacher RK, van Schilfgaarde R (1989) Expanded polytetrafluoroethylene patch for the repair of large abdominal wall defects. Br J Surg 76:803–805

    Article  PubMed  Google Scholar 

  18. Bleichrodt RP, Simmermacher RK, van der Lei B, Schakenraad JM (1993) Expanded polytetrafluoroethylene patch versus polypropylene mesh for the repair of contaminated defects of the abdominal wall. Surg Gynecol Obstet 176:18–24

    PubMed  CAS  Google Scholar 

  19. Watson LC, Friedman HI, Griffin DG, Norton LW, Mellick PW (1980) Small bowel neomucosa. J Surg Res 28:280–291

    Article  PubMed  CAS  Google Scholar 

  20. Thompson JS, Kampfe PW, Newland JR, Vanderhoof JA (1986) Growth of intestinal neomucosa on prosthetic materials. J Surg Res 41:484–492

    Article  PubMed  CAS  Google Scholar 

  21. Yilmaz HG, Odabaşi M, Büyükbayram H, Baç B (2001) Effectiveness of fibrin tissue adhesive for colocolic anastomosis reliability. Ulus Travma Derg 7:87–90

    PubMed  CAS  Google Scholar 

  22. Karahasanoglu T, Alcicek S, Altunkaya E et al (1997) Effect of fibrin glue on irradiated colonic anastomoses. Dis Colon Rectum 40:1240–1243

    Article  PubMed  CAS  Google Scholar 

  23. Gómez NA, Roura E, León CJ, Vargas P, Zapatier JE (2003) Use of a polytetrafluoroethylene tube and patch in the repair of a difficult duodenal stump. Acta Gastroenterol Latinoam 33:9–12

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. A. Uzun.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Uzun, M.A., Koksal, N., Ozkan, O.F. et al. Salvage repair of anastomotic dehiscence following colon surgery using an expanded polytetrafluoroethylene graft. Tech Coloproctol 16, 169–173 (2012). https://doi.org/10.1007/s10151-010-0638-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10151-010-0638-4

Keywords

Navigation