title: Management of colorectal anastomotic leakage: differences between salvage and anastomotic takedown.
abstract: BACKGROUND
  The aim of this study was to evaluate and compare the morbidity associated with 2 strategies of treatment of colorectal anastomotic leakage: surgical drainage of anastomosis with loop ileostomy versus anastomotic takedown.
  
  
  METHODS
  An observational study of patients operated on for ileocolic or colorectal anastomotic leakage between 2001 and 2009. Patients were classified into 2 groups: group 1, salvage of the anastomosis, and group 2, anastomotic takedown. Mortality and morbidity were assessed. Morbidity and mortality of bowel restoration were also evaluated.
  
  
  RESULTS
  Thirty-nine patients were included into group 1 and 54 into group 2. Mortality was 15% for group 1 and 37% for group 2 (P = .022). The rate of patients suitable for stoma reversal was 91% for loop ileostomy and 38% for end stoma (P < .001). Morbidity was 18% after loop ileostomy closure and 71% after end stoma reversal (P = .021). Hospitalization was 10 days and 21 days, respectively (P = .009). There was no mortality.
  
  
  CONCLUSIONS
  Salvage of anastomosis with loop ileostomy is an effective strategy to control peritoneal sepsis for colorectal anastomotic leakage.
authors: Department of Surgery, Colorectal Unit, Bellvitge University Hospital and IDIBELL, University of Barcelona, Barcelona, Spain.
authors: Domenico
authors: D
authors: Fraccalvieri
authors: Sebastiano
authors: S
authors: Biondo
authors: Jose
authors: J
authors: Saez
authors: Monica
authors: M
authors: Millan
authors: Esther
authors: E
authors: Kreisler
authors: Thomas
authors: T
authors: Golda
authors: Ricardo
authors: R
authors: Frago
authors: Bernat
authors: B
authors: Miguel