title: Intraoperative anastomotic dye test significantly decreases incidence of anastomotic leaks in patients undergoing resection for rectal cancer.
abstract: BACKGROUND
  Anastomotic leakage is still a major complication in colorectal surgery. Prompt recognition and immediate treatment of anastomotic leak during surgery may reduce postoperative morbidity and mortality. Various types of intraoperative anastomotic test have been proposed to reduce the incidence of this complication. The aim of this study was to assess our experience with intraoperative dye test in rectal cancer surgery.
  
  
  METHODS
  Between 2006 and 2009, a retrospective review of a single general surgeon's practice identified 76 patients who underwent the intraoperative dye test in rectal cancer surgery. Seventy-three of these 76 patients underwent elective surgery without creation of a diverting stoma. Diluted dye was routinely introduced into the rectal lumen to test anastomotic integrity. Intraoperative leak was repaired prior to the completion of the procedure. No routine radiological survey assessed anastomotic integrity postoperatively.
  
  
  RESULTS
  In 11 (14.5 %) out of 76 patients, anastomotic leaks were found and treated intraoperatively. None of the 65 patients without intraoperative leaks developed clinical leaks during the follow-up period. Postoperative leakage only occurred in one patient (1.3 %). He developed pelvic abscess evidenced by abdominal computed tomography scan and was treated non-operatively.
  
  
  CONCLUSIONS
  The favorable results allow the authors to recommend the routine use of the intraoperative dye test for colorectal anastomoses.
authors.affiliation: Division of Traumatology, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
authors.forename: C-W
authors.initials: CW
authors.lastname: Chen
authors.forename: M-J
authors.initials: MJ
authors.lastname: Chen
authors.forename: Y-S
authors.initials: YS
authors.lastname: Yeh
authors.forename: H-L
authors.initials: HL
authors.lastname: Tsai
authors.forename: Y-T
authors.initials: YT
authors.lastname: Chang
authors.forename: J-Y
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000175:diagnosis / Q000517:prevention & control*; D015331:Cohort Studies; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D004396:Coloring Agents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D004396:Coloring Agents