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The use of intraoperative endoscopy for early detection and prevention of gastrointestinal anastomotic complications


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Objective. To assess the role of intraoperative endoscopy in early detection and prevention of gastrointestinal anastomotic complications. Material and methods. Between June 2015 and March 2016, 41 patients underwent surgery on the gastrointestinal tract (32 - left side of colon, 9 - stomach and esophagus) with primary anastomosis and its intraoperative endoscopic evaluation (we assessed bleeding and integrity). Results. Intraoperative endoscopy after left-sided colorectal surgery didn't show any anastomotic leak (air leakage test was negative). There were not postoperative clinical leaks. Anastomotic bleeding was detected in 1 case (3%) and required clipping. Intraoperative endoscopy after surgery on the stomach and esophagus showed leak in 1 case (11,1%), after subtotal distal resection of the stomach, and required oversewing of the suture line. Anastomotic bleedings were not detected. There was 1 postoperative clinical leak (11,1%) after gastrectomy, which required stent placement in this area. Conclusions. Intraoperative endoscopy is safe and useful. It can detect anastomotic leakage (positive air leakage test) and bleeding. These complications can be repaired by oversewing of the suture line (in case of leakage) or clipping (in case of bleeding) at the time of surgery.

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