Complications in colon and rectal surgery. Early diagnosis and management

Surgery for colon and rectum has significant complications.

This review article was undertaken to discuss the prevention, recognition, and management of the most common complications after colon and rectal surgery.

Some serious complications such as anastomotic leak and wound infection can be minimized with good bowel preparation, proper use of antibiotics, good technique, and judgment. Complications such as bladder dysfunction, and sexual dysfunction can also be minimized by the proper anatomic dissection which can avoid an unnecessary disruption of the pelvic nerves. Some complications can even be prevented: a splenic injury can be prevented by an adequate exposure, avoiding traction of the greater omentum, and first dividing the adhesions of omentum to the spleen before a full mobilization of the colon; necrosis and retraction of colostomy and ileostomy, especially in obese patients, can be prevented by an adequate mobilization to avoid tension and attention to the blood supply to the entire length of the ostomy limb. Some complications are unavoidable: massive life-threatening intraoperative pelvic bleeding from basivertebral veins requires a thumbtack occlusion; when to operate on on patients with a prolongated postoperative small bowel obstruction requires a good judgment and skill.

An appropriate knowledge of common and uncommon complications following colon and rectal surgery should permit a successful management.