Clinical Challenges in Colorectal Surgery: Management of Anastomotic Leaks

This episode offers a practical, case-based overview of evaluating and managing anastomotic leaks in colorectal surgery. It highlights early clinical warning signs, optimal imaging, and a framework for choosing nonoperative versus operative strategies, including when to drain, divert, repair, or revise an anastomosis. The discussion also covers management considerations in diverted patients and those with Crohn’s disease, as well as long-term issues such as chronic leak–related complications and planning for stoma reversal. Join Drs. Jared Hendren, Elissa Dabaghi, Joseph Trunzo, Ajaratu Keshinro, and David Rosen as they discuss this clinical challenge in colorectal surgery.

Hosts:
- Jared Hendren, MD
ο Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
- Elissa Dabaghi, MD
ο Institution: Department of General Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
- Joseph Trunzo, MD
ο Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
ο Social Media Handle: X/Twitter @joseph_trunzo
- Ajaratu Keshinro, MD
ο Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
ο Social Media Handle: X/Twitter- @AJKesh
- David Rosen, MD
ο Institution: Department of Colon and Rectal Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, Ohio
- Social Media Handle: X/Twitter- @davidrrosenmd

Learning Objectives: By the end of this episode, listeners will be able to:

1. Assess postoperative changes that warrant imaging and/or intervention in suspected anastomotic leaks.
2. Apply a structured decision-making approach to determine when nonoperative management, drainage, diversion, or operative intervention is most appropriate.
3. Recognize key considerations in managing leaks in diverted patients and those with Crohn’s disease, including long-term complications and factors influencing stoma reversal planning.

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