Clinical Challenges in Colorectal Surgery: Management of Anastomotic Leaks

Behind The Knife: The Surgery Podcast

Medicine, Health & Fitness, Education, Science

4.8 • 1.4K Ratings

🗓️ 8 January 2026

⏱️ 31 minutes

🔗️ Recording | iTunes | RSS

🧾️ Download transcript

Summary

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:

Assess postoperative changes that warrant imaging and/or intervention in suspected anastomotic leaks.
Apply a structured decision-making approach to determine when nonoperative management, drainage, diversion, or operative intervention is most appropriate.
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.

Transcript

Click on a timestamp to play from that location

0:00.0	Behind the Night, the Surgery Podcast, relevant and engaging content designed to help you
0:11.6	dominate the day. Hi, all you BTK listeners. It's Scott here. Want to talk a little bit about our
0:25.8	colorectal surgery oral board audio review. With upwards of 50 plus high-ield scenarios designed
0:34.0	for colorectal surgeons by colorectal surgeons, the scenarios are five to seven minutes long, a variety of tactics styles.
0:40.3	We also have a high-yield commentary to each scenario. It includes tips and tricks that help you dominate the most challenging scenarios.
0:49.3	In addition to practical, easy to think through, easy to understand, teaching style that covers the most confusing, the most interesting, and the most basic of topics that we all face as colorectal surgeons.
1:01.0	So we are confident that you will find this unique, dual format approach, highly effective way to prepare for your test.
1:07.0	Check it out, Behind theknife.org.
1:10.0	Hey everyone and welcome to Behind the Knife. My name is Alyssa Deboggi. I'm a general
1:14.7	surgery resident at the Cleveland Clinic. And I'm Jared Hendren. I'm a general surgery resident
1:18.9	at Cleveland Clinic as well. My name is Dave Rosen. I'm the section head of the
1:23.9	Division of Colorectal Surgery at Cleveland Clinic Fairview Hospital.
1:34.8	I am Adiratsu, also known as AJ Kishina. I'm one of the partners, one of Dr. Rose's partners.
1:40.3	And I'm Joseph Trunzel, also one of the partners here at Cleveland Clinic Fairview and Associate Program Director for General Surgery Residency. All right, so today we're tackling one of the most challenging complications in colorectal surgery
1:47.4	and asthmotic leaks.
1:49.0	Our discussion will focus on how to manage them both in the OR and post-op
1:53.1	and some practical decision-making tips that can help surgeons navigate these high-stakes
1:57.4	situations.
1:58.1	So let's start with the case.
1:59.7	We have a 50-year-old man,
2:01.2	history of recurrent sigmoid diverticulitis. His last episode was six months ago, and he's been symptom-free since then. And he sees y'all for an elective laparoscopic sigmoid clectomy. In trope, there's no signs of acute inflammation, although the sigmoid's a little thickened, and you ultimately perform a stapled
2:17.6	end-to-end colorectal anastomosis without tension or difficulty, and your interop, a leak test
	...

Please login to see the full transcript.

Previous episode | Next episode

Disclaimer: The podcast and artwork embedded on this page are from Behind The Knife: The Surgery Podcast, and are the property of its owner and not affiliated with or endorsed by Tapesearch.

Generated transcripts are the property of Behind The Knife: The Surgery Podcast and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.