Narrow Band Imaging Can Be Used for Anastomotic Assessment

Abstract

Background: Anastomotic leak is the most dreaded complication and it accounts for one third of post-operative deaths in colorectal surgery. There is strong need of research in this field in order to reduce anastomotic leak rate. If there was a test available to signify probability of leak at the time of surgery, it would potentially avoid a leak at a later date. Aim: We propose that intra operative use of narrow band imaging colonoscopy in left sided colonic anastomosis can predict and detect anastomosis related problems, problems i.e. vascularity, anastomotic lumen patency and rigidness of anastomosis which in turn lead to correction at the time of surgery resulting in significant decrease in anastomotic leak rate associated with morbidity and mortality. Methodology: A pilot, single blind, prospective, randomised controlled trial. Aim is to divide patient in 2 groups, containing 15 patients in each group. One group will be assessed by intra-operative NBI colonoscopy and other with standard technique. Analysis: This will be performed using SPSS with the help of statistician. Significance: This area of research is particularly important because it improves survival by reducing morbidity and mortality associated with anastomotic leak. If a leak is avoided then it does not only mean early recovery but it also saves NHS in terms of ICU care, NHS bed, inpatient nursing care and home help, unfortunately all required if leak is to occur. As a result, this research will have better financial implication with significantly improve patient care.