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140 ECO-LEAK project: diagnosis of anastomotic leak by the use of transvaginal ultrasound
  1. Victor Lago1,
  2. Manel Montesinos Albert2,
  3. Marta Arnáez De La Cruz1,
  4. Enrique Chacon3,
  5. Luis Chiva3,
  6. Jose Luis Sanchez4,
  7. Antonio Gil Moreno4,
  8. Pablo Padilla-Iserte1,
  9. Luis Matute1,
  10. Marta Gurrea1,
  11. Alberto Rafael Guijarro Campillo5 and
  12. Santiago Domingo1
  1. 1La Fe University and Polytechnic Hospital, Valencia, Spain
  2. 2University Hospital La Fe, Valencia, Spain
  3. 3Clinica Universidad de Navarra, Madrid, Spain
  4. 4Hospital Universitari Vall Hebrón, Barcelona, Spain
  5. 5University Hospital La Arrixaca, Murcia, Spain


Introduction/Background Different tests can be used to diagnose leak during the post-operative period, like CT-enema or proctoscopy. Nevertheless, there is no published evidence about the use of ultrasound for this purpose and its role is still to be established. In order to diagnose the presence of anastomotic leakage in female patients after colorectal anastomosis, we devised this diagnostic test (ECO-LEAK) during the postoperative period.

Methodology Between 2022–2023 this test was performed on patients undergoing colorectal resection and anastomosis in the gynecology department according to the previously described technique (Lago et al IJGC 2022).

Transvaginal ultrasound with enema is performed by the instillation of 180 cc of serum under ultrasound vision with the probe in the vagina and sagittal and mid-sagittal exploration. If no new free peri-anastomotic/pelvic fluid appears, the test is considered negative. If there is a new appearance of pelvic free fluid with respect to the baseline examination (fluid present at the beginning of the examination), the test is considered positive.

Results 40 patients were included. 88% underwent surgery due to ovarian cancer, 8% endometrial cancer and 1 endometriosis 4%. The range of age was 50–71 years. Te mean distance between anal verge and anastomosis was 8 cm (range 6–12).

ECO-LEAK was performed on 4th POD (Range 3rd-5th). The mean visual pain scale was 1.2 out of 10. The rate of anastomotic leak (AL) was 2,5% (1/40). The detection rate was 100% with a negative predictive value of 100% for AL in the first week.

Conclusion ECO-LEAK can accurately predict the presence of anastomotic leak being the test painless. A normal result of the tests has a high negative predictive value. This trial is ongoing (NCT05942209), 300 patients are expected ted to be recruited.

Disclosures None

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