Epiploic steal: is this concept the key to reducing colorectal anastomotic leak rates?

Ensuring optimal colonic perfusion is a critical step in every colorectal anastomosis. The aim of this study is to describe the concept of epiploic steal.

A literature review was performed to identify studies evaluating anastomotic blood supply. The fundamental principle of epiploic steal is outlined.

Epiploic steal has not been previously evaluated in the literature, and likely has a negative effect on colonic blood supply. Resection of colonic epiploicae may improve perfusion at the distal most lengths of a mobilised colonic conduit where the anastomosis requires it.

This novel concept has the potential to change practice and reduce colorectal anastomotic leak rates. Further clinical studies are required.