Jagon Babu,
- Nursing Scholar, Department of Nursing, Acute Colorectal–Gastrointestinal Surgical Ward, Monash Health, Melbourne, Victoria, Australia
Abstract
Purpose: Postoperative colorectal anastomotic leak (AL) is one of the most feared complications after colorectal surgery because of its association with sepsis, reoperation, mortality, prolonged hospital stay, delayed adjuvant therapy, and permanent stoma formation. This narrative practice review outlines the frontline role of surgical-ward nurses in the early identification, escalation, and interim management of AL within the Australian acute-care context. Methods: A narrative synthesis of contemporary consensus statements, systematic reviews, and observational studies on colorectal AL was undertaken, with a focus on incidence, timing, clinical, and laboratory indicators, imaging strategies, and escalation frameworks relevant to ward-based nursing practice. Australian safety and quality standards for recognizing and responding to clinical deterioration were used as a contextual framework. Results: Reported AL rates range from approximately 1–19% depending on specific patient, anatomical, and technical factors, with typical presentation between postoperative days 5–7. Early detection relies on vigilant bedside surveillance of vital signs, abdominal findings, wound, and drain output, gastrointestinal recovery, and neurological and perfusion status, supported by early warning scores and serial laboratory markers (C-reactive protein, white cell count, procalcitonin, lactate, and drain/serum amylase ratio). Structured escalation through standardized communication, sepsis protocols, and prompt computed tomography (CT) imaging—preferably with rectal contrast where indicated—can shorten time to definitive surgical or radiological intervention. Nurses are central to interim resuscitative measures, documentation, patient, and family education, and quality-improvement feedback. Conclusion: In colorectal surgery, surgical-ward nurses are pivotal “early detectors” of AL. Embedding AL-focused surveillance into routine ward practice, supported by clear escalation pathways, biomarker monitoring, and multidisciplinary collaboration, can improve the timeliness of diagnosis and the safety of postoperative care.
Keywords: Anastomotic leak, Australia, colorectal surgery, early warning scores, escalation of care, nursing
[This article belongs to Research and Reviews : Journal of Surgery ]
Jagon Babu. Role of the Surgical-Ward Nurse in Identifying, Escalating, and Managing Postoperative Anastomotic Leak in Colorectal Patients: A Narrative Synthesis in an Australian Nursing Perspective. Research and Reviews : Journal of Surgery. 2026; 15(01):7-12.
Jagon Babu. Role of the Surgical-Ward Nurse in Identifying, Escalating, and Managing Postoperative Anastomotic Leak in Colorectal Patients: A Narrative Synthesis in an Australian Nursing Perspective. Research and Reviews : Journal of Surgery. 2026; 15(01):7-12. Available from: https://journals.stmjournals.com/rrjos/article=2026/view=238357
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Research and Reviews : Journal of Surgery
| Volume | 15 |
| Issue | 01 |
| Received | 21/01/2026 |
| Accepted | 07/03/2026 |
| Published | 12/03/2026 |
| Publication Time | 50 Days |
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