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Digestive Surgery

Juliette C Slieker, Daniel Clerc, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
INTRODUCTION: Enhanced recovery after surgery (ERAS) pathways proved to reduce complications, length of hospital stay and costs after colorectal surgery. Standardized discharge criteria have been established that are fulfilled after complete medical recovery is achieved. This study aimed to assess the timing of complete medical recovery in relation to the timing of actual discharge, and to assess reasons for prolonged hospital stay within an ERAS pathway. METHODS: One hundred fourteen consecutive patients undergoing elective colorectal surgery within an ERAS pathway were included in this prospective analysis...
December 10, 2016: Digestive Surgery
Patrícia Andrade, Armando Ribeiro, Rosa Ramalho, Susana Lopes, Guilherme Macedo
BACKGROUND AND AIMS: Most international guidelines recommend performing a routine colonoscopy after the conservative management of acute diverticulitis, mainly to rule out a colorectal malignancy; however, data to support these recommendations are scarce and conflicting. This study is aimed at determining the rate of advanced colonic neoplasia (ACN) found by colonoscopy, and hence the need for routine colonoscopy after CT-diagnosed acute diverticulitis. METHODS: We retrospectively analyzed all patients hospitalized for acute diverticulitis between July 2008 and June 2013...
December 10, 2016: Digestive Surgery
Florian Fanget, Arnaud Pasquer, Filbert Djeudji, Jacques Chabanon, Xavier Barth
AIMS: Buschke-Lowenstein tumor (BLT) of the anal margin is a histologically benign tumor whose degeneration can lead to a deadly local evolution because of difficult and late diagnosis. The objective of this study was to report our experience and propose a therapeutic strategy for these rare tumors. METHODS: From 1996 to 2014, 10 men with a median age of 45 years (25-64) were treated for a BLT of the anal margin with a first local excision possibly followed by rectal amputation...
December 10, 2016: Digestive Surgery
Sho Nambara, Tomohiro Iguchi, Eiji Oki, Patrick Tan, Yoshihiko Maehara, Koshi Mimori
BACKGROUND: Among several candidate genes that promote peritoneal dissemination extracted by comprehensive expression analysis of both in vivo selected metastatic cell lines and patients with gastric cancer, we focused on the chemokine (C-X-C motif) receptor (CXCR7) and explored its clinicopathological significance in gastric cancer. METHODS: CXCR7 expression was evaluated by microarray data in the Singapore cohort (n = 196) and by immunohistochemistry and reverse transcription quantitative real-time polymerase chain reaction in the Japanese cohort (n = 195)...
December 10, 2016: Digestive Surgery
Jun-Yong Ma, Xi-Feng Li, Zhen-Lin Yan, Mohammad Mahboob Hasan, Kui Wang, Yu Wang, Wen-Chao Wang, Qiang Yan, Feng Shen, Le-Hua Shi, Xiao-Feng Zhang
BACKGROUND/AIMS: To explore the possibility and feasibility of hepatic portal reocclusion for detecting bile leakage during hepatectomy. METHODS: Data were prospectively collected from 200 patients who underwent hepatectomy alone for removal of various benign or malignant tumors between March 2014 and November 2014. The surgical procedure used a conventional method for all patients, and one additional step (hepatic portal reocclusion) was included in group B. The postoperative outcomes of the patients in group A (subjected to the traditional procedure) and group B (subjected to hepatic portal reocclusion) were compared during the same period, and the incidence rates of postoperative bile leakage and other complications in the 2 groups were also analyzed...
December 10, 2016: Digestive Surgery
Min-Wei Zhou, Zi-Hao Wang, Zong-You Chen, Jian-Bin Xiang, Xiao-Dong Gu
BACKGROUND/AIM: Preventive ileostomy is frequently constructed to minimizethe consequences of anastomotic leakage after resection of rectal cancer. There is no consensus regarding the best timing for temporary stoma closure after proctectomy for rectal cancer. This retrospective study sought to determine whether the timing of stoma closure influenced postoperative outcomes. METHODS: Subjects were 123 patients with rectal cancer undergoing laparoscopic or open total mesorectal excision surgery with preventive ileostomy from 2012 to 2015...
December 10, 2016: Digestive Surgery
Tomoyuki Wakahara, Nozomi Ueno, Shohei Komatsu, Hiroshi Ashitani, Shinobu Tsuchida, Akihiro Toyokawa
BACKGROUND: The influence of chronic kidney disease (CKD) on the outcome of gastric cancer surgery has rarely been reported. METHODS: Retrospectively collected clinicopathological data on patients who underwent elective gastrectomy between January 2007 and December 2014 were analyzed (n = 500). The patients were divided into 2 groups based on the preoperative estimated glomerular filtration rate (eGFR): a non-CKD group (eGFR ≥60 ml/min/1.73 m2, n = 392) and a CKD group (eGFR <60 ml/min/1...
December 10, 2016: Digestive Surgery
Chun-Geun Ryu, Pyeongsu Kim, Min Jeng Cho, Milljae Shin, Eun-Joo Jung
AIMS: This study was designed to review the clinical features of stercoral colonic perforation and to evaluate the appropriate intraoperative procedures and postoperative management to achieve the best surgical outcomes. METHODS: Between January 2009 and December 2015, 12 patients with stercoral perforation confirmed surgically and pathologically were included in this study, and their medical records were reviewed retrospectively. RESULTS: The enrolled patients included 2 men and 10 women; their mean age was 73...
December 10, 2016: Digestive Surgery
Ian S Reynolds, Roisin M Heaney, Waqar Khan, Iqbal Z Khan, Ronan Waldron, Kevin Barry
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) is a novel biomarker that has been recently studied in diverticulitis. The primary aim of this study was to assess the accuracy of NLR in predicting which patients had complicated diverticulitis and which patients required a radiological or surgical intervention. The accuracy of NLR was compared to C-reactive protein (CRP), white blood cell (WBC) count, neutrophil count and white cell to lymphocyte ratio (WLR). METHODS: Details of all patients admitted with acute diverticulitis over an 18-month period were collected prospectively...
December 10, 2016: Digestive Surgery
Kuen-Lin Wu, Ko-Chao Lee, Chia-Cheng Liu, Hong-Hwa Chen, Chien-Chang Lu
BACKGROUND/AIMS: The study aimed to perform a meta-analysis comparing laparoscopic and open surgery for diverticulitis. METHODS: Studies comparing the outcomes of laparoscopic surgery versus open surgery for diverticulitis that reported quantitative data were included. Outcome measures were mortality and morbidity rates and length of hospital stay. RESULTS: Four randomized controlled trials - 3 prospective and 21 retrospective - were included in the analysis...
December 10, 2016: Digestive Surgery
Didier Roulin, Mirza Muradbegovic, Valérie Addor, Catherine Blanc, Nicolas Demartines, Martin Hübner
BACKGROUND/AIMS: Enhanced recovery after surgery (ERAS) protocols for elective colorectal surgery reduce the intensity of postoperative complications, hospital stays and costs. Improvements in clinical outcome are directly proportional to the adherence to the recommended pathway (compliance). The aim of the present study was to analyze reasons for the non-compliance of colorectal surgeries with the ERAS protocol. METHODS: A consecutive cohort of patients undergoing elective colorectal surgery was prospectively analyzed with regards to the surgery's compliance with the ERAS protocol...
December 10, 2016: Digestive Surgery
Yasumitsu Hirano, Masakazu Hattori, Kenji Douden
BACKGROUND: Utilization of single-incision laparoscopic surgery for the management of colon cancer has increased; however, the feasibility of single-incision laparoscopic colectomy (SILC) for patients with stage IV colon cancer (ST4) has not been well examined. METHODS: Fifty-four patients with ST4 could be identified who electively underwent single-incision laparoscopic surgery. In a matched pairs design, 54 patients were then chosen out of a collective of 275 patients undergoing single-incision laparoscopic surgery for stages 0-III colon cancer (ST0-3)...
December 10, 2016: Digestive Surgery
Toru Tochigi, Kiyohiko Shuto, Tsuguaki Kono, Gaku Ohira, Takayuki Tohma, Hisashi Gunji, Koichi Hayano, Kazuo Narushima, Takeshi Fujishiro, Toshiharu Hanaoka, Yasunori Akutsu, Shinichi Okazumi, Hisahiro Matsubara
BACKGROUND: Intratumoral heterogeneity is a well-recognized characteristic feature of cancer. The purpose of this study is to assess the heterogeneity of the intratumoral glucose metabolism using fractal analysis, and evaluate its prognostic value in patients with esophageal squamous cell carcinoma (ESCC). METHODS: 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) studies of 79 patients who received curative surgery were evaluated. FDG-PET images were analyzed using fractal analysis software, where differential box-counting method was employed to calculate the fractal dimension (FD) of the tumor lesion...
December 9, 2016: Digestive Surgery
Tomohiro Iguchi, Toru Ikegami, Tetsuhiro Fujiyoshi, Tomoharu Yoshizumi, Ken Shirabe, Yoshihiko Maehara
BACKGROUND/AIMS: Despite the development of strategies to minimize blood loss during hepatectomy challenges remain. Our aim was to determine whether low positive airway pressure (PAP) without positive end-expiratory pressure (PEEP) could minimize blood loss during hepatectomy. METHODS: Forty-one living liver donors who underwent extended left lobectomy or right lobectomy between December 2012 and November 2013 were retrospectively analyzed. In the standard PAP group (n = 18), tidal volume was 8-10 ml/kg, respiratory rate was 10-12/min and PEEP was maintained at 5 cm H2O...
December 9, 2016: Digestive Surgery
Ola Ahmed, Claire L Donohoe, Daragh B Murphy, Brian J Marsh, John Conneely, Gerry P McEntee
BACKGROUND: Until recently, a diagnosis of infected pancreatic necrosis (IPN) warranted necrosectomy, which was associated with high morbidity and mortality rates greater than 20%. Preoperative percutaneous drainage delayed the need for necrosectomy with improved outcomes. METHODS: In 2008, this institution changed its approach to the management of such cases opting instead for percutaneous drainage with selective deferred necrosectomy. A total of 38 consecutive patients with IPN from January 2008 to December 2014 were included...
December 9, 2016: Digestive Surgery
Marie-Louise Kulas Søborg, Julie Leganger, Jacob Rosenberg, Jakob Burcharth
BACKGROUND/AIMS: Ehlers-Danlos syndromes (EDSs) constitute a rare group of inherited connective tissue diseases, characterized by multisystemic manifestations and general tissue fragility. Most severe complications include vascular and gastrointestinal (GI) emergencies requiring acute surgery. The purpose of this systematic review was to assess the causes of GI-related surgery and related mortality and morbidity in patients with EDSs. METHODS: A systematic search was conducted in PubMed, Embase, and Scopus to identify relevant studies...
December 9, 2016: Digestive Surgery
Calogero Iacono
No abstract text is available yet for this article.
2017: Digestive Surgery
Dezső Kelemen
No abstract text is available yet for this article.
2017: Digestive Surgery
Toshimichi Tanaka, Takeo Sato, Keishi Yamashita, Kei Hosoda, Takatoshi Nakamura, Masahiko Watanabe
BACKGROUND/AIMS: Postoperative complications of colorectal cancer (CRC) can sometimes be life threatening. Prevention of morbidity is therefore the most important issue, and among such complications, surgical site infections (SSIs) are the most critical. Predictive factors for SSI were evaluated. PATIENTS AND METHODS: This was a retrospective study of 432 patients with CRC. SSIs were classified into incisional SSIs (iSSIs) and organ/space SSIs (o/sSSIs). RESULTS: Preoperative serum albumin (relative risk (RR) 2...
2017: Digestive Surgery
Yasuhiro Ito, Yuta Abe, Kan Handa, Shintaro Shibutani, Tomohisa Egawa, Atsushi Nagashima, Minoru Kitago, Osamu Itano, Yuko Kitagawa
BACKGROUND/AIMS: Postoperative delirium (POD) is one of the most common complications after various types of surgery. The aim of this study was to investigate the incidence and risk factors for delirium after pancreaticoduodenectomy (PD). METHODS: This was a retrospective study of 146 consecutive patients who underwent PD between April 2007 and June 2015 at Saiseikai Yokohamashi Tobu Hospital. RESULTS: Twenty-nine patients (19.9%) were diagnosed with delirium...
2017: Digestive Surgery
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