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anastomosis leakage

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https://www.readbyqxmd.com/read/28537563/anastomotic-leaks-in-gastrointestinal-surgery-and-their-prevention
#1
Tomasz Banasiewicz, Adam Dziki, Paweł Lampe, Zbigniew Lorenc, Marek Szczepkowski, Jacek Zieliński, Grzegorz Wallner
Anastomotic leak in the gastrointestinal tract is one of the most important complications of resection. They are the main cause of reoperation, their occurrence worsens the prognosis of the patient, increasing the proportion of direct mortality, as well as being a significant risk factor for recurrence of cancer. The risk of leaks within the gastrointestinal tract is greatly varied, depending on the location and extent of the resection, but also on patient, disease or a surgical procedure, including surgeon...
April 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28536898/impact-of-tissue-adhesives-on-the-prevention-of-anastomotic-leakage-of-colonic-anastomoses-an-in-vivo-study
#2
Konstantinos A Vakalopoulos, Joanna W A M Bosmans, Kevin W Y van Barneveld, Ruben R M Vogels, Geesien S A Boersema, Zhouqiao Wu, Marion J J Gijbels, Johannes Jeekel, Gert-Jan Kleinrensink, Nicole D Bouvy, Johan F Lange
BACKGROUND: Tissue adhesives (TA) may be useful to strengthen colorectal anastomoses, thereby preventing anastomotic leakage (AL). Previous studies have identified cyanoacrylate (CA) TAs as the most promising colonic anastomotic sealants. This study investigates the protective effects of sealing colonic anastomoses with various CAs. MATERIALS AND METHODS: Fifty-five Wistar rats underwent laparotomy and transection of the proximal colon. An anastomosis was created with 4 interrupted sutures followed by either application of Histoacryl Flexible, Omnex, Glubran 2, or no TA seal...
May 23, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28534329/-predictive-value-of-procalcitonin-in-postoperative-intra-abdominal-infections-after-definitive-operation-of-intestinal-fistulae
#3
Huajian Ren, Gefei Wang, Guosheng Gu, Qiongyuan Hu, Guanwei Li, Zhiwu Hong, Xiuwen Wu, Jianan Ren
OBJECTIVE: To investigate the predictive value of procalcitonin(PCT) in postoperative intra-abdominal infections (IAI) after definitive operation of intestinal fistulae(IF). METHODS: With the exclusion of emergence operation, preoperative clinical infection, preoperative renal or hepatic dysfunction, and age less than 18 years, a total of 356 consecutive patients who underwent elective digestive tract reconstruction of intestinal fistulae from February 2012 to December 2015 at Intestinal Fistula Center of Jinling Hospital were prospectively enrolled in the study...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28530630/-laparoscopic-management-of-ureteroileal-stenosis-long-term-follow-up
#4
Esteban Emiliani, Pavel Gavrilov, Olga Mayordomo, Josep Salvador, Joan Palou, Antonio Rosales, Humberto Villavicencio
OBJECTIVE: To describe the laparoscopic approach for uretero-ileal anastomosis strictures and to analyse our long term series. METHODS: A retrospective review was performed evaluating our series of patients with benign ureteroileal anastomosis strictures treated laparoscopically from 2011 to 2017. Demographics and perioperative data were obtained and analyzed. Complications were described with the Clavien-Dindo classification. The surgical technique was described and a literature review was performed...
May 2017: Archivos Españoles de Urología
https://www.readbyqxmd.com/read/28526077/the-optimal-extent-of-gastrectomy-for-middle-third-gastric-cancer-distal-subtotal-gastrectomy-is-superior-to-total-gastrectomy-in-short-term-effect-without-sacrificing-long-term-survival
#5
Xin Ji, Yan Yan, Zhao-De Bu, Zi-Yu Li, Ai-Wen Wu, Lian-Hai Zhang, Xiao-Jiang Wu, Xiang-Long Zong, Shuang-Xi Li, Fei Shan, Zi-Yu Jia, Jia-Fu Ji
BACKGROUND: The optimal extent of gastrectomy for middle-third gastric cancer remains controversial. In our study, the short-term effects and longer-term survival outcomes of distal subtotal gastrectomy and total gastrectomy are analysed to determine the optimal extent of gastrectomy for middle-third gastric cancer. METHODS: We retrospectively collect and analyse clinicopathologic data and follow-up outcomes from a prospectively collected database at the Peking University Cancer Hospital...
May 19, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28515754/traumatic-tension-pneumopericardium-and-amputation-of-the-left-main-bronchus
#6
Lech Krawczyk, Tomasz P Byrczek, Agata Łuczyk, Bogusz D Jagoda, Rafał Kazanowski, Michał J Stasiowski
A 27-year-old woman sustained a blunt chest trauma after a car accident. Computed tomography revealed tension pneumopericardium, bilateral pneumothorax, and a suspected rupture of the left main bronchus. Emergent pericardial needle aspiration was successfully performed. Bronchial amputation was confirmed by bronchofiberoscopy. Despite total detachment of the distal part of the bronchial tree, the ventilation of the left lung was maintained without air leakage by use of pleural drains. Bronchial obturation resulted from the injury, and was effectively treated by bronchoscopic sputum suction at the distal end of the bronchus...
March 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28514887/transanal-inspection-and-management-of-low-colorectal-anastomosis-performed-with-a-new-technique-the-ticrant-study
#7
Francesco Crafa, Sebastian Smolarek, Giulia Missori, Mostafa Shalaby, Silvia Quareisma, Adele Noviello, Diletta Cassini, Pasquale Ascenzi, Luana Franceschilli, Paolo Delrio, Giannandrea Baldazzi, Ucchino Giampiero, Jacques Megevand, Giovanni Maria Romano, Pierpaolo Sileri
BACKGROUND: Anastomotic leakage is one of the most serious complications after rectal cancer surgery. METHOD: A prospective multicenter interventional study to assess a newly described technique of creating the colorectal and coloanal anastomosis. The primary outcome was to access the safety and efficacy of this technique in the reduction of anastomotic leak. RESULT: Fifty-three patients with rectal cancer who underwent low or ultra-low anterior resection were included in the study...
May 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28488729/randomized-clinical-trial-of-biodegradeable-intraluminal-sheath-to-prevent-anastomotic-leak-after-stapled-colorectal-anastomosis
#8
I S Bakker, A N Morks, H O Ten Cate Hoedemaker, J G M Burgerhof, H G Leuvenink, J B van Praagh, R J Ploeg, K Havenga
BACKGROUND: Anastomotic leakage is a potential major complication after colorectal surgery. The C-seal was developed to help reduce the clinical leakage rate. It is an intraluminal sheath that is stapled proximal to a colorectal anastomosis, covering it intraluminally and thus preventing intestinal leakage in case of anastomotic dehiscence. The C-seal trial was initiated to evaluate the efficacy of the C-seal in reducing anastomotic leakage in stapled colorectal anastomoses. METHODS: This RCT was performed in 41 hospitals in the Netherlands, Germany, France, Hungary and Spain...
May 10, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28488177/anastomotic-complications-after-laparoscopic-total-gastrectomy-with-esophagojejunostomy-constructed-by-circular-stapler-orvil-%C3%A2-versus-linear-stapler-overlap-method
#9
Hideki Kawamura, Yosuke Ohno, Nobuki Ichikawa, Tadashi Yoshida, Shigenori Homma, Masahiro Takahashi, Akinobu Taketomi
BACKGROUND: Esophagojejunostomy after laparoscopic total gastrectomy (LTG) is the most technically difficult type of anastomosis; thus, anastomotic complications such as leakage and stenosis sometimes occur. Identification of the safest anastomotic procedure is important for successful LTG. We have performed LTG since 2004 either with a circular stapler using an OrVil(™) anvil or via the overlap Orringer method with a linear stapler. This retrospective study aimed to determine which method results in a lower incidence of anastomotic complications in patients undergoing LTG...
May 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28485190/complications-and-morbidity-associated-with-loop-ileostomies-in-patients-with-ulcerative-colitis
#10
J Park, B Gessler, M Block, E Angenete
BACKGROUND AND AIMS: Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting. MATERIAL AND METHODS: Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively...
May 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28474202/neoadjuvant-capeox-therapy-followed-by-sphincter-preserving-surgery-for-lower-rectal-cancer
#11
Taishi Hata, Hidekazu Takahashi, Daisuke Sakai, Naotsugu Haraguchi, Junichi Nishimura, Toshihiro Kudo, Matsuda Chu, Ichiro Takemasa, Satoh Taroh, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
PURPOSE: This retrospective study investigates the safety of neoadjuvant chemotherapy with oxaliplatin capecitabine (CapeOx), followed by laparoscopic surgery, for lower rectal cancer, and its efficacy in preserving the sphincter. METHODS: Ten patients with diagnosed lower rectal cancer received three or four cycles of neoadjuvant CapeOx chemotherapy, prior to undergoing low anterior resection or intersphincteric resection, with total mesorectal excision. The primary outcomes were R0 resection and the rate of sphincter preservation...
May 4, 2017: Surgery Today
https://www.readbyqxmd.com/read/28462437/clinical-assessment-of-reconstruction-involving-gastric-pull-up-combined-with-free-jejunal-graft-after-total-pharyngolaryngoesophagectomy
#12
Hiroshi Miyata, Keijiro Sugimura, Masaaki Motoori, Yoshiyuki Fujiwara, Takeshi Omori, Masahiro Mun, Masayuki Ohue, Masayoshi Yasui, Norikatsu Miyoshi, Takashi Fujii, Hiroki Tajima, Tomoyuki Kurita, Masahiko Yano
BACKGROUND: Total pharyngolaryngoesophagectomy (PLE) is used as a curative treatment for synchronous laryngopharyngeal and thoracic esophageal cancer or for multiple cancers in the cervical and thoracic esophagus. Gastric pull-up is commonly used after PLE, but postoperative complications are common. The present study evaluated these procedures in patients with esophageal cancer. METHODS: Fourteen patients (7 with synchronous pharyngeal and thoracic esophageal cancer, 4 with synchronous cervical and thoracic esophageal cancer, and 3 with cervicothoracic esophageal cancer) underwent reconstructive surgery after PLE involving gastric pull-up combined with free jejunal graft between 2004 and 2015...
May 1, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28432462/novel-esophageal-stent-for-treatment-of-cervical-anastomotic-leakage-after-esophagectomy
#13
Gang Wu, Meipan Yin, Yan Shi Zhao, Yi Fang, Gaofeng Zhao, Jia Zhao, Xinwei Han
BACKGROUND: Dedicated stents for treatment of cervical anastomotic leakage are currently unavailable. In this study, we aimed to assess the feasibility and efficacy of using custom-designed stents for treatment of cervical anastomotic leakage after esophagectomy. METHODS: The stents were designed according to the location and size of the leakage and the residual esophageal length as determined by esophagography in each case. It had a cup-shaped upper end and a globular lower end and a total height of 60-85 mm...
April 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28431531/short-term-surgical-outcomes-of-laparoscopy-assisted-versus-totally-laparoscopic-billroth-ii-gastrectomy-for-gastric-cancer-a-matched-cohort-study
#14
Ji-Hyun Kim, Kyong-Hwa Jun, Hyung-Min Chin
BACKGROUND: To evaluate feasibility and benefits of intracorporeal anastomosis, we compared short-term surgical outcomes between laparoscopy-assisted distal gastrectomy (LADG) and totally laparoscopic distal gastrectomy (TLDG) with Billroth-II (B-II) anastomosis for gastric cancer. METHODS: Sixty patients underwent attempted B-II TLDG from 2011 through 2013. Patients who underwent B-II LADG prior to 2011 were matched to TLDG cases for demographics, comorbidities, tumor characteristics, and TNM stage...
April 21, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28424985/postoperative-complications-and-functional-outcome-after-esophageal-atresia-repair-results-from-longitudinal-single-center-follow-up
#15
Florian Friedmacher, Birgit Kroneis, Andrea Huber-Zeyringer, Peter Schober, Holger Till, Hugo Sauer, Michael E Höllwarth
BACKGROUND: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) represent major therapeutic challenges, frequently associated with serious morbidities following surgical repair. The aim of this longitudinal study was to assess temporal changes in morbidity and mortality of patients with EA/TEF treated in a tertiary-level center, focusing on postoperative complications and their impact on long-term gastroesophageal function. METHODS: One hundred nine consecutive patients with EA/TEF born between 1975 and 2011 were followed for a median of 9...
April 19, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28415434/design-and-development-of-a-hybrid-bioartificial-water-induced-shape-memory-polymeric-material-as-an-integral-component-for-the-anastomosis-of-human-hollow-organs
#16
Siriana Paonessa, Niccoletta Barbani, Elisa Cibrario Rocchietti, Claudia Giachino, Caterina Cristallini
A large number of pathologies require the resection of the bowel and anastomoses to rejoin the two remaining stumps to regain lumen patency. Various materials have been used to rejoin one bowel end to the other such as catgut, stainless steel, and absorbable sutures. The present method for anastomosis surgery uses an entero-entero anastomosis (EEA) circular stapler with only a staple line. This method can have some drawbacks, such as intracellular fluid leakage and local inflammations. The aim of this study is to design and develop a novel bioartificial polymer with a ring shape made of polyvinyl alcohol (PVA) and gelatin (80/20 ratio (w/w)) loaded both directly with acetylsalicylic acid and with nanoparticles incorporating the same drug to reduce local inflammation even for a prolonged period of time...
June 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28415168/an-update-on-endoscopic-management-of-post-liver-transplant-biliary-complications
#17
Hyun Woo Lee, Najmul Hassan Shah, Sung Koo Lee
Biliary complications are the most common post-liver transplant (LT) complications with an incidence of 15%-45%. Furthermore, such complications are reported more frequently in patients who undergo a living-donor LT (LDLT) compared to a deceased-donor LT (DDLT). Most post-LT biliary complications involve biliary strictures, bile leakage, and biliary stones, although many rarer events, such as hemobilia and foreign bodies, contribute to a long list of related conditions. Endoscopic treatment of post-LT biliary complications has evolved rapidly, with new and effective tools improving both outcomes and success rates; in fact, the latter now consistently reach up to 80%...
April 17, 2017: Clinical Endoscopy
https://www.readbyqxmd.com/read/28408988/sutureless-functional-end-to-end-anastomosis-using-a-linear-stapler-with-polyglycolic-acid-felt-for-intestinal-anastomoses
#18
Masanori Naito, Hirohisa Miura, Takatoshi Nakamura, Takeo Sato, Takahiro Yamanashi, Atsuko Tsutsui, Masahiko Watanabe
BACKGROUND: Gastrointestinal anastomosis remains associated with a considerable burden of morbidity and, in some cases, mortality. Functional end-to-end anastomosis, whilst extremely efficient, is vulnerable to increased intestinal pressure in the immediate postoperative period, which may predispose to development of anastomotic leakage or bleeding. Therefore, there is a requirement for new techniques that facilitate safe and efficacious anastomotic procedures. MATERIALS AND METHODS: This study examined the clinical application of functional end-to-end anastomosis with a stapler that automatically applies a bioabsorbable polyglycolic acid sheet (Endo GIA™ Reinforced Reload with Tri-Staple™ Technology)...
May 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28399882/liver-necrosis-shortly-after-pancreaticoduodenectomy-with-resection-of-the-replaced-left-hepatic-artery
#19
Michihiro Yamamoto, Masazumi Zaima, Hidekazu Yamamoto, Hideki Harada, Junichiro Kawamura, Masahiro Yamada, Tekefumi Yazawa, Junya Kawasoe
BACKGROUND: Surgeons, in general, underestimate the replaced left hepatic artery (rLHA) that arises from the left gastric artery (LGA), compared with the replaced right hepatic artery (rRHA), especially in standard gastric cancer surgery. During pancreaticoduodenectomy (PD), preservation of the rRHA arising from the superior mesenteric artery (SMA) is widely accepted to prevent critical postoperative complications, such as liver necrosis, bile duct ischemia, and biliary anastomotic leakage...
April 11, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28399874/early-closure-of-defunctioning-stoma-increases-complications-related-to-stoma-closure-after-concurrent-chemoradiotherapy-and-low-anterior-resection-in-patients-with-rectal-cancer
#20
Tzu-Chieh Yin, Hsiang-Lin Tsai, Ping-Fu Yang, Wei-Chih Su, Cheng-Jen Ma, Ching-Wen Huang, Ming-Yii Huang, Chun-Ming Huang, Jaw-Yuan Wang
BACKGROUND: After a low anterior resection, creating a defunctioning stoma is vital for securing the anastomosis in low-lying rectal cancer patients receiving concurrent chemoradiotherapy. Although it decreases the complication and reoperation rates associated with anastomotic leakage, the complications that arise before and after stoma closure should be carefully evaluated and managed. METHODS: This study enrolled 95 rectal cancer patients who received neoadjuvant concurrent chemoradiotherapy and low anterior resection with anastomosis of the bowel between July 2010 and November 2012...
April 11, 2017: World Journal of Surgical Oncology
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