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anastomosis leakage

Felipe Donoso, Helene Engstrand Lilja
Background Since 2005, infants with esophageal atresia (EA) in our unit are given prophylactic proton pump inhibitors (PPI) after repair until 1 year of age. The aims of this study were to identify risk factors for anastomotic strictures (AS) and to assess the efficacy of postoperative PPI prophylaxis in reducing the incidence of AS compared with symptomatic PPI. Methods Patients who underwent EA repair from 1994 to 2013 in our unit were included in this retrospective observational study approved by the local ethics review board...
October 21, 2016: European Journal of Pediatric Surgery
Qingbin Wu, Chengwu Jin, Tao Hu, Mingtian Wei, Ziqiang Wang
AIM: To compare intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in laparoscopic right colectomy (LRC) in terms of intraoperative and postoperative outcomes. METHODS: A systematic literature search with no limits was performed in PubMed and Embase. The last search was performed on April 9, 2016. The outcomes of interests included intraoperative outcomes (operative time, blood loss, length of incision, conversion, lymph nodes harvested, and intraoperative complications) and postoperative outcomes (time to first flatus, time to first defecation, time to liquid diet, length of hospital stay, postoperative complications, mortality, ileus, anastomotic leakage, anastomotic bleeding, wound infection, hernia, and intra-abdominal abscess)...
October 21, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Lucas Goense, Peter S N van Rossum, Jelle P Ruurda, Marco van Vulpen, Stella Mook, Gert J Meijer, Richard van Hillegersberg
BACKGROUND: Concerns have been raised regarding the toxicity of neoadjuvant chemoradiotherapy (nCRT) for esophageal cancer that could contribute to an increased risk of postoperative complications. The aim of this study was to determine the influence of the radiation dose to the gastric fundus on the risk of postoperative anastomotic leakage in patients undergoing nCRT followed by transthoracic esophagectomy. METHODS: Between January 2012 and July 2015, 97 consecutive patients who underwent nCRT followed by transthoracic esophagectomy were included in this single-center cohort study...
October 17, 2016: Annals of Thoracic Surgery
Charbel Karam, Sally Lord, Rohan Gett, Alan P Meagher
BACKGROUND: Leak rates of over 5% following anastomoses between the ileum and colon continue to be reported in large series and are associated with substantial morbidity and with mortality rates of 10-20%. In 1994, we began performing circumferentially oversewn inverted stapled anastomoses in patients undergoing ileo-colic anastomoses or ileostomy closure. It has become increasingly apparent that this method is associated with a low risk of leakage, which we should report. METHODS: The anastomotic technique described was used in all patients undergoing ileo-colic anastomosis or closure of ileostomy by surgeon 1 (1994-2015) and in all ileo-colic anastomoses by surgeon 2 (2007-2015)...
October 20, 2016: ANZ Journal of Surgery
Dong Jin Kim, Wook Kim, Jun Hyun Lee
PURPOSE: Intra-corporeal esophagojejunostomy (EJ) using a linear stapler creates a stapler entry hole that requires secure closure during the totally laparoscopic total gastrectomy (TLTG) procedure for gastric cancer. Since a standard method has not been established yet, the feasibility of using V-loc 180 (Covidien, Mansfield, MA, USA) suture material was evaluated in this study. MATERIALS AND METHODS: During January 2012 to March 2015, 25 patients who underwent linear stapling EJ and V-loc 180 closure of remaining enterotomy were included in this study...
October 20, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Frans van Workum, Stefan A W Bouwense, Misha D P Luyer, Grard A P Nieuwenhuijzen, Donald L van der Peet, Freek Daams, Ewout A Kouwenhoven, Marc J van Det, Frits J H van den Wildenberg, Fatih Polat, Suzanne S Gisbertz, Mark I van Berge Henegouwen, Joos Heisterkamp, Barbara S Langenhoff, Ingrid S Martijnse, Janneke P Grutters, Bastiaan R Klarenbeek, Maroeska M Rovers, Camiel Rosman
BACKGROUND: Currently, a cervical esophagogastric anastomosis (CEA) is often performed after minimally invasive esophagectomy (MIE). However, the CEA is associated with a considerable incidence of anastomotic leakage requiring reintervention or reoperation and moderate functional results. An intrathoracic esophagogastric anastomosis (IEA) might reduce the incidence of anastomotic leakage, improve functional results and reduce costs. The objective of the ICAN trial is to compare anastomotic leakage and postoperative morbidity, mortality, quality of life and cost-effectiveness between CEA and IEA after MIE...
October 18, 2016: Trials
Senthil Murugan, Reena Rachel John, V B Krihnakumar Raja, Ajay Mohan, Lokesh Bhanumurthy
INTRODUCTION: Successful outcome of any vascularised free flap basically depends upon the successful restoration of circulation in the flap after anastomosis. As the flap ischemic time is the significant factor which determines the outcome of any free flaps, due consideration is given to reduce the time for anastomosis for reperfusion. The present study compares and evaluates whether the usage of microvascular couplers with the conventional suturing reduce the ischemic time of the free flaps...
September 2016: Journal of Maxillofacial and Oral Surgery
M Szabo-Pap, G Zadori, R Fedor, L Illesy, F Toth, Z Kanyari, D A Kovacs, B Nemes
Surgical complications (SCs) are still high potential causes of graft loss. The incidence has a huge amount of variations depending on many factors. Our aim was to study the postoperative technical complications following kidney transplantations (KTs) during a 5-year period between 2011 and 2015. In the observed time frame there were 47 SCs occurring in 32 (19.4%) patients of 165 KTs. Every complication was classified into 3 groups: vascular (11; 6.6%), urologic (16; 9.7%), and any others (20; 12.1%). The most common postoperative SCs in our center were hemorrhage (14; 8...
September 2016: Transplantation Proceedings
Joo Hyun Park, SiHyun Cho, Young Sik Choi, Seok Kyo Seo, Byung Seok Lee
The objective of this study was to evaluate whether robotic tubal reanastomosis after segmental resection of tubal pregnancy is a feasible means of preserving tubal integrity and natural fertility in those with compromised contralateral tubal condition.The study was performed at a university medical center in a retrospective manner where da Vinci robotic system-guided segmental resection of tubal ectopic mass followed by reanastomosis was performed to salvage tubal patency and fertility in those with a single viable fallopian tube...
October 2016: Medicine (Baltimore)
A V Semenkov, E F Kim, A V Filin, D S Burmistrov, A V Metelin, Yu R Kamalov, T N Galyan, A V Goncharova
AIM: to estimate the effect of decompressive stented drainage of biliary anastomosis on incidence of biliary complications. MATERIAL AND METHODS: 294 patients aged from 5 months to 61 years (mean 13.8±0.81) were enrolled. They underwent liver fragments transplantation in the Department of Liver Transplantation of Petrovsky Russian Research Center of Surgery for the period from March 1997 to January 2016. Decompressive stented drainage tubes were used in 28 (9.5%) patients...
2016: Khirurgiia
Juan Manuel Suárez-Grau, Carlos Bernardos García, Carmen Cepeda Franco, Cristina Mendez García, Salud García Ruiz, Fernando Docobo Durantez, Salvador Morales-Conde, Javier Padillo Ruiz
AIM: To evaluate the effectiveness of human fibrinogen-thrombin collagen patch (TachoSil(®)) in the reinforcement of high-risk colon anastomoses. METHODS: A quasi-experimental study was conducted in Wistar rats (n = 56) that all underwent high-risk anastomoses (anastomosis with only two sutures) after colectomies. The rats were divided into two randomized groups: Control group (24 rats) and treatment group (24 rats). In the treatment group, high-risk anastomosis was reinforced with TachoSil(®) (a piece of TachoSil(®) was applied over this high-risk anastomosis, covering the gap)...
September 27, 2016: World Journal of Gastrointestinal Surgery
Daisuke Taniguchi, Hiroshi Saeki, Yuichiro Nakashima, Ryosuke Tsutsumi, Sho Nishimura, Kensuke Kudou, Yu Nakaji, Hirotada Tajiri, Satoshi Tsutsumi, Takafumi Yukaya, Ryota Nakanishi, Masahiko Sugiyama, Hideto Sonoda, Kippei Ohgaki, Eiji Oki, Yoshihiko Maehara
A 65-year-old man with cT3N2M0 stage III cervical esophageal cancer underwent subtotal esophagectomy and gastric tube reconstruction through the retrosternal route after neoadjuvant chemoradiotherapy. The anastomosis was located adjacent to the left side of the trachea, and a circular stapler was used for anastomosis. Postoperative anastomotic leakage occurred, and an esophagotracheal fistula between the esophagogastric anastomotic site and cartilage portion of the trachea was observed on postoperative day 44...
December 2016: Surgical Case Reports
Gürhan Güngör, Gökhan Demiral, Metin Şenol, Barış Bayraktar, Yahya Çelik, Salih Bölük
INTRODUCTION: Major complications of colonic anastomosis include fistula, bleeding, and anastomotic stricture, and the most common one is anastomotic leakage. Many organic or inorganic tissue adhesives are being used such as fibrin glue or cyanoacrylate to strengthen or protect colonic anastomosis. Up to now, a great number of studies have been carried out to investigate the effects of these biomaterials. AIM: To determine the effect of cyanoacrylate application on anastomosis safety...
2016: Przegla̜d Gastroenterologiczny
Francesco Greco
BACKGROUND: Recent data show that some patients will have insufficient weight loss or experience weight regain after sleeve gastrectomy. Dilation of the sleeve over time or use of an inadequate technique may contribute to relapse of morbid obesity. Repeat sleeve gastrectomy is the most obvious option but requires stapling of scarred tissue, has a higher risk of leakage, and is prone to re-enlargement with time. We herein describe a simple and innovative technique with which to revise vertical sleeve gastrectomy (VSG) into functional single-anastomosis gastric bypass (f-SAGB)...
October 5, 2016: Obesity Surgery
Lars Nelson, Rena C Moon, Andre F Teixeira, Manoel Galvão, Almino Ramos, Muhammad A Jawad
Background: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was introduced into bariatric surgery by Sanchez-Pernaute et al. as an advancement of the biliopancreatic diversion with duodenal switch. Aim: To evaluate the SADI-S procedure with regard to weight loss, comorbidity resolution, and complication rate in the super obese population. Methods: A retrospective chart review was performed on initial 72 patients who underwent laparoscopic or robot-assisted laparoscopic SADI-S between December 17th, 2013 and July 29th, 2015...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Frederick H Koh, Ker-Kan Tan
BACKGROUND: Anastomotic leakage after gastrointestinal surgery is associated with significant morbidity and mortality.1 Insufficient vascular supply is one cause.2 Recent reports of using intraoperative indocyanine green (ICG) fluorescent angiography to evaluate whether perfusion of the anastomosis is adequate has yielded positive outcomes.3 (-) 6 The authors describe their use of ICG-enhanced fluorescence angiography in a laparoscopic anterior resection. METHODS: The patient was an 80-year-old with an upper rectal adenocarcinoma and significant cardiovascular risk factors...
September 28, 2016: Annals of Surgical Oncology
Lin Zhou, Peng Ge, Jiakuan Chen, Jian Wang, Ming Wang, Xiaofei Li, Tao Jiang
OBJECTIVE: To explore the clinical efficacy and safety of gastroepiploic tunnel esophagogastrostomy applied in minimally invasive esophagectomy and gastroesophageal cervical anastomosis. METHODS: Clinical data of 137 esophageal cancer patients who received minimally invasive esophagectomy from December 2013 to June 2015 in Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University were analyzed retrospectively, including 84 patients receiving anastomosis with tubular anastomat (circular staple group), and 53 patients receiving gastroepiploic tunnel anastomosis(tunnel group, position of tunnel anastomosis located in the side of gastrocolic omentum, about 2-3 cm apart from fundus)...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Xiaofeng Duan, Lei Gong, Xiaobin Shang, Hongjing Jiang, Peng Tang, Zhentao Yu
OBJECTIVE: To study the impact of preoperative fasting plasma glucose(FPG) on postoperative morbidity and outcome following surgical resection of esophageal squamous cell carcinoma (ESCC), and to analyze the risk factor of postoperative complication in ESCC. METHODS: Clinicopathological data of 314 ESCC patients undergoing esophagectomy in our center between January 2011 and December 2012 were retrospectively collected. Patients were divided into two groups according to their preoperative FBG: normal FPG group (FPG<6...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Dong Lin, Ting Ye, Longfei Ma, Longlong Shao, Zuodong Song, Shujun Jiang, Jiaqing Xiang
OBJECTIVE: To compare the safety and efficacy between three-field lymphadenectomy and normative Ivor-Lewis two-field lymphadenectomy for thoracic esophageal squamous cell carcinoma METHODS: Clinical data of 375 patients with thoracic esophageal squamous cell carcinoma who underwent three-field lymphadenectomy(3FL) or Ivor-Lewis two-field lymphadenectomy(2FL, Ivor-Lewis) in Fudan University Shanghai Cancer Center during 2013 were retrieved and collected from electronic medical record system...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Frans van Workum, Jolijn van der Maas, Frits J H van den Wildenberg, Fatih Polat, Ewout A Kouwenhoven, Marc J van Det, Grard A P Nieuwenhuijzen, Misha D Luyer, Camiel Rosman
BACKGROUND: Both cervical esophagogastric anastomosis (CEA) and intrathoracic esophagogastric anastomosis (IEA) are used to restore gastrointestinal integrity following minimally invasive esophagectomy (MIE). No prospective randomized data on functional outcome, postoperative morbidity, and mortality between these techniques are currently available. METHODS: A comparison was conducted including all consecutive patients with esophageal carcinoma of the distal esophagus or gastroesophageal junction undergoing MIE with CEA or MIE with IEA from October 2009 to July 2014 in 3 high-volume esophageal cancer centers...
September 24, 2016: Annals of Thoracic Surgery
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