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Ileostomy

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https://www.readbyqxmd.com/read/28090504/fortune-of-temporary-ileostomies-in-patients-treated-with-laparoscopic-low-anterior-resection-for-rectal-cancer
#1
Mustafa Haksal, Nuri Okkabaz, Ali Emre Atici, Osman Civil, Yasar Ozdenkaya, Ayhan Erdemir, Nihat Aksakal, Mustafa Oncel
PURPOSE: The current study aims to analyze the risk factors for the failure of ileostomy reversal after laparoscopic low anterior resection for rectal cancer. METHODS: All patients who underwent a laparoscopic low anterior resection for rectal cancer with a diverting ileostomy between 2007 and 2014 were abstracted. The patients who underwent and did not undergo a diverting ileostomy procedure were compared regarding patient, tumor, treatment related parameters, and survival...
January 2017: Annals of Surgical Treatment and Research
https://www.readbyqxmd.com/read/28078466/does-stoma-site-specimen-extraction-increase-postoperative-ileostomy-complication-rates
#2
Wanglin Li, Cigdem Benlice, Luca Stocchi, Hermann Kessler, Emre Gorgun, Meagan Costedio
BACKGROUND: Minimizing incisions has the potential to decrease hernia formation and wound complications following laparoscopic surgery. It is currently unknown if using the stoma site for specimen extraction affects outcomes. This study aims to evaluate the impact of stoma site extraction on postoperative complication rates in laparoscopic colorectal surgery. METHODS: After IRB approval, a retrospective comparative review of 738 consecutive patients (405 M) who underwent laparoscopic colorectal surgery with ileostomy between January 2008 and December 2014 was performed...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28072899/endoluminal-vacuum-therapy-as-treatment-for-anastomotic-colorectal-leakage
#3
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Simona Grande, Francesca Cabry, Michele Grande
BACKGROUND: The clinical leakage rate after anterior resection varies from 2.8-20%, with a 6-22% mortality rate and a 10-80% risk of permanent stoma. Endo-SPONGE® (B. Braun Melsungen AG, Melsungen, Germany) may treat extraperitoneal anastomotic leakage in the lesser pelvis. It consists of an open-pored sponge inserted into the cavity. A drainage tube fixed to a low vacuum drainage system is then connected to the sponge through the anus. MATERIAL AND METHODS: Between January 2007 and December 2014, 14 patients with anastomotic leakage following low anterior resection were treated with Endo-SPONGE® and were prospectively evaluated...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28068698/combined-endoscopic-and-surgical-covered-stent-placement-a-new-tailored-treatment-for-enteroatmospheric-fistula-in-patients-with-terminal-ileostomy
#4
Lionel Rebibo, Adrien Wacrenier, Henri Thiebault, Richard Delcenserie, Jean-Marc Regimbeau
No abstract text is available yet for this article.
February 2017: Endoscopy
https://www.readbyqxmd.com/read/28066859/the-long-term-outcome-of-anti-tnf-alpha-therapy-in-perianal-crohn-s-disease
#5
J Rayen, T Currie, R B Gearry, F Frizelle, T Eglinton
BACKGROUND: The aim of the present study was to evaluate the long-term outcomes of anti-tumour necrosis factor alpha therapy in perianal Crohn's disease and identify factors predicting response to treatment. METHODS: Data from hospital clinical records and coding databases were retrospectively reviewed from a tertiary care hospital in Christchurch, New Zealand. The study included 75 adult patients with perianal Crohn's disease commenced on anti-tumour necrosis factor alpha therapy from January 2000 to December 2012...
January 9, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28059966/readmission-after-ileostomy-creation-retrospective-review-of-a-common-and-significant-event
#6
Daniel R Fish, Carol A Mancuso, Julio E Garcia-Aguilar, Sang W Lee, Garrett M Nash, Toyooki Sonoda, Mary E Charlson, Larissa K Temple
OBJECTIVE: To evaluate causes and predictors of readmission after new ileostomy creation. BACKGROUND: New ileostomates have been reported to have higher readmission rates compared with other surgical patients, but data on predictors are limited. METHODS: A total of 1114 records at 2 associated hospitals were reviewed to identify adults undergoing their first ileostomy. Primary outcome was readmission within 60 days of surgery. Multiple logistic regression was used to identify independent predictors; area under the receiver-operator characteristic curves (AUC) were used to evaluate age-stratified models in secondary analysis...
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28059919/reducing-readmissions-while-shortening-length-of-stay-the-positive-impact-of-an-enhanced-recovery-protocol-in-colorectal-surgery
#7
Puja M Shah, Lily Johnston, Bethany Sarosiek, Amy Harrigan, Charles M Friel, Robert H Thiele, Traci L Hedrick
BACKGROUND: Hospital readmission rates are an increasingly important quality metric since enactment of the 2012 Hospital Readmissions Reduction Program. The proliferation of enhanced recovery protocols and earlier discharge raises concerns for increased readmission rates. OBJECTIVE: We evaluated the effect of enhanced recovery on readmissions and identified risk factors for readmission. DESIGN: This study involved implementation of a multidisciplinary enhanced recovery protocol...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28054168/minimally-invasive-surgery-for-complicated-diverticulitis
#8
Najjia N Mahmoud, Elijah W Riddle
Recent guidelines recommend an individualized approach to recurrent uncomplicated diverticulitis, reflecting research showing that non-operative treatment is safe. Thus, the majority of operations for diverticulitis in the future may be for complicated indications. A laparoscopic approach may be used for both acute and chronic complicated diverticulitis in appropriate patients, as described in the American and European guidelines. However, a safe approach to minimally invasive surgery requires recognition when conditions deteriorate or are not suited to laparoscopy as well as knowledge of a variety of technical maneuvers that elucidate difficult anatomy and facilitate resection...
January 4, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28052855/syn-004-ribaxamase-an-oral-%C3%AE-lactamase-designed-to-protect-the-gut-microbiome-from-the-deleterious-effects-of-certain-intravenously-administered-%C3%AE-lactam-antibiotics-degrades-ceftriaxone-excreted-into-the-intestine-in-phase-2a-clinical-studies
#9
John F Kokai-Kun, Tracey Roberts, Olivia Coughlin, Eric Sicard, Marianne Rufiange, Richard Fedorak, Christian Carter, Marijke H Adams, James Longstreth, Heidi Whalen, Joseph Sliman
SYN-004 (ribaxamase) is a β-lactamase designed to be orally administered concurrently with intravenous β-lactam antibiotics including most penicillins and cephalosporins. Ribaxamase's anticipated mechanism of action is to degrade excess β-lactam antibiotic that is excreted into the small intestine. This enzymatic inactivation of excreted antibiotic is expected to protect the gut microbiome from disruption and thus prevent undesirable side effects including secondary infections like Clostridium difficile as well as other antibiotic-associated diarrheas...
January 4, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/28049025/correction-of-vitamin-d-deficiency-using-sublingually-administered-vitamin-d2-in-a-crohn-s-disease-patient-with-mal-absorption-and-a-new-ileostomy
#10
REVIEW
Patrick McCullough, Robert Heaney
Vitamin D deficiency has been shown to be associated with many adverse health problems. Studies have shown that patients with Crohn's disease who have low vitamin D levels have a poorer quality of life than those with more adequate levels. It has also been shown that patients with mal-absorption problems have a difficult time achieving normal vitamin D levels in spite of aggressive supplementation, and that exposure to UVB radiation may be the most effective treatment option for these patients. We present a case in which 25-hydroxyvitamin D levels were normalized within 2 weeks in a severely vitamin D deficient patient with Crohn's disease with mal-absorption and a new ileostomy, utilizing sublingually administered vitamin D2...
December 31, 2016: Journal of Steroid Biochemistry and Molecular Biology
https://www.readbyqxmd.com/read/28045769/diverting-ileostomy-for-the-treatment-of-severe-refractory-pediatric-inflammatory-bowel-disease
#11
Elizabeth C Maxwell, Noor Dawany, Robert N Baldassano, Petar Mamula, Peter Mattei, Lindsey Albenberg, Judith R Kelsen
OBJECTIVES: Diverting ileostomy is used as a temporizing therapy in patients with perianal Crohn disease; however, little data exist regarding its use for colonic disease. The primary aim of the present study was to determine the role of diversion in severe refractory colonic inflammatory bowel disease (IBD) in a pediatric population. METHODS: Retrospective study of patients who underwent diverting ileostomy at The Children's Hospital of Philadelphia from 2000 to 2014 for the management of severe, refractory colonic IBD...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28045234/feasibility-of-umbilical-loop-ileostomy-in-overweight-and-obese-patients-with-rectal-cancer-during-laparoscopic-surgery-preliminary-results
#12
Seiji Ishiguro, Shunichiro Komatsu, Keiichi Ando, Takaaki Osawa, Kohei Yasui, Takashi Arikawa, Norifumi Ohashi, Masahiko Miyachi, Tsuyoshi Sano
We examined the feasibility of umbilical diverting ileostomy for overweight and obese patients with rectal cancer undergoing laparoscopic surgery. Four patients who were overweight or obese (BMI > 27 kg/m(2) ) were initially scheduled for the creation of a conventional loop ileostomy. Intraoperatively, however, this was considered too complicated because of thick subcutaneous fat, bulky mesentery, or both. Instead, patients received a diverting ileostomy with the placement of an umbilical stoma. All patients had protruding umbilical ileostomies...
February 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28044949/sphincter-sparing-surgery-in-patients-with-mid-and-low-rectal-cancer-risk-factors-for-local-recurrence-and-anastomotic-leakage
#13
Denis Aslan, Florin Grama, Daniel Cristian, Adrian Bordea, Traean Burcoş
: Background: Rectal cancer is a major health problem. The current treatment of distal rectal cancer involves a multimodality approach aimed at achieving an optimal oncologic control and an increased quality of life. PURPOSE: The purpose of this article is to identify the risk factors for local recurrence and anastomotic leakage after sphincter-sparing surgery for low and mid rectal cancer. Material and Methods: We prospectively analyzed a group of 38 patients with low and middle rectal cancer who underwent sphincter-sparing surgery...
November 2016: Chirurgia
https://www.readbyqxmd.com/read/28044239/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-effects-on-patient-reported-quality-of-life-and-functional-outcome
#14
T W A Koedam, G H van Ramshorst, C L Deijen, A K E Elfrink, W J H J Meijerink, H J Bonjer, C Sietses, J B Tuynman
BACKGROUND: Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis. METHODS: Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated...
January 2, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28039168/correlation-of-the-rutgeerts-score-and-recurrence-of-crohn-s-disease-in-patients-with-end-ileostomy
#15
Vasutakarn Chongthammakun, Andre Fialho, Andrea Fialho, Rocio Lopez, Bo Shen
BACKGROUND: Recurrence of Crohn's disease (CD) can occur after surgery, including end ileostomy (EI). The Rutgeerts score (RS) was developed to predict postsurgical CD recurrence via ileocolonoscopy in patients having ileocolonic resection. The role of ileoscopic evaluation via stoma for assessing recurrence of CD has not been investigated. The aim of this study was to evaluate the role of ileoscopy for predicting disease recurrence in CD patients after EI with the use of RS. METHODS: A total of 73 eligible CD patients with at least two ileoscopies in our institution following EI were included...
December 30, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/28035458/modified-martius-flap-procedure-for-refractory-ileal-pouch-vestibular-fistula-a-report-of-three-cases
#16
Toshimitsu Araki, Yoshiki Okita, Mikio Kawamura, Satoru Kondo, Yuji Toiyama, Junichiro Hiro, Shigeyuki Yoshiyama, Keiichi Uchida, Masato Kusunoki
PURPOSE: Pouch-vaginal or vestibular fistula is an uncommon, but devastating complication that occurs in women after ileal J pouch-anal anastomosis. The management of these fistulae is challenging, and it is associated with high recurrence and pouch loss rates. This report describes the use of the modified Martius flap procedure for three patients with ulcerative colitis who developed refractory pouch-vestibular fistulae. RESULTS: Three patients with ulcerative colitis, who underwent total colectomy, mucosal proctectomy, and ileal pouch-anal anastomosis, developed pouch-vestibular fistulae...
December 29, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28030494/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#17
Leah Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura B Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multi-center retrospective cohort study was performed across three Level I Trauma Centers encompassing traumatic colon injuries from January 2006 through June 2014...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28029394/non-anion-gap-metabolic-acidosis-a-clinical-approach%C3%A2-to%C3%A2-evaluation
#18
Mandana Rastegar, Glenn T Nagami
Acid-base disturbances can result from kidney or nonkidney disorders. We present a case of high-volume ileostomy output causing large bicarbonate losses and resulting in a non-anion gap metabolic acidosis. Non-anion gap metabolic acidosis can present as a form of either acute or chronic metabolic acidosis. A complete clinical history and physical examination are critical initial steps to begin the evaluation process, followed by measuring serum electrolytes with a focus on potassium level, blood gas, urine pH, and either direct or indirect urine ammonium concentration...
October 28, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28027216/recycling-small-intestinal-contents-from-proximal-ileostomy-in-low-birth-weight-infants-with-small-bowel-perforation
#19
Seiichiro Inoue, Akio Odaka, Yuki Muta, Yoshifumi Beck, Hisanori Sobajima, Masanori Tamura
No abstract text is available yet for this article.
January 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28013111/risk-of-rectal-cancer-after-colectomy-for-patients-with-ulcerative-colitis-a-national-cohort-study
#20
Maie Abdalla, Kalle Landerholm, Peter Andersson, Roland E Andersson, Pär Myrelid
BACKGROUND & AIMS: Patients with ulcerative colitis (UC) have an increased risk of rectal cancer, so reconstruction with an ileal pouch anal anastomosis (IPAA) is generally preferred to an ileo-rectal anastomosis (IRA) after subtotal colectomy. Similarly, completion proctectomy is recommended for patients with ileostomy and diverted rectum, although this approach has been questioned because anti-inflammatory agents might reduce cancer risk. We performed a national cohort study in Sweden to assess the risk of rectal cancer in patients with UC who have an IRA, IPAA, or diverted rectum after subtotal colectomy...
December 21, 2016: Clinical Gastroenterology and Hepatology
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