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Anastomotic leaks

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https://www.readbyqxmd.com/read/28718940/changes-in-treatment-and-outcome-of-oesophageal-cancer-in-denmark-between-2004-and-2013
#1
D W Kjaer, H Larsson, L B Svendsen, L S Jensen
BACKGROUND: Since 2003, care for patients with oesophageal cancer has been centralized in a few dedicated centres in Denmark. The aim of this study was to assess changes in the treatment and outcome of patients registered in a nationwide database. METHODS: All patients diagnosed with oesophageal cancer or cancer of the gastro-oesophageal junction who underwent oesophagectomy in Denmark between 2004 and 2013, and who were registered in the Danish clinical database of carcinomas in the oesophagus, gastro-oesophageal junction and stomach (DECV database) were included...
July 18, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28717916/colon-perfusion-patterns-during-colorectal-resection-using-visible-light-spectroscopy
#2
Henry Hoffmann, Tarik Delko, Philipp Kirchhoff, Rachel Rosenthal, Juliane Schäfer, Marko Kraljević, Christoph Kettelhack
BACKGROUND: The impact of blood supply to the anastomosis on development of anastomotic leakage is still a matter of debate. Considering that bowel perfusion may be affected by manipulation during surgery, perfusion assessment of the anastomosis alone may be of limited value. We propose perfusion assessment at different time points during surgery to explore the dynamics of bowel perfusion during colorectal resection and its impact on outcome. METHODS: In this prospective cohort study, patients undergoing elective colorectal resection were eligible...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28710609/laparoscopic-colectomy-in-the-obese-morbidly-obese-and-super-morbidly-obese-when-does-weight-matter
#3
Bradley J Champagne, Madhuri Nishtala, Justin T Brady, Benjamin P Crawshaw, Morris E Franklin, Conor P Delaney, Scott R Steele
PURPOSE: Previous studies have demonstrated that obese patients (BMI >30) undergoing laparoscopic colectomy have longer operative times and increased complications when compared to non-obese cohorts. However, there is little data that specifically evaluates the outcomes of obese patients based on the degree of their obesity. The aim of this study was to evaluate the impact of increasing severity of obesity on patients undergoing laparoscopic colectomy. METHODS: A retrospective review was performed of all patients undergoing laparoscopic colectomy between 1996 and 2013...
July 14, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28702861/outcomes-of-a-single-surgeon-based-transanal-total-mesorectal-excision-tatme-for-rectal-cancer
#4
Antonio Caycedo-Marulanda, Henry Y Jiang, Erica L Kohtakangas
BACKGROUND: Several studies have shown the transanal total mesorectal excision (TATME) is emerging as a safe and effective technique for proctectomy. The majority of these studies to date, however, is based on procedures done in centers with teams of two surgeons working simultaneously. Few were performed by single-surgeon teams with sizeable case load. The objective of our study was to identify the feasibility and safety of a single-surgeon TATME. METHODS: Chart review of prospectively collected data on 27 patients who underwent TATME at our institution from June 2015 to September 2016 were included in this study...
July 13, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28700005/fluorescent-test-accurately-predicts-leak-of-ischemic-colon-anastomosis-in-rats
#5
Laura Moschetti, Tiago Leal Ghezzi, Belisa Gomes Müller, Adriano Basso Dias, Oly Campos Corleta
Purpose: To investigate if fluorescein fluorescent test can predict dehiscence in a model of ischemic colonic anastomosis in rats. Methods: This experimental controlled trial randomly assigned 55 rats to four groups. Anastomoses were performed in non-ischemic colon segments (control group) and in ischemic colon segments measuring 1, 2 or 3 cm long (groups 1, 2 and 3, respectively). Fluorescein was injected and the tissues were examined under ultraviolet light. Seven days later, a second-look surgery was performed to check for the presence or absence of anastomosis dehiscence...
June 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/28695460/inversion-technique-for-the-removal-of-partially-covered-self-expandable-metallic-stents
#6
Christine Hill, Bassem K Khalil, Sindhu Barola, Abhishek Agnihotri, Robert A Moran, Yen-I Chen, Saowanee Ngamruengphong, Vikesh K Singh, Leigh A Frame, Michael A Schweitzer, Thomas H Magnuson, Mouen A Khashab, Patrick I Okolo, Vivek Kumbhari
BACKGROUND AND AIMS: Partially covered self-expandable metallic stents (PCSEMS), although an effective treatment for anastomotic/staple line leaks and strictures, can be difficult to remove. This study examines the effectiveness of the inversion technique for the removal of PCSEMS in the treatment of leaks and strictures that occurred post-sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). METHODS: Consecutive patients who underwent PCSEMS removal for a leak and/or stricture post-SG or RYGB between July 2013 and December 2016 at the Johns Hopkins Medical Institutions were reviewed...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28695459/endoscopic-vacuum-therapy-evt-a-new-concept-for-complication-management-in-bariatric-surgery
#7
Fabian Schmidt, Rudolf Mennigen, Thorsten Vowinkel, Philipp A Neumann, Norbert Senninger, Daniel Palmes, Mike G Laukoetter
BACKGROUND: Bariatric surgery is the most efficient therapy for morbid obesity. Staple line and anastomotic leakage are the most feared postoperative complications after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy (LSG). Traditional treatment options like revisional surgery and endoscopic stent placement are associated with high morbidity and mortality as well as variable success rates. Endoscopic vacuum therapy (EVT) has shown to be a new successful and feasible treatment option for leaks of different etiology after major gastro-esophageal surgery...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28695192/diagnosis-and-management-of-intraoperative-colorectal-anastomotic-leaks-a-global-retrospective-patient-chart-review-study
#8
A Schiff, S Roy, M Pignot, S K Ghosh, E J Fegelman
BACKGROUND: This targeted chart review study reports the first ever detailed global account of clinical approaches adopted to detect and manage anastomotic leaks identified during surgery in routine clinical practice. METHOD: 156 surgeons from eight countries retrospectively extracted data from surgical records of 458 patients who underwent colorectal surgery with an identified intraoperative leak at the circular anastomosis. Demographic details, procedures, and outcomes were analyzed descriptively, by country...
2017: Surgery Research and Practice
https://www.readbyqxmd.com/read/28685223/the-robotic-approach-significantly-reduces-length-of-stay-after-colectomy-a-propensity-score-matched-analysis
#9
Ahmed M Al-Mazrou, Codruta Chiuzan, Ravi P Kiran
PURPOSE: Robotic surgery has helped overcome several of the inherent limitations of conventional laparoscopy. The aim of this study is to identify any short-term advantage of robotic-assisted (RC) over laparoscopic colectomy (LC) using standardized nationwide data. METHODS: Patients from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) 2012-2014 datasets who underwent elective LC or RC were compared for patient demographics, comorbidity, diagnosis, extent of colon resection, operative duration, and conversion rates...
July 7, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28684934/considerations-in-stoma-reversal
#10
REVIEW
Karen L Sherman, Steven D Wexner
Temporary stomas are frequently used in the management of diverticulitis, colorectal cancer, and inflammatory bowel disease. These temporary stomas are used to try to mitigate septic complications from anastomotic leaks and to avoid the need for reoperation. Once acute medical conditions have improved and after the anastomosis has been proven to be healed, stomas can be reversed. Contrast enemas, digital rectal examination, and endoscopic evaluation are used to evaluate the anastomosis prior to reversal. Stoma reversal is associated with complications including anastomotic leak, postoperative ileus, bowel obstruction, enterocutaneous fistula, and, most commonly, surgical site infection...
July 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28682966/management-of-low-colorectal-anastomotic-leakage-in-the-laparoscopic-era-more-than-a-decade-of-experience
#11
Stephen Alexander Boyce, Craig Harris, Andrew Stevenson, John Lumley, David Clark
BACKGROUND: Anastomotic leak after colorectal surgery increases postoperative mortality, cancer recurrence, permanent stoma formation, and poor bowel function. Anastomosis between the colon and rectum is a particularly high risk. Traditional management mandates laparotomy, disassembly of the anastomosis, and formation of an often-permanent stoma. After laparoscopic colorectal surgery it may be possible to manage anastomotic failure with laparoscopy, thus avoiding laparotomy. OBJECTIVE: The purpose of this study was to determine the feasibility of the laparoscopic management of failed low colorectal anastomoses...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28677072/disparity-in-access-and-outcomes-for-emergency-neonatal-surgery-intestinal-atresia-in-kampala-uganda
#12
Sarah Cairo, Nasser Kakembo, Phyllis Kisa, Arlene Muzira, Maija Cheung, James Healy, Doruk Ozgediz, John Sekabira
BACKGROUND/AIM: Intestinal atresia is one of the leading causes of neonatal intestinal obstruction (NIO). The purpose of this study was to analyze the presentation and outcome of IA and compare with those from both similar and high-income country settings. PATIENTS AND METHODS: A retrospective review of prospectively collected data from patient charts and pediatric surgical database for 2012-2015 was performed. Epidemiological data and patient characteristics were analyzed and outcomes were compared with those reported in other LMICs and high-income countries (HICs)...
August 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28664443/vacuum-assisted-early-transanal-closure-of-leaking-low-colorectal-anastomoses-the-clean-study
#13
W A A Borstlap, G D Musters, L P S Stassen, H L van Westreenen, D Hess, S van Dieren, S Festen, E J van der Zaag, P J Tanis, W A Bemelman
INTRODUCTION: Non-healing of anastomotic leakage can be observed in up to 50% after total mesorectal excision for rectal cancer. This study investigates the efficacy of early transanal closure of anastomotic leakage after pre-treatment with the Endosponge(®) therapy. METHODS: In this prospective, multicentre, feasibility study, transanal suturing of the anastomotic defect was performed after vacuum-assisted cleaning of the presacral cavity. Primary outcome was the proportion of patients with a healed anastomosis at 6 months after transanal closure...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28661215/anastomotic-leak-after-surgical-repair-of-type-a-aortic-dissection-prevalence-and-consequences-in-midterm-follow-up
#14
Tamer Ghazy, Adrian Mahlmann, Zuzana Fajfrova, Ayham Darwish, Mohamed Eraqi, Helena Hegelmann, Ralf-Thorsten Hoffmann, Ahmed Ouda, Klaus Matschke, Utz Kappert, Norbert Weiss
BACKGROUND: This study reports the mid-term prevalence and therapeutic consequences of anastomotic leaks after surgery for Stanford type A aortic dissections. PATIENTS AND METHODS: From July 2007 to July 2013, 93 patients survived surgery for acute type A dissections at our center and underwent a standardized follow-up. The pre-, peri-, and postoperative as well as the midterm results were collected prospectively. Follow-up computed tomography (CT) imaging was performed 7 days, 3, and 12 months after surgery, and yearly thereafter, to assess the presence or progression of anastomotic leaks at the aorto-prosthesis anastomotic sites...
June 29, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28658159/outcomes-of-primary-gastric-transposition-for-long-gap-esophageal-atresia-in-neonates
#15
Zhandong Zeng, Fengli Liu, Juan Ma, Yun Fang, Hongwei Zhang
BACKGROUND: Gastric transposition is a relatively novel method of esophageal replacement. The purpose of this retrospective study was to assess the outcomes of long-gap esophageal atresia (LGEA) treated with esophageal replacement using primary gastric transposition in neonates. METHODS: Between March 2008 and May 2015, 14 newborns with LGEA were treated in our hospital. They were all found to have gaps of over 3 cm at the time of the surgery and were diagnosed with LGEA...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28654851/a-colovesical-fistula-with-a-persistent-descending-mesocolon-due-to-partial-situs-inversus-a-case-report
#16
Tetsuya Mochizuki, Hirofumi Tazawa, Yuzo Hirata, Yoshio Kuga, Tomohiro Miwata, Sotaro Fukuhara, Kouki Imaoka, Seiji Fujisaki, Mamoru Takahashi, Saburo Fukuda, Toshihiro Nishida, Hideto Sakimoto
INTRODUCTION: Situs inversus viscerum, a congenital condition in which the visceral organs are a mirror image of their normal physiological positions, could be total or partial. Persistent descending mesocolon (PDM) is a congenital anomaly that is asymptomatic because of its short length. PDM causing intestinal obstruction is a known clinical complication. PRESENTATION OF CASE: A 74-year-old woman presented with pneumaturia and enteruria for two months, and recurrent cystitis for a month...
June 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28650528/urinary-diversions-in-low-resource-settings
#17
Jeffrey P Wilkinson
Obstetric fistula is a devastating consequence of poorly attended childbirth which occurs almost exclusively in low resource settings. Most women with fistula can be cured or significantly improved by one or more vaginal surgeries. The last resort for women with otherwise incurable obstetric fistula is urinary diversion. The ileal conduit urinary diversion was the procedure considered by the authors of the accompanying article (Walker et al BJOG). Under optimal conditions, any urinary diversion is fraught with numerous potential risks...
June 26, 2017: BJOG: An International Journal of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28649270/low-values-of-central-venous-oxygen-saturation-scvo2-during-surgery-and-anastomotic-leak-of-abdominal-trauma-patients
#18
Andres Isaza-Restrepo, Jose F Moreno-Mejia, Juan S Martin-Saavedra, Milciades Ibañez-Pinilla
BACKGROUND: There is a well known relationship between hypoperfusion and postoperative complications like anastomotic leak. No studies have been done addressing this relationship in the context of abdominal trauma surgery. Central venous oxygen saturation is an important hypoperfusion marker of potential use in abdominal trauma surgery for identifying the risk of anastomotic leak development. The purpose of this study was to identify the relationship between low values of central venous oxygen saturation and anastomotic leak of gastrointestinal sutures in the postoperative period in abdominal trauma surgery...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28644545/robotic-versus-laparoscopic-rectal-surgery-in-high-risk-patients
#19
Jamil Ahmed, Han Cao, Sofoklis Panteleimonitis, Jim Khan, Amjad Parvaiz
AIM: Laparoscopic rectal surgery is associated with a steep learning curve and high conversion rate despite progress in equipment design and consistent practice. The robotic system has shown the advantage over laparoscopic approach due to stable three-dimensional views, improved dexterity and better ergonomics. These factors make the robotic approach more favourable for rectal surgery. The aim of this study was to compare the perioperative outcomes of laparoscopic and robotic rectal cancer surgery in high-risk patients...
June 23, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28643075/a-standardized-comparison-of-peri-operative-complications-after-minimally-invasive-esophagectomy-ivor-lewis-versus-mckeown
#20
Andrew M Brown, Michael J Pucci, Adam C Berger, Talar Tatarian, Nathaniel R Evans, Ernest L Rosato, Francesco Palazzo
BACKGROUND: While our institutional approach to esophageal resection for cancer has traditionally favored a minimally invasive (MI) 3-hole, McKeown esophagectomy (MIE 3-hole) during the last five years several factors has determined a shift in our practice with an increasing number of minimally invasive Ivor Lewis (MIE IL) resections being performed. We compared peri-operative outcomes of the two procedures, hypothesizing that MIE IL would be less morbid in the peri-operative setting compared to MIE 3-hole...
June 22, 2017: Surgical Endoscopy
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