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Anastomotic leaks

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https://www.readbyqxmd.com/read/29682711/-imaging-diagnosis-and-imaging-risk-factors-of-anastomotic-leakage-after-rectal-cancer-surgery
#1
Yi Wang
Dispite continual improvements in diagnostic and management techniques, anastomotic leak (AL) remains one of the most devastating consequences of rectal cancer surgery. Recently, many investigations have attempted to identify the risk factors and established risk model to predict and prevent anastomotic leakage after low anterior resection. The distance between the lower edge of rectal cancer and the anal verge measured by magnetic resonance imaging was demonstrated as one of the independent risk factors associated with AL...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682710/-surgical-skills-in-the-prevention-of-anastomotic-leakage-after-rectal-neoplasm-surgery
#2
Qianqian Shao, Guole Lin
For colorectal surgeons, how to reduce anastomotic leakage after laparoscopic rectal cancer surgery remains to be challenging. We provide a brief discussion regarding the surgical skills required to prevent anastomotic leakage after rectal cancer surgery, such as the following: 1) Low ligation of inferior mesenteric vessel during laparoscopic total mesorectal excision can improve anastomotic tension and blood supply, thus reducing the risk of anastomotic leakage. While high ligation of inferior mesenteric artery results in poor blood supply and high tension in atastomotic site, thus increasing the risk of anastomotic leakage...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682708/-early-diagnosis-and-treatment-of-anastomotic-leak-after-rectal-cancer-surgery
#3
Tinghan Yang, Ziqiang Wang
Anastomotic leakage is the most common major complication after mid-low rectal cancer surgery. Due to lack of knowledge regarding the virtual mechanisms of anastomotic leakage, not much can be done to prevent its development. The aim of the present review was to discuss the prevention, early diagnosis, and treatment of anastomotic leakage after rectal cancer surgery. For patients with risk factors, such as anastomotic site within 4 cm from anus, obese men, lack of blood supply of the anastomotic site, neoadjuvant chemo radiotherapy, or patients with severe co-morbidity, aggressive preventive strategy should be adopted...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682705/-reflection-on-the-present-study-of-anastomotic-leakage-after-colorectal-surgery
#4
Zhouqiao Wu, Jinyao Shi, Ziyu Li, Jiafu Ji
Anastomotic leakage is one of the most serious complications of colorectal surgery. Despite progress in available surgical techniques, the morbidity associated with anastomotic leakage remains high. In this review, we summarize the current clinical status of this complication, the problems it causes, and relevant research achievements. To date, a lack of consensus regarding the diagnosis of anastomotic leakage has resulted in varying rates of diagnosis across countries and regions worldwide. Accurately predicting the occurrence of anastomotic leakage using the established risk factors and preoperative scoring systems remains difficult...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29676288/predictors-of-morbidity-and-mortality-post-emergency-abdominal-surgery-a-national-study
#5
Afnan Altamimi, Mazen Hassanain, Thamer Nouh, Khawlah Ateeq, Murad Aljiffry, Abrar Nawawi, Ghaith Al Saied, Mohammed Riaz, Huda Alanbar, Abdullah Altamimi, Saeed Alsareii, Mashael Al-Mousa, Abeer Al-Shammari, Saleh Alnuqaydan, Amal Ghzwany
Background/Aim: Emergency surgeries have increased in Saudi Arabia. This study examines these surgeries and associated complications. Patients and Methods: This was a prospective multicenter cohort study of patients undergoing emergency intraperitoneal surgery from the eight health sectors of Saudi Arabia. Patients' data were collected over 14 days. Results: In total, 283 patients were included (163 men [54.06%]). The majority of cases were open surgery (204 vs...
April 18, 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29675476/peritoneal-tuberculosis-after-robot-assisted-laparoscopic-prostatectomy-with-extended-lymph-node-dissection
#6
Suruga Saito, Katsuhiro Ito, Keiyu Matsumoto, Motofumi Tajima, Takayuki Goto, Haruki Ito, Yumi Manabe, Mutsuki Mishina, Hiroshi Okuno
Background: Peritoneal tuberculosis (TB) is a relatively uncommon presentation of extrapulmonary TB. Early diagnosis of peritoneal TB is difficult because of its nonspecific clinical manifestation such as abdominal pain, fever, or ascites. Especially early after surgery of abdomen or pelvis, these symptoms can be misdiagnosed as septic peritonitis. There are few reports of peritoneal TB as a postoperative complication of laparoscopic surgery. Here, we describe a first case of peritoneal TB after robot-assisted laparoscopic prostatectomy (RALP) with extended lymph node dissection...
2018: Journal of Endourology Case Reports
https://www.readbyqxmd.com/read/29668894/endoscopic-treatment-of-ileal-pouch-sinus
#7
Nan Lan, Bo Shen
Background and aims: Pouch sinus is a serious complication in patients undergoing ileal pouch-anal anastomosis. The aim of this study was to verify the efficacy and safety of endoscopic needle knife sinusotomy (NKSi) in the management of pouch sinus. Methods: All consecutive patients with a pouch sinus treated with NKSi from 2008 to 2016 were identified. The primary outcomes were complete healing of the sinus and pouch survival. Results: A total of 109 patients were included...
April 12, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29663330/multicentre-phase-ii-trial-of-near-infrared-imaging-in-elective-colorectal-surgery
#8
F Ris, E Liot, N C Buchs, R Kraus, G Ismael, V Belfontali, J Douissard, C Cunningham, I Lindsey, R Guy, O Jones, B George, P Morel, N J Mortensen, R Hompes, R A Cahill
BACKGROUND: Decreasing anastomotic leak rates remain a major goal in colorectal surgery. Assessing intraoperative perfusion by indocyanine green (ICG) with near-infrared (NIR) visualization may assist in selection of intestinal transection level and subsequent anastomotic vascular sufficiency. This study examined the use of NIR-ICG imaging in colorectal surgery. METHODS: This was a prospective phase II study (NCT02459405) of non-selected patients undergoing any elective colorectal operation with anastomosis over a 3-year interval in three tertiary hospitals...
April 16, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29661283/2-octylcyanoacrylate-for-the-prevention-of-anastomotic-leak
#9
Anthony B Costales, Deepa Patil, Anny Mulya, John P Kirwan, Chad M Michener
BACKGROUND: Anastomotic leak after colorectal surgery is a significant cause of morbidity and mortality. The aim of this study was to evaluate the impact of a reinforced colo-colonic anastomosis with tissue adhesive, 2-octylcyanoacrylate (2-OCA), on the integrity of anastomotic healing as measured by anastomotic bursting pressure. METHODS: Sixty-eight female Sprague-Dawley rats underwent a rectosigmoid colon transection and a sutured end-to-end anastomosis followed by randomization to receive no further intervention or reinforcement with the tissue adhesive, 2-OCA...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29660354/novel-treatment-for-anastomotic-leak-following-ivor-lewis-esophagectomy
#10
Joseph Costa, Lyall A Gorenstein, Frank D'Ovidio
Intra-thoracic anastomotic leaks following esophagogastrostomy occur frequently, often resulting in prolonged hospitalization and delays in advancing oral nutrition and hydration. Management of anastomotic esophageal leaks vary based on time of occurrence to the intervention, condition of the patient and location. Conservative approaches such as endo-clips and endo-stents have gained momentum in addressing esophageal leaks and fistulas, replacing the original paradigm of surgical approach as initial management...
April 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29658991/novel-de-novo-synthesized-phosphate-carrier-compound-aba-peg20k-pi20-suppresses-collagenase-production-in-enterococcus-faecalis-and-prevents-colonic-anastomotic-leak-in-an-experimental-model
#11
M Wiegerinck, S K Hyoju, J Mao, A Zaborin, C Adriaansens, E Salzman, N H Hyman, O Zaborina, H van Goor, J C Alverdy
BACKGROUND: Previous work has demonstrated that anastomotic leak can be caused by collagenolytic bacteria such as Enterococcus faecalis via an effect on wound collagen. In humans, E. faecalis is the organism cultured most commonly from a leaking anastomosis, and is not routinely eliminated by standard oral or intravenous antibiotics. Novel strategies are needed to contain the virulence of this pathogen when present on anastomotic tissues. METHODS: Polyphosphorylated polymer ABA-PEG20k-Pi20 was tested in mice for its ability to prevent anastomotic leak caused by collagenolytic E...
April 16, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29644184/anastomotic-leaks-and-catheter-time-after-salvage-robot-assisted-radical-prostatectomy
#12
EDITORIAL
Marco Bandini, Giorgio Gandaglia, Nicola Fossati, Francesco Montorsi, Alberto Briganti
No abstract text is available yet for this article.
March 2018: Translational Andrology and Urology
https://www.readbyqxmd.com/read/29643956/serum-cytokines-in-early-prediction-of-anastomotic-leakage-following-low-anterior-resection
#13
Marek Zawadzki, Małgorzata Krzystek-Korpacka, Andrzej Gamian, Wojciech Witkiewicz
Introduction: Anastomotic leakage continues to be one of the most serious complications following low anterior resections. Early diagnosis of a leak is difficult but critical to minimize morbidity and mortality. Aim: To evaluate changes in serum concentrations of 27 different cytokines following low anterior resection, with the goal of finding new, early biomarkers of anastomotic leak. Material and methods: This is a prospective observational study that includes 32 patients undergoing elective low anterior resection for rectal cancer...
March 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29629802/anastomotic-leaks-after-small-and-large-bowel-surgery-diagnostic-performance-of-ct-and-the-importance-of-intraluminal-contrast-administration
#14
Karim Bahadurali Samji, Ania Zofia Kielar, Michael Connolly, Najla Fasih, Geoffrey Doherty, Andrew Chung, Etienne Hache
OBJECTIVE: The objective of our study was to evaluate the diagnostic performance of CT in the identification of anastomotic leaks. MATERIALS AND METHODS: This was a study of patients who underwent bowel surgery and a subsequent postoperative CT examination performed specifically for investigating for an anastomotic leak. The study group included patients with surgically confirmed anastomotic leaks (n = 59), and the control group included patients without anastomotic leaks (n = 48) confirmed by either repeat surgery or uneventful clinical follow-up for at least 6 months...
April 9, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29629219/novel-endoscopic-stent-for-anastomotic-leaks-after-total-gastrectomy-using-an-anchoring-thread-and-fully-covering-thick-membrane-prevention-of-embedding-and-migration
#15
Gum Mo Jung, Seung Hyun Lee, Dae Seong Myung, Wan Sik Lee, Young Eun Joo, Mi Ran Jung, Seong Yeob Ryu, Young Kyu Park, Sung Bum Cho
Purpose: The endoscopic management of a fully covered self-expandable metal stent (SEMS) has been suggested for the primary treatment of patients with anastomotic leaks after total gastrectomy. Embedded stents due to tissue ingrowth and migration are the main obstacles in endoscopic stent management. Materials and Methods: The effectiveness and safety of endoscopic management were evaluated for anastomotic leaks when using a benign fully covered SEMS with an anchoring thread and thick silicone covering the membrane to prevent stent embedding and migration...
March 2018: Journal of Gastric Cancer
https://www.readbyqxmd.com/read/29624485/microbial-glucuronidase-inhibition-reduces-severity-of-diclofenac-induced-anastomotic-leak-in-rats
#16
Simon T K Yauw, Melissa Arron, Roger M L M Lomme, Petra van den Broek, Rick Greupink, Aadra P Bhatt, Matthew R Redinbo, Harry van Goor
BACKGROUND: The non-steroidal anti-inflammatory drug diclofenac has been associated with intestinal anastomotic leakage, although the underlying pathophysiology is unclear. Previous data suggest that reactivation of biliary diclofenac metabolites by microbial β-glucuronidases in the gut plays a role in harming the intestinal mucosa, and that microbiome-targeted glucuronidase inhibition prevents this damage. Here, the microbial glucuronidase inhibitor Inh1 was examined for its ability to reduce diclofenac-induced anastomotic leakage in rats...
April 6, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29623587/postoperative-intra-abdominal-infection-is-an-independent-prognostic-factor-of-disease-free-survival-and-disease-specific-survival-in-patients-with-stage-ii-colon-cancer
#17
P Sánchez-Velázquez, M Pera, M Jiménez-Toscano, X Mayol, X Rogés, L Lorente, M Iglesias, M Gallén
BACKGROUND: Recurrence occurs in up to 20% of patients with stage II colon cancer operated on for cure. Although postoperative intra-abdominal infection has been linked with an increased risk of recurrence, the association is controversial. The aim was to investigate the impact of postoperative intra-abdominal infection on disease-free survival and disease-specific survival in patients with stage II colon cancer. METHODS: Patients undergoing elective surgery for colon cancer stage II, between 2003 and 2014, were included...
April 5, 2018: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29606350/analysis-of-quality-indicators-for-colorectal-cancer-surgery-in-units-accredited-by-the-spanish-association-of-coloproctology
#18
Fernando de la Portilla, Sergio Builes, Alejandra García-Novoa, Eloy Espín, Esther Kreisler, José María Enríquez-Navascues, Sebastiano Biondo, Antonio Codina
INTRODUCTION: Currently, there is growing interest in analyzing the results from surgical units and the implementation of quality standards in order to identify good healthcare practices. Due to this fact, the Spanish Association of Coloproctology (AECP) has developed a unit accreditation program that contemplates basic standards. The aim of this article is to evaluate and analyze the specific quality indicators for the surgical treatment of colorectal cancer, established by the program...
March 29, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29605022/posttransplant-complications-in-adult-recipients-of-intestine-grafts-without-bowel-decontamination
#19
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
BACKGROUND: Selective digestive decontamination is commonly used to decrease lumenal bacterial flora. Preoperative bowel decontamination may be associated with a lower wound infection rate but has not been shown to decrease risk of intra-abdominal abscess or lower leak rate for enteric anastomoses. Alternatively, the decontamination disrupts the normal flora of the gastrointestinal tract and may affect normal physiology, including immunologic function. This study reports complication rates of an intestine transplant program that has never used bowel decontamination...
May 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29595182/c-reactive-protein-as-predictor-of-anastomotic-complications-after-minimally-invasive-oesophagectomy
#20
Vladimir Prochazka, Filip Marek, Lumir Kunovsky, Roman Svaton, Martina Farkasova, Martin Potrusil, Petr Moravcik, Zdenek Kala
BACKGROUND: Anastomotic leaks after oesophagectomy with tabularised stomach replacement are a significant factor in post-operative mortality and morbidity. Early detection and treatment of this complication allow for improving operative and oncological results. When assessing laboratory values - elevation of inflammatory parameters - complicated interpretation is an issue (systemic inflammatory response syndrome, surgical versus non-surgical complication). Results studying the relationship between C-reactive protein (CRP) and complications following oesophagectomies are inconsistent...
March 23, 2018: Journal of Minimal Access Surgery
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