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Anastomotic leaks

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https://www.readbyqxmd.com/read/29234924/a-new-direction-in-anastomotic-research-should-we-redesign-the-angle-of-sorrow
#1
Omar E Aly
INTRODUCTION: Despite advances in oncological outcomes in colo-rectal surgery, rates of anastomotic leak have not improved. The precise mechanisms of anastomotic leak remain poorly understood. Current research has focused on anastomotic reinforcement to tackle anastomotic leak with little success. The 'Angle of Sorrow', the corner of the anastomosis is prone to anastomotic leak, but remains a persistent feature in the gastrointestinal anastomosis. The tendency for stress forces to concentrate in the vulnerable 'Angle of Sorrow' prompts the need for anastomotic design research...
December 12, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29232658/a-meta-analysis-of-randomized-controlled-trials-on-the-use-of-suction-drains-following-rectal-surgery
#2
Francesco Guerra, Giuseppe Giuliani, Diego Coletta, Marcello Boni, Fabio Rondelli, Paolo Pietro Bianchi, Andrea Coratti
BACKGROUND: Anastomotic leakage is one of the most feared complications of rectal resections. The role of drains in limiting this occurrence or facilitating its early recognition is still poorly defined. We aimed to study whether the presence of prophylactic pelvic drains affects the surgical outcomes of patients undergoing rectal surgery with extraperitoneal anastomosis. METHODS: PubMed, EMBASE, and the Cochrane Library were systematically searched for randomized controlled trials comparing drained with undrained anastomoses following rectal surgery...
December 12, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29230940/the-effects-of-recreational-ketamine-cystitis-on-urinary-tract-reconstruction-a-surgical-challenge
#3
Néha Sihra, Jeremy Ockrim, Dan Wood
OBJECTIVES: To identify the rate of post-operative complications in patients who require surgical reconstruction for ketamine-induced urinary tract dysfunction and to identify any predictors for poor post-operative outcome with subsequent management strategies. MATERIALS AND METHODS: A retrospective review of data collected between 2007 and 2017 was performed. Evaluation included CT urogram, cystoscopy and biopsy. Indications and outcomes for surgical intervention were assessed...
December 12, 2017: BJU International
https://www.readbyqxmd.com/read/29229157/long-term-outcomes-of-sigmoid-diverticulitis-a-single-center-experience
#4
Ido Mizrahi, Abbas Al-Kurd, Katya Chapchay, Yael Ag-Rejuan, Natalia Simanovsky, Ahmed Eid, Haggi Mazeh
BACKGROUND: During the last decade, guidelines for the treatment of sigmoid diverticulitis have dramatically changed. The aim of this study is to report the long-term outcomes of patients treated for diverticulitis at a nonspecialized single center. MATERIALS AND METHODS: After obtaining institutional review board approval, medical records of all patients admitted to our institution with the diagnosis of sigmoid diverticulitis between 1998 and 2008 were reviewed...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229151/ketorolac-use-may-increase-risk-of-postoperative-pancreatic-fistula-after-pancreaticoduodenectomy
#5
Stacy J Kowalsky, Mazen S Zenati, Jennifer Steve, Kenneth K Lee, Melissa E Hogg, Herbert J Zeh, Amer H Zureikat
BACKGROUND: Ketorolac (Toradol), a commonly used nonselective nonsteroidal anti-inflammatory drug (NSAID) in the postoperative period, has been associated with increased risk of anastomotic leak after colon resection. The effect of postoperative NSAID and ketorolac use on postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is unknown. METHODS: Retrospective review of consecutive PDs at a high-volume pancreas center from 2012 to 2015. POPF was identified and graded using International Study Group on Pancreatic Fistula criteria...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29225732/laparoscopic-complete-mesocolic-excisions-for-colonic-cancer-in-the-last-decade-five-year-survival-in-a-single-centre
#6
Kristian Eeg Storli, Kristin Bentung Lygre, Knut Børge Iversen, Maria Decap, Geir Egil Eide
AIM: To analyse clinical and long-term oncologic results after laparoscopic complete mesocolic excision (CME) for colonic cancer over a 10-year period. METHODS: Consecutive patients who received laparoscopic CME at our hospital from 2007 to 2017 were prospectively registered and retrospectively analysed. In total, 341 patients were included with tumour-nodal-metastasis (TNM) stages 0-III. RESULTS: The mean age of the patients was 71.9 years...
November 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29224798/slide-esophagoplasty-vs-end-to-end-anastomosis-for-recalcitrant-esophageal-stricture-after-esophageal-atresia-repair
#7
Ali Kamran, Charles J Smithers, Michael A Manfredi, Thomas E Hamilton, Peter D Ngo, David Zurakowski, Russell W Jennings
BACKGROUND: Anastomotic stricture is a common complication following esophageal atresia (EA) repair. Patients with a recalcitrant stricture may require surgical intervention. The technique of re-anastomosis after stricture resection can affect patient outcomes. STUDY DESIGN: EA patients who underwent anastomotic stricture resection from July 2010 to February 2017 were reviewed. Patients after stricture resection in which slide esophagoplasty was performed were compared to the conventional approach of end-to-end anastomosis...
December 7, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29220430/postoperative-outcomes-in-ustekinumab-treated-patients-undergoing-abdominal-operations-for-crohn-s-disease
#8
Amy L Lightner, Nicholas P McKenna, Chung Sang Tse, Neil Hyman, Radhika Smith, Gayane Ovsepyan, Phillip Fleshner, Kristen Crowell, Walter Koltun, Marc Ferrante, Andre D'Hoore, Nathalie Lauwers, Bram Verstockt, Antonino Spinelli, Francesca DiCandido, Laura E Raffals, Kellie L Mathis, Edward V Loftus
Introduction: Ustekinumab, a monoclonal antibody targeting interleukins-12 and -23 is used to treat adults with Crohn's disease (CD). We determined the 30-day postoperative infectious complication rate among CD patients who received ustekinumab within 12 weeks prior to an abdominal operation as compared to patients who received anti-tumor necrosis factor (TNF) agents. Methods: A retrospective chart review of adults with CD who underwent an abdominal operation between 1/1/2015 and 5/1/2017 was performed across six sites...
December 6, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29218671/robotic-versus-laparoscopic-right-colectomy-an-updated-systematic-review-and-meta-analysis
#9
Leonardo Solaini, Francesca Bazzocchi, Davide Cavaliere, Andrea Avanzolini, Alessandro Cucchetti, Giorgio Ercolani
BACKGROUND: In the right colon surgery, there is a growing literature comparing the safety of robotic right colectomy (RRC) to that of laparoscopic right colectomy (LRC). With this paper we aim to systematically revise and meta-analyze the latest comparative studies on these two minimally invasive procedures. METHODS: A systematic review of studies published from 2000 to 2017 in the PubMed, Scopus, and Embase databases was performed. Primary endpoints were postoperative morbidity and mortality...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29217909/predictive-factors-for-small-intestinal-and-colonic-anastomotic-leak-a-multivariate-analysis
#10
Ahmad Sakr, Sameh Hany Emile, Emad Abdallah, Waleed Thabet, Wael Khafagy
Anastomotic leak (AL) is a serious complication of intestinal surgery with various predisposing factors. This study aims to assess several risk factors associated with AL after small intestinal and colonic anastomoses through a multivariate analysis. Two hundred twenty-four patients (126 males) with intestinal anastomosis of a median age of 44 years were reviewed. Independent factors associated with AL were male gender (OR = 2.59, P = 0.02), chronic liver disease (CLD) (OR = 8.03, P < 0.0001), more than one associated comorbidity (OR = 5...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29207920/endoscopic-ultrasound-guided-versus-surgical-transrectal-drainage-of-pelvic-abscesses
#11
D V G Meylemans, L E Oostenbrug, C M Bakker, M N Sosef, J H M B Stoot, H J Belgers
BACKGROUND: Pelvic abscesses are common but only small case series reporting outcome of either endoscopic ultrasound (EUS) guided or surgical transrectal drainage have been reported. METHODS: We performed a retrospective consecutive cohort study, assessing effectivity and safety of EUS guided or surgical transrectal drainage of previously untreated pelvic abscesses from all causes, diagnosed using CT scan between 09/2010 and 06/2014 in a Dutch teaching hospital...
December 5, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29207407/triple-stenting-to-treat-a-complete-wirsung-to-jejunum-anastomotic-leak-after-pancreaticoduodenectomy
#12
Massimiliano Mutignani, Edoardo Forti, Francesco Pugliese, Alberto Tringali, Marcello Cintolo, Giulia Bonato, Lorenzo Dioscoridi
No abstract text is available yet for this article.
December 5, 2017: Endoscopy
https://www.readbyqxmd.com/read/29206677/benchmarking-complications-associated-with-esophagectomy
#13
Donald E Low, Madhan Kumar Kuppusamy, Derek Alderson, Ivan Cecconello, Andrew C Chang, Gail Darling, Andrew Davies, Xavier Benoit D'Journo, Suzanne S Gisbertz, S Michael Griffin, Richard Hardwick, Arnulf Hoelscher, Wayne Hofstetter, Blair Jobe, Yuko Kitagawa, Simon Law, Christophe Mariette, Nick Maynard, Christopher R Morse, Philippe Nafteux, Manuel Pera, C S Pramesh, Sonia Puig, John V Reynolds, Wolfgang Schroeder, Mark Smithers, B P L Wijnhoven
OBJECTIVE: Utilizing a standardized dataset with specific definitions to prospectively collect international data to provide a benchmark for complications and outcomes associated with esophagectomy. SUMMARY OF BACKGROUND DATA: Outcome reporting in oncologic surgery has suffered from the lack of a standardized system for reporting operative results particularly complications. This is particularly the case for esophagectomy affecting the accuracy and relevance of international outcome assessments, clinical trial results, and quality improvement projects...
December 4, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29203981/triple-test-a-predictor-of-anastomotic-integrity-in-patients-undergoing-low-anterior-resection-after-neoadjuvant-chemoradiotherapy
#14
Madhu Muralee, Nithish R Acharya, Wagh Mira Sudham, Arun Peter Mathew, Kurian Cherian, K Chandramohan, Paul Augustine, M Iqbal Ahamed
Anastomotic leak after low anterior resection for rectal cancer is a dreaded complication. Diversion stoma helps tiding over this crisis and it is routinely practised in most centres, especially in post chemoradiotherapy setting. But a diversion stoma has got its own problems. In this study, we attempt to use the triple test as a predictor of anastomotic integrity and thereby avoid a diverting stoma, and patients undergoing low anterior resection after neoadjuvant chemoradiotherapy were spared the trouble of a diverting stoma if the on table triple test was negative...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29203735/histomorphologic-changes-of-esophageal-mucosa-in-experimental-third-degree-stricture
#15
Volodymyr O Shaprynskyi, Yevgeniy V Shaprinskiy, Yaroslav V Karyi, Serhii A Lysenko
INTRODUCTION: Nowadays the level of early and late complications after the operations for esophageal corrosive strictures such as esophago-organ anastomotic leak, development of infections, pneumonia, pleural empyema, mediastinitis, peritonitis, postoperative corrosive stricture development etc. remains rather high. Besides, postoperative mortality rate is high as well - 3.5-30 %. For that reason, an experimental model of esophageal stricture was suggested and ultrastructural mucosal changes in the stricture itself were studied to elaborate the unified pathogenic approach in treatment of esophageal stricture and improvement of its results...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29203037/near-infrared-perfusion-assessment-of-gastric-conduit-during-minimally-invasive-ivor-lewis-esophagectomy
#16
Brian G A Dalton, Abubaker A Ali, Marie Crandall, Ziad T Awad
INTRODUCTION: Anastomotic leak and conduit necrosis are devastating complications following Ivor Lewis esophagectomy. Near infrared imaging (NIR) using IndoCyanine Green allows for real time tissue perfusion assessment which may reduce anastomotic leak during minimally invasive Ivor Lewis esophagectomy (MIE). METHODS: Forty consecutive MIE were performed by a single surgeon at a tertiary referral center. The first 20 were assessed for gastric conduit perfusion by clinical criteria (Group 1)...
November 28, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29198768/combination-oral-and-mechanical-bowel-preparations-decreases-complications-in-both-right-and-left-colectomy
#17
Emily F Midura, Andrew D Jung, Dennis J Hanseman, Vikrom Dhar, Shimul A Shah, Janice F Rafferty, Bradley R Davis, Ian M Paquette
BACKGROUND: Before elective colectomy, many advocate mechanical bowel preparation with oral antibiotics, whereas enhanced recovery pathways avoid mechanical bowel preparations. The optimal preparation for right versus left colectomy is also unclear. We sought to determine which strategy for bowel preparation decreases surgical site infection (SSI) and anastomotic leak (AL). METHODS: Elective colectomies from the National Surgical Quality Improvement Program colectomy database (2012-2015) were divided by (1) type of bowel preparation: no preparation (NP), mechanical preparation (MP), oral antibiotics (PO), or mechanical and oral antibiotics (PO/MP); and (2) type of colonic resection: right, left, or segmental colectomy...
November 30, 2017: Surgery
https://www.readbyqxmd.com/read/29193751/the-triune-of-intestinal-microbiome-genetics-and-inflammatory-status-and-its-impact-on-lower-gastrointestinal-anastomosis-healing
#18
Jou A Lee, Timothy J A Chico, Stephen A Renshaw
Gastrointestinal resections are a common operation and most involve an anastomosis to re-join the ends of the remaining bowel to restore gastrointestinal (GIT) continuity. While most joins heal uneventfully, in up to 26% of patients healing fails and an anastomotic leak (AL) develops. Despite advances in surgical technology and techniques, the rate of anastomotic leaks has not decreased over the last few decades raising the possibility that perhaps we do not yet fully understand this phenomenon of AL and are thus ill-equipped to prevent it...
November 28, 2017: FEBS Journal
https://www.readbyqxmd.com/read/29191359/evaluation-of-esophageal-anastomotic-integrity-with-serial-pleural-amylase-levels
#19
Daniel L Miller, Gerald A Helms, William R Mayfield
BACKGROUND: An anastomotic leak is the most devastating and potentially fatal complication after esophagectomy. Current detection methods can be inaccurate and place patients at risk of other complications. Analysis of pleural fluid for amylase may be more accurate and place patients at less of a risk for evaluating the integrity of an esophageal anastomosis. METHODS: We retrospectively reviewed prospective data of 45 consecutive patients who underwent an Ivor Lewis esophagectomy over an 18-month period and evaluated their anastomotic integrity with serial pleural amylase levels (PAL)...
November 27, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29188353/-quality-indicators-for-surgery-of-rectal-cancer-evidence-based-development-of-a-set-of-indicators-for-quality
#20
REVIEW
A Wiegering, H-J Buhr, C Klinger, A Fürst, T Schiedeck, O Schwandner, S Stelzner, C-T Germer
The definition of valid quality indicators is an essential task of medical self-administration and quality assurance. Based on the literature and the results of the Study, Documentation, and Quality Center (StuDoQ) Rectal Cancer Registry, we suggest the following QIs: rate of circumferential resection margin (CRM) positive resected material, rate of anastomotic leak in patients with anastomoses, rate of abdominal wound healing disorders and rate of patients with newly established permanent urinary diversion...
November 29, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
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