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Anastomotic leaks

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https://www.readbyqxmd.com/read/29451185/early-versus-conventional-stoma-closure-following-bowel-surgery-a-randomized-controlled-trial
#1
Thirugnanasambandam Nelson, Amuda R Pranavi, Sathasivam Sureshkumar, Gubbi S Sreenath, Vikram Kate
Background/Aim: To compare early stoma closure with conventional stoma closure following defunctioning diversion stoma surgery with respect to the frequency of complications, health-related quality of life (QoL), and length of hospitalization (LoH). Patients and Methods: This study was designed as a prospective parallel-arm randomized controlled trial. Patients who underwent temporary stoma following bowel surgery between February 2014 and November 2015 were included...
January 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
https://www.readbyqxmd.com/read/29450852/major-pancreatic-resections-normal-postoperative-findings-and-complications
#2
Marco Chincarini, Giulia A Zamboni, Roberto Pozzi Mucelli
OBJECTIVES: (1) To illustrate and describe the main types of pancreatic surgery; (2) to discuss the normal findings after pancreatic surgery; (3) to review the main complications and their radiological findings. BACKGROUND: Despite the decreased postoperative mortality, morbidity still remains high resulting in longer hospitalisations and greater costs. Imaging findings following major pancreatic resections can be broadly divided into "normal postoperative alterations" and real complications...
February 15, 2018: Insights Into Imaging
https://www.readbyqxmd.com/read/29445302/anastomotic-reinforcement-with-omentoplasty-reduces-anastomotic-leakage-for-minimally-invasive-esophagectomy-with-cervical-anastomosis
#3
Dong Zhou, Quan-Xing Liu, Xu-Feng Deng, Hong Zheng, Xiao Lu, Ji-Gang Dai, Li Jiang
Purpose: Anastomotic leakage is the most feared postoperative complication after esophagectomy. Omentoplasty, wrapping the omentum around the alimentary tract anastomosis, is thought to decrease the anastomotic leakage rate. The purpose of this clinical study is to investigate the use of omentoplasty to reinforce cervical esophagogastrostomy after minimally invasive esophagectomy (MIE). Patients and methods: In this retrospective study, the data of 160 consecutive patients who underwent cervical esophagogastrostomy after MIE between September 2012 and May 2015 were analyzed, 87 who underwent omentoplasty (group A) and 73 who did not undergo omentoplasty (group B)...
2018: Cancer Management and Research
https://www.readbyqxmd.com/read/29442243/treatment-of-benign-perforations-and-leaks-of-the-esophagus-factors-associated-with-success-after-stent-placement
#4
Cheal Wung Huh, Joon Sung Kim, Hyun Ho Choi, Ja In Lee, Jeong-Seon Ji, Byung-Wook Kim, Hwang Choi
BACKGROUND: Self-expanding metal stent (SEMS) is effective and safe for the treatment of benign esophageal perforations or leaks. The purpose of this study was to identify factors associated with clinical success after SEMS placement. METHODS: Patients who received SEMS placement for treatment of benign esophageal perforations or leaks were retrospectively identified. These patients were analyzed for factors associated with clinical success and complications. RESULTS: A total of 31 patients underwent stent insertion for benign esophageal perforations (n = 11) or anastomotic leaks (n = 20)...
February 13, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29436979/thoracoscopic-total-esophagogastrectomy-with-supercharged-colon-interposition-for-the-treatment-of-esophageal-adenocarcinoma-in-situs-inversus
#5
Alexandros Charalabopoulos, Ali Kordzadeh, Elias Sdralis, Bruno Lorenzi, Fateh Ahmad
BACKGROUND: Esophagectomy in situs inversus is challenging. With long-segment supercharged reconstruction, it becomes more perplexing and multidisciplinary surgical skills are needed. Challenges met and the surgical technique used is presented in this case report. METHODS: The case of a 49-year old patient with situs inversus abdominus and a locally advanced distal esophageal adenocarcinoma extending to the stomach is presented. RESULTS: Following neoadjuvant chemotherapy and due to inability to use the stomach as a conduit, a thoracoscopic total esophagogastrectomy with long-segment reconstruction was performed...
February 13, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29436277/initial-load-stability-of-different-trachea-suture-techniques-tests-on-an-ex-vivo-model
#6
Andreas Kirschbaum, Helen Abing, Nikolas Mirow
Objective Tracheal anastomosis can be performed with different suture techniques. In this experimental work, the resilience of anastomotic techniques to pressure and tensile stress was studied. Study Design Ex vivo pig model. Setting Experimental. Subjects and Methods The trachea with the 2 main bronchi in freshly slaughtered pigs was isolated and intubated (CH 8.0). Both main bronchi were closed distally by a stapler. After resection of the trachea, an anastomosis (n = 15 per group) was created: group 1, single interrupted sutures; group 2, continuous running suture; group 3, mixed technique...
February 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29432225/nonsteroidal-anti-inflammatory-drugs-and-cancer-pain
#7
Jenny Strawson
PURPOSE OF REVIEW: This review aims to appraise the most recent evidence for the use of NSAIDS in cancer pain. RECENT FINDINGS: The Cochrane review reveals the paucity of high-quality evidence for the use of NSAIDS for cancer pain, highlighting methodological considerations for future research. There is limited evidence for the role of combined NSAIDs (celecoxib and diclofenac) alongside opioids for cancer pain. Recent retrospective data suggests NSAIDS may contribute to better pain control in hospitalized patients...
February 9, 2018: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29428689/impact-of-age-on-risk-of-complications-after-gastric-bypass-a-cohort-study-from-the-scandinavian-obesity-surgery-registry-soreg
#8
Peter Gerber, Claes Anderin, Eva Szabo, Ingmar Näslund, Anders Thorell
BACKGROUND: An increasing number of older patients undergo bariatric surgery. OBJECTIVE: To define the risk for complications and mortality in relation to age after gastric bypass. SETTING: A national registry-based study. METHODS: Patients (n = 47,660) undergoing gastric bypass between May 2007 and October 2016 and registered in the Scandinavian Obesity Register were included. Risk between age groups was compared by multivariate analysis...
January 4, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29428155/statin-medications-are-associated-with-decreased-risk-of-sepsis-and-anastomotic-leaks-after-rectal-resections
#9
David Disbrow, Corie L Seelbach, Jeremy Albright, Jane Ferraro, Juan Wu, Jon M Hain, Beth-Ann Shanker, Robert K Cleary
BACKGROUND: This study was designed to determine the effect of statins on colorectal postoperative complications related to sepsis. Previous studies have reported conflicting results. METHODS: This is a retrospective propensity score analysis of postoperative outcomes from a large regional database of patients who underwent elective colorectal resection from June 2012-July 2015. RESULTS: 7285 patients met inclusion criteria: 34.5% received statins...
January 31, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29414520/diagnosing-conduit-leak-after-esophagectomy-for-esophageal-cancer-by-computed-tomography-leak-protocol-and-standard-esophagram-is-old-school-still-the-best
#10
Diana Palacio, Edith M Marom, Arlene Correa, Sonia L Betancourt-Cuellar, Wayne L Hofstetter
The imaging modalities available to evaluate anastomotic leak complicating esophagectomy include CT-Esophageal Protocol (CTEP) and esophagram. The purpose of this study was to compare the performance of these two modalities, alone or in combination, with the final diagnosis of leak established by endoscopy, surgery and/or the clinical course and evaluate management implications.
January 31, 2018: Clinical Imaging
https://www.readbyqxmd.com/read/29412450/intrathoracic-versus-cervical-anastomosis-and-predictors-of%C3%A2-anastomotic-leakage-after-oesophagectomy-for-cancer
#11
J A H Gooszen, L Goense, S S Gisbertz, J P Ruurda, R van Hillegersberg, M I van Berge Henegouwen
BACKGROUND: Studies comparing the anastomotic leak rate in patients with an intrathoracic versus a cervical anastomosis after oesophagectomy are equivocal. The aim of this study was to compare clinical outcome after oesophagectomy in patients with an intrathoracic or cervical anastomosis, and to identify predictors of anastomotic leakage in a nationwide audit. METHODS: Between January 2011 and December 2015, all consecutive patients who underwent oesophagectomy for cancer were identified from the Dutch Upper Gastrointestinal Cancer Audit...
February 7, 2018: British Journal of Surgery
https://www.readbyqxmd.com/read/29398873/impact-of-mechanical-bowel-preparation-in-elective-colorectal-surgery-a-meta-analysis
#12
Katie E Rollins, Hannah Javanmard-Emamghissi, Dileep N Lobo
AIM: To analyse the effect of mechanical bowel preparation vs no mechanical bowel preparation on outcome in patients undergoing elective colorectal surgery. METHODS: Meta-analysis of randomised controlled trials and observational studies comparing adult patients receiving mechanical bowel preparation with those receiving no mechanical bowel preparation, subdivided into those receiving a single rectal enema and those who received no preparation at all prior to elective colorectal surgery...
January 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29398323/delaying-surgery-after-neoadjuvant-chemoradiotherapy-in-rectal-cancer-has-no-influence-in-surgical-approach-or-short-term-clinical-outcomes
#13
Nuno Figueiredo, Sofoklis Panteleimonitis, Sotiris Popeskou, Jose F Cunha, Tahseen Qureshi, Geerard L Beets, Richard J Heald, Amjad Parvaiz
AIMS: In rectal cancer, increasing the interval between the end of neoadjuvant chemoradiotherapy (CRT) and surgery could improve the pathological complete response (pCR) rates, allow full-dose neoadjuvant chemotherapy, and select patients with a clinical complete response (cCR) for inclusion in a "watch & wait" program (W&W). However, controversy arises from waiting more than 8-12 weeks after CRT, as it might increase fibrosis around the total mesorectal excision (TME) plane potentially leading to technical difficulties and higher surgical morbidity...
February 1, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29394558/-hepatic-lateral-segmentectomy-for-management-of-liver-and-adrenal-abscess-following-a-laparoscopy-assisted-left-hemicolectomy-a-case-report
#14
Makoto Aoki, Hiroyuki Fukunari, Yosuke Kawai, Akemi Watanabe, Yuya Umebayashi, Toshifumi Saito, Kenji Shitara, Tetsuji Hayashi
A 67-year-old woman underwent laparoscopy-assisted left hemicolectomy for early descending colon cancer(pTis, pN0, cH0, cM0, Stage 0).Her postoperative course was uneventful, without fever and/or tenderness at the anastomotic site.A month following discharge from the hospital, enhanced computed tomography revealed a liver abscess measuring 80mm in diameter at the lateral segment and a left adrenal abscess measuring 30mm in diameter.Although some free air and fluid collection was noted near the anastomotic site, there was no tenderness, and a gastrografin enema did not reveal leakage and/or pooling of the contrast agent near the anastomotic site...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29380065/a-single-surgeon-s-experience-transitioning-to-robotic-assisted-right-colectomy-with-intracorporeal-anastomosis
#15
Alexandra C W Reitz, Ed Lin, Seth A Rosen
BACKGROUND: Despite substantial evidence demonstrating benefits of minimally invasive surgery, a large percentage of right colectomies are still performed via an open technique. Most laparoscopic right colectomies are completed as a hybrid procedure with extracorporeal anastomosis. As part of a pure minimally invasive procedure, intracorporeal anastomosis (ICA) may confer additional benefits for patients. The robotic platform may shorten the learning curve for minimally invasive right colectomy with ICA...
January 29, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29377872/systematic-review-and-meta-analysis-of-objective-assessment-of-physical-fitness-in-patients-undergoing-colorectal-cancer-surgery
#16
Chun Hin Angus Lee, Joseph C Kong, Hilmy Ismail, Bernhard Riedel, Alexander Heriot
BACKGROUND: Gas exchange-derived variables obtained from cardiopulmonary exercise testing allow objective assessment of functional capacity and hence physiological reserve to withstand the stressors of major surgery. Field walk tests provide an alternate means for objective assessment of functional capacity that may be cheaper and have greater acceptability, in particular, in elderly patients. OBJECTIVE: This systematic review evaluated the predictive value of cardiopulmonary exercise testing and field walk tests in surgical outcomes after colorectal surgery...
March 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29374306/intraoperative-colonic-pulse-oximetry-in-left-sided-colorectal-surgery-can-it-predict-anastomotic-leak
#17
Johannes M Salusjärvi, Monika A Carpelan-Holmström, Johanna M Louhimo, Olli Kruuna, Tom M Scheinin
BACKGROUND: An anastomotic leak is a fairly common and a potentially lethal complication in colorectal surgery. Objective methods to assess the viability and blood circulation of the anastomosis could help in preventing leaks. Intraoperative pulse oximetry is a cheap, easy to use, fast, and readily available method to assess tissue viability. Our aim was to study whether intraoperative pulse oximetry can predict the development of an anastomotic leak. METHODS: The study was a prospective single-arm study conducted between the years 2005 and 2011 in Helsinki University Hospital...
January 26, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29372374/cysto-cholecystostomy-a-more-physiological-procedure-for-hepatic-cysts-with-biliary-communications-and-cystic-dilatations-of-main-intrahepatic-ducts
#18
Mei Diao, Long Li, Wei Cheng
OBJECTIVE: Hepatic cysts with biliary communications (HC) and cystic dilatations of main intrahepatic ducts (CIHD) can cause biliary obstruction, cholestasis, stone formation, cholangitis, liver damage and carcinoma. Conventionally, Roux-Y cysto-jejunostomy is employed to manage these conditions. However, it is technically demanding and may be complicated with major biliary disruption and bacteria migration from intestine to intrahepatic duct. We have carried out laparoscopic cysto-cholecystostomies for HC with biliary communication and CIHD and evaluated outcomes...
January 25, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29367043/conversion-is-a-risk-factor-for-postoperative-anastomotic-leak-in-rectal-cancer-patients-a-retrospective-cohort-study
#19
Xuan-Hui Liu, Xian-Rui Wu, Chi Zhou, Xiao-Bin Zheng, Jia Ke, Hua-Shan Liu, Tuo Hu, Yu-Feng Chen, Xiao-Wen He, Xiao-Sheng He, Yong-le Chen, Yi-Feng Zou, Jian-Ping Wang, Xiao-Jian Wu, Ping Lan
AIM: The impact of conversion from laparoscopic surgery to laparotomy on the development of anastomotic leak (AL) in rectal cancer patients following laparoscopic low anterior resection (LAR) with total mesorectal excision (TME) has not been evaluated. The aim of this study was to evaluate the impact of conversion on the risk of AL and develop a prediction nomogram for postoperative AL. METHODS: All rectal cancer patients following laparoscopic LAR with TME from January 2010 to October 2014 were enrolled in the primary cohort...
January 20, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29364021/a-tale-of-three-stents-aortic-stenting-prior-to-oesophagectomy-after-oesophageal-stents
#20
C E Munro, Gfw Stamp, A W Phillips, S M Griffin
The use of endoluminal stents to treat anastomotic leaks post oesophagogastric resection remains controversial. While some advocate stents to expedite recovery, others advise caution due to the risk of major morbidity and mortality. We describe a case of anastomotic leak following total gastrectomy for adenocarcinoma treated with a self-expanding metallic stent. Complications with the initial stent were treated with a further stent, which compromised the function of the oesophagus and eroded into the aorta, necessitating a colonic reconstruction and endovascular aortic stenting...
January 24, 2018: Annals of the Royal College of Surgeons of England
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