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Anastomotic leaks

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https://www.readbyqxmd.com/read/28223090/roux-en-y-gastric-bypass-for-the-treatment-of-severe-complications-after-omega-loop-gastric-bypass
#1
Tigran Poghosyan, Clementine Caille, David Moszkowicz, Mouna Hanachi, Claire Carette, Jean-Luc Bouillot
BACKGROUND: Omega-loop gastric bypass (OLGB) may be associated with severe complications, including anastomotic leak, refractory ulcer or stenosis, undernutrition, and disabling digestive disorders (chronic diarrhea, steatorrhea, bile reflux, and vomiting). OLGB conversion to Roux-en-Y gastric bypass (RYGB) was suggested to treat these complications. OBJECTIVES: To evaluate the efficacy and risk of severe complications after OLGB conversion to RYGB. SETTING: University hospital...
December 9, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28223086/long-term-10-year-outcomes-after-laparoscopic-roux-en-y-gastric-bypass
#2
Shanu N Kothari, Andrew J Borgert, Kara J Kallies, Matthew T Baker, Brandon T Grover
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been the "gold standard" for weight loss surgery. Long-term data are limited, and reporting methods for LRYGB outcomes vary in the literature. In addition, follow-up compliance within bariatric centers is poor due to insurance and access to care issues, making long-term follow-up evaluation difficult. OBJECTIVE: Evaluate long-term LRYGB outcomes using standard outcome reporting definitions. SETTING: Integrated multispecialty health system...
December 22, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28217251/biliary-complications-following-liver-transplantation-single-center-experience-over-three-decades-and-recent-risk-factors
#3
Alexander Kaltenborn, André Gutcke, Jill Gwiasda, Jürgen Klempnauer, Harald Schrem
AIM: To identify independent risk factors for biliary complications in a center with three decades of experience in liver transplantation. METHODS: A total of 1607 consecutive liver transplantations were analyzed in a retrospective study. Detailed subset analysis was performed in 417 patients, which have been transplanted since the introduction of Model of End-Stage Liver Disease (MELD)-based liver allocation. Risk factors for the onset of anastomotic biliary complications were identified with multivariable binary logistic regression analyses...
January 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28214365/peripheral-blood-leukocytes-show-differential-expression-of-tumour-progression-related-genes-in-colorectal-cancer-patients-who-have-a-postoperative-intra-abdominal-infection-a-prospective-matched-cohort-study
#4
S Alonso, X Mayol, L Nonell, S Salvans, M Pascual, M Pera
AIM: Anastomotic leak is associated with higher rates of recurrence after surgery for colorectal cancer. However, the mechanisms responsible are unknown. We hypothesized that the infection-induced inflammatory response may induce overexpression of tumour progression-related genes in immune cells. The aim was to investigate the effect of postoperative intra-abdominal infection on the gene expression patterns of peripheral blood leukocytes (PBL) after surgery for colorectal cancer. METHODS: Prospective matched cohort study...
February 18, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28207541/examination-of-a-crp-first-approach-for-the-detection-of-postoperative-complications-in-patients-undergoing-surgery-for-colorectal-cancer-a-pragmatic-study
#5
Stephen T McSorley, Bo Y Khor, Graham J MacKay, Paul G Horgan, Donald C McMillan
The aim of the present study was to examine whether a C-reactive protein (CRP) first approach would improve the detection rate of postoperative complications by CT.CRP is a useful biomarker to identify major complications following surgery for colorectal cancer.Patients with histologically confirmed colorectal cancer, who underwent elective surgery between 2008 and 2015 at a single centre were included. Exceeding the established CRP threshold of 150 mg/L on postoperative day (POD) 4 was recorded. Results of CT performed between postoperative days 4 and 14 were recorded...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28206940/resection-of-gastrointestinal-metastases-in-stage-iv-melanoma-correlation-with-outcomes
#6
Sangeetha Prabhakaran, William J Fulp, Ricardo J Gonzalez, Vernon K Sondak, Ragini R Kudchadkar, Geoffrey T Gibney, Jeffrey S Weber, Jonathan S Zager
The prognosis of patients with gastrointestinal (GI) melanoma metastases is poor. Surgery renders select patients disease free and/or palliates symptoms. We reviewed our single-institution experience of resection with GI melanoma metastases. A retrospective review was performed on patients who underwent surgery for GI melanoma metastases from 2007 to 2013. Fifty-four patients were identified and separated based on completeness of resection into curative 13 (24%) and palliative 41 (75.9%) groups. Thiry-six (63...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28205124/routine-radiologic-contrast-agent-examination-after-gastrectomy-for-gastric-cancer-is-not-useful
#7
Benjamin Struecker, Sascha Chopra, Ann-Christin Heilmann, Johanna Spenke, Christian Denecke, Igor M Sauer, Marcus Bahra, Johann Pratschke, Andreas Andreou, Matthias Biebl
Many studies have showed that routine upper gastrointestinal contrast agent examinations (RCE) for testing the patency of the anastomosis after esophagectomy or the stapler line after sleeve gastrectomy cannot be recommended due to low sensitivity. However, the clinical value of RCE after gastrectomy for gastric cancer remains unclear. We have retrospectively analyzed the clinical course of 377 consecutive patients who underwent gastrectomy for gastric cancer in our institution between 2005 and 2015. To date, we have performed a RCE on the fifth postoperative day before removal of the nasogastric tube and return to oral intake...
February 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28205051/impact-of-preoperative-steroid-or-immunosuppressant-use-on-short-term-outcomes-following-colectomy-in-crohn-s-disease-patients
#8
N Valizadeh, A C A Murray, K Suradkar, A Al-Mazrou, R P Kiran
BACKGROUND: Evaluating the impact of steroid or immunosuppressants (SI) therapy prior to colectomy in Crohn's disease (CD) patients on postoperative septic and colectomy-specific outcomes using the American College of Surgeons (ACS)-National Surgical Quality Improvement Program (NSQIP)-targeted colectomy database. METHODS: All CD patients undergoing colectomy were retrieved from the 2012-2013 NSQIP-targeted database. Thirty-day postoperative outcomes were compared for patients who were on steroids or immunosuppressants (SI) within the 30 days prior to colectomy to the others using univariable and multivariable analyses...
February 15, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28199016/systematic-review-of-the-feasibility-of-laparoscopic-reoperation-for-early-postoperative-complications-following-colorectal-surgery
#9
REVIEW
D B Wright, C E Koh, M J Solomon
BACKGROUND: Returning to the operating theatre for management of early postoperative complications after colorectal surgery is an important key performance indicator. Laparoscopic surgery has benefits that may be useful in surgical emergencies. This study explored the evidence for the advantages of laparoscopic reoperation. METHODS: A systematic review was performed to identify publications reporting the outcomes of laparoscopy as a mode of reoperation for the management of early postoperative complications of colorectal surgery...
March 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28190552/use-of-balloon-dilatation-for-management-of-postoperative-intestinal-strictures-in-children-with-short-bowel-syndrome
#10
Christina Belza, Kevin Fitzgerald, Joao Amaral, Karen Steinberg, Yaron Avitzur, Paul W Wales
PURPOSE: Children with short bowel syndrome (SBS) often require numerous operations to optimize intestinal function. Postoperative intestinal strictures are a complication that inhibits enteral feeding advancement and prolongs parenteral nutrition dependency, often requiring reoperation. Our objective was to review our experience with fluoroscopic balloon dilatation to treat intestinal strictures. METHODS: A retrospective cohort study of intestinal failure patients with SBS was completed...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28166091/oral-polyphosphate-suppresses-bacterial-collagenase-production-and-prevents-anastomotic-leak-due-to-serratia-marcescens-and-pseudomonas-aeruginosa
#11
Sanjiv K Hyoju, Robin E Klabbers, Melissa Aaron, Monika A Krezalek, Alexander Zaborin, Mara Wiegerinck, Neil H Hyman, Olga Zaborina, Harry Van Goor, John C Alverdy
OBJECTIVE: The objective of this study was to determine the effect of polyphosphate on intestinal bacterial collagenase production and anastomotic leak in mice undergoing colon surgery. BACKGROUND: We have previously shown that anastomotic leak can be caused by intestinal pathogens that produce collagenase. Because bacteria harbor sensory systems to detect the extracellular concentration of phosphate which controls their virulence, we tested whether local phosphate administration in the form of polyphosphate could attenuate pathogen virulence and prevent leak without affecting bacterial growth...
February 3, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28163000/peri-operative-chemotherapy-with-or-without-bevacizumab-in-operable-oesophagogastric-adenocarcinoma-uk-medical-research-council-st03-primary-analysis-results-of-a-multicentre-open-label-randomised-phase-2-3-trial
#12
David Cunningham, Sally P Stenning, Elizabeth C Smyth, Alicia F Okines, William H Allum, Sam Rowley, Laura Stevenson, Heike I Grabsch, Derek Alderson, Thomas Crosby, S Michael Griffin, Wasat Mansoor, Fareeda Y Coxon, Stephen J Falk, Suzanne Darby, Kate A Sumpter, Jane M Blazeby, Ruth E Langley
BACKGROUND: Peri-operative chemotherapy and surgery is a standard of care for patients with resectable oesophagogastric adenocarcinoma. Bevacizumab, a monoclonal antibody against VEGF, improves the proportion of patients responding to treatment in advanced gastric cancer. We aimed to assess the safety and efficacy of adding bevacizumab to peri-operative chemotherapy in patients with resectable gastric, oesophagogastric junction, or lower oesophageal adenocarcinoma. METHODS: In this multicentre, randomised, open-label phase 2-3 trial, we recruited patients aged 18 years and older with histologically proven, resectable oesophagogastric adenocarcinoma from 87 UK hospitals and cancer centres...
February 2, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28153961/novel-insight-into-the-role-of-microbiota-in-colorectal-surgery
#13
REVIEW
Radu Bachmann, Daniel Leonard, Nathalie Delzenne, Alex Kartheuser, Patrice D Cani
Recent literature undeniably supports the idea that the microbiota has a strong influence on the healing process of an intestinal anastomosis. Understanding the mechanisms by which the bacterial community of the gut influences intestinal healing could open the door for new preventive and therapeutic approaches. Among the different mechanisms, data have shown that the production of specific reactive oxygen species (ROS) and the activation of specific formyl peptide receptors (FPRs) regulate intestinal wound healing...
February 2, 2017: Gut
https://www.readbyqxmd.com/read/28151800/comparative-effectiveness-and-risks-of-bowel-preparation-before-elective-colorectal-surgery
#14
Sarah E Koller, Katherine W Bauer, Brian L Egleston, Radhika Smith, Matthew M Philp, Howard M Ross, Nestor F Esnaola
OBJECTIVE: The objective of this study was to determine the relationship between bowel preparation and surgical site infections (SSIs), and also other postoperative complications, after elective colorectal surgery. BACKGROUND: SSI is a major source of postoperative morbidity/costs after colorectal surgery. The value of preoperative bowel preparation to prevent SSI remains controversial. METHODS: We analyzed 32,359 patients who underwent elective colorectal resections in the American College of Surgeons National Surgery Quality Improvement Program database from 2012 to 2014...
February 1, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28149549/calcification-of-arteries-supplying-the-gastric-tube-increases-the-risk-of-anastomotic-leakage-after-esophagectomy-with-cervical-anastomosis
#15
Liang Zhao, Gefei Zhao, Jiagen Li, Bin Qu, Susheng Shi, Xiaoli Feng, Hao Feng, Jun Jiang, Qi Xue, Jie He
BACKGROUND: Anastomotic leak is an important cause of morbidity and mortality after esophagectomy for esophageal cancer patients. Calcification of the arteries supplying the gastric tube has been found to be associated with leakage after esophagectomy with cervical anastomosis in Europeans. The purpose of this study is to evaluate the association between calcifications of the supplying arteries of the gastric tube and the occurrence of anastomotic leakage after esophagectomy with cervical anastomosis in Chinese patients with esophageal cancer...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28148456/common-side-closure-type-but-not-stapler-brand-or-oversewing-influences-side-to-side-anastomotic-leak-rates
#16
V A Fleetwood, K N Gross, G C Alex, C S Cortina, J B Smolevitz, S Sarvepalli, S R Bakhsh, J Poirier, J A Myers, M A Singer, B A Orkin
BACKGROUND: Anastomotic leak (AL) increases costs and cancer recurrence. Studies show decreased AL with side-to-side stapled anastomosis (SSA), but none identify risk factors within SSAs. We hypothesized that stapler characteristics and closure technique of the common enterotomy affect AL rates. METHODS: Retrospective review of bowel SSAs was performed. Data included stapler brand, staple line oversewing, and closure method (handsewn, HC; linear stapler [Barcelona technique], BT; transverse stapler, TX)...
January 13, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28144745/intraoperative-colonoscopy-for-the-assessment-and-prevention-of-anastomotic-leakage-in-low-anterior-resection-for-rectal-cancer
#17
Seung Yoon Yang, Jeonghee Han, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Nam Kyu Kim, Byung Soh Min
PURPOSE: Anastomotic leakage (AL) after stapled anastomosis in rectal cancer surgery is a major concern. Various types of intraoperative anastomotic air leakage tests (ALTs) have been proposed to reduce AL. This study aimed to evaluate the impact of intraoperative colonoscopy (IOC) as an intraoperative ALT in low anterior resection for rectal cancer. METHODS: A total of 1266 patients were retrospectively reviewed. Among them, 215 patients who underwent IOC as an ALT in rectal cancer surgery were identified...
January 31, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28144066/erosion-of-esophageal-stent-into-left-main-bronchus-causing-airway-compromise
#18
S Aneeshkumar, L Sundararajan, Rajan Santosham, Rajkumar Palaniappan, Ubal Dhus
Covered or uncovered self-expanding metal stents are currently used for the palliative treatment of neoplastic esophageal strictures or compressions and esophageal leaks or fistulas due to malignancies. Erosion of esophageal stents into the respiratory tract is a rare complication and that too has been reported mostly as an early complication within few days or weeks. Here, we present the case of a 31-year-old female, who presented with a late complication of an esophageal stent eroding into the left main bronchus causing respiratory distress...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28132113/a-systematic-analysis-of-controlled-clinical-trials-using-the-niti-car%C3%A2-compression-ring-in-colorectal-anastomoses
#19
REVIEW
R Tabola, R Cirocchi, A Fingerhut, A Arezzo, J Randolph, V Grassi, G A Binda, V D'Andrea, I Abraha, G Popivanov, S Di Saverio, A Zbar
Anastomotic leak following colorectal surgery can be a devastating adverse event. The ideal stapling device should be capable of rapid creation of an anastomosis with serosal apposition without the persistence of a foreign body or a foreign body reaction which potentially contribute to early anastomotic dehiscence or late anastomotic stricture. A systematic review was performed examining available data on controlled randomized and non-randomized trials assessing the NiTi compression anastomosis ring-(NiTi CAR™) (NiTi Solutions, Netanyah Israel) in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) standards...
January 28, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28132052/neutrophil-to-lymphocyte-ratio-and-c-reactive-protein-as-two-predictive-tools-of-anastomotic-leak-in-colorectal-cancer-open-surgery
#20
Michal Mik, Lukasz Dziki, Maciej Berut, Radzislaw Trzcinski, Adam Dziki
PURPOSE: To assess the prognostic value of postoperative C-reactive protein (CRP) and neutrophil to lymphocyte ratio (NLR) in the development of anastomotic leak (AL) in patients after surgery for colorectal cancer (CRC). METHODS: Patients operated on for CRC between 2010 and 2014 were enrolled into the study. The sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPVs) were calculated for the CRP and NLR measured on the 4th postoperative day (POD)...
January 28, 2017: Digestive Surgery
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