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Anastomotic leaks

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https://www.readbyqxmd.com/read/28817358/evaluation-of-gastric-conduit-perfusion-during-esophagectomy-with-indocyanine-green-fluorescence-imaging
#1
Francisco Schlottmann, Marco G Patti
BACKGROUND: Anastomotic leakage is a determining factor of morbidity and mortality after an esophagectomy. An adequate blood supply of the gastric conduit is vital to prevent this complication. We aimed to determine the feasibility and usefulness of indocyanine green (ICG) fluorescence imaging to evaluate the gastric conduit perfusion during an esophagectomy. METHODS: Patients with distal esophageal cancer or esophagogastric junction cancer scheduled for esophagectomy were enrolled in this study...
August 17, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28815077/salvage-esophagectomy-safe-therapeutic-strategy
#2
REVIEW
Sara Jamel, Sheraz R Markar
The objectives of this review were to assess both the short- and long-term clinical outcomes in patients managed with definitive chemoradiotherapy, and salvage esophagectomy subsequently in comparison to those neoadjuvant chemoradiotherapy followed by planned esophagectomy (NCRS) for esophageal cancer from published literature. Eleven studies comprising 1,906 patients were included, 563 in the salvage group and 1,343 in the NCRS group. Pooled analysis showed no significant difference between salvage and NCRS groups in overall survival [hazard ratio (HR) =1...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28803998/high-serum-lactate-as-an-adjunct-in-the-early-prediction-of-anastomotic-leak-following-oesophagectomy
#3
B Ip, K T Ng, S Packer, S Paterson-Brown, G W Couper
BACKGROUND: Anastomotic leak (AL) following oesophagectomy carries a high mortality and morbidity. Early detection and intervention is required for a successful outcome. We have examined the role of a high postoperative serum lactate in predicting which patients are at risk of developing an anastomotic leak(AL). MATERIALS AND METHODS: All patients who underwent transthoracic oesophagectomy over a 3-year period were identified from a prospectively collected database...
August 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28803344/outcome-one-year-after-robot-assisted-rectal-cancer-surgery-a-consecutive-cohort-study
#4
Sanne Harsløf, Anders Stouge, Niels Thomassen, Sissel Ravn, Søren Laurberg, Lene Hjerrild Iversen
PURPOSE: The aim of this study was to investigate outcome after robot-assisted rectal cancer surgery (RARCS). We focused on conversion rate, postoperative complications, pathological evaluation (adequacy of resection margins), and bowel function (low anterior resection syndrome (LARS)) 1 year after surgery. METHODS: An observational study of prospectively registered patients with data obtained from medical records. Data comprise the initial 208 rectal cancer patients operated with robot-assisted surgery at a single Danish university hospital from October 2011 to October 2014...
August 13, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28799279/oesophageal-replacement-with-stomach-a-personal-series-and-review-of-published-experience
#5
Karim Awad, Bruce Jaffray
AIM: To describe the outcomes of oesophageal replacement using stomach in children. METHODS: All children undergoing oesophageal replacement in a regional centre were prospectively recorded in a customised database and subjected to continual follow up. Complications within 30 days were classified as early, and all other complications were classified as late. Outcomes were related to a comprehensive analysis of published experience where studies were classified as having long-term follow up if the median duration exceeded 5 years...
August 11, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28796065/a-scoring-system-to-predict-mortality-in-infants-with-esophageal-atresia-a-case-control-study
#6
Xiao-Wen Li, Ya-Jun Jiang, Xue-Qiu Wang, Jia-Lin Yu, Lu-Quan Li
Esophageal atresia (EA) is a rare anomaly that mandates surgical intervention. Patients with EA often have complicated medical courses due to both esophageal anomalies and related comorbidities. Although several prognostic classification systems have been developed to decrease the mortality rate in EA, most systems focus only on the influence of the major anomaly, and external risk factors that could be influenced by the neonatal caregivers to a certain extent are not included. The aim of this study was to investigate the risk factors for in-hospital mortality in neonates with EA and develop a scoring model to predict mortality...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28796016/a-propensity-score-matched-analysis-of-open-versus-minimally-invasive-transthoracic-esophagectomy-in-the-netherlands
#7
Maarten F J Seesing, Suzanne S Gisbertz, Lucas Goense, Richard van Hillegersberg, Hidde M Kroon, Sjoerd M Lagarde, Jelle P Ruurda, Annelijn E Slaman, Mark I van Berge Henegouwen, Bas P L Wijnhoven
OBJECTIVE: The aim of this study was to compare open esophagectomy (OE) with minimally invasive esophagectomy (MIE) in a population-based setting. BACKGROUND: Randomized controlled trials and cohort studies have shown that MIE is associated with reduced pulmonary complications and shorter hospital stay as compared to OE. METHODS: Patients who underwent transthoracic esophagectomy for cancer between 2011 and 2015 were selected from the national Dutch Upper Gastrointestinal Cancer Audit...
August 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28768254/intracorporeal-versus-extracorporeal-anastomoses-following-laparoscopic-right-colectomy-in-obese-patients-a-case-matched-study
#8
Andrea Vignali, Ugo Elmore, Maria Lemma, Giovanni Guarnieri, Giovanni Radaelli, Riccardo Rosati
BACKGROUND/AIMS: To compare short- and long-term outcomes of intracorporeal anastomosis (IA) versus extracorporeal anastomosis (EA) in obese (body mass index >30 kg/m2) patients. PATIENTS AND METHODS: Sixty-four consecutive obese patients who underwent laparoscopic (LPS) right colectomy with IA were matched with 64 patients who underwent LPS right colectomy with EA. Intraoperative variables, short-term outcomes, readmission rates, and morbidity and mortality rates were analyzed along with long-term outcomes...
August 3, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28751430/persistent-air-leak-after-pulmonary-transplantation
#9
Laurence Pearmain, Piotr Krysiak, John Blaikley, Mohamed Alaloul
A 59-year-old man with bilateral apical emphysema underwent a double lung transplant for end-stagechronic obstructive pulmonary disease leaving remnant right apical native tissue due to pleural adhesions. Initial postoperative course was uneventful until the chest drains were removed. This revealed a small pneumomediastinum, which progressively increased in size causing gross surgical emphysema. Re-insertion of the chest drain stabilised the patient so that the cause could be identified and corrected. Two bronchoscopies excluded anastomotic dehiscence as a cause...
July 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28749112/serum-procalcitonin-predicts-anastomotic-leaks-in-colorectal-surgery
#10
Firdaus Hayati, Zairul Azwan Mohd Azman, Dian Nasriana Nasuruddin, Luqman Mazlan, Andee Dzulkarnaen Zakaria, Ismail Sagap
Background: Anastomotic leaks in colorectal surgery results in a high morbidity and mortality rate. Serum procalcitonin levels is known as a sensitive and specific marker of sepsis and could be use as a marker for early detection of a leak allowing early intervention. It may help a clinician decide to perform a CT scan even earlier especially when the diagnosis of a leak is uncertain. The aim of this study is to determine whether serum procalcitonin is a good predictor of anastomotic leak in colorectal surgery...
July 27, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28745410/short-and-medium-term-outcomes-following-primary-ileocaecal-resection-for-crohn-s-disease-in-two-specialist-centres
#11
A de Buck van Overstraeten, E J Eshuis, S Vermeire, G Van Assche, M Ferrante, G R D'Haens, C Y Ponsioen, A Belmans, C J Buskens, A M Wolthuis, W A Bemelman, A D'Hoore
BACKGROUND: Despite improvements in medical therapy, the majority of patients with Crohn's disease still require surgery. The aim of this study was to report safety, and clinical and surgical recurrence rates, including predictors of recurrence, after ileocaecal resection for Crohn's disease. METHODS: This was a cohort analysis of consecutive patients undergoing a first ileocaecal resection for Crohn's disease between 1998 and 2013 at one of two specialist centres...
July 26, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28744744/the-effect-of-neoadjuvant-chemoradiation-on-anastomotic-leak-and-additional-30-day-morbidity-and-mortality-in-patients-undergoing-total-gastrectomy-for-gastric-cancer
#12
Ivy N Haskins, Matthew D Kroh, Richard L Amdur, Jeffrey L Ponksy, John H Rodriguez, Khashayar Vaziri
INTRODUCTION: In addition to increased perioperative morbidity, anastomotic leak following gastric resection for gastric cancer can have detrimental effects on overall and disease-free survival. The risk of anastomotic leak following neoadjuvant therapy remains unknown. The purpose of this study is to investigate the association of preoperative chemotherapy and radiation therapy with postoperative anastomotic leak and additional 30-day morbidity and mortality outcomes following total gastrectomy with reconstruction for gastric cancer using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP)...
July 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28743178/multicenter-analysis-of-transanal-tube-placement-for-prevention-of-anastomotic-leak-after-low-anterior-resection
#13
Saori Goto, Koya Hida, Kenji Kawada, Ryosuke Okamura, Suguru Hasegawa, Takahisa Kyogoku, Shuichi Ota, Yukito Adachi, Yoshiharu Sakai
BACKGROUND: Anastomotic leak (AL) is a serious complication of low anterior resection (LAR). This study aimed to evaluate the effect of transanal tube placement for prevention of AL. METHODS: This multicenter retrospective cohort study enrolled 328 consecutive patients who underwent LAR for rectal cancer at participating hospitals from 2009 to 2014. Multivariate logistic regression was used to adjust for confounding factors. RESULTS: A transanal tube was placed in 205 patients (TA group) and not placed in 123 patients (non-TA group)...
July 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28739093/individual-surgeon-is-an-independent-risk-factor-for-leak-after-double-stapled-colorectal-anastomosis-an-institutional-analysis-of-800-patients
#14
Eduardo García-Granero, Francisco Navarro, Carlos Cerdán Santacruz, Matteo Frasson, Alvaro García-Granero, Franco Marinello, Blas Flor-Lorente, Alejandro Espí
BACKGROUND: Our aim was to assess whether the individual surgeon is an independent risk factor for anastomotic leak in double-stapled colorectal anastomosis after left colon and rectal cancer resection. METHODS: This retrospective analysis of a prospectively collected database consists of a consecutive series of 800 patients who underwent an elective left colon and rectal resection with a colorectal, double-stapled anastomosis between 1993 and 2009 in a specialized colorectal unit of a tertiary hospital with 7 participating surgeons...
July 21, 2017: Surgery
https://www.readbyqxmd.com/read/28738953/morbidity-associated-with-diverting-loop-ileostomies-weighing-diversion-in-rectosigmoid-resection
#15
Nathan Belkin, Liliana G Bordeianou, Paul C Shellito, Alexander T Hawkins
Anterior resection with primary anastomosis is the procedure of choice for patients with rectosigmoid cancers with good sphincter function. Surgeons may perform an associated diverting loop ileostomy (DLI) to minimize the likelihood and/or the severity of an anastomotic leak. To examine the morbidity of DLIs, we performed a review of a prospectively maintained database. Participants included all patients at the Massachusetts General Hospital who underwent anterior resection from January 2013 to July 2015 for rectosigmoid cancers and who subsequently underwent adjuvant chemotherapy...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738239/delayed-graft-duodenal-perforation-due-to-impacted-food-five-years-after-simultaneous-pancreas-kidney-transplantation-a-case-report
#16
Taizo Sakata, Hideki Katagiri, Tadao Kubota, Takashi Sakamoto, Kentaro Yoshikawa, Alan Kawarai Lefor, Cheol Woong Jung, Toru Kojima
INTRODUCTION: Pancreas transplantation is the best treatment option in selected patients with type 1 diabetes mellitus. Here we report a patient with a nonmarginal duodenal perforation five years after a simultaneous pancreas-living donor kidney transplantation (SPLKT). PRESENTATION OF CASE: A 31-year old male who underwent SPLKT five years previously presented with severe abdominal pain. He had a marginal duodenal perforation four years later, treated by primary closure and drainage...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28736640/systematic-review-and-a-meta-analysis-of-hospital-and-surgeon-volume-outcome-relationships-in-colorectal-cancer-surgery
#17
Ya Ruth Huo, Kevin Phan, David L Morris, Winston Liauw
BACKGROUND: Numerous hospitals worldwide are considering setting minimum volume standards for colorectal surgery. This study aims to examine the association between hospital and surgeon volume on outcomes for colorectal surgery. METHODS: Two investigators independently reviewed six databases from inception to May 2016 for articles that reported outcomes according to hospital and/or surgeon volume. Eligible studies included those in which assessed the association hospital or surgeon volume with outcomes for the surgical treatment of colon and/or rectal cancer...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#18
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC).. METHOD: Patients were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
July 22, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28732747/shorter-overall-operative-time-when-barbed-suture-is-used-in-primary-laparoscopic-gastric-bypass-a-cohort-study-of-25-006-cases
#19
Bjarni Vidarsson, Magnus Sundbom, David Edholm
BACKGROUND: Closing the remaining opening in a linear stapled anastomosis, for example in laparoscopic Roux-en-Y gastric bypass (LRYGB), can be challenging. OBJECTIVES: To evaluate if the novel unidirectional barbed suture (BS) is of value in LRYGB compared with polyfilament (PS) suture. We have compared operative time, early complications, and length of stay, as well as anastomotic strictures and small bowel obstruction during the first year. SETTING: Retrospective study from the Scandinavian Obesity Surgery Registry (SOReg)...
April 25, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#20
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
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