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Diverticulitis and surgery indications

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https://www.readbyqxmd.com/read/28612145/transanal-hartmann-s-colostomy-reversal-assisted-by-laparoscopy-outcomes-of-the-first-10-patients
#1
Jean-Sébastien Trépanier, María Clara Arroyave, Raquel Bravo, Marta Jiménez-Toscano, Francisco B DeLacy, María Fernandez-Hevia, Antonio M Lacy
INTRODUCTION: Restoration of intestinal continuity after Hartmann's procedure is a technically difficult surgery associated with significant morbidity and mortality. This study presents the short-term results of a new approach: a transanal Hartmann's colostomy reversal assisted by laparoscopy. METHOD: This is a retrospective analysis of data collected in one tertiary hospital, from October 2013 to November 2015. RESULTS: During the study period, there were ten cases of transanal Hartmann's reversal...
June 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28547631/management-of-diverticulitis-in-2017
#2
Sarah E Deery, Richard A Hodin
Diverticulitis has become increasingly more common in the 20(th) century and is now one of the most frequent indications for gastrointestinal tract-related hospitalizations. The spectrum of clinical presentation can vary widely from mild, uncomplicated disease that can be managed as an outpatient, to complicated diverticulitis with peritonitis and sepsis. Historically, all patients with diverticulitis were managed with, at a minimum, a course of antibiotics, with many patients undergoing urgent or emergent surgery with a sigmoid colectomy, end colostomy, and oversewn rectosigmoid "Hartmann's" stump...
May 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28489013/-incidence-cause-and-treatment-of-colonic-perforations-in-iceland-1998-2007-a-nationwide-study
#3
MULTICENTER STUDY
Kristin Jonsdottir, Elsa B Valsdottir, Shreekrishna Datye, Fritz Berndsen, Pall Helgi Moller
INTRODUCTION: Colon perforation is a serious illness with mortality reported from 0-39%. Surgery used to be the gold standard but treatment has changed as studies have indicated comparable results with less invasive treatment. The aim of this study was to evaluate the incidence of acute colon perforations in Iceland, causes and treatment. MATERIAL AND METHODS: A retrospective, nationwide, multicenter analysis was performed based on ICD-10 codes from databases of the main hospitals in Iceland...
February 2017: Læknablađiđ
https://www.readbyqxmd.com/read/28453588/-diverticular-disease-myths-and-realities
#4
Daniela Fluxá, Rodrigo Quera
Diverticulosis and diverticular disease of the colon are common conditions in Western countries. The incidence and prevalence of these diseases are increasing and becoming significant for health systems. A growing body of knowledge is shifting the paradigm of the pathogenesis and treatment of diverticular disease. Low-grade inflammation, altered intestinal microbiota, visceral hypersensitivity, and abnormal colonic motility have been identified as factors leading to diverticular disease. The risk of developing diverticulitis among individuals with diverticulosis is lower than 10 to 25%...
February 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28429952/rare-cases-imitating-acute-appendicitis-three-case-reports-and-a-review-of-literature
#5
L Kunovsky, Z Kala, L Mitas, V Can, J Dolina, E Nemcová, L Klvacova, T Gajdosova, I Penka
Acute appendicitis with its characteristic clinical course is one of the most common diagnoses that require urgent surgery. The following three case reports present patients with symptoms typical of acute appendicitis which was, however, not confirmed intraoperatively. Preoperative CT or MRI were not requested because symptoms clearly indicated acute appendicitis. The first case describes a male patient with right-sided diverticulitis, the second case report involves a pregnant woman in 33rd week of gestation with right adnexal torsion due to a dermoid cyst, and in the last report, a case of spontaneous perforation of appendiceal mucinous neoplasm is presented...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28404008/surgery-versus-conservative-management-for-recurrent-and-ongoing-left-sided-diverticulitis-direct-trial-an-open-label-multicentre-randomised-controlled-trial
#6
Bryan J M van de Wall, Marguerite A W Stam, Werner A Draaisma, R Stellato, Willem A Bemelman, Marja A Boermeester, Ivo A M J Broeders, Eric J Belgers, Boudewijn R Toorenvliet, Hubert A Prins, Esther C J Consten
BACKGROUND: Patients with recurrent or persisting complaints after an episode of left-sided diverticulitis are managed with either conservative measures or elective sigmoidectomy. To date, there are no data from randomised trials. We aimed to establish which treatment leads to a better quality of life for patients with diverticulitis. METHODS: We did an open-label, multicentre, randomised controlled trial (DIRECT trial) in 24 teaching and two academic hospitals in the Netherlands...
January 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28288068/emergency-surgery-for-medicare-beneficiaries-admitted-to-critical-access-hospitals
#7
Andrew M Ibrahim, Scott E Regenbogen, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: The aim of this study was to compare the surgical outcomes of emergency operations performed at critical access and non-critical access hospitals. BACKGROUND: Critical access hospitals are often the only source of surgical care for rural populations. Previous studies have demonstrated that patients undergoing common, elective operations at these rural hospitals have similar outcomes to their urban counterparts. Little is known, however, about the quality of care these hospitals provide for emergency operations for which they are most essential...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28054168/minimally-invasive-surgery-for-complicated-diverticulitis
#8
Najjia N Mahmoud, Elijah W Riddle
Recent guidelines recommend an individualized approach to recurrent uncomplicated diverticulitis, reflecting research showing that non-operative treatment is safe. Thus, the majority of operations for diverticulitis in the future may be for complicated indications. A laparoscopic approach may be used for both acute and chronic complicated diverticulitis in appropriate patients, as described in the American and European guidelines. However, a safe approach to minimally invasive surgery requires recognition when conditions deteriorate or are not suited to laparoscopy as well as knowledge of a variety of technical maneuvers that elucidate difficult anatomy and facilitate resection...
April 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27928602/-implementation-of-hybrid-notes-sigmoidectomy-for-diverticular-disease-in-a%C3%A2-center-for-minimally-invasive-surgery
#9
D C Steinemann, A Zerz, S H Lamm
BACKGROUND: Natural orifice transluminal endoscopic surgery (NOTES) describes surgical procedures through a natural orifice. In hybrid-NOTES small transabdominal trocars are combined with a NOTES access. OBJECTIVE: To evaluate hybrid-NOTES sigmoidectomy as a standard procedure for diverticulitis. MATERIAL AND METHODS: Elective laparoscopic sigmoidectomies performed between May 2011 and January 2016 were prospectively collated. Primary endpoint was the feasibility of hybrid-NOTES sigmoidectomy...
December 7, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/27865426/surgical-treatment-of-acute-diverticulitis-a-retrospective-multicentre-study
#10
José Vicente Roig, Antonio Salvador, Matteo Frasson, Míriam Cantos, Celia Villodre, Zutoia Balciscueta, Rafael García-Calvo, Javier Aguiló, Juan Hernandis, Rodolfo Rodríguez, Francisco Landete, Eduardo García-Granero
INTRODUCTION: To analyze short and medium-term results of different surgical techniques in the treatment of complicated acute diverticulitis (CAD). METHODS: Multicentre retrospective study including patients operated on as surgical emergency or deferred-urgency with the diagnosis of CAD. RESULTS: A series of 385 patients: 218 men and 167 women, mean age 64.4±15.6 years, operated on in 10 hospitals were included. The median (25(th)-75(th) percentile) time from symptoms to surgery was 48 (24-72) h, being peritonitis the main surgical indication in a 66% of cases...
December 2016: Cirugía Española
https://www.readbyqxmd.com/read/27779971/robotic-colorectal-surgery-our-initial-experience
#11
Ahmed Dehal, Sunal Patel, Hanna Park, Patrick Nguyen, Robert Yuhan, Joseph Ruan
Robotic colorectal surgery was first performed at our institution in January 2014. The objective of this study is to present our initial experience with robotic colorectal surgery. This is a retrospective review of the prospectively collected data of all patients who underwent robotic colorectal surgery from January 2014 to April 2015. Baseline, perioperative, and postoperative data were obtained for analysis. A total of 101 patients with a mean age of 56 and a body mass index of 31 underwent robotic colorectal surgery between January 2014 and April 2015...
October 2016: American Surgeon
https://www.readbyqxmd.com/read/27745889/operative-management-of-diverticulitis-in-a-tertiary-care-center
#12
David R Rosen, Grace S Hwang, Glenn T Ault, Adrian E Ortega, Kyle G Cologne
BACKGROUND: Diverticulitis has become a medically managed disease process; the indications and timing of surgical intervention have evolved. METHODS: We retrospectively reviewed all patients who underwent surgical intervention due to diverticular disease by the Division of Colon and Rectal Surgery from 2012 to 2014. RESULTS: Ninety-eight surgeries were performed. Indications included colovesicular fistula, multiple recurrences of diverticulitis, medically refractory diverticulitis, stricture, abscess, colocutaneous fistula, and colovaginal fistula...
July 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/27741423/treatment-of-patients-with-acute-colonic-diverticulitis-complicated-by-abscess-formation-a-systematic-review
#13
REVIEW
Rasmus Gregersen, Laura Quitzau Mortensen, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
PURPOSE: This study aimed to systematically review the literature and present the evidence on outcomes after treatment for acute diverticulitis with abscess formation. Secondly, the paper aimed to compare different treatment options. METHODS: PubMed, EMBASE and the Cochrane Library were searched. Two authors screened the records independently, initially on title and abstract and subsequently on full-text basis. Articles describing patients treated acutely for Hinchey Ib and II were included...
November 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27607745/prevalence-of-parastomal-hernia-and-factors-associated-with-its-development
#14
Beverley Temple, Trevor Farley, Kristine Popik, Carisa Ewanyshyn, Elaine Beyer, Brenden Dufault
PURPOSE: The purpose of this study was to identify risk factors for development of a parastomal hernia (PH). DESIGN: Cross-sectional survey. SETTING AND SUBJECTS: The target population comprised 2854 persons receiving services from the Manitoba Ostomy Program. Seven hundred sixty-four responses were received, yielding a response rate of 29.3%. Respondents average age was 70 years (SD = 12.8); 425 (55.6%) had a colostomy, 236 (30.8%) had an ileostomy, 63 (8...
September 2016: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/27494997/changing-paradigms-in-the-management-of-diverticulitis
#15
REVIEW
Nir Horesh, Nir Wasserberg, Andrew P Zbar, Aviad Gravetz, Yaniv Berger, Mordechai Gutman, Danny Rosin, Oded Zmora
The management of diverticular disease has evolved in the last few decades from a structured therapeutic approach including operative management in almost all cases to a variety of medical and surgical approaches leading to a more individualized strategy. There is an ongoing debate among surgeons about the surgical management of diverticular disease, questioning not only the surgical procedure of choice, but also about who should be operated and the timing of surgery, both in complicated and uncomplicated diverticular disease...
September 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27403114/self-expanding-metal-stenting-in-the-management-of-a-benign-colonic-stricture
#16
Kegan Jessamy, Nuri Ozden, Howard M Simon, Semaan Kobrossi, Ezinnaya Ubagharaji
Colonic postanastomotic strictures occur in 1.5-8% of patients following colorectal surgery. Traditionally, colonic strictures were treated by multiple modalities including endoscopic dilatation. Self-expanding metal stents (SEMS) have been indicated in the management of benign colonic strictures; however, there are limited available data with regard to their efficacy. We present the case of a 68-year-old male who had perforated sigmoid diverticulitis followed by Hartmann's procedure with eventual reanastomosis 6 months later...
January 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27229107/risks-of-adverse-events-in-colorectal-patients-population-based-study
#17
Tina M Hernandez-Boussard, Kathryn M McDonald, Doug E Morrison, Kim F Rhoads
BACKGROUND: Postoperative (PO) outcomes are rapidly being integrated into value-based purchasing programs and associated penalties are slated for inclusion in the near future. Colorectal surgery procedures are extremely common and account for a high proportion of morbidity among general surgery. We sought to assess adverse events in colorectal surgical patients. METHODS: We performed a retrospective study using the Nationwide Inpatient Sample database, 2008-2012...
May 15, 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27156370/diverticulosis-and-diverticulitis
#18
REVIEW
Joseph D Feuerstein, Kenneth R Falchuk
Diverticular disease is a common condition that is associated with variable presentations. For this review article, we performed a review of articles in PubMed through February 1, 2016, by using the following MeSH terms: colon diverticula, colonic diverticulitis, colonic diverticulosis, colonic diverticulum, colonic diverticula, and diverticula. Diverticula are structural alterations within the colonic wall that classically form "pockets" referred to as diverticula. Diverticula form from herniation of the colonic mucosa and submucosa through defects in the circular muscle layers within the colonic wall...
August 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27106275/diverticulitis-does-age-matter
#19
Nir Horesh, Chaya Shwaartz, Imri Amiel, Avinoam Nevler, Esther Shabtai, Alexander Lebedeyev, Roi Nadler, Danny Rosin, Mordechai Gutman, Oded Zmora
OBJECTIVE: Acute diverticulitis has been traditionally associated with worse outcome in young patients, indicating a more aggressive surgical approach is required for them. The aim of this study was to assess whether acute diverticulitis was more virulent in young patients. METHODS: A retrospective, cross-sectional study included all patients who were admitted for a first episode of acute diverticulitis between January 2004 and December 2013. The patients were divided into two groups (≤50 years and >50 years) based on their age...
May 2016: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/27086288/management-of-sigmoid-diverticulitis-an-update
#20
REVIEW
Patrick Ambrosetti, Pascal Gervaz
The role, indications and modalities of elective resection for sigmoid diverticulitis remain the cause of fierce debate. During the past two decades clinicians have increasingly recognized that: (1) young patients (<50) are no more at risk to develop more aggressive course of the disease; and (2) patients who present initially with a first uncomplicated attack are no more at risk for developing subsequent complicated diverticulitis requiring emergency surgery. Hence, the previously well-recognized indications (based upon age of the patients or the number of attacks) are no longer valid...
March 2016: Updates in Surgery
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