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https://www.readbyqxmd.com/read/28819783/factors-associated-with-hospital-readmission-following-diverting-ileostomy-creation
#1
W Li, L Stocchi, D Cherla, G Liu, A Agostinelli, C P Delaney, S R Steele, E Gorgun
BACKGROUND: The creation of a diverting loop ileostomy is associated with the risk of readmission due to stoma-related complications. We hypothesized that the assessment of our institution-specific readmissions following ileostomy creation would help identifying at-risk groups which should be the focus of future preventative strategies. METHODS: Patients who underwent loop ileostomy formation from 2009 to 2013 were reviewed. We evaluated readmissions within 30 days after discharge following loop ileostomy construction...
August 17, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28795776/redo-coloanal-anastomosis-for-anastomotic-leakage-after-low-anterior-resection-for-rectal-cancer-an-analysis-of-59-cases
#2
Emma Westerduin, Wernard A Borstlap, Gijsbert D Musters, Marinke Westerterp, Anna A W van Geloven, Pieter J Tanis, Albert M Wolthuis, Willem A Bemelman, André D'Hoore
AIM: Constructing a new coloanal anastomosis (CAA) following anastomotic leakage after low anterior resection (LAR) is challenging. The available literature on this topic is scarce. The aim of this two-centre study was to determine the clinical success and morbidity after redo CAA. METHOD: In this retrospective cohort study, all patients with anastomotic leakage after LAR for rectal cancer who underwent a redo CAA between 2010 and 2014 in two tertiary referral centres were included...
August 10, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28765178/stercoral-perforation-of-the-colon-in-a-heroin-addict
#3
Cameron Douglas Brown, Fraser Maxwell, Paul French, Gary Nicholson
A 27-year-old female heroin addict presented with a peritonitic and distended abdomen. Her medical history included depression and a 3-year history of heroin abuse with attendant constipation. CT scan showed free intraperitoneal gas, massive faecal distension of the rectum and sigmoid colon and likely bowel necrosis. She underwent an emergency Hartmann's procedure for perforation of the sigmoid colon. Pathology identified two areas of stercoral ulceration, one of them being the area of perforation. Postoperatively, the patient developed a deep vein thrombosis and is now on anticoagulant therapy...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28761765/endoscopic-stenting-as-bridge-to-surgery-versus-emergency-resection-for-left-sided-malignant-colorectal-obstruction-an-updated-meta-analysis
#4
REVIEW
Niccolò Allievi, Marco Ceresoli, Paola Fugazzola, Giulia Montori, Federico Coccolini, Luca Ansaloni
INTRODUCTION: Emergency resection represents the traditional treatment for left-sided malignant obstruction. However, the placement of self-expanding metallic stents and delayed surgery has been proposed as an alternative approach. The aim of the current meta-analysis was to review the available evidence, with particular interest for the short-term outcomes, including a recent multicentre RCT. METHODS: We considered randomized controlled trials comparing stenting as a bridge to surgery and emergency surgery for the management of left-sided malignant large bowel obstruction, performing a systematic review in MEDLINE, PubMed database, and the Cochrane libraries...
2017: International Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28760355/decreasing-readmissions-by-focusing-on-complications-and-underlying-reasons
#5
Cigdem Benlice, Dilara Seyidova-Khoshknabi, Luca Stocchi, Tracy Hull, Scott Steele, Emre Gorgun
BACKGROUND: To analyze demographics and outcomes of patients focusing on 30-day readmission status and identify procedure-specific risk factors. METHODS: Patients undergoing abdominal colorectal surgery (2011-2013) were identified Demographics and outcomes including in-hospital complications were compared based on readmission status. RESULTS: A total of 6637 patients were identified with a mean age of 51.2(±17.1) years. Seven hundred and seventy five(11...
July 21, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28759426/a-descriptive-study-to-assess-quality-of-life-in-egyptian-patients-with-a-stoma
#6
Sherif Boraii
The creation of a stoma changes bodily appearance and function, which can affect quality of life (QOL). A descriptive study using the Short Form 36 (SF-36) questionnaire, an instrument that measures 8 physical and mental health concepts, was conducted to quantify QOL among patients with a stoma and to interpret how stoma creation affects their lives. Participants included a convenience sample of persons served by an outpatient surgery clinic in an Egyptian university hospital in Cairo between August 2013 and January 2015...
July 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28751222/the-use-of-a-composite-synthetic-mesh-in-the-vicinity-of-bowel-for-repair-and-prophylaxis-of-parastomal-hernias-does-it-increase-the-risk%C3%A2-of-short-term-infective-complications
#7
Zhaowei Zhou, Amarvir Bilkhu, Suhail Anwar
AIMS: The use of synthetic meshes in potentially infected operative fields such as in the vicinity of large bowel, is controversial. This study describes our experience with the use of a synthetic composite mesh for prophylaxis and repair of parastomal hernias. METHODS: Data were collected retrospectively over a 7-year period from 2008 to 2015. An IPOM (DynaMesh™) was used either during the formation of the stoma to reinforce the abdominal wall around the stoma or during the surgical repair of existing parastomal hernias, using keyhole or sandwich technique...
July 24, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28748420/risk-factors-for-early-postoperative-small-bowel-obstruction-after-anterior-resection-for-rectal-cancer
#8
Katsuhito Suwa, Takuro Ushigome, Masamichi Ohtsu, Satoshi Narihiro, Shunjin Ryu, Yuya Shimoyama, Tomoyoshi Okamoto, Katsuhiko Yanaga
PURPOSE: The aim of the study was to evaluate risk factors for small bowel obstruction (SBO) in early postoperative period after anterior resection for rectal cancer. METHODS: Patients who underwent anterior resection (AR) [high AR (HAR) or low AR (LAR)] for rectal cancer between January 2009 and April 2016 were enrolled into the study after fulfilling selection criteria. In included patients, risk factors for early postoperative SBO (EPSBO) were analyzed by means of univariate and multivariate analysis...
July 26, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28741192/parastomal-hernia-repair-with-a-3d-funnel-intraperitoneal-mesh-device-and-same-sided-stoma-relocation-results-of-56-cases
#9
Ines Fischer, Helwig Wundsam, Martin Mitteregger, Gernot Köhler
BACKGROUND: Parastomal hernias (PSHs) are a common and challenging issue. In previous studies, three-dimensional (3D) funnel mesh devices have been used successfully for the repair of PSHs. METHODS: We performed an analysis of prospectively collected data of patients who underwent a same-sided stoma reposition with 3D funnel-shaped mesh augmentation in intraperitoneal (IPOM) position at our department between the years of 2012 and 2015. Primary outcome parameters were intra- and postoperative surgical complications and recurrence rate during the follow-up period...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28726144/anastomotic-stricture-after-ultralow-anterior-resection-or-intersphincteric-resection-for-very-low-lying-rectal-cancer
#10
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
BACKGROUND: Anastomotic stricture following colorectal cancer surgery is not a rare complication, but proper management of anastomotic stricture located close to the anal verge is uncertain. This study aimed to investigate risk factors and management strategies for anastomotic stricture after ultralow anterior resection (ULAR). METHODS: We retrospectively reviewed a database of patients with rectal cancer who underwent surgery between January 2007 and June 2015, and included patients with an anastomosis within 4 cm from the anal verge...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28705638/laparoscopic-assisted-duhamel-procedure-with-ex-anal-rectal-transection-for-total-colonic-aganglionosis
#11
Xi Zhang, Guo-Qing Cao, Shao-Tao Tang, Xiao-Pan Chang, Shuai Li, Li Yang, Kang Li, Ying Zhou, De-Hua Yang
PURPOSE: Laparoscopic-assisted Duhamel procedure has a larger anastomosis and a reservoir which allows early recovery of defecation frequency, but concerns have been raised regarding the long operative time, high incidence of pouchitis and Hirschsprung associated enterocolitis (HAEC). The purpose of this study was to evaluate the postoperative complications and functional outcomes for patients with TCA undergoing modified laparoscopic-assisted Duhamel procedure (MLDP) with ex-abdominal partial colectomy and ex-anal rectal transection...
June 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28684935/the-role-of-temporary-fecal-diversion
#12
REVIEW
Amy L Lightner, John H Pemberton
The use of temporary fecal diversion is of great importance to tenuous anastomosis, immunosuppressed patient, or actively infected patient. Its use protects newly constructed intestinal anastomoses from being the culprit of pelvic sepsis or systemic illness. Thus, potential morbidity and mortality can be averted. However, its appropriate or optimal use is often debated. We herein discuss the evidence for when to best use a diverting stoma for colorectal, coloanal, and ileoanal anastomoses. We also discuss the importance of considering a temporary diverting stoma in the setting of high-dose immunosuppression (e...
July 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28684934/considerations-in-stoma-reversal
#13
REVIEW
Karen L Sherman, Steven D Wexner
Temporary stomas are frequently used in the management of diverticulitis, colorectal cancer, and inflammatory bowel disease. These temporary stomas are used to try to mitigate septic complications from anastomotic leaks and to avoid the need for reoperation. Once acute medical conditions have improved and after the anastomosis has been proven to be healed, stomas can be reversed. Contrast enemas, digital rectal examination, and endoscopic evaluation are used to evaluate the anastomosis prior to reversal. Stoma reversal is associated with complications including anastomotic leak, postoperative ileus, bowel obstruction, enterocutaneous fistula, and, most commonly, surgical site infection...
July 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28682966/management-of-low-colorectal-anastomotic-leakage-in-the-laparoscopic-era-more-than-a-decade-of-experience
#14
Stephen Alexander Boyce, Craig Harris, Andrew Stevenson, John Lumley, David Clark
BACKGROUND: Anastomotic leak after colorectal surgery increases postoperative mortality, cancer recurrence, permanent stoma formation, and poor bowel function. Anastomosis between the colon and rectum is a particularly high risk. Traditional management mandates laparotomy, disassembly of the anastomosis, and formation of an often-permanent stoma. After laparoscopic colorectal surgery it may be possible to manage anastomotic failure with laparoscopy, thus avoiding laparotomy. OBJECTIVE: The purpose of this study was to determine the feasibility of the laparoscopic management of failed low colorectal anastomoses...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28681072/postoperative-course-of-laparoscopic-subtotal-colectomy-is-affected-by-prolonged-preoperative-anti-tnf-therapy-in-patients-with-acute-colitis-complicating-inflammatory-bowel-disease
#15
Marie Monsinjon, Diane Mege, Léon Maggiori, Xavier Treton, Yoram Bouhnik, Yves Panis
PURPOSE: The aim of medical treatment of severe acute colitis (SAC) complicating inflammatory bowel disease (IBD) is to avoid surgery, but in 20 to 50% of the cases, colectomy remains necessary. This study aimed to determine the impact of the different lines of medical therapy (i.e., steroids, anti-TNF, or ciclosporin) on postoperative course after laparoscopic subtotal colectomy for SAC complicating IBD. METHODS: All the patients who underwent laparoscopic subtotal colectomy for SAC were included and divided into two groups: those who presented with postoperative morbidity (group A) and those with an uneventful postoperative course (group B)...
July 6, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28667683/pouch-failures-following-ileal-pouch-anal-anastomosis-for-ulcerative-colitis
#16
Anders Mark-Christensen, Rune Erichsen, Søren Brandsborg, Frederik Rønne Pachler, Charlotte Buchard Nørager, Niels Johansen, Jørn Helmut Pachler, Ole Thorlacius-Ussing, Mie Dilling Kjaer, Niels Qvist, Louise Preisler, Jens Hillingsø, Jacob Rosenberg, Søren Laurberg
BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients with ulcerative colitis operated with ileal pouch-anal anastomosis in Denmark in the period 1980-2013 were included. Pouch failure was defined as excision of the pouch or presence of a stoma un-reversed within one year after its creation...
July 1, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28657898/negative-pressure-wound-therapy-for-a-complicated-abdominal-laparotomy-in-neonatal-necrotizing-enterocolitis-a-case-report
#17
Miriam García Gonzalez, Isabel Casal Beloy, Alba Gómez Dovigo, Lorena Miguez Fortes, Teresa Dargallo Carbonell, Salvador Pita-Fernández, Jesús Caramés Bouzán
Necrotizing enterocolitis (NEC) is the most common surgical emergency in neonatal intensive care units, and patients who require surgery have high mortality and morbidity rates. The utility of negative pressure in the management of adults with complicated abdominal wounds has been documented, but there are few reports describing the use of negative pressure wound therapy (NPWT) in children or following neonatal surgery. The case of a 6 day old, 5-weeks premature neonate with NEC is presented. An exploratory midline laparotomy was performed on day 3 of life owing to rectal bleeding and abdominal distension that did not respond to gastric decompression, bowel rest, and intravenous antibiotics...
June 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28654318/a-novel-technique-for-parastomal-hernia-repair-combining-a-laparoscopic-and-ostomy-opening-approach
#18
Gernot Köhler, Ines Fischer, Helwig Wundsam
INTRODUCTION: The aim of this study was to evaluate a new method of parastomal hernia (PSH) repair by using a hybrid approach with a cylindrical-shaped mesh of 4 cm funnel length. MATERIALS AND METHODS: In a pilot prospective case series, 12 patients underwent surgical repair of PSHs with a combined laparoscopic and ostomy-opening approach. After laparoscopic adhesiolysis, the ostomy opening was excised from outside and the bowel was closed. The hernia sac was excised after reduction of its content...
June 27, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28646333/feeding-jejunostomy-associated-small-bowel-necrosis-after-elective-esophago-gastric-resection
#19
Omer S Al-Taan, Robert N Williams, James A Stephenson, Melanie Baker, S Murthy Nyasavajjala, David J Bowrey
BACKGROUND: Feeding jejunostomy has increasingly become a standard adjunctive procedure during major esophago-gastric resections. They provide nutritional support during the post-operative period as required. However, significant early complications have been reported, most notably small bowel necrosis. Literature reports have been restricted to case reports or series. This study aims to determine the frequency of this complication in a cohort of patients undergoing esophago-gastric resection, and identify any difference in the risk of this complication between patients undergoing esophagectomy and gastrectomy...
June 23, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28643316/-endoscopic-metallic-stent-followed-by-elective-laparoscopic-surgery-for-malignant-colorectal-obstruction
#20
Qingping Lu, Qilong Lan, Long Chen, Dongbo Xu, Jun Li, Shuangmin Lin, Changrong Que, Jianxun Chen
OBJECTIVE: To investigate the feasibility of endoscopic metallic stent as a bridge to elective laparoscopic surgery in patients with malignant colorectal obstruction. METHODS: Clinical data of 63 patients with obstructive colorectal cancer who underwent endoscopic metallic stent insertion under radiologic monitoring at the Longyan First Hospital between June 2012 and August 2016 were analyzed retrospectively. After complete remission of the obstruction, all the patients received multi-disciplinary team (MDT) evaluation to make the further treatment strategy...
June 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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