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Endoluminal Stent Rectum

Guido Woeste
Most procedures in gastrointestinal (GI) surgery require reconstruction with an anastomosis. Depending on the location within the GI tract, the perfusion and comorbidities of the patients there is a risk for anastomotic leakage. In case of peritonitis with sepsis usually a surgical treatment is required. A stable patient can be treated nonoperatively. In the following overview different treatment options of anastomotic leakage after surgery of the GI tract are described. In case of a leakage of an esophagojejunal or esophagogastric anastomosis after resection of the esophagus or stomach endoscopic treatment can be successful using either clip or stent or negative pressure therapy (NPT)...
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Marc Bludau, Hans F Fuchs, Till Herbold, Martin K H Maus, Hakan Alakus, Felix Popp, Jessica M Leers, Christiane J Bruns, Arnulf H Hölscher, Wolfgang Schröder, Seung-Hun Chon
BACKGROUND: Esophageal perforations and postoperative leakage of esophagogastrostomies are considered to be life-threatening conditions due to the potential development of mediastinitis and consecutive sepsis. Vacuum-assisted closure (VAC) techniques, a well-established treatment method for superficial infected wounds, are based on a negative pressure applied to the wound via a vacuum-sealed sponge. Endoluminal VAC (E-VAC) therapy as a treatment for GI leakages in the rectum was introduced in 2008...
April 2018: Surgical Endoscopy
D Benedix, F Meyer, F Fischbach, A Janitzky, Z Halloul
Introduction Abnormal links between the arterial system and other luminal systems are a challenge to those in charge of their adequate diagnostic and therapeutic management. Objective Scientific case report on an individual who underwent successful treatment combining vascular-surgical and interventional radiology techniques for a rare right uretero-iliac artery fistula based on personal clinical experience, a selective literature research and a detailed discussion of current recommendations for diagnostic workup and subsequent treatment...
September 20, 2017: Aktuelle Urologie
Ricardo Frago, Elena Ramirez, Monica Millan, Esther Kreisler, Emilio del Valle, Sebastiano Biondo
BACKGROUND: The management of colonic obstruction has changed in recent years. In distal obstruction, optimal treatment remains controversial, particularly after the appearance and use of colonic endoluminal stents. The purpose of this study was to review the current treatment of acute malignant large bowel obstruction according to the level of evidence of the available literature. METHODS: A systematic search was conducted in PubMed, MEDLINE, Embase, and Google Scholar for articles published through January 2013 to identify studies of large bowel obstruction and colorectal cancer...
January 2014: American Journal of Surgery
M Wettstein, T Frieling, R Lüthen, T Heintges, C Niederau, M Oette, C Vogt, S Vom Dahl
Surgery has been the mainstay of therapy in patients with gastrointestinal perforations, leakage or fistulas. New techniques for endoscopic closure of gastrointestinal perforations provide tools for an effective treatment by less invasive procedures. Temporary placement of covered self-expanding stents is an established therapy for oesophageal perforations and anastomotic leaks. Using conventional endoclips small perforations and leaks in the oesophagus and gastrointestinal tract may be closed. With the new over-the-scope-clips a more effective endoscopic full wall closure is possible in the upper gastrointestinal tract and the rectum...
June 2011: Zeitschrift Für Gastroenterologie
Yik Hong Ho, Mohamed Ahmed Tawfik Ashour
Colorectal anastomotic leak remains one of the most feared post-operative complications, particularly after anterior resection of the rectum with, the shift from abdomino-peritoneal resections to total mesorectal excision and primary anastomosis. The literature fails to demonstrate superiority of stapled over hand-sewn techniques in colorectal anastomosis, regardless of the level of anastomosis, although a high stricture rate was noted in the former technique. Thus, improvements in safety aspects of anastomosis and alternatives to hand-sewn and stapled techniques are being sought...
April 7, 2010: World Journal of Gastroenterology: WJG
George A Poultsides, Elliot L Servais, Leonard B Saltz, Sujata Patil, Nancy E Kemeny, Jose G Guillem, Martin Weiser, Larissa K F Temple, W Douglas Wong, Phillip B Paty
PURPOSE: The purpose of this study was to describe the frequency of interventions necessary to palliate the intact primary tumor in patients who present with synchronous, stage IV colorectal cancer (CRC) and who receive up-front modern combination chemotherapy without prophylactic surgery. PATIENTS AND METHODS: By using a prospective institutional database, we identified 233 consecutive patients from 2000 through 2006 with synchronous metastatic CRC and an unresected primary tumor who received oxaliplatin- or irinotecan-based, triple-drug chemotherapy (infusional fluorouracil, leucovorin, and oxaliplatin; bolus fluorouracil, leucovorin, and irinotecan; or fluorouracil, leucovorin, and irinotecan) with or without bevacizumab as their initial treatment...
July 10, 2009: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Sascha Santosh Chopra, Karl Mrak, Michael Hünerbein
BACKGROUND: Despite surgical advances, anastomotic leaks remain a major complication after rectal resection. Endoscopic techniques are increasingly used as an alternative or in addition to conventional operative therapy of anastomotic leakage. We have analyzed the impact of endoscopic treatment on the outcome of patients with leaks after resection of rectal cancer. METHODS: From January 2000 to December 2005, rectal resection was performed in 274 patients with rectal cancer...
February 2009: Surgery
Zurab Tsereteli, Emanuel Sporn, Timothy M Geiger, Dava Cleveland, Shellaine Frazier, Arthur Rawlings, Sharon L Bachman, Brent W Miedema, Klaus Thaler
BACKGROUND: Anastomotic leaks after colorectal operation continue to be a significant cause of morbidity. A covered endoluminal stent could seal a leak and eliminate the need for diversion. The aim of this study was to test the efficacy of a temporary covered stent to prevent leak related complications. METHODS: Sixteen adult pigs (80-120 lbs) underwent open transection of the rectosigmoid followed by anastomosis with a circular stapler. Eight animals (study group) underwent endoscopic placement of a 21-mm covered polyester stent...
November 2008: Surgery
J L Ponsky
Flexible endoscopy has evolved from a diagnostic tool practiced predominantly by gastroenterologists to a minimally invasive surgical tool. Therapeutic endoluminal procedures have become the standard of care for many gastric, biliary, pancreatic and colonic maladies. New technologies are under investigation for endoscopic treatment of gastroesophageal reflux, morbid obesity, and ablation of premalignant tissue. In the future flexible endoscopes may play a role in "natural orifice" surgery, performing operations through the mouth or rectum without the need for external incisions...
April 2006: Surgical Endoscopy
Anna-Maria Blake, Narinder Monga, Ernest M Dunn
OBJECTIVES: Perforation of the bowel during placement of a biliary stent is a known complication of this procedure. We report the endoluminal loss of a biliary stent during routine stent extraction that ultimately led to a chronic colovaginal fistula. This case emphasizes the need for evaluation of fecal passage of stents in patients with a known dislodged prosthesis. CASE REPORT: A 65-year-old white female underwent biliary stent placement for an episode of choledocholithiasis...
January 2004: JSLS: Journal of the Society of Laparoendoscopic Surgeons
Anil M Bahadursingh, Walter E Longo
OBJECTIVE: To review the diagnosis and treatment of colovaginal fistulas from various causes. DATA SOURCES: Papers on colovaginal fistulas were identified using Ovid and PubMed. The search terms used were as follows: colovaginal fistulas, rectovaginal fistulas, diverticular disease and fistulas. METHODS OF STUDY: Articles were selected based on their relevance to colovaginal fistulas and were then further subdivided into epidemiology, etiology, presentation, diagnosis and management...
July 2003: Journal of Reproductive Medicine
K Seymour, R Johnson, R Marsh, J Corson
OBJECTIVE: Untreated malignant large bowel obstruction is rapidly fatal. Short-term palliation of symptoms can be achieved by formation of a stoma in those patients for whom resection surgery is inappropriate. In the final months of life, a stoma represents a significant burden for both patients and carers. Palliative endoluminal stenting may therefore be an attractive alternative option for this poor prognosis group. In this paper, we examine our experience of palliative endoluminal colonic stenting. PATIENTS: Twenty patients, 11 males and 9 females of median age 81 years were referred for stenting...
July 2002: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
M B Welborn, J M Seeger
Ischemia of the colon, rectum, and pelvis continues to be a significant source of morbidity and mortality after aortic reconstruction. Complications associated with colonic and pelvic ischemia are severe and include impotency, buttock claudication, colonic and rectal infarction, buttock and perineal necrosis, and spinal cord or lumbar plexus injury. To prevent these complications the vascular surgeon must make every attempt to guarantee the adequacy of colonic and pelvic blood supply after aortic reconstructive procedures...
December 2001: Seminars in Vascular Surgery
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