Anastomic leak

The Erwiniaceae are a family of gram-negative, aerobic coliforms which are pathogenic to a number of plants. Recently described within this family are the Pantoea , strains of which have been associated with infection in immunocompromised children and post-surgical meningitis but also colonisation of a healthy human subject's gastrointestinal tract, as well as a variety of agricultural diseases. In 2015, a further clade of this family was established as the genus Mixta . In this case report, we describe infection of the pleural space and lung parenchyma with members of Mixta in a term neonate following an anastomic leak post-primary repair of congenital trache-oesophageal fistula, causing a respiratory and cardiovascular deterioration...

Objective: Transanal total mesorectal excision (taTME) was a very hot topic in the first few years since its appearance, but now more introspections and controversies on this procedure have emerged. One of the reasons why the Norwegian Ministry of Health stopped taTME was the high incidence of postoperative anastomotic leak. In current study, the incidence and risk factors of anastomotic leak after taTME were analyzed based on the data registered in the Chinese taTME Registry Collaborative (CTRC). Methods: A case-control study was carried out...

BACKGROUND: Surgical-site infections (SSIs) represent the most common complications after colorectal surgery (CS). Role of preoperative administration of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP), alone or in combination, in the prevention of SSIs after CS is debated. Aim of this study was to assess the effect of the introduction of an Implemented Infection Prevention Bundle (IIPB) in preventing SSIs in CS. METHODS: A group of 251 patients (Group 1) who underwent CS receiving only preoperative intravenous antibiotic prophylaxis (IAP) was compared to a Group of 107 patients (Group 2) who also received the IIPB...

BACKGROUND: We have obtained a diagnostic score (DIACOLE) in order to detect anastomotic leakage in the postoperative period of colorectal cancer surgery. METHODS: Systematic review to identify any symptoms and clinical or analytical signs associated with anastomotic leakage after colorectal cancer surgery and a meta-analysis of each of these factors. The DIACOLE score encompasses all factors that reached statistical significance in their respective meta-analyses...

BACKGROUND: Anastomotic leak is considered the major complication following abdominal surgery. In recent years, the use of a variety of sealing materials for the prevention of leaks has been analyzed. Different biomaterials have been employed as scaffolds to favour tissue repair and regeneration. Among these materials we must mention alginate, a natural polymer with different applications as temporary supporting matrix. The aim of the present study is to evaluate the behavior of both alginate-impregnated sutures and lyophilized alginate sponges in the healing process of colonic anastomes using an experimental animal model...

BACKGROUND: Anastomotic leak after rectal resection carries substantial morbidity and mortality. A diverting ileostomy is beneficial for high-risk anastomoses, but its creation and reversal carry a surgical risk in addition to that of resection itself. We sought an alternative method for managing complications of rectal anastomosis. METHODS: We developed an endoluminal negative-pressure technology with a diverting proximal sump, and hypothesized that it would close anastomotic disruptions in pigs...

PURPOSES: We retrospectively assessed our experience with the W-shaped orthotopic ileal pouch, which was constructed with non-absorbable titanium staples. For these purpose, we discuss the results of bladder capacity, urinary continence and early and long-term postoperative complications. MATERIALS AND METHODS: We included in the study 17 patients who underwent radical cystoprostatectomy followed by construction of an orthotopic W-shaped ileal pouch between October 2000 and November 2009...

BACKGROUND: The main complication observed after total gastrectomy is the oesophagojejunal anastomosic fistla. Its incidence varies between 7.4% and 11.5%. The mortality after anastomic leafage is high at around 20%, representing 30% and 54% of global mortality after total gastrectomy. AIM: This study aimed to evaluate mortality and morbidity after total gastrectomy and to determine their predictive factor METHODS: this is retrospective study about 80 cases of total gastrectomy for gastric cancer, collected in the departmentof General Surgery of the University Hospital Habib Thameur Tunis during the period 1 January 1995 to 31 December 2010...

The nature of the pancreatic or duodenal injury itself influences mortality, and is co-dependent on the presence of multiple other injuries, which account for most of the early mortality. Intra-abdominal sepsis leading to multiple organ failure accounts for most of the late deaths, indicating the importance of early haemodynamic stabilization, adequate debridement of devitalized tissue and wide drainage. Most duodenal injuries can be adequately managed with primary repair or resection and anastomosis. The presence of a pancreatic injury certainly increases the likelihood of an anastomic leak from a duodenal repair...

BACKGROUND AND OBJECTIVES: Hyperthermia, either alone or in combination with anticancer drugs, is becoming more and more a clinical reality for the treatment of far advanced gastrointestinal cancers, acting as a cytotoxic agent at a temperature between 40-42.5 degrees C. Although hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC) is demonstrated to have some benefit in selected patients with peritoneal seeding, there are not enough data on the risk of damage of normal tissue that increases as the temperature rises, with possible serious and, sometimes, lethal complications...

BACKGROUND: The purpose of the study was to evaluate the utilization and morbidity associated with feeding jejunostomy tubes (JT) placed at the time of gastroesophageal resection (GER). METHODS: Under institutional review board approval, a prospective database of patients undergoing GER from January 2004 to September 2010 was reviewed. Data analyzed included patient demographics, postoperative complications, JT use, and JT specific complications. Fisher's exact tests explored associations with utilization of a JT following resection...

Although total mesorectal excision (TME) has been generally accepted as a principle of rectal cancer surgery, the corresponding laparoscopic approach still needs evaluation in depth, especially the controversial dissection of lateral pelvic areas. At our center, 982 patients with rectal cancers received laparoscopic or laparoscopic-assisted surgery during the past ten years. Short-term results showed an anastomic leakage rate of 4.2% (29/683) in patients with anal sphincter preservation and an average hospitalization of 8...

AIM: The impact of anastomic leakage (AL) on the oncological outcome after anterior resection (AR) for rectal cancer is still controversial. We explored the impact of AL regarding local recurrence (LR), distant metastasis and overall recurrence (OAR). Overall and cancer-specific survival was analysed. METHOD: Patients undergoing AR for rectal cancer with a registered AL between 1995 and 1997 and a control group were identified in the Swedish Rectal Cancer Registry...

The authors analyzed a group of 1281 subjects with colorectal cancer operated and followed up in a single institution from I/1992 to VIII/2007. Colon carcinoma patients were assessed separately (C18). Patients with rectal and rectosigmoid tumors are not included in the presentation. A total of 846 patients were operated for colon carcinomas. In 546 subjects, radical R0 resections were achieved. In the R0 group, the male/female ratio is 315/231, age 29-94 years, the mean age of 69 years. The R0 group stratification by TNM classification was: I 17...

Although appendectomy is the most commonly performed emergency operation septic complications of appendectomy remain a major source of morbidity. Historically, advanced appendicitis has been treated by appendectomy with cecostomy and/or drainage tubes. Our objective was to evaluate the use of ileocecal resection for the immediate treatment of advanced appendicitis. We examined the cases of all patients undergoing ileocecal resection for appendicitis from August 1989 through April 2000. There were 92 patients (60 male and 32 female) with a median age of 34 (range 6-71)...

BACKGROUND: Circular staplers have reduced the incidence of anastomotic leaks in esophagovisceral anastomosis. However, the prevalence of stenosis is greater with staplers than with manual suturing. The aim of this study was to analyze potential risk factors for the onset of anastomotic stenoses and to evaluate their treatment and final outcome. METHODS: Between 1990 and 1995, 187 patients underwent esophagectomy and esophagogastrostomy with anastomosis performed inside the chest using a circular stapler...

Fifteen years of experience in the management of postoperative complications following GI surgery are reviewed. In the surgical ICU of the Hôpital Saint Antoine, Paris, France, a referral center for these conditions, 385 cases of postoperative peritonitis and 500 cases of enterocutaneous fistulas were observed from 1980 to 1995. Original techniques of management are described in surgical treatment: temporary stomas, intubation irrigation of leaks situated on the upper GI tract, primary closure of the abdominal wall without tension...

The tendency toward sphincter-preserving resection for distal rectal cancers has led in recent years to a revival of the technique of coloanal anastomosis (CAA). Our experience with intersphincteric resection in combination with CAA was reviewed with the aim of assessing morbidity, functional outcome, and cancer treatment results. A total of 119 patients treated for primary rectal cancer by CAA between 1978 and 1994 were studied retrospectively. Seventy-six percent of the tumors were located in the lower third of the rectum...

The safety of low colorectal anastomosis constructed with autosuture technique (U.S. EEA-stapling device, USSC) and the functional results were assessed in consecutive series of patients operated upon for rectal carcinoma. The operative procedure was greatly facilitated and certainly, many of the patients would otherwise have been subjected to abdominoperineal resection with permanent colostomy. Clinical leaks were observed in 4 of the 25 patients (16%) and another 4 patients were shown to have subclinical leaks, as demonstrated by endoscopy and/or X-ray...

156 patients undersent colorectal surgery during a prospective blind study at the Städt. Krankenhaus München-Harlaching. The study showed that administration of 4,0 g Paromomycin (= Humatin) on each of the two preoperative days combined with mechanical cleansing of the intestine has a beneficial effect. Our test group showed significantly lower incidence of wound complications at the abdominal laparotomies (p less than 0,05; X2) and at the anastomoses (p less than 0,01; X2 than the control group. Anastomic leakage (major leaks) and following septical complications occurred nearly exclusively in our "Not-Humatin-group"...