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Leak intestinal

Kristina Guyton, John C Alverdy
Surgery involving the gastrointestinal tract continues to prove challenging because of the persistence of unpredictable complications such as anastomotic leakage and life-threatening infections. Removal of diseased intestinal segments results in substantial catabolic stress and might require complex reconstructive surgery to maintain the functional continuity of the intestinal tract. As gastrointestinal surgery necessarily involves a breach of an epithelial barrier colonized by microorganisms, preoperative intestinal antisepsis is used to reduce infection-related complications...
October 12, 2016: Nature Reviews. Gastroenterology & Hepatology
Rahman Şenocak, Mustafa Tahir Özer, Şahin Kaymak, Zafer Kılbaş, Armağan Günal, Metin Uyanık, Orhan Kozak
PURPOSE: Anastomotic leaks following intestinal operations may cause devastating effects on patients. Ischemia may also occur at the intestinal walls in the presence of strangulations. In this study, we examined the effects of human recombinant (Hr)-epidermal growth factor (EGF) given at a single intramural dose into the intestinal walls and daily intraperitoneal cavity on ischemia and the healing process of anastomosis. MATERIALS AND METHODS: Sixteen male New Zeland white rabbits were randomly divided into four groups (n = 4 in each group)...
October 3, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Martin D Brand, Renata L S Goncalves, Adam L Orr, Leonardo Vargas, Akos A Gerencser, Martin Borch Jensen, Yves T Wang, Simon Melov, Carolina N Turk, Jason T Matzen, Victoria J Dardov, H Michael Petrassi, Shelly L Meeusen, Irina V Perevoshchikova, Heinrich Jasper, Paul S Brookes, Edward K Ainscow
Using high-throughput screening we identified small molecules that suppress superoxide and/or H2O2 production during reverse electron transport through mitochondrial respiratory complex I (site IQ) without affecting oxidative phosphorylation (suppressors of site IQ electron leak, "S1QELs"). S1QELs diminished endogenous oxidative damage in primary astrocytes cultured at ambient or low oxygen tension, showing that site IQ is a normal contributor to mitochondrial superoxide-H2O2 production in cells. They diminished stem cell hyperplasia in Drosophila intestine in vivo and caspase activation in a cardiomyocyte cell model driven by endoplasmic reticulum stress, showing that superoxide-H2O2 production by site IQ is involved in cellular stress signaling...
October 11, 2016: Cell Metabolism
Keisuke Gotanda, Takeshi Hirota, Jumpei Saito, Masato Fukae, Yu Egashira, Noritomo Izumi, Mariko Deguchi, Miyuki Kimura, Shunji Matsuki, Shin Irie, Ichiro Ieiri
A variant in the breast cancer resistance protein (BCRP) gene, 421C> A is a useful biomarker for describing large inter-individual differences in the pharmacokinetics of sulfasalazine (SASP), a BCRP substrate. However, large intra-genotypic variability still exists in spite of the incorporation of this variant into the pharmacokinetics of SASP. Since miR-328 negatively regulates BCRP expression in human tissues, we hypothesized that exosomal miR-328 in plasma, which leaks from the intestines, is a possible biomarker for estimating BCRP activity in the human intestines...
2016: Scientific Reports
Peep Talving, Konstantinos Chouliaras, Alexander Eastman, Margaret Lauerman, Pedro G Teixeira, Joseph DuBose, Joseph Minei, Thomas Scalea, Demetrios Demetriades
BACKGROUND: Discontinuity of the bowel following intestinal injury and resection is a common practice in damage control procedures for severe abdominal trauma. However, there are concerns that complete occlusion of the bowel, especially in the presence of hypotension or edema that may result in ischemic bowel changes or increase bacterial or toxin translocation. METHODS: This was a retrospective study from three Level-1 trauma centers. Included were trauma patients who required bowel resection and damage control...
August 19, 2016: World Journal of Surgery
Christian Fredrik Rushfeldt, Uwe Conrad Agledahl, Baldur Sveinbjørnsson, Kjetil Søreide, Tom Wilsgaard
BACKGROUND: Perioperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) is associated with risk of anastomotic leak (AL). However, concomitant use of other drugs could infer a bias in risk assessment. Thus, we aimed to interrogate the risk of AL associated with NSAIDs and steroids used perioperatively. METHODS: This study includes a consecutive series of patients having surgery involving an intestinal anastomosis from Jan 2007 to Dec 2009. Data records included demographic, perioperative, and surgical characteristics; AL rates; and use of NSAIDs and steroids...
November 2016: World Journal of Surgery
Monika A Krezalek, John C Alverdy
PURPOSE OF REVIEW: The purpose of this review is to highlight new research findings in the complex bidirectional crosstalk that occurs between the intestinal microbiome and the host immune system in the context of surgical recovery and outcomes. RECENT FINDINGS: Significant evidence has been generated emphasizing the central role of the intestinal microbiome on surgical outcomes such as wound healing, surgical site infections and anastomotic leak. Current preventive strategies, including the use of some parenteral antibiotics, may actually exacerbate the problem by selecting for drug-resistant pathogens...
June 23, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
I P Yerko, S B Balabushko
The results of reconstructive-restoration operations, performed after obstructive resection of large bowel for colorectal cancer, were analyzed. The postoperative complications rate have constituted 11.7%. The most frequent cause of morbidity, 3.9%, was partial insufficiency of sutures of interintestinal anastomosis, formatted in the end to end fashion. Lethality have constituted 1.1%.
January 2016: Klinichna Khirurhiia
Michael S Thomas, David A Margolin
The aim of this article is to present strategies for preventing and managing the failure of the surgical restoration of intestinal continuity. Despite improvements in surgical technique and perioperative care, anastomotic leaks still occur, and with them occur increased morbidity, mortality, length of stay, and costs. Due to the devastating consequences for patients with failed anastomoses, there have been a myriad of materials and techniques used by surgeons to create better intestinal anastomoses. We will also discuss the management strategies for anastomotic leak when they do inevitably occur...
June 2016: Clinics in Colon and Rectal Surgery
Nawal Kishore Jha, Sanjay Kumar Yadav, Rajshekhar Sharma, Dipendra Kumar Sinha, Sandip Kumar, Marshal Daud Kerketta, Mini Sinha, Abhinav Anand, Anjana Gandhi, Satish Kumar Ranjan, Jitin Yadav
OBJECTIVE: To determine the presentation, anatomical distribution, diagnostic method, management and outcome of hollow viscus injury (HVI) from blunt abdominal trauma. METHODS: This  was  a  retrospective  cross-ecnal  study  including  patients  with  blunt  abdominal  trauma leading to HVI admitted at Rajendra Institute of Medical Sciences, Ranchi, over a period of 4.5 years (January 2009 to July 2014). Data were retrieved from patients' medical records...
October 2014: Bulletin of Emergency and Trauma
Azad Shademan, Ryan S Decker, Justin D Opfermann, Simon Leonard, Axel Krieger, Peter C W Kim
The current paradigm of robot-assisted surgeries (RASs) depends entirely on an individual surgeon's manual capability. Autonomous robotic surgery-removing the surgeon's hands-promises enhanced efficacy, safety, and improved access to optimized surgical techniques. Surgeries involving soft tissue have not been performed autonomously because of technological limitations, including lack of vision systems that can distinguish and track the target tissues in dynamic surgical environments and lack of intelligent algorithms that can execute complex surgical tasks...
May 4, 2016: Science Translational Medicine
Estíbaliz Echazarreta-Gallego, Manuela Elía-Guedea, Elena Córdoba-Díaz de Laspra
BACKGROUND: The use of a new chemotherapy as adjuvant treatment of colorectal cancer is not free of complications. Monoclonal antibodies are associated with bleeding and intestinal perforations. OBJECTIVE: To report the case of a patient who developed a serious complication after treatment with an antiangiogenic drug for colorectal neoplasm. CLINICAL CASE: The case is presented of a 42-year-old male operated on due to subocclusive rectal cancer with metástasis at the time of diagnosis...
April 29, 2016: Cirugia y Cirujanos
Rubina Khullar Mahajan, Sudha Jasmine Rajan, John Victor Peter, Mayur Keshav Suryawanshi
Organophosphate poisoning has significant gastrointestinal manifestations including vomiting, diarrhea, cramps and increased salivation. We report an uncommon gastrointestinal complication of multiple small intestinal perforations following organophosphorus poisoning. A 28-year old male presented after ingesting dichlorvos mixed with alcohol. Following the initial cholinergic symptoms, the patient developed severe shock with fever, attributed to aspiration pneumonia. Despite appropriate antibiotics, shock was persistent...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Kin Wai Edwin Chan, Kim Hung Lee, Siu Yan Bess Tsui, Jennifer Wai Cheung Mou, Yuk Him Peter Tam
BACKGROUND: The aim of this review was to study the characteristics and the outcome of children who underwent laparoscopic management of the antenatally detected choledochal cyst. METHODS: A retrospective review was conducted for all children who underwent excision of antenatally detected choledochal cyst and hepaticojejunostomy from 2005 to 2015. RESULTS: Fourteen patients (11 females and 3 males) were included in this study. The mean diameter of the cyst was 5...
April 29, 2016: Surgical Endoscopy
P J Allan, P Stevens, A Abraham, P Paine, K Farrer, A Teubner, G Carlson, S Lal
BACKGROUND/OBJECTIVES: Bariatric surgery for morbid obesity provides sustained weight loss. Complications of bariatric surgery include severe nutritional decline, but minimal data describing occurrence and outcome of intestinal failure (IF) exist. SUBJECTS/METHODS: All patients referred to one of the UK's National IF units (IFU) are prospectively entered onto a database; case notes were assessed for bariatric surgery details, IF onset, outcomes, resulting intestinal anatomy, mortality and catheter-related bloodstream infections (CRBSIs)...
July 2016: European Journal of Clinical Nutrition
Dongliang Li, Ming Wang, Jun Zhu, Shenwei Wu
OBJECTIVE: To explore the related factors of anastomotic leakfollowing anterior resection for the rectal cancer and the association of the preoperative nutritional risk screening 2002(NRS2002) score. METHODS: Clinical data of 396 rectal cancer patients who underwent elective anterior resection from January 2010 to July 2015 at Affiliated Lu'an Hospital of Anhui Medical University were collected. Patient's nutritional risk score on admission was calculated by NRS2002 scoring system according to original medical records...
April 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Lei Jia, Jinqi Lu, Xiefeng Ma, Honggang Jiang, Yi Zhu, Yuting Liu, Ying Cai, Yuqi Zhang
OBJECTIVE: To investigate the risk factors of intra-abdominal infection(IAI) after colorectal cancer surgery. METHODS: Clinical and follow-up data of 773 colorectal cancer patients undergoing operation in our hospital from October 2011 to December 2014 were retrospectively analyzed. Patients were divided into intra-abdominal cavity infection group (110 cases, IAI group) and non intra-abdominal infection group(663 cases, non-IAI group). All the patients administered prophylactic antibiotics 30 minutes to 2 hours before operation...
April 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Steven G Leeds, James S Burdick, James W Fleshman
No abstract text is available yet for this article.
June 1, 2016: JAMA Surgery
W A A Borstlap, N Harran, P J Tanis, W A Bemelman
AIM: The aim of this study was to report on the feasibility of transanal minimally invasive surgery (TAMIS) as a novel approach to redo colorectal or ileoanal anastomoses. METHODS: From October 2014, a prospective institutional database was created for all consecutive patients who underwent redo surgery by TAMIS for presacral sinus or anastomotic stenosis after low anterior resection or pouch-related problems following restorative proctocolectomy. Intra-operative feasibility, 30-day postoperative outcomes, intestinal continuity and complications after 6-month follow-up were evaluated...
April 11, 2016: Surgical Endoscopy
Jie Cao, Min Wang, Huiqi Xie, Renqian Wei
OBJECTIVE: To prepare the small intestinal submucosa (SIS)-silk composite scaffold for anterior cruciate ligament (ACL) reconstruction, and to evaluate its properties of biomechanics, biocompatibility, and the influence on synovial fluid leaking into tibia tunnel so as to provide a better choice in the clinical application of ACL reconstruction. METHODS: The silk was used to remove sericin and then weaved as silk scaffold, which was surrounded cylindrically by SIS to prepare a composite scaffold...
December 2015: Chinese Journal of Reparative and Reconstructive Surgery
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