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colorectal anastomotic leakage

S J van Rooijen, D Huisman, M Stuijvenberg, J Stens, R M H Roumen, F Daams, G D Slooter
BACKGROUND: Colorectal anastomotic leakage (CAL) is a major surgical complication in intestinal surgery. Despite many optimizations in patient care, the incidence of CAL is stable (3-19%) [1]. Previous research mainly focused on determining patient and surgery related risk factors. Intraoperative non-surgery related risk factors for anastomotic healing also contribute to surgical outcome. This review offers an overview of potential modifiable risk factors that may play a role during the operation...
October 15, 2016: International Journal of Surgery
Yusuf Sevim, Suleyman Utku Celik, Hana Yavarifar, Cihangir Akyol
Anastomotic leakage is an unfortunate complication of colorectal surgery. This distressing situation can cause severe morbidity and significantly affects the patient's quality of life. Additional interventions may cause further morbidity and mortality. Parenteral nutrition and temporary diverting ostomy are the standard treatments of anastomotic leaks. However, technological developments in minimally invasive treatment modalities for anastomotic dehiscence have caused them to be used widely. These modalities include laparoscopic repair, endoscopic self-expandable metallic stents, endoscopic clips, over the scope clips, endoanal repair and endoanal sponges...
September 27, 2016: World Journal of Gastrointestinal Surgery
Frederick H Koh, Ker-Kan Tan
BACKGROUND: Anastomotic leakage after gastrointestinal surgery is associated with significant morbidity and mortality.1 Insufficient vascular supply is one cause.2 Recent reports of using intraoperative indocyanine green (ICG) fluorescent angiography to evaluate whether perfusion of the anastomosis is adequate has yielded positive outcomes.3 (-) 6 The authors describe their use of ICG-enhanced fluorescence angiography in a laparoscopic anterior resection. METHODS: The patient was an 80-year-old with an upper rectal adenocarcinoma and significant cardiovascular risk factors...
September 28, 2016: Annals of Surgical Oncology
A Vallance, S Wexner, M Berho, R Cahill, M Coleman, N Haboubi, R J Heald, R H Kennedy, B Moran, N Mortensen, R W Motson, R Novell, P R O'Connell, F Ris, T Rockall, A Senapati, A Windsor, D G Jayne
The reduction of the incidence, detection, and treatment of anastomotic leakage (AL) continues to challenge the colorectal surgical community. AL is not consistently defined and reported in clinical studies, its occurrence is variably reported and its impact on long-term morbidity and healthcare resources has received relatively little attention. Controversy continues about the best strategies to reduce the risk. Diagnostic tests lack sensitivity and specificity, resulting in delayed diagnosis and increased morbidity...
September 27, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Cloë L Sparreboom, Zhou-Qiao Wu, Jia-Fu Ji, Johan F Lange
Colorectal anastomotic leakage (CAL) remains a major complication after colorectal surgery. Despite all efforts during the last decades, the incidence of CAL has not decreased. In this review, we summarize the available strategies regarding prevention, prediction and intervention of CAL and categorize them into three categories: communication, infection and healing disturbances. These three major factors actively interact during the onset of CAL. We aim to provide an integrated approach to CAL based on its etiology...
August 28, 2016: World Journal of Gastroenterology: WJG
Kristian Kiim Jensen, Rune Erichsen, Peter-Martin Krarup
BACKGROUND: Long-term mortality after colonic cancer is not only related to the disease itself, but also to other factors such as surgical complications. Incisional hernia after abdominal surgery is a common complication; however, the impact on mortality is unknown. We thus sought to examine the impact of incisional hernia on mortality after colonic cancer resection. METHOD: This was a nationwide cohort study comprising data from the Danish Colorectal Cancer Group's database, the Danish National Patient Registry (NPR), and the Danish Central Person Registry...
September 7, 2016: Surgical Endoscopy
Amanda C R K Bos, Felice N van Erning, Marloes A G Elferink, Harm J Rutten, Martijn G H van Oijen, Johannes H W de Wilt, Valery E P P Lemmens
BACKGROUND: High-volume hospitals have been associated with improved patient outcomes for tumors with a relatively low incidence that require complex surgeries, such as esophageal and pancreatic cancer. The volume-outcome association for colorectal cancer is under debate. OBJECTIVE: This study investigated whether hospital volume for colorectal cancer is associated with surgical care characteristics and 5-year overall survival. DESIGN: This is a population-based study...
October 2016: Diseases of the Colon and Rectum
Andrew J Russ, Mark A Casillas
Colorectal anastomotic leakage is a dreaded complication after colorectal surgery and causes high morbidity and mortality. The pathophysiology of anastomotic healing remains unclear despite numerous studies. In this article, our aim is to provide different perspectives on what is known about the role of the gastrointestinal tract microbiome and its relation to anastomotic integrity.
September 2016: Clinics in Colon and Rectal Surgery
Luigi Boni, Abe Fingerhut, Alessandro Marzorati, Stefano Rausei, Gianlorenzo Dionigi, Elisa Cassinotti
INTRODUCTION: Colorectal anastomoses after anterior resection for cancer carry a high risk of leakage. Different factors might influence the correct healing of anastomosis, but adequate perfusion of the bowel is highlighted as one of the most important elements. Fluorescence angiography (FA) is a new technique that allows the surgeon to perform real-time intraoperative angiography to evaluate the perfusion of the anastomosis and hence, potentially, reduce leak rate. AIM: The aim of this study was to evaluate the impact of FA of the bowel on postoperative complications and anastomotic leakage after laparoscopic anterior resection with total mesorectal excision (TME)...
August 23, 2016: Surgical Endoscopy
Masanori Naito, Takahiro Yamanashi, Takatoshi Nakamura, Hirohisa Miura, Atsuko Tsutsui, Takeo Sato, Masahiko Watanabe
INTRODUCTION: Laparoscopic surgery is widely used for the treatment of colorectal cancer, but it is often associated with postoperative anastomotic complications. Generally, gastrointestinal anastomosis for colorectal surgery is performed using mechanical anastomosis with a double stapling technique. Using the automatic suture device with bioabsorbable polyglycolic acid (PGA) felt is expected to adequately reinforce staple lines on fragile tissue, helping to prevent anastomotic complications, including leakage...
August 5, 2016: Asian Journal of Endoscopic Surgery
Miu Yee Chan, Chi Chung Foo, Jensen Tung Chung Poon, Wai Lun Law
BACKGROUND: The benefit of mechanical bowel preparation (MBP) in patients undergoing laparoscopic colorectal resections remains a question. This study aimed to evaluate the effect of omitting MBP on patients undergoing laparoscopic bowel resections. METHODS: The outcomes of patients who underwent elective colorectal resections for cancer of colon and upper rectum without MBP were compared to a retrospective cohort who had MBP. RESULTS: There were 97 patients in the No-MBP group and 159 patients in the MBP group...
August 2016: Annals of Medicine and Surgery
Muralidharan Parthasarathy, Martin Greensmith, David Bowers, Thomas Groot-Wassink
AIM: A large prospectively collected clinical database was analysed to determine the various pre- and intraoperative factors affecting anastomotic leakage (AL) in colorectal surgery. METHOD: Data on 17,518 patients having a colorectal resection with anastomosis from the 2013 American College of Surgeons National Surgical Quality Improvement Program database were included in the study. Multivariable logistic regression analysis was carried out to identify risk-adjusted predictive factors for AL...
July 30, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Alexandra C Gordon, Andrea J Cross, Elizabeth W Foo, Ross H Roberts
BACKGROUND: Post-operative C-reactive protein (CRP) has been investigated as a predictor of anastomotic leak (AL) following colorectal surgery, but its role in oesophago-gastric surgery is not yet established. METHODS: Clinical data and post-operative CRP values of patients who underwent elective oesophago-gastric resection between January 2004 and July 2014 were analysed retrospectively. Only patients with an oesophageal anastomosis were included. AL was defined as leakage of contrast material seen on imaging or a leak confirmed intraoperatively on return to theatre...
July 25, 2016: ANZ Journal of Surgery
Tadanobu Shimura, Yuji Toiyama, Junichiro Hiro, Hiroki Imaoka, Hiroyuki Fujikawa, Minako Kobayashi, Masaki Ohi, Yasuhiro Inoue, Yasuhiko Mohri, Masato Kusunoki
BACKGROUND: Preoperative hypoalbuminemia is a well-known risk factor for anastomotic leakage after colorectal surgery, but the association between perioperative albumin level and anastomotic leakage has not been fully investigated in curative colorectal cancer (CRC) patients. METHODS: In total, 200 CRC patients (Stage I-III) undergoing curative laparoscopic surgery between January 2004 and December 2013 were enrolled in this study. We collected data on surgical factors, perioperative levels of serum albumin and inflammatory markers, and perioperative factors affecting hypoalbuminemia from 196 CRC patients to assess the relation to anastomotic leakage...
July 19, 2016: Asian Journal of Surgery
Masafumi Kuramoto, Satoshi Ikeshima, Kenichiro Yamamoto, Keisuke Morita, Tomoyuki Uchihara, Rumi Itouyama, Shinichi Yoshimatsu, Shinya Shimada, Hideo Baba
The double stapling technique (DST) is an intestinal reconstruction technique that has been widely adopted in anterior resection (AR) for rectal cancer. However, anastomotic leakage (AL) after the operation remains a major concern for colorectal surgeons. The sharp-angled corner of the remnant rectum that is often created by the ordinary DST can be a risk factor for AL. We have developed a new method of performing intentional oblique transection DST (IOT-DST). Using this technique, the anal side of the rectum is intentionally obliquely transected with linear staplers, and the area of the sharp-angled edge is totally punched out with a circular stapler...
July 14, 2016: Surgery Today
Andrea Cimitan, Tania Contardo, Roberta Molaro, Emilio Morpurgo
AIM OF THE STUDY: The aim of this study was to describe the role of laparoscopy in the treatment of leaks occurring after minimally invasive colorectal resections. MATERIALS AND METHODS: Thirty-four of 566 consecutive patients who underwent minimally invasive colorectal resection for cancer between January 2004 and December 2012 and who showed signs of anastomotic leakage (6%) requiring reoperation were studied using a prospectively maintained database. Patient characteristics, clinical signs, the surgical approach, the role of laparoscopy, operative and postoperative results, and the rate of permanent stoma were analyzed...
August 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Francisco Mateo Vallejo
No abstract text is available yet for this article.
January 2015: International Journal of Surgery
Kenji Kawada, Suguru Hasegawa, Toshiaki Wada, Ryo Takahashi, Shigeo Hisamori, Koya Hida, Yoshiharu Sakai
BACKGROUND: Decreased blood perfusion is an important risk factor for postoperative anastomotic leakage (AL). Fluorescence imaging with indocyanine green (ICG) provides a real-time assessment of intestinal perfusion. This study evaluated the utility of ICG fluorescence imaging in determining the transection line of the proximal colon during laparoscopic colorectal surgery with double stapling technique (DST) anastomosis. METHODS: This was a prospective single-institution study of 68 patients with left-sided colorectal cancers who underwent laparoscopic colorectal surgery between August 2013 and December 2014...
June 28, 2016: Surgical Endoscopy
Zoran Kostić, Damjan Slavković, Zoran Mijusković, Marina Panisić, Mile Ignjatović
BACKGROUND/AIM: C-reactive protein (CRP) is considered to be an indicator of postoperative complications in. abdominal surgery. The aim of this study was to determine the significance of serial measurement of CRP in drainage fluid in the detection of anastomotic leakage (AL) in patients with colorectal resection. METHODS: CRP values in serum and drainage fluid, respectively, were measured on the first, third, fifth, and seventh postoperative day (POD) in 150 patients with colorectal resection and primary anastomosis...
March 2016: Vojnosanitetski Pregled. Military-medical and Pharmaceutical Review
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