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colorectal anastomotic leakage

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https://www.readbyqxmd.com/read/28072899/endoluminal-vacuum-therapy-as-treatment-for-anastomotic-colorectal-leakage
#1
Giovanni Milito, Giorgio Lisi, Dario Venditti, Michela Campanelli, Elena Aronadio, Simona Grande, Francesca Cabry, Michele Grande
BACKGROUND: The clinical leakage rate after anterior resection varies from 2.8-20%, with a 6-22% mortality rate and a 10-80% risk of permanent stoma. Endo-SPONGE® (B. Braun Melsungen AG, Melsungen, Germany) may treat extraperitoneal anastomotic leakage in the lesser pelvis. It consists of an open-pored sponge inserted into the cavity. A drainage tube fixed to a low vacuum drainage system is then connected to the sponge through the anus. MATERIAL AND METHODS: Between January 2007 and December 2014, 14 patients with anastomotic leakage following low anterior resection were treated with Endo-SPONGE® and were prospectively evaluated...
January 10, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/28070659/diagnosis-treatment-and-consequences-of-anastomotic-leakage-in-colorectal-surgery
#2
Bodil Gessler, Olle Eriksson, Eva Angenete
PURPOSE: The aim of this study was to explore the choice of modality for diagnosis, treatments, and consequences of anastomotic leakage. METHODS: This is a retrospective study of consecutive patients who underwent surgery that included a colorectal anastomosis due to colorectal cancer, diverticulitis, inflammatory bowel disease (IBD), or benign polyps. RESULTS: A total of 600 patients were included during 2010-2012, and 60 (10%) had an anastomotic leakage...
January 9, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27943617/relation-between-postoperative-ileus-and-anastomotic-leakage-after-colorectal-resection-a-post-hoc-analysis-of-a-prospective-randomized-controlled-trial
#3
E G Peters, M Dekkers, F W van Leeuwen-Hilbers, F Daams, K W E Hulsewé, W J de Jonge, W A Buurman, M D P Luyer
AIM: Anastomotic leakage (AL) following abdominal surgery is a critical determinant of postoperative recovery, of which the aetiology is largely unknown. Interestingly, interventions aimed at reducing the inflammatory response and postoperative ileus (POI) have an unexpected effect on AL. The aim of this study was to investigate the relation of POI with inflammation and AL after colorectal resection. METHOD: A post-hoc analysis of a prospective RCT, in which patients underwent a colorectal resection was performed...
December 10, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27942836/comparison-of-three-different-application-routes-of-butyrate-to-improve-colonic-anastomotic-strength-in-rats
#4
J W A M Bosmans, A C H M Jongen, B T C Boonen, S van Rijn, F Scognamiglio, L Stucchi, M J J Gijbels, E Marsich, N D Bouvy
INTRODUCTION: Despite extensive research, anastomotic leakage (AL) remains one of the most dreaded complications after colorectal surgery. Since butyrate enemas are known to enhance anastomotic healing, several administration routes have been explored in this study. METHODS: Three intraluminal approaches involving butyrate were investigated: (1) butyrin-elucidating patch, (2) a single injection of hyaluronan-butyrate (HA-But) prior to construction of the proximal anastomosis and (3) rectal hyaluronan-butyrate (HA-But) enemas designed for distal anastomoses...
December 9, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27930362/monitoring-of-procalcitonin-but-not-interleukin-6-is-useful-for-the-early-prediction-of-anastomotic-leakage-after-colorectal-surgery
#5
Urszula Zielińska-Borkowska, Naser Dib, Wiesław Tarnowski, Tomasz Skirecki
BACKGROUND: Early recognition of patients who have developed anastomotic leakage (AL) after colorectal surgery is crucial for the successful treatment of this complication. The aim of this study was to assess the usefulness of the assessment of procalcitonin (PCT) and interleukin-6 (IL-6) levels in the prognosis of AL. METHODS: This observational study included 157 patients who underwent major elective colorectal surgery. The most common indications for surgery were cancer and inflammatory bowel diseases...
December 8, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27928685/laparoscopic-deloyers-procedure-for-tension-free-anastomosis-after-extended-left-colectomy-technique-and-results
#6
A Sciuto, C Grifasi, F Pirozzi, P Leon, R E M Pirozzi, F Corcione
BACKGROUND: The Deloyers procedure, which includes inversion of the right colon around the axis of the ileocolic vessels, can be used to achieve a well vascularized, tension-free colorectal anastomosis after extended left colectomy. The aim of this study is to report our technique and outcome in a series of ten consecutive patients who underwent right colonic transposition by laparoscopic approach. METHODS: Charts were retrospectively reviewed to analyze postoperative outcome and bowel function...
December 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27926556/natural-orifice-specimen-extraction-with-single-stapling-colorectal-anastomosis-for-laparoscopic-anterior-resection-feasibility-outcomes-and-technical-considerations
#7
Bansal Saurabh, Sheng-Chi Chang, Tao-Wei Ke, Yu-Chun Huang, Takashi Kato, Hwei-Ming Wang, William Tzu-Liang Chen, Abe Fingerhut
BACKGROUND: Double and triple stapling techniques to close the rectal stump in laparoscopic anterior resection are fraught with technical drawbacks that could possibly be avoided with the use of the single stapling technique. However, little is known of its safety in laparoscopic surgery or outcomes when combined with natural orifice specimen extraction. OBJECTIVE: This study aims to analyze the feasibility and the operative and immediate postoperative outcomes of single-stapled anastomosis and natural orifice specimen extraction with conventional techniques...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27917665/the-potential-effect-of-biological-sealants-on-colorectal-anastomosis-healing-in-experimental-research-involving-severe-diabetes
#8
K Stergios, K Kontzoglou, V Pergialiotis, L M Korou, M Frountzas, O Lalude, N Nikiteas, D N Perrea
Colorectal anastomoses continuous to pose a significant challenge in current surgical practice. Anastomotic leakage remains one of the most frequent and dramatic complications of colorectal surgery, even in centres of high specialisation. Diabetes is a well-established independent factor which results in higher anastomotic leakage rates. Fibrin sealants have been applied in experimental and clinical studies for the prevention of anastomotic dehiscence. However, little is known regarding their impact on diabetic patients...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27897974/delayed-coloanal-anastomosis-for-rectovaginal-fistula-after-colorectal-resection-for-deep-endometriosis
#9
Gaetano Gallo, Alberto Realis Luc, Roberta Tutino, Giuseppe Clerico, Mario Trompetto
AIM: The deep infiltrating endometriosis, defined as a subperitoneal infiltration of endometrial implants of ≥ 5 mm involving not only the colorectal tract but also rectovaginal septum, vagina and bladder often requires a challenging surgery. Endometriosis nodes of the rectovaginal septum, if symptomatic, need a resection of the involved colorectal tract with colorectal or coloanal anastomosis. Unfortunately in these cases is not uncommon the possibility of a postoperative rectovaginal fistula (RVF), caused by the weakness of the septum that must be skeletonized to completely remove the endometriosis nodes...
November 28, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27894710/bowel-dysfunction-after-anastomotic-leakage-in-laparoscopic-sphincter-saving-operative-intervention-for-rectal-cancer-a-case-matched-study-in-46-patients-using-the-low-anterior-resection-score
#10
Elisabeth Hain, Gilles Manceau, Léon Maggiori, Cécile Mongin, Justine Prost À la Denise, Yves Panis
BACKGROUND: After sphincter-saving operation for rectal cancer, the impact of anastomotic leakage on function has been well studied. The purpose of the present work was to assess the influence of symptomatic and asymptomatic anastomotic leakage on bowel function and health-related quality of life using the Low Anterior Resection Syndrome score and the disease-specific questionnaire European Organization for Research and Treatment of Quality of Life Questionnaire for Colorectal Cancer...
November 25, 2016: Surgery
https://www.readbyqxmd.com/read/27870782/safety-of-laparoscopic-colorectal-resection-in-patients-with-severe-comorbidities
#11
Nobuki Ichikawa, Shigenori Homma, Kazuaki Nakanishi, Keizo Kazui, Sayuri Kashiwakura, Masafumi Ohira, Takeshi Tsuji, Takashi Suzuki, Tomohiro Ishikawa, Akinobu Taketomi
We aimed to assess the safety of laparoscopic colorectal resection in patients with severe comorbidities. High operative risk was defined as an American Society of Anesthesiologists (ASA) class 3 score. Outcomes in 34 patients with an ASA score of 3 undergoing laparoscopic surgery (LAP3) were compared with 172 laparoscopic surgery patients with an ASA score ≤2 (LAP2) and 32 laparotomy patients with an ASA score of 3 (OP3). The postoperative complication rate in LAP3 was similar to that seen in LAP2 and significantly lower than that seen in OP3 (LAP2, 4...
December 2016: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/27853330/effect-of-human-amniotic-membrane-on-prevention-of-colorectal-anastomosis-leakage-in-cases-with-neoadjuvant-radiotherapy-an-experimental-animal-study
#12
Sam Moslemi, Sajjad Ahmadi Joraghi, Reza Roshanravan, Leila Ghahramani, Mohammad Mohammadianpanah, Masood Hosseinzadeh, Abbas Rezaianzadeh, Ahmed Mohammed Ali Hussein, Neda Najibpour, Seyed Vahid Hosseini
BACKGROUND: Radiotherapy is one of the most important factors which results in negative effects on wound healing and increases anastomosis leakage. Diverting loop ileostomy has been usually performed after colorectal anastomosis in cases of colorectal cancer with a history of neoadjuvant radiotherapy to decrease the chance of leakage. Considering the side effects of diverting loop ileostomy, the objective of the present study is to investigate the effect of human amniotic membrane (HAM) on colorectal anastomosis leakage after neo-adjuvant radiotherapy...
November 2016: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/27832466/cost-effectiveness-analysis-of-the-temporary-percutaneous-ileostomy-for-faecal-diversion-after-colorectal-resection-in-elderly
#13
W Bugiantella, F Rondelli, L Mariani, A Polistena, A Sanguinetti, N Avenia, E Mariani
BACKGROUND: Conventional loop ileostomy (CLI) is a suitable procedure for transitory faecal diversion after colorectal anastomosis, but it causes relevant morbidities (dehydration, discomfort, peristomal infections) and requires a second operation to be closed. We already described an alternative technique of temporary percutaneous ileostomy (TPI), which can be removed without surgery. AIMS: We analyse the outcomes and the costs of the TPI in protecting low colorectal anastomosis in elderly, compared to the CLI...
November 10, 2016: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/27792472/management-of-peritonitis-after-minimally-invasive-colorectal-surgery-can-we-stick-to-laparoscopy
#14
Alessandra Marano, Maria Carmela Giuffrida, Giorgio Giraudo, Luca Pellegrino, Felice Borghi
BACKGROUND: Although laparoscopy is becoming the standard of care for the treatment of colorectal disease, its application in case of postoperative peritonitis is still not widespread. The objective of this article is to evaluate the role of laparoscopy in the management of postoperative peritonitis after elective minimally invasive colorectal resection for malignant and benign diseases. MATERIALS AND METHODS: Between April 2010 and May 2016, 536 patients received primary minimally invasive colorectal surgery at our Department...
October 28, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27783239/risk-scores-as-useful-predictors-of-perioperative-complications-in-patients-with-rectal-cancer-who-received-radical-surgery
#15
Hiroshi Miyakita, Sotaro Sadahiro, Gota Saito, Kazutake Okada, Akira Tanaka, Toshiyuki Suzuki
BACKGROUND: Rectal cancer is associated with a higher rate of surgical complications. The ability to predict the risk of complications before treatment would facilitate the design of personalized treatment strategies optimally suited for each patient. METHODS: We retrospectively studied 260 patients with rectal cancer who underwent radical surgery to examine the relations between complications and 5 types of risk scores. RESULTS: Complications developed in 56 patients (21...
October 25, 2016: International Journal of Clinical Oncology
https://www.readbyqxmd.com/read/27781246/-influences-of-inferior-mesenteric-artery-types-and-riolan-artery-arcade-absence-on-the-incidence-of-anastomotic-leakage-after-laparoscopic-resection-of-rectal-cancer
#16
Jun Huang, Jiaming Zhou, Yingjie Wan, Yanghao Lin, Yanhong Deng, Zhiyang Zhou, Jianping Qiu, Jianping Wang, Meijin Huang
OBJECTIVE: To evaluate the influences of inferior mesenteric artery (IMA) types and Riolan artery arcade absence on the incidence of anastomotic leakage(AL) after laparoscopic resection of rectal cancer. METHODS: Clinical data of 116 local advanced rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from January 2012 to December 2014 were analyzed retrospectively. IMA and Riolan artery arcade were examined by preoperative computed tomography angiography (CTA) reconstruction...
October 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27756644/intraoperative-modifiable-risk-factors-of-colorectal-anastomotic-leakage-why-surgeons-and-anesthesiologists-should-act-together
#17
REVIEW
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...
December 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27721925/minimally-invasive-management-of-anastomotic-leaks-in-colorectal-surgery
#18
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
https://www.readbyqxmd.com/read/27682998/fluorescent-angiography-used-to-evaluate-the-perfusion-status-of-anastomosis-in-laparoscopic-anterior-resection
#19
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...
December 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27671222/a-collaborative-review-of-the-current-concepts-and-challenges-of-anastomotic-leaks-in-colorectal-surgery
#20
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 longterm morbidity and health-care resources has received relatively little attention. Controversy continues regarding the best strategies to reduce the risk. Diagnostic tests lack sensitivity and specificity, resulting in delayed diagnosis and increased morbidity...
January 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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