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colorectal anastomotic leakage

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https://www.readbyqxmd.com/read/28304142/biomarkers-and-anastomotic-leakage-in-colorectal-surgery-c-reactive-protein-trajectory-is-the-gold-standard
#1
Stephen R Smith, Peter Pockney, Ryan Holmes, Fiona Doig, John Attia, Elizabeth Holliday, Rosemary Carroll, Brian Draganic
BACKGROUND: Anastomotic leakage is a feared complication following colorectal surgery. Early prediction results in improved clinical outcome, but accurate predictive factors remain elusive. Many biomarkers have been studied with respect to diagnosis of anastomotic leakage but the concept of trajectory testing, using biomarkers, has not been assessed with regards to early diagnosis of anastomotic leak. METHODS: C-reactive protein (CRP), procalcitonin (PCT), white cell count (WCC) and gamma-glutamyl transferase were assessed for predictive utility in diagnosing anastomotic leakage with emphasis on identifying an association with change in their levels or trajectory...
March 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28295255/systematic-review-of-the-role-of-biomarkers-in-diagnosing-anastomotic-leakage-following-colorectal-surgery
#2
REVIEW
B U Su'a, H L Mikaere, J L Rahiri, I B Bissett, A G Hill
BACKGROUND: Anastomotic leakage (AL) following colorectal surgery can be difficult to diagnose owing to varying clinical presentations. This systematic review aimed to assess biomarkers as potential diagnostic tests for preclinical detection of AL. METHODS: A comprehensive literature review was conducted according to PRISMA guidelines. All published studies evaluating biomarkers, both systemic and peritoneal, in the context of AL following colorectal surgery were included...
April 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28285536/comparison-of-short-term-outcomes-between-laparoscopic-assisted-and-open-complete-mesocolic-excision-cme-for-the-treatment-of-transverse-colon-cancer
#3
COMPARATIVE STUDY
Yong Wang, Chuan Zhang, Yi-Fei Feng, Zan Fu, Yue-Ming Sun
BACKGROUND: Colorectal cancer (CRC) is the third most common cancer worldwide. Although laparoscopic-assisted complete mesocolic excision (LCME) is a superior treatment, there are few studies available on it owe to the low incidence and technical difficulty of LCME in transverse colon cancer. METHODS: The clinical data of 78 patients with transverse colon cancer who were treated by LCME and open complete mesocolic excision (OCME) were retrospectively analyzed. A total of 39 cases had been treated by LCME, compared with 39 cases treated by OCME...
February 2017: Chinese Clinical Oncology
https://www.readbyqxmd.com/read/28281123/icg-fluorescence-imaging-for-quantitative-evaluation-of-colonic-perfusion-in-laparoscopic-colorectal-surgery
#4
Toshiaki Wada, Kenji Kawada, Ryo Takahashi, Mami Yoshitomi, Koya Hida, Suguru Hasegawa, Yoshiharu Sakai
BACKGROUND: Fluorescence technology with indocyanine green (ICG) provides a real-time assessment of intestinal perfusion. However, a subjective evaluation of fluorescence intensity based on the surgeon's visual judgement is a major limitation. This study evaluated the quantitative assessment of ICG fluorescence imaging in determining the transection line of the proximal colon during laparoscopic colorectal surgery. METHODS: This is a retrospective analysis of a prospectively maintained database of 112 patients who underwent laparoscopic surgery for left-sided colorectal cancers...
March 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28267012/bmi-as-a-predictor-for-perioperative-outcome-of-laparoscopic-colorectal-surgery-a-pooled-analysis-of-comparative-studies
#5
Yazhou He, Jiarong Wang, He Bian, Xiangbing Deng, Ziqiang Wang
BACKGROUND: There has been a long-lasting controversy about whether higher BMI is associated with worse perioperative outcomes of laparoscopic colorectal surgery. Recently, a number of newly published investigations have made it possible to draw a quantitative conclusion. OBJECTIVE: We conducted this comprehensive meta-analysis to clarify the exact effect that BMI imposes on perioperative outcome of laparoscopic colorectal surgery. DATA SOURCES: We systematically searched MEDLINE, Embase, and Cochrane Library databases to identify all relevant studies...
April 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28261765/complicated-colorectal-cancer-in-nonagenarian-patients-is-it-better-not-to-perform-anastomosis-in-emergency
#6
Belinda De Simone, Federico Coccolini, Luca Ansaloni, Antonio Tarasconi, Gianluca Baiocchi, Nereo Vettoretto, Peggy Joly, Marianne Ferron, Alessandro Pozzo, Lionel Charre, Salomone Di Saverio, Josephine Andrea Napoli, Ferdinando Agresta, Massimo Sartelli, Fausto Catena
BACKGROUND: Colorectal cancer (CRC) is predominantly a disease of elderly people. Cancer in nonagenarian patients presents an ethical dilemma for surgeons and oncologists, and management of this group of patients in emergency for complicated CRC is debated. Presently described is retrospective study reporting experience of 6 departments of emergency surgery with management of nonagenarian patients sent to emergency surgery for CRC complications. METHODS: Data concerning patients aged over 90 years hospitalized from January 2011 to June 2015 in 6 departments of emergency surgery for complicated CRC were retrospectively analyzed...
January 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28209099/does-calcium-score-in-great-pelvic-vessels-predict-colorectal-anastomotic-leakage-a-prospective-study-of-one-hundred-anastomoses
#7
M T Norooz, H Moradi, M Safdarian, F Jahangiri, H A Amoli
BACKGROUND: Anastomotic leakage is one of the most severe surgical complications following surgery. This prospective study was designed to investigate an association between the calcification in the descending aorta and its major branches using a calcium-scoring software and colorectal anastomotic leakage. METHODS: From January 2012 to March 2013, one hundred patients underwent surgeries involving colorectal anastomosis procedures. Calcium score in descending aorta and great pelvic vessels was measured using the Syngo-CT 2006G-W software...
September 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/28195642/functional-mucous-layer-and-healing-of-proximal-colonic-anastomoses-in-an-experimental-model
#8
J W A M Bosmans, A C H M Jongen, G M H Birchenough, E E L Nyström, M J J Gijbels, J P M Derikx, N D Bouvy, G C Hansson
BACKGROUND: Anastomotic leakage (AL) is the most dreaded complication after colorectal surgery, causing high morbidity and mortality. Mucus is a first line of defence against external factors in the gastrointestinal tract. In this study, the structural mucus protein Muc2 was depleted in genetically engineered mice and the effect on healing of colonic anastomoses studied in an experimental model. METHODS: Mice of different Muc2 genotypes were used in a proximal colonic AL model...
February 13, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28166091/oral-polyphosphate-suppresses-bacterial-collagenase-production-and-prevents-anastomotic-leak-due-to-serratia-marcescens-and-pseudomonas-aeruginosa
#9
Sanjiv K Hyoju, Robin E Klabbers, Melissa Aaron, Monika A Krezalek, Alexander Zaborin, Mara Wiegerinck, Neil H Hyman, Olga Zaborina, Harry Van Goor, John C Alverdy
OBJECTIVE: The objective of this study was to determine the effect of polyphosphate on intestinal bacterial collagenase production and anastomotic leak in mice undergoing colon surgery. BACKGROUND: We have previously shown that anastomotic leak can be caused by intestinal pathogens that produce collagenase. Because bacteria harbor sensory systems to detect the extracellular concentration of phosphate which controls their virulence, we tested whether local phosphate administration in the form of polyphosphate could attenuate pathogen virulence and prevent leak without affecting bacterial growth...
February 3, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28153961/novel-insight-into-the-role-of-microbiota-in-colorectal-surgery
#10
REVIEW
Radu Bachmann, Daniel Leonard, Nathalie Delzenne, Alex Kartheuser, Patrice D Cani
Recent literature undeniably supports the idea that the microbiota has a strong influence on the healing process of an intestinal anastomosis. Understanding the mechanisms by which the bacterial community of the gut influences intestinal healing could open the door for new preventive and therapeutic approaches. Among the different mechanisms, data have shown that the production of specific reactive oxygen species (ROS) and the activation of specific formyl peptide receptors (FPRs) regulate intestinal wound healing...
April 2017: Gut
https://www.readbyqxmd.com/read/28141746/tumor-size-as-an-independent-risk-factor-for-postoperative-complications-in-laparoscopic-low-anterior-resection-for-advanced-rectal-cancer-a-multicenter-japanese-study
#11
Masayoshi Yasui, Ichiro Takemasa, Yuichiro Miyake, Taishi Hata, Masataka Ikeda, Yasuhiro Miyake, Junichi Hasegawa, Hirofumi Ota, Chu Matsuda, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
This study aimed to identify the risk factors for postoperative complications after laparoscopic low anterior resection for the treatment of advanced rectal cancers. A prospectively maintained database was retrospectively analyzed. Oncological parameters in resected specimens and clinical risk factors for postoperative complications, including anastomotic leakage, were examined in patients with clinical stage II and III upper rectal cancer who underwent laparoscopic low anterior resection, including total mesorectal excision...
January 30, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28124742/the-small-height-of-an-anastomotic-colonic-doughnut-is-an-independent-risk-factor-of-anastomotic-leakage-following-colorectal-resection-results-of-a-prospective-study-on-154-consecutive-cases
#12
François Cauchy, Solafah Abdalla, Christophe Penna, Benjamin Angliviel, Benoit Lambert, Bruno Costaglioli, Antoine Brouquet, Stéphane Benoist
PURPOSE: The aim of this prospective study was to assess the influence of morphological characteristics of anastomotic doughnuts on the risk of anastomotic leakage (AL) after double-stapled colorectal anastomosis. METHODS: This single-center prospective study enrolled all patients undergoing double-stapled colorectal anastomosis between December 2012 and December 2015. Maximal diameter and minimal and maximal heights and widths of both colonic and rectal doughnuts were measured by surgeons in the operating room...
January 26, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28072899/endoluminal-vacuum-therapy-as-treatment-for-anastomotic-colorectal-leakage
#13
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
#14
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
#15
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
#16
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...
March 2017: 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
#17
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
#18
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
#19
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
#20
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
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