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colorectal anastomotic leakage

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https://www.readbyqxmd.com/read/29754169/short-and-long-term-outcomes-after-colorectal-anastomotic-leakage-is-affected-by-surgical-approach-at-reoperation
#1
Jens Ravn Eriksen, Henrik Ovesen, Ismail Gögenur
BACKGROUND: Anastomotic leakage is the most serious surgical complication following colorectal resection, and surgical intervention is often required. The purpose of the study was to investigate short- and long-term outcomes after reoperation for anastomotic leakage. METHOD: Patients with a symptomatic anastomotic leakage following a laparoscopic colorectal cancer resection from January 2009 to December 2014 were identified from our local prospective database. Patients were grouped according to the management of anastomotic leaks: local, lap, or open approach...
May 12, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29721734/short-term-outcomes-and-benefits-of-eras-program-in-elderly-patients-undergoing-colorectal-surgery-a-case-matched-study-compared-to-conventional-care
#2
Patricia Tejedor, Carlos Pastor, Santiago Gonzalez-Ayora, Mario Ortega-Lopez, Hector Guadalajara, Damian Garcia-Olmo
PURPOSE: The aim of the study was to evaluate the benefits of implementing Enhanced Recovery After Surgery (ERAS) protocols in elderly patients undergoing elective colorectal surgery. METHODS: A retrospective non-randomized cohort study was conducted from September 2012 to December 2016. We included patients ≥ 70 years undergoing elective colorectal surgery. Outcome measures, compliance with interventions, and postoperative complications of patients treated under ERAS were case-matched (based on gender, age, type of surgery, and the presence/absence of a temporal stoma) to a retrospective group of patients ≥ 70 years treated under conventional care...
May 3, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29701133/a-new-perspective-on-vacuum-assisted-closure-for-the-treatment-of-anastomotic-leak-following-low-anterior-resection-for-rectal-cancer-is-it-worthy
#3
Rosa Maria Jimenez-Rodriguez, Angela Araujo-Miguez, Salvador Sobrino-Rodriguez, Frederick Heller, Jose M Díaz-Pavon, Juan M Bozada Garcia, Fernando De la Portilla
BACKGROUND: Anastomotic dehiscence is a common complication of anterior resection. In this work, we evaluate the management of the pelvic cavity after low rectal resection using vacuum closure (VAC) with a gastroscope, and we establish factors that determine the success of closure and analyzed the rate of ileostomy closure after leakage was resolved. PATIENTS AND METHODS: This is a descriptive case series analysis conducted at a tertiary hospital. Twenty-two patients with low colorectal anastomosis leakage or opening of the rectal stump after anterior resection for rectal cancer were included...
April 1, 2018: Surgical Innovation
https://www.readbyqxmd.com/read/29696058/our-20-year-experience-with-experimental-colonic-anastomotic-healing
#4
REVIEW
Dimitrios Raptis, Manousos-Georgios Pramateftakis, Ioannis Kanellos
Aim: To present our experience with experimental colonic anastomoses and compare it with the results of other experienced researchers. Materials and Method: The published experimental studies of our research group up to 1996, as well as results of other researchers in this field, are demonstrated and discussed. Different actions of administered substances on the anastomotic healing were compared and represented. Various chemotherapeutic agents were evaluated in experimental models without colorectal cancer as independent risk factors for the anastomotic healing...
January 2018: Journal of Medicine and Life
https://www.readbyqxmd.com/read/29682719/-evolution-and-prospect-of-colorectal-anastomosis
#5
Qi Liu, Xinxiang Li
Colorectal cancer is the third most common malignant tumor among men, and the second most common malignant tumor among women worldwide. As one of the most common malignant tumor, colorectal cancer has a great threat to the health of people. Although the development of radiotherapy and chemotherapy could improve the prognosis of colorectal cancer, surgery, the complete resection of the tumor, remains the only chance for the cure of this disease. Over the past hundred years, surgical oncology went in the direction of protecting organ function and improving quality of life...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682710/-surgical-skills-in-the-prevention-of-anastomotic-leakage-after-rectal-neoplasm-surgery
#6
Qianqian Shao, Guole Lin
For colorectal surgeons, how to reduce anastomotic leakage after laparoscopic rectal cancer surgery remains to be challenging. We provide a brief discussion regarding the surgical skills required to prevent anastomotic leakage after rectal cancer surgery, such as the following: 1) Low ligation of inferior mesenteric vessel during laparoscopic total mesorectal excision can improve anastomotic tension and blood supply, thus reducing the risk of anastomotic leakage. While high ligation of inferior mesenteric artery results in poor blood supply and high tension in atastomotic site, thus increasing the risk of anastomotic leakage...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682705/-reflection-on-the-present-study-of-anastomotic-leakage-after-colorectal-surgery
#7
Zhouqiao Wu, Jinyao Shi, Ziyu Li, Jiafu Ji
Anastomotic leakage is one of the most serious complications of colorectal surgery. Despite progress in available surgical techniques, the morbidity associated with anastomotic leakage remains high. In this review, we summarize the current clinical status of this complication, the problems it causes, and relevant research achievements. To date, a lack of consensus regarding the diagnosis of anastomotic leakage has resulted in varying rates of diagnosis across countries and regions worldwide. Accurately predicting the occurrence of anastomotic leakage using the established risk factors and preoperative scoring systems remains difficult...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682704/-anastomotic-leakage-after-rectal-cancer-surgery-classification-and-management
#8
Pan Chi, Shenghui Huang
Many studies have focused on the identification of risk factors and prevention of anastomotic leakage following rectal cancer surgery. However, there is little knowledge regarding classification and management of anastomotic leakage in clinic. Herein, we reviewed and summarized the classification and management of anastomotic leakage after rectal cancer surgery. The relevant treatments of anastomotic leakage should be chosen based on patient's manifestation, including general and local reactions, anatomical location, and nature of the leakage (contained or free, controlled or uncontrolled leakage)...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29671066/hartmann-s-reversal-after-colonic-perforation-or-anastomosis-leakage-is-it-the-same-procedure-a-retrospective-study-of-150-patients
#9
Nathalie Chereau, Jeremie H Lefevre, Najim Chafai, Thevy Hor, Clotilde Debove, Emmanuel Tiret, Yann Parc
PURPOSE: The high morbidity rates reported might influence surgeons' decisions of whether to perform Hartmann's reversal (HR). Our aim was to report the results of HR after "primary" Hartmann's procedure (HP) or in redo surgery for failed anastomosis. METHODS: All patients operated between 2007 and 2015 were included. Data and postoperative course were obtained from a review of medical records and databases. RESULTS: One hundred fifty patients (age 60, range (20-91) years, 62% male) were included...
April 18, 2018: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/29611153/indocyanine-green-icg-enhanced-fluorescence-for-intraoperative-assessment-of-bowel-microperfusion-during-laparoscopic-and-robotic-colorectal-surgery-the-quest-for-evidence-based-results
#10
Alberto Mangano, Federico Gheza, Liaohai Leo Chen, Eleonora Maddalena Minerva, Pier Cristoforo Giulianotti
Anastomotic leakage is a severe complication after colonic/rectal surgery. One of the most important causes of anastomotic leakage is poor vascular supply. However, microvascular impairment at the anastomotic site is very often not detected intraoperatively by observation under white light. Indocyanine green (ICG)-enhanced fluorescence is a technology that may be useful for detecting microvascular alterations and potentially preventing anastomotic leakage. The aim of this Editorial-Minireview is to briefly and critically assess the literature evidence regarding the feasibility of using an ICG ?uorescent tracer for detecting microvascular changes in the perianastomotic tissue and its potential role in preventing anastomotic leakage...
March 29, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29609024/short-interval-between-preoperative-short-course-radiotherapy-and-operation-for-rectal-cancer-increases-anastomotic-leakage
#11
Cloë L Sparreboom, Zhouqiao Wu, Hester F Lingsma, Anand G Menon, Gert-Jan Kleinrensink, Joost J Nuyttens, Michel Wjm Wouters, Johan F Lange
BACKGROUND: Short-course preoperative radiotherapy is indicated in patients with resectable rectal cancer to control local recurrence. Although no clear evidence is available, short-course radiotherapy with surgery within a week is common practice. The aim of this study was to investigate the impact of timing of surgery for rectal cancer after short-course radiotherapy on anastomotic leakage. STUDY DESIGN: Data from the Dutch ColoRectal Audit (DCRA) were used. All patients who received short-course preoperative radiotherapy and underwent elective surgery within 14 days for rectal cancer between January 1st, 2011 and December 31th, 2016 were included...
March 30, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29602975/standardization-of-surgical-procedures-to-reduce-risk-of-anastomotic-leakage-reoperation-and-surgical-site-infection-in-colorectal-cancer-surgery-a-retrospective-cohort-study-of-1189-patients
#12
Ken Eto, Mitsuyoshi Urashima, Makoto Kosuge, Masahisa Ohkuma, Rota Noaki, Kai Neki, Daisuke Ito, Yasuhiro Takeda, Hiroshi Sugano, Katsuhiko Yanaga
PURPOSE: Anastomotic leakage (AL) and surgical site infection (SSI) are prevalent complications of colorectal surgery. To lower this risk, we standardized our surgical procedures in 2012, with a preferential use of laparoscopic approach (LS) for both colon and rectal surgery, combined with triangulating anastomosis (TA) for colon surgery and defunctioning ileostomy (DI) for low anterior resection. Our aim was to evaluate the outcomes of our standardized procedures. METHODS: The incidence rate of AL (primary outcome) and of reoperation and SSI (secondary outcome) was compared before (early period, n = 648) and after (late period, n = 541) standardization, through a retrospective analysis...
March 30, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29577556/the-effect-of-increasing-body-mass-index-on-laparoscopic-surgery-for-colon-and-rectal-cancer
#13
Stephen Bell, Joseph C Kong, Roger Wale, Margaret Staples, Karen Oliva, Simon Wilkins, Paul Mc Murrick, Satish K Warrier
BACKGROUND: Obesity is common in Western countries and its prevalence is increasing. Colorectal cancer is common, and surgery for colorectal cancer is technically more challenging in obese patients. Laparoscopic surgery for colon cancer has been shown to be oncologically equivalent, with improved short- term outcomes. Laparoscopic surgery for rectal cancer has proven technically challenging, and recent results have raised concerns about oncologic equivalence. OBJECTIVE: To evaluate the effect of body mass index (BMI) on the clinical and oncological outcomes of surgery for colorectal cancer, including the rate at which laparoscopic surgery is attempted and the rate at which laparoscopic surgery is converted to open surgery...
March 25, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29577216/-application-of-inner-figure-of-eight-suture-to-laparoscopic-colorectal-surgery
#14
Jianjun Chen, Ming Zhong
Regardless of laparoscopic or open colorectal surgeries, intestinal anastomosis is usually an important operative procedure. Even if stapler is widely used in different intestinal surgery nowadays, hand sewn suture is an indispensable procedure in clinical practice, meanwhile after stapled anastomosis, additional hand sewn suture is usually performed to ensure the safety of anastomosis. The inner figure-of-eight suture is a single layer suture technique which has been widely used in skin, tendon, rectus and uterus for quick and secure approximation...
March 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29566371/influence-of-visceral-fat-in-the-outcomes-of-colorectal-cancer
#15
André Goulart, Nuno Malheiro, Hugo Rios, Nuno Sousa, Pedro Leão
AIM: To determine the relationship of visceral fat (VF) with the surgical outcome of the patients with colorectal cancer (CRC) submitted to curative surgery. METHODS: Retrospective analysis of all patients submitted to CRC surgery during 3 years with a minimum of 5 years of follow-up. We assessed the length of hospital stay, complications, pathologic reports, surgical re-interventions and hospital re-admissions, relapses, survival time and disease-free time. VF was calculated based on patients' pre-operative CT-scan...
March 22, 2018: Digestive Surgery
https://www.readbyqxmd.com/read/29566031/assessment-of-mmp-2-9-expression-by-fluorescence-endoscopy-for-evaluation-of-anastomotic-healing-in-a-murine-model-of-anastomotic-leakage
#16
Philipp-Alexander Neumann, Vanessa Twardy, Felix Becker, Christiane Geyer, Katrin Schwegmann, Annika Mohr, Andreas Faust, Philipp Lenz, Emile Rijcken
BACKGROUND: Disturbance of intestinal wound closure leads to insufficient anastomotic healing and is associated with considerable morbidity following colorectal resections. Matrix metalloproteinases (MMPs) play a crucial role in regulation of wound closure. Here fluorescence endoscopy was evaluated for assessment of MMP-2/-9 expression during failed intestinal anastomotic healing. METHODS: Distal colonic anastomoses were performed as a model for disturbed healing in 36 Balb/c mice...
2018: PloS One
https://www.readbyqxmd.com/read/29564651/effectiveness-of-mechanical-bowel-preparation-versus-no-preparation-on-anastomotic-leakage-in-colorectal-surgery-a-systematic-review-and-meta-analysis
#17
REVIEW
Jobbe P L Leenen, Judith E K R Hentzen, Henrietta D L Ockhuijsen
It has been a standard practice to perform mechanical bowel preparation (MBP) prior to colorectal surgery to reduce the risk of colorectal anastomotic leakages (CAL). The latest Cochrane systematic review suggests there is no benefit for MBP in terms of decreasing CAL, but new studies have been published. The aim of this systematic review and meta-analysis is to update current evidence for the effectiveness of preoperative MBP on CAL in patients undergoing colorectal surgery. Consequently, PubMed, MEDLINE, Embase, CENTRAL and CINAHL were searched from 2010 to March 2017 for randomised controlled trials (RCT) that compared the effects of MBP in colorectal surgery on anastomotic leakages...
March 21, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29551948/application-of-fast-track-surgery-in-routine-nursing-for-patient-with-colorectal-cancer
#18
Yongrui Liu
Objective : To investigate the clinical effect of fast track surgery (FTS) in perioperative nursing of colorectal cancer surgery. Background : In recent years, many complicated surgery began to develop in the direction of low invasion and short hospital time, which provides an unprecedented opportunity for the development of fast track surgery (FTS). Methods : According to different nursing measures, 156 cases of colorectal cancer patients treated in our hospital were divided into FTS nursing group (86 cases) and traditional nursing group (70 cases)...
December 2017: Saudi Journal of Biological Sciences
https://www.readbyqxmd.com/read/29529206/mechanical-bowel-preparation-mbp-prior-to-elective-colorectal-resections-in-crohn-s-disease-patients
#19
Igors Iesalnieks, Melanie Hoene, Theresa Bittermann, Hans J Schlitt, Christina Hackl
Background: Studies addressing the role of mechanical bowel preparation (MBP) in Crohn's disease (CD) patients are lacking. Methods: Consecutive elective colorectal resections for CD have been included in the present analysis. Exclusion criteria were small bowel resections not including colon, urgent surgeries, surgeries for cancer, and abdominoperineal resections for perianal disease. MBP was performed routinely between 1992 and 2004, omitted between 2005 and 2015, and reintroduced in 2016...
March 19, 2018: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/29525185/-evidence-based-ways-of-colorectal-anastomotic-complications-prevention-in-the-setting-of-digestive-deep-endometriosis-resection-cngof-has-endometriosis-guidelines
#20
J Loriau, E Petit, A Mephon, B Angliviel, E Sauvanet
Management of deep pelvic and digestive endometriosis can lead to colorectal resection and anastomosis. Colorectal anastomosis carries risks for dreaded infectious and functional morbidity. The aim of the study was to establish, regarding the published data, the role of the three most common used surgical techniques to prevent such complications: pelvic drainage, diverting stoma, epiplooplasty. Even if many studies and articles have focused on colorectal anastomotic leakage prevention in rectal cancer surgery data regarding this topic in the setting of endometriosis where lacking...
March 2018: Gynecologie, Obstetrique, Fertilite & Senologie
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