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colorectal anastomotic leakage

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
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...
February 24, 2018: Inflammatory Bowel Diseases
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 7, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
J Trotter, L Onos, C McNaught, M Peter, M Gatt, K Maude, J MacFie
Introduction One of the most feared complications of colorectal surgery is anastomotic leak. Numerous techniques have been studied in the hope of decreasing leakage. This study was designed to assess the handling characteristics of a novel adhesive tissue patch (TissuePatch™; Tissuemed, Leeds, UK) applied to colorectal anastomoses in a pilot study. This was with a view to assessing its potential role in aiding anastomotic healing in subsequent trials. Methods A patch was applied to colorectal anastomoses after the surgeon had completed the anastomosis and prior to abdominal closure...
March 2018: Annals of the Royal College of Surgeons of England
Elisa Cassinotti, Stefano Costa, Stefano DE Pascale, Barbara Oreggia, Giorgio Palazzini, Luigi Boni
BACKGROUND: Anastomotic leakage (AL) is a serious complication in colorectal surgery leading to significant morbidity and mortality. Progressively lower anastomoses are associated with a greater leak rate. Adequate bowel perfusion has been stressed as one of the key elements for suture healing. Currently, there is no widespread method to assess and quantify the perfusion of gastrointestinal anastomoses intraoperatively, besides the subjective evaluation by the surgeon. The aim of this paper is to describe the basis of Indocyanine Green (ICG) fluorescence guided surgery applied to assessment of bowel perfusion and to highlight studies on the use of fluorescence angiography (FA) in laparoscopic rectal surgery...
February 21, 2018: Minerva Chirurgica
Attila Bokor, Peter Lukovich, Noemi Csibi, Thomas D'Hooghe, Dan Lebovic, Reka Brubel, Janos Rigo
STUDY OBJECTIVE We first present a detailed description of a modified NOSE-colectomy technique. Secondly, we report the postoperative outcomes of our prospective case series when compared to conventional laparoscopic bowel resection in a relatively large series of patients. DESIGN Canadian Task Force Classification II-1. SETTING University tertiary referral center. PATIENTS Patient selection The last 90 consecutive patients in our care with DIE of the bowel are presented in this study. Patients were diagnosed at the 1st Department of OB/GYN Semmelweis Universtiy Budapest, Hungary...
February 14, 2018: Journal of Minimally Invasive Gynecology
Yafan Yang, Guiying Wang, Jingli He, Jianfeng Zhang, Jinchuan Xi, Feifei Wang
BACKGROUND: Colorectal cancer surgery includes "high tie" and "low tie"of the inferior mesenteric artery(IMA). However, different ligation level is closely related to the blood supply of anastomosis, which may increase the leakage rate, and it is unclear which technique confers a lower anastomotic leakage rate(AL) and survival advantage. OBJECTIVE: To compare the effectiveness and impact of inferior mesenteric artery (IMA) high ligation versus IMA low ligation on anastomotic leakage, lymph nodes yield rates and 5-year survival...
February 9, 2018: International Journal of Surgery
Emmeline G Peters, Boudewijn J J Smeets, Jesper Nors, Christian M Back, Jonas A Funder, Thorbjørn Sommer, Søren Laurberg, Uffe S Løve, Wouter K G Leclercq, Gerrit D Slooter, Tammo S de Vries Reilingh, Johannes A Wegdam, Grard A P Nieuwenhuijzen, Mickaël Hiligsmann, Marc P Buise, Willem A Buurman, Wouter J de Jonge, Harm J T Rutten, Misha D P Luyer
BACKGROUND: Postoperative ileus and anastomotic leakage severely impair recovery after colorectal resection. We investigated the effect of perioperative lipid-enriched enteral nutrition versus standard care on the risk of postoperative ileus, anastomotic leakage, and other clinical outcomes. METHODS: We did an international, multicentre, double-blind, randomised, controlled trial of patients (≥18 years) undergoing elective colorectal surgery with primary anastomosis at six clinical centres in the Netherlands and Denmark...
February 6, 2018: Lancet. Gastroenterology & Hepatology
Felix J Hüttner, Rene Warschkow, Bruno M Schmied, Markus K Diener, Ignazio Tarantino, Alexis Ulrich
BACKGROUND: There is limited information regarding the impact of anastomotic leakage on oncologic outcome in exclusively colon cancer patients. METHODS: The colorectal database of the Department of Surgery of the University of Heidelberg was used to assess the impact of anastomotic leakage on oncologic outcome in patients undergoing curative resection for Stage I-III colon cancer. Risk-adjusted Cox regression analysis and propensity score methods were used to assess overall, disease-free, and relative survival...
January 30, 2018: European Journal of Surgical Oncology
Ryo Otsuka, Shuji Saito, Ryouichi Hirayama, Yasuaki Miura, Kazunori Sasaki, Ayako Miyajima, Nobutsuna Kuwamoto, Ryoko Kataoka, Yukito Shindo, Rikiya Fujita
INTRODUCTION: Colonic stent insertion is widely used as a bridge to surgery(BTS)for obstructive colorectal cancer. Stenting can shorten hospitalization and decrease complication and colostomy rates in comparison with emergency surgery. We investigated patients who underwent colonic stent insertion for BTS in our hospital. PATIENTS: Sixteen patients(8 men, 8 women) with a colorectal obstruction score of 0 or 1 who underwent colonic stent insertion as a BTS between April 2015 and April 2017 period were investigated...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Makoto Aoki, Hiroyuki Fukunari, Yosuke Kawai, Akemi Watanabe, Yuya Umebayashi, Toshifumi Saito, Kenji Shitara, Tetsuji Hayashi
A 67-year-old woman underwent laparoscopy-assisted left hemicolectomy for early descending colon cancer(pTis, pN0, cH0, cM0, Stage 0).Her postoperative course was uneventful, without fever and/or tenderness at the anastomotic site.A month following discharge from the hospital, enhanced computed tomography revealed a liver abscess measuring 80mm in diameter at the lateral segment and a left adrenal abscess measuring 30mm in diameter.Although some free air and fluid collection was noted near the anastomotic site, there was no tenderness, and a gastrografin enema did not reveal leakage and/or pooling of the contrast agent near the anastomotic site...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Madhuri Pattamatta, Boudewijn J J Smeets, Silvia M A A Evers, Harm J T Rutten, Misha D P Luyer, Mickael Hiligsmann
BACKGROUND: Postoperative ileus (POI) and anastomotic leakage (AL) following colorectal surgery severely increase healthcare costs and decrease quality of life. This study evaluates the effects of reducing POI and AL via perioperative gum chewing compared to placebo (control) on in-hospital costs, health-related quality of life (HRQoL), and assesses cost-effectiveness. METHODS: In patients undergoing elective, open colorectal surgery, changes in HRQoL were assessed using EORTC-QLQ-C30 questionnaires and costs were estimated from a hospital perspective...
January 30, 2018: Acta Chirurgica Belgica
Toshiaki Wada, Kenji Kawada, Kenjiro Hirai, Kosuke Toda, Masayoshi Iwamoto, Suguru Hasegawa, Yoshiharu Sakai
Daikenchuto (DKT), a traditional Japanese medicine, is widely used to treat various gastrointestinal disorders. This study aimed to investigate whether DKT could promote the anastomotic healing in a rat model. Pedicled colonic segments were made in left colon by ligation of the feeding arteries, and then intestinal continuity was restored. Colonic blood flow was analyzed by using ICG fluorescence imaging: Fmax, Tmax, T1/2, and Slope were calculated. Anastomotic leakage (AL) was found in 6 of 19 rats (31.6%) in the control group, whereas in 1 of 16 rats (6...
January 18, 2018: Scientific Reports
Masakatsu Numata, Tomohiro Yamaguchi, Yusuke Kinugasa, Akio Shiomi, Hiroyasu Kagawa, Yushi Yamakawa, Akinobu Furuatni, Shoichi Manabe, Yusuke Yamaoka, Kakeru Torii, Shunichiro Kato
INTRODUCTION: The safety and feasibility of laparoscopic reoperation for anastomotic leakage remain unclear. METHODS: A total of 3321 patients underwent laparoscopic surgery for primary colorectal cancer at a tertiary referral center from September 2002 to May 2016. Of these, 31 patients who underwent reoperation for treatment of anastomotic leakage were enrolled in this study and divided into two reoperation groups: laparoscopic (n = 15) and open (n = 16)...
January 11, 2018: Asian Journal of Endoscopic Surgery
Andreas Brandl, Wieland Raue, Felix Aigner, Maria Clara Arroyave, Johann Pratschke, Beate Rau
AIM: Extraperitoneal rectal resection combined with complete peritonectomy of the pelvis in patients with peritoneal metastases is associated with a high rate of morbidity and mortality due to anastomotic leakage (AL). Therefore, many centers tend to perform loop ileostomy to reduce the clinical impact of AL. The aim of this study was to analyze the need for protective stoma creation in this patient group to avoid major complications and mortality in the case of AL. METHOD: We analyzed 53 patients who underwent extraperitoneal rectal resection from 409 consecutive patients treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) at our department between January 1997 and December 2016...
January 6, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Elisabeth Hain, Léon Maggiori, Magaly Zappa, Justine Prost À la Denise, Yves Panis
AIM: To assess outcome according to location of anastomotic leakage (AL) after side-to-end stapler or manual low colorectal or coloanal anastomosis following laparoscopic total mesorectal excision (TME) for rectal cancer. METHODS: All patients presenting with symptomatic or asymptomatic AL after TME and side-to-end low anastomosis for rectal cancer performed from 2005 to 2014 were identified from our prospective database. CT-scans with contrast enema were reviewed to assess location of AL origin...
January 6, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
C Ferrier, H Roman, Y Alzahrani, E Mathieu d'Argent, S Bendifallah, N Marty, M Perez, C Rubod, P Collinet, E Daraï, M Ballester
STUDY QUESTION: What are the fertility outcomes in women wishing to conceive after experiencing a severe complication from surgical removal of colorectal endometriosis? SUMMARY ANSWER: The pregnancy rate (PR) among women who wished to conceive after a severe complication of surgery for colorectal endometriosis was 41.2% (spontaneously for 80%, after ART procedure for 20%). WHAT IS KNOWN ALREADY: While the long-term benefit of surgery on pain and quality of life is well documented for women with colorectal endometriosis, it exposes women to the risk of severe complications...
January 5, 2018: Human Reproduction
Boris Jansen-Winkeln, Evangelos Tagkalos, Axel Heimann, Timo Gaiser, Daniela Hirsch, Ines Gockel, Jens Mittler, Hauke Lang, Stefan Heinrich
BACKGROUND: Many centers use the Pringle's maneuver during liver resections. Since this maneuver might impair healing of bowel anastomoses, we evaluated its influence on the healing of colonic anastomosis in rats. METHODS: Male Wistar rats underwent median laparotomy and sigmoid resection with end-to-end anastomosis under inhalation anesthesia. Thereafter, rats received a 25 minutes Pringle's maneuver (PM, group 1) or were kept under anesthesia for the same period of time (group 2)...
January 3, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Jasper B van Praagh, Marcus C de Goffau, Ilsalien S Bakker, Harry van Goor, Hermie J M Harmsen, Peter Olinga, Klaas Havenga
OBJECTIVE: The aim of the present study is to investigate the association of gut microbiota, depending on treatment method, with the development of colorectal anastomotic leakage (AL). BACKGROUND: AL is a major cause for morbidity and mortality after colorectal surgery, but the mechanism behind this complication still is not fully understood. METHODS: Bacterial DNA was isolated from 123 "donuts" of patients where a stapled colorectal anastomosis was made and was analyzed using 16S MiSeq sequencing...
January 9, 2018: Annals of Surgery
Henrik Iversen, Madelene Ahlberg, Marja Lindqvist, Christian Buchli
BACKGROUND: Anastomotic leakage is a serious clinical problem after colorectal resections and is associated with a significantly increased length of stay, morbidity and mortality. The aim of the present study was to evaluate the effect of changes in clinical practice on anastomotic leakage rate after colorectal resections. METHODS: Retrospective cohort study based on prospectively collected data. All 894 patients with primary anastomosis after colorectal resection at a tertiary referral center between 2006 and 2013 were analyzed...
December 28, 2017: World Journal of Surgery
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