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"anastomotic leak" and colon

Tammy Ju, Ivy N Haskins, Xiangyu Kuang, Richard L Amdur, Fred J Brody, Vincent Obias, Samir Agarwal
BACKGROUND: Robotic surgery has increased in recent years for the treatment of colorectal cancer; however, it is not yet the standard of care. This study aims to compare the 30-day outcomes after robotic colectomy for right-sided colon cancer from our institution with those from a national dataset, the targeted colectomy American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. METHODS: Patients undergoing elective, robotic, right colon resection for stage I, II, and III colon cancer were identified within the targeted colectomy ACS-NSQIP database from 2012 to 2014...
August 10, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Diane Mege, Gilles Manceau, Laura Beyer-Berjot, Valérie Bridoux, Zaher Lakkis, Aurélien Venara, Thibault Voron, Francesco Brunetti, Igor Sielezneff, Mehdi Karoui
AIM: To report the results of surgery for obstructive right colon cancer (ORCC) and to identify risk factors associated with worse outcomes that may help surgeons to choose the best surgical option. METHODS: This is a retrospective national cohort study, including all patients operated on for ORCC from 2000 to 2015. Those treated with colonic stent or symptomatic treatment were excluded. We described outcomes after surgery for ORCC and performed multivariate analyses for mortality, morbidity and survival...
July 6, 2018: European Journal of Surgical Oncology
Aryan Modasi, David Pace, Marshall Godwin, Chris Smith, Bryan Curtis
BACKGROUND: Current enhanced recovery guidelines suggest that opioid sparing medications should be used for analgesia whenever possible following colorectal surgery. The present study aims to assess whether post-operative NSAID use is associated with an increased anastomotic leak rate after a colonic or rectal anastomosis. METHODS: A systematic review was performed for studies investigating anastomotic leak rate following NSAID use vs control after colonic or rectal anastomosis...
July 11, 2018: Surgical Endoscopy
Jordi Castellví Valls, Javier Pérez Calvo, Ana Centeno Álvarez, Verónica Gonzâlez Santín, Lorenzo Viso Pons, Sergio Mompart García, Luis Ortiz de Zárate, Nuria Farreras Catasus, Jordi Mas Jove, Vicente Fernández Trigo, Domenico Sabia
INTRODUCTION: Bowel reconstruction techniques after right hemicolectomy has currently been objective of review, due to the high rate of anastomotic leak. The aim of this study is to analyse our results of the mechanical reinforced terminolateral ileo-transverse anastomosis. MATERIALS AND METHODS: A prospective and descriptive study of a consecutive series of right colonic cancer cases that underwent right hemicolectomy. Mechanical reinforced terminolateral ileo-transverse anastomosis technique was carried out in all patients...
July 5, 2018: Surgical Technology International
Jarek Kobiela, Emilio Bertani, Wanda Petz, Cristiano Crosta, Giuseppe De Roberto, Simona Borin, Dario Ribero, Diana Baldassari, Piotr Spychalski, Giuseppe Spinoglio
In robotic right hemicolectomy for colorectal cancer (CRC), appropriate lymphadenectomy and anastomotic leak prevention are critical. Visualisation of lymph nodes and blood flow with near-infrared (NIR) fluorescence DaVinci® imaging system is a recent development. Herein, we present an improved robotic modified complete mesocolic excision (mCME) technique using indocyanine green (ICG) fluorescence. Before surgery, ICG is injected into the submucosa around the tumour with endoscopy for intraoperative detection of lymph nodes...
June 27, 2018: Journal of Minimal Access Surgery
G Pellino, M Frasson, A García-Granero, P Granero-Castro, J L Ramos Rodríguez, B Flor-Lorente, J Bargallo Berzosa, N Alonso Hernández, F J Labrador Vallverdú, P A Parra Baños, G Ais Conde, E Garcia-Granero
AIM: Reports detailing the morbidity-mortality after left colectomy are sparse and do not allow definitive conclusions to be drawn. We aimed to identify risk factors for anastomotic leakage, perioperative mortality and complications following left colectomy for colonic malignancies. METHOD: We undertook a STROBE-compliant analysis of left colectomies included in a national prospective online database. Forty-two variables were analysed as potential independent risk factors for anastomotic leakage, postoperative morbidity and mortality...
June 19, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Yusuke Fujii, Yoshitsugu Tajima, Shunsuke Kaji, Takashi Kishi, Yoshiko Miyazaki, Takahito Taniura, Noriyuki Hirahara
BACKGROUND: Negative pressure wound therapy (NPWT) is a widely accepted technique to treat local infectious wounds of the skin, subcutaneous tissue, fascia, or muscle. Recently, several reports describing the efficacy of NPWT for various types of fistulas and anastomotic leaks have been published. We herein describe a patient with an open abdominal wound due to colonic anastomotic leakage and diffuse peritonitis, in whom abdominal vacuum sealing (AVS) as a modified NPWT was useful for the management of this complex wound...
June 15, 2018: BMC Surgery
Suat Chin Ng, Douglas Stupart, David Bartolo, David Watters
BACKGROUND: The purpose of this study was to determine the anastomotic leak rate for colorectal cancer resections in patients with metastases (compared to those without), and to determine the impact of anastomotic leaks on survival. METHODS: This is a retrospective analysis of all patients who underwent resection and primary anastomosis for colorectal adenocarcinoma at a single institution between January 2002 and December 2014. RESULTS: A total of 843 patients underwent a resection and primary anastomosis for colorectal adenocarcinoma (661 colon and 182 rectal)...
June 12, 2018: ANZ Journal of Surgery
Christopher J Salgado, Ajani Nugent, Joseph Kuhn, Meghan Janette, Heidi Bahna
Background: Many techniques have been described for reconstruction of the vaginal canal for oncologic, traumatic, and congenital indications. An increasing role exists for these procedures within the transgender community. Most often, inverted phallus skin is used to create the neovagina in transwomen. However, not all patients have sufficient tissue to achieve satisfactory depth and those that do must endure cumbersome postoperative dilation routines to prevent contracture. In selected patients, the sigmoid colon can be used to harvest ample tissue while avoiding the limitations of penile inversion techniques...
2018: BioMed Research International
Craig S Johnson, Andrew Kassir, Daryl S Marx, Mark K Soliman
Applications for surgical staplers continue to grow, due to the increase in minimally invasive surgical approaches, and range from vessel ligation to tissue transection and anastomoses. Complications associated with stapled tissue, such as bleeding or leaks, continue to be a concern for surgeons, as both can be associated with prolonged operative times and can contribute to postoperative morbidity and mortality. The goal of this retrospective study was to evaluate the performance of the da Vinci® Xi EndoWrist® Stapler 45 with SmartClamp™ technology during robotic-assisted right colectomy with intracorporeal anastomosis...
May 30, 2018: Journal of Robotic Surgery
Volodymyr O Shaprynskyi, Yevhen V Shaprynskyi, Yaroslav V Karyi, Serhii A Lysenko, Oleg O Vorovskyi, Andrii I Semenenko
OBJECTIVE: Introduction: Nowadays operative treatment of corrosive esophageal strictures remains one of the difficult and unsolved problems in surgery. The level of postoperative complications such as anastomotic leak (develops in 7-30% of cases), infections, pneumonia, pleural empyema, mediastinitis, peritonitis, postoperative corrosive strictures is still rather high. The aim of our work was to improve the results of surgical treatment of patients with corrosive esophageal strictures by analyzing and refining on conservative therapy options as well as differentiated approach to each operative treatment method...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
L Martínek, F Pazdírek, J Hoch, P Kocián
INTRODUCTION: Anastomotic leak after colorectal surgery is a serious complication. Tissue perfusion plays a key role for anastomotic healing. Fluorescence angiography with indocyanine green under near-infrared excitation allows a real-time perfusion assessment. The aim of this study was to evaluate the feasibility and the potential benefit of intraoperative assessment of anastomotic perfusion in colorectal surgery using indocyanine green-enhanced fluorescence in near-infrared light. METHODS: 53 patients with primary anastomosis after elective colon or rectum resection were enrolled between 1 January 2016 and 31 January 2017...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Uma M Sachdeva, Michael Lanuti
Cervical exenteration is a radical procedure for the treatment of locally invasive cancers of the trachea, esophagus, or thyroid, as well as recurrent tumors at the site of a tracheal stoma, and occasionally for benign disease. Exenteration involves removal of the larynx, pharynx, esophagus, and trachea, as well as associated lymphatic tissue. The tracheal stump is brought up as a cervical or mediastinal tracheostomy, depending on the length and the location of the distal resection site. The alimentary tract can be reconstructed with several types of conduits, but most commonly the stomach or left colon are used...
March 2018: Annals of Cardiothoracic Surgery
Leonardo Solaini, Thijs de Rooij, E Madelief Marsman, Wouter W Te Riele, Pieter J Tanis, Thomas M van Gulik, Dirk J Gouma, Neal H Bhayani, Thilo Hackert, Olivier R Busch, Marc G Besselink
BACKGROUND: Radical resection of advanced pancreatic cancer may occasionally require a simultaneous colon resection. The risks and benefits of this combined procedure are largely unknown. This systematic review aimed to assess short and long term outcome after pancreatoduodenectomy with colon resection (PD-colon) for pancreatic ductal adenocarcinoma (PDAC). METHODS: A systematic literature search was performed in PubMed, Embase, and the Cochrane Library for studies published between 1994 and 2017 concerning PD-colon for PDAC...
April 25, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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...
August 2018: Surgical Innovation
Anthony B Costales, Deepa Patil, Anny Mulya, John P Kirwan, Chad M Michener
BACKGROUND: Anastomotic leak after colorectal surgery is a significant cause of morbidity and mortality. The aim of this study was to evaluate the impact of a reinforced colo-colonic anastomosis with tissue adhesive, 2-octylcyanoacrylate (2-OCA), on the integrity of anastomotic healing as measured by anastomotic bursting pressure. METHODS: Sixty-eight female Sprague-Dawley rats underwent a rectosigmoid colon transection and a sutured end-to-end anastomosis followed by randomization to receive no further intervention or reinforcement with the tissue adhesive, 2-OCA...
June 2018: Journal of Surgical Research
M Wiegerinck, S K Hyoju, J Mao, A Zaborin, C Adriaansens, E Salzman, N H Hyman, O Zaborina, H van Goor, J C Alverdy
BACKGROUND: Previous work has demonstrated that anastomotic leak can be caused by collagenolytic bacteria such as Enterococcus faecalis via an effect on wound collagen. In humans, E. faecalis is the organism cultured most commonly from a leaking anastomosis, and is not routinely eliminated by standard oral or intravenous antibiotics. Novel strategies are needed to contain the virulence of this pathogen when present on anastomotic tissues. METHODS: Polyphosphorylated polymer ABA-PEG20k-Pi20 was tested in mice for its ability to prevent anastomotic leak caused by collagenolytic E...
April 16, 2018: British Journal of Surgery
P Sánchez-Velázquez, M Pera, M Jiménez-Toscano, X Mayol, X Rogés, L Lorente, M Iglesias, M Gallén
BACKGROUND: Recurrence occurs in up to 20% of patients with stage II colon cancer operated on for cure. Although postoperative intra-abdominal infection has been linked with an increased risk of recurrence, the association is controversial. The aim was to investigate the impact of postoperative intra-abdominal infection on disease-free survival and disease-specific survival in patients with stage II colon cancer. METHODS: Patients undergoing elective surgery for colon cancer stage II, between 2003 and 2014, were included...
April 5, 2018: Clinical & Translational Oncology
Fernando de la Portilla, Sergio Builes, Alejandra García-Novoa, Eloy Espín, Esther Kreisler, José María Enríquez-Navascues, Sebastiano Biondo, Antonio Codina
INTRODUCTION: Currently, there is growing interest in analyzing the results from surgical units and the implementation of quality standards in order to identify good healthcare practices. Due to this fact, the Spanish Association of Coloproctology (AECP) has developed a unit accreditation program that contemplates basic standards. The aim of this article is to evaluate and analyze the specific quality indicators for the surgical treatment of colorectal cancer, established by the program...
April 2018: Cirugía Española
S Hallam, B S Mothe, Rmr Tirumulaju
Background Hartmann's procedure is a commonly performed operation for complicated left colon diverticulitis or malignancy. The timing for reversal of Hartmann's is not well defined as it is technically challenging and carries a high complication rate. Methods This study is a retrospective audit of all patients who underwent Hartmann's procedure between 2008 and 2014. Reversal of Hartmann's rate, timing, American Society of Anesthesiologists grade, length of stay and complications (Clavien-Dindo) including 30-day mortality were recorded...
April 2018: Annals of the Royal College of Surgeons of England
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