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Anastomotic leak

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https://www.readbyqxmd.com/read/29792717/postoperative-monitoring-of-colorectal-anastomosis-experimental-study
#1
J Kalvach, O Ryska, J Pazin, J Hadac, S Juhas, J Juhásová, J Martínek, M Ryska
INTRODUCTION: Inadequate blood supply is one of the major risk factors for colorectal anastomotic leak. Early postoperative detection of local ischemic changes can predict complicated healing and lead to better outcome. Microdialysis (MD) offers real-time evaluation of adequate bowel perfusion through monitoring of tissue metabolism. The aim of this study was to assess the feasibility of MD for early detection of ischemic changes in colorectal anastomosis. METHOD: Five pigs with end-to-end colorectal anastomosis were included...
2018: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/29786579/operative-treatment-of-corrosive-esophageal-strictures
#2
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
https://www.readbyqxmd.com/read/29784042/neoadjuvant-oxaliplatin-and-capecitabine-combined-with-bevacizumab-plus-radiotherapy-for-locally-advanced-rectal-cancer-results-of-a-single-institute-phase-ii-study
#3
Xin Yu, Qiao-Xuan Wang, Wei-Wei Xiao, Hui Chang, Zhi-Fan Zeng, Zhen-Hai Lu, Xiao-Jun Wu, Gong Chen, Zhi-Zhong Pan, De-Sen Wan, Pei-Rong Ding, Yuan-Hong Gao
BACKGROUND: Neoadjuvant chemoradiotherapy followed by surgery is recommended as the standard of care for locally advanced rectal cancer, reducing local recurrence but not distant metastasis. Intensified systemic therapy is warranted to reduce the risk of distant metastasis. The present study aimed to evaluate the safety and efficacy of neoadjuvant oxaliplatin and capecitabine (XELOX) combined with bevacizumab plus radiotherapy for locally advanced rectal cancer. METHODS: Patients with stages II to III rectal cancer received one cycle of induction chemotherapy and concurrent chemoradiotherapy with XELOX plus bevacizumab...
May 21, 2018: Cancer communications
https://www.readbyqxmd.com/read/29782434/endoscopic-treatment-of-the-coloanal-anastomotic-dehiscence-and-stricture-stenting-via-rendezvous-technique
#4
Erkin Oztas, Fatih Saygili, Murat Ulas, Selcuk Disibeyaz
An anastomotic leak is a serious complication of colorectal surgery. Leak management is often grueling, and a definitive stoma is often mandatory for rescue therapy. Herein, we present a patient who experienced coloanal anastomotic dehiscence and complete stricture at the proximal part of the anastomosis. This case was successfully treated with a fully covered self-expandable metallic stent placement via the combined endoscopic (per ileostomy) and manual (per anal channel) rendezvous technique.
May 18, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/29780603/male-gender-is-associated-with-an-increased-risk-of-anastomotic-leak-in-rectal-cancer-patients-after-total-mesorectal-excision
#5
Chi Zhou, Xian-Rui Wu, Xuan-Hui Liu, Yu-Feng Chen, Jia Ke, Xiao-Wen He, Xiao-Sheng He, Tuo Hu, Yi-Feng Zou, Xiao-Bin Zheng, Hua-Shan Liu, Jian-Cong Hu, Xiao-Jian Wu, Jian-Ping Wang, Ping Lan
Background: The impact of a patient's gender on the development of anastomotic leak (AL) in rectal cancer patients following total mesorectal excision (TME) remains controversial. The aim of this study was to evaluate the association between patients' gender and the risk of AL. Methods: All rectal cancer patients following TME with a primary anastomosis during the study period from 2010 to 2014 were examined. Comparisons of the post-operative AL incidence rate between male and female patients were performed...
May 2018: Gastroenterology Report
https://www.readbyqxmd.com/read/29777268/defunctioning-stomas-result-in-significantly-more-short-term-complications-following-low-anterior-resection-for-rectal-cancer
#6
Andrew Emmanuel, Ezzat Chohda, Christo Lapa, Andrew Miles, Amyn Haji, Joe Ellul
BACKGROUND: Studies suggest that defunctioning stomas reduce the rate of anastomotic leakage and urgent reoperations after anterior resection. Although the magnitude of benefit appears to be limited, there has been a trend in recent years towards routinely creating defunctioning stomas. However, little is known about post-operative complication rates in patients with and without a defunctioning stoma. We compared overall short-term post-operative complications after low anterior resection in patients managed with a defunctioning stoma to those managed without a stoma...
May 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29770885/does-near-infrared-nir-fluorescence-angiography-modify-operative-strategy-during-emergency-procedures
#7
Emilie Liot, Michela Assalino, Nicolas Christian Buchs, Boris Schiltz, Jonathan Douissard, Philippe Morel, Frédéric Ris
INTRODUCTION: Bowel viability can be difficult to evaluate during emergency surgery. Near-infrared (NIR) fluorescence angiography allows an intraoperative assessment of organ perfusion during elective surgery and might help to evaluate intestinal perfusion during emergency procedures. The aim of this study was to assess if NIR modified operative strategy during emergency surgery. MATERIALS AND METHODS: From July 2014 to December 2015, we prospectively evaluated all consecutive patients, who had NIR assessment during emergency surgery...
May 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29770846/peripheral-vs-pedicle-division-in-laparoscopic-resection-of-sigmoid-diverticulitis-a-10-year-experience
#8
Alberto Posabella, Niccolò Rotigliano, Athanasios Tampakis, Markus von Flüe, Ida Füglistaler
PURPOSE: Laparoscopic rectosigmoid resection is the standard surgical treatment for recurrent sigmoid diverticulitis. However, speaking of mesenterium division, no unique standard procedure is actually provided. Surgeons can perform it at the level of either the sigmoid vessels or the inferior mesenteric vessels. The objective of this study was to compare intra- and postoperative complications of both techniques. METHODS: From a prospective collected database of patients that underwent elective laparoscopic sigmoid resection between January 2004 and December 2014, a retrospective analysis according to the selected operative technique was performed...
May 17, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29766228/relationship-between-visceral-obesity-and-postoperative-inflammatory-response-following-minimally-invasive-esophagectomy
#9
Akihiko Okamura, Masayuki Watanabe, Ian Fukudome, Kotaro Yamashita, Masami Yuda, Masaru Hayami, Yu Imamura, Shinji Mine
BACKGROUND: Esophagectomy for esophageal cancer is one of the most invasive surgeries. However, the factors influencing postoperative systemic inflammatory response following esophagectomy have not been elucidated. Recently, visceral fat has been shown to play an important role in both chronic and acute inflammation. In this study, we assessed the relationship between visceral obesity and postoperative inflammatory response following minimally invasive esophagectomy (MIE). METHODS: Visceral fat area (VFA) was measured using computed tomography in 152 patients undergoing MIE for esophageal cancer...
May 15, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29757360/decision-analysis-supports-the-use-of-drain-amylase-based-enhanced-recovery-method-after-esophagectomy
#10
B Jiang, V P Ho, J Ginsberg, S J Fu, Y Perry, L Argote-Greene, P A Linden, C W Towe
Postesophagectomy anastomotic leak is a common postsurgical complication. The current standard method of detecting leak is esophagram usually late in the postoperative period. Perianastomotic drain amylase level had shown promising results in early detection anastomosis leak. Previous studies have shown that postoperative day 4 amylase level is more specific and sensitive than esophagram. The purpose of this study is to determine if implementing a drain amylase-based screening method for anastomotic leak can reduce length of stay and hospital cost relative to a traditional esophagram-based pathway...
May 10, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29756648/direct-percutaneous-endoscopic-jejunostomy-procedural-and-nutrition-outcomes-in-a-large-patient-cohort
#11
Priya K Simoes, Kaitlin M Woo, Moshe Shike, Robin B Mendelsohn, Hans Gerdes, Arnold J Markowitz, Emmy Ludwig, Pari M Shah, Mark A Schattner
BACKGROUND: Direct percutaneous endoscopic jejunostomy (DPEJ) is used for enteral nutrition (EN) in patients with postoperative anastomotic leaks after esophagectomy/gastrectomy and at high risk for aspiration. We characterized the indications, technical success, procedural/nutrition outcomes, and adverse events in a large cohort of patients undergoing DPEJ insertion. METHODS: Patients undergoing DPEJ insertion between January 2009 and March 2015 were identified from an institutional endoscopy database...
December 27, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29754169/short-and-long-term-outcomes-after-colorectal-anastomotic-leakage-is-affected-by-surgical-approach-at-reoperation
#12
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/29751360/intact-intraoperative-fluorescence-angiography-ifa-to-prevent-anastomotic-leak-in-rectal-cancer-surgery-a-randomised-controlled-trial
#13
G Armstrong, J Croft, N Corrigan, J M Brown, V Goh, P Quirke, C Hulme, D Tolan, A Kirby, R Cahill, R O'Connell, D Miskovic, M Coleman, D G Jayne
PURPOSE: Anastomotic leak (AL) is a major complication of rectal cancer surgery. Despite advances in surgical practice, rates of AL have remained static at around 10-15%. The aetiology of AL is multifactorial, but one of the most crucial risk factors, which is mostly under the control of the surgeon, is blood supply to the anastomosis. The MRC/NIHR IntAct study will determine whether assessment of anastomotic perfusion using a fluorescent dye (Indocyanine Green) and near-infrared laparoscopy can minimise the rate of anastomotic leak as compared to conventional white light laparoscopy...
May 11, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29747950/esophagectomy-in-patients-with-human-immunodeficiency-virus-and-acquired-immune-deficiency-syndrome-a-viable-option
#14
Michael Mwachiro, Eric Mitchell, Hillary M Topazian, Russell White
The objective of this study was to assess the outcomes for patients with human immunodeficiency virus (HIV) and acquired immune deficiency virus (AIDS) who had esophagectomy done for both benign and malignant conditions. A retrospective chart review of patients with HIV and AIDS undergoing esophagectomy at a rural referral hospital was done for the period of 2009-2014. Patient postoperative complications, outcomes, and follow-up data were charted. All procedures were done by a single lead surgeon. Nine patients met the study criteria, 7 of whom had esophageal cancer, and 2 with strictures...
April 2018: Seminars in Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29736773/risk-factors-for-early-postoperative-complications-and-length-of-hospital-stay-in-ileocecal-resection-and-right-hemicolectomy-for-crohn-s-disease-a-single-center-experience
#15
Christian Galata, Christel Weiss, Julia Hardt, Steffen Seyfried, Stefan Post, Peter Kienle, Karoline Horisberger
PURPOSE: To determine risk factors for early postoperative complications and longer hospital stay after ileocecal resection and right hemicolectomy in a single-center cohort of patients with Crohn's disease (CD). METHODS: A retrospective analysis of the prospectively maintained surgical database for patients with CD at our institution was performed. All consecutive patients operated on between January 2010 and December 2016 were included. RESULTS: A total of 305 patients were included...
May 7, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29730075/neoadjuvant-therapy-or-upfront-surgery-a-systematic-review-and-meta-analysis-of-t2n0-esophageal-cancer-treatment-options
#16
REVIEW
F C Mota, I Cecconello, F R Takeda, F Tustumi, R A A Sallum, W M Bernardo
BACKGROUND: Esophageal carcinoma usually shows poor long-term survival rates, even when esophagectomy, the standard curative treatment is performed. As a result, there has been increasing interest in the neoadjuvant therapy, which could potentially downstage cancer, eliminate micrometastasis and ergo increase resectability and curative (R0) resection. Currently, for the earliest stage esophageal cancers, most guidelines point out to the role of endoscopic treatment, and for T1bN0 upfront surgery...
May 3, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29726262/-intra-operative-fluorescence-angiography-of-colorectal-anastomotic-perfusion-a-technical-aspects
#17
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
https://www.readbyqxmd.com/read/29722074/analysis-of-caudate-lobe-biliary-anatomy-and-its-implications-in-living-donor-liver-transplantation-a-single-centre-prospective-study
#18
Kausar Makki, Vishal Chorasiya, Ajitabh Srivastava, Ashish Singhal, Arif Ali Khan, Vivek Vij
Biliary complications are a significant cause of morbidity after living donor liver transplant (LDLT). Bile leak may occur from bile duct (anastomotic site in recipient and repaired bile duct stump in donor), cystic duct stump, cut surface pedicles or from divided caudate ducts. The first three sites are amenable to post-operative endoscopic stenting as they are in continuation with biliary ductal system. However, leaks from divided isolated caudate ducts can be stubborn. To minimize caudate duct bile leaks, it is important to understand the anatomy of hilum with attention to the caudate lobe biliary drainage...
May 2, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
https://www.readbyqxmd.com/read/29718160/safety-and-feasibility-of-robotic-assisted-ivor-lewis-esophagectomy
#19
K Meredith, J Huston, O Andacoglu, R Shridhar
Esophagectomy is associated with substantial morbidity. Robotic surgery allows complex resections to be performed with potential benefits over conventional techniques. We applied this technology to transthoracic esophagectomy to assess safety, feasibility, and reliability of this technology. A retrospective cohort study of all patients undergoing robotic-assisted Ivor-Lewis esophagectomy (RAIL) from 2009 to 2014 was conducted. Clinicopathologic factors and surgical outcomes were recorded and compared. All statistical tests were two-sided and a P-value of <0...
May 1, 2018: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29717372/combined-repeat-laparoscopy-and-transanal-endolumenal-repair-hybrid-approach-in-the-early-management-of-postoperative-colorectal-anastomotic-leaks-technique-and-outcomes
#20
William Tzu-Liang Chen, Saurabh Bansal, Tao-Wei Ke, Sheng-Chi Chang, Yu-Chun Huang, Takashi Kato, Hwei-Ming Wang, Abe Fingerhut
BACKGROUND: Few clear recommendations exist for the management of colorectal anastomotic leaks, often based on surgeon preferences or institutional protocols. The primary goal was to evaluate the feasibility and safety of the combined laparoscopic and transanal (hybrid) approach to treat postoperative colorectal anastomotic leaks. The secondary goals included comparison of outcomes following early (< 5 days after initial resection) versus late (≥ 5 days) detection of leaks...
May 1, 2018: Surgical Endoscopy
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