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Anastomotic leak

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https://www.readbyqxmd.com/read/29331260/multifaceted-behavior-of-meckel-s-diverticulum-in-children
#1
Qingjiang Chen, Zhigang Gao, Lifeng Zhang, Yuebin Zhang, Tao Pan, Duote Cai, Qixing Xiong, Qiang Shu, Yunzhong Qian
PURPOSE/BACKGROUND: Meckel's diverticulum (MD) is one of the most common congenital malformations of gastrointestinal tract in children. However, the nonspecific clinical manifestations of MD often cause a diagnostic as well as therapeutic challenge to pediatric surgeon. This study aimed to review our experience in managing this disease while evaluating the management strategies. METHODS: We retrospectively analyzed the clinical data of all patients diagnosed with MD admitted to our center between January 2010 and December 2015...
December 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29327167/does-laparoscopic-intracorporeal-ileocolic-anastomosis-decreases-surgical-site-infection-rate-a-propensity-score-matched-cohort-study
#2
L Martinek, K You, S Giuratrabocchetta, M Gachabayov, K Lee, R Bergamaschi
AIM: Foreshortened mesentery or thick abdominal wall constitutes a rationale for laparoscopic intracorporeal ileocolic anastomoses (ICA). The aim of this study was to compare intracorporeal to extracorporeal ICA in terms of surgical site infections in patients with Crohn's ileitis and overweight patients with right colon tumors. METHOD: This was a prospective propensity score-matched cohort study enrolling consecutive patients with Crohn's terminal ileitis and overweight patients with right colon tumors undergoing elective laparoscopic right colon resection with intracorporeal or extracorporeal ICA...
January 11, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29321843/esophagocoloplasty-fistula-successfully-treated-with-vacuum-assisted-closure
#3
Santiago A Endara, Fernando J Terán, Armando J Serrano, Manuela J Castillo, Gabriel A Molina
Esophageal fistulas in the cervical region are usually difficult to manage and carry a high morbidity. We report a case of an esophago-colonic fistula after colonic interposition, successfully managed with vacuum-assisted closure 'V.A.C. system', (Kinetic Concepts Inc., San Antonio, TX, USA). The patient initially presented with purulent fluid from the cervical wound 13 days after surgery. Esophagogram confirmed a leak. Since the patient had a history of anastomotic leaks, a surgical intervention was not the treatment of choice...
January 2018: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29315152/impact-of-surgeon-self-evaluation-and-positive-deviance-on-postoperative-adverse-events-after-non-cardiac-thoracic-surgery
#4
Jelena Ivanovic, Fargol Mostofian, Caitlin Anstee, Sebastien Gilbert, Donna E Maziak, Farid M Shamji, Ramanadhan Sudhir Sundaresan, Patrick James Villeneuve, Andrew J E Seely
As an innovative approach to improve quality of surgical care, we combined surgeon self-assessment and anonymized peer comparison with continuous quality improvement seminars using positive deviance (CQI/PD) to identify surgeon(s) with the lowest rates of adverse events (AEs) to guide group practice recommendations. Our objective was to quantify the impact these interventions on postoperative AEs rates after major non-cardiac chest operations. All postoperative AEs after all thoracic operations (n = 1,084, March, 2013 to February, 2016, single-center) were prospectively collected using the thoracic morbidity and mortality system, based on Clavien-Dindo schema...
January 8, 2018: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/29315090/incidence-and-risk-factors-for-anastomotic-failure-in-1594-patients-treated-by-transanal-total-mesorectal-excision-results-from-the-international-tatme-registry
#5
Marta Penna, Roel Hompes, Steve Arnold, Greg Wynn, Ralph Austin, Janindra Warusavitarne, Brendan Moran, George B Hanna, Neil J Mortensen, Paris P Tekkis
OBJECTIVE: To determine the incidence of anastomotic-related morbidity following Transanal Total Mesorectal Excision (TaTME) and identify independent risk factors for failure. BACKGROUND: Anastomotic leak and its sequelae are dreaded complications following gastrointestinal surgery. TaTME is a recent technique for rectal resection, which includes novel anastomotic techniques. METHODS: Prospective study of consecutive reconstructed TaTME cases recorded over 30 months in 107 surgical centers across 29 countries...
January 5, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29312708/substernal-reconstruction-following-esophagectomy-operation-of-last-resort
#6
Jacob R Moremen, DuyKhanh P Ceppa, Karen M Rieger, Thomas J Birdas
Background: The posterior mediastinum is the preferred location for reconstruction following esophagectomy. Occasionally alternative routes are required. We examined patient outcomes of esophageal reconstruction in order to determine whether substernal reconstruction (SR) is an equivalent alternative to orthotopic placement. Methods: Following IRB approval, we performed a retrospective review of all patients who underwent an esophagectomy from 1988-2014. Only patients reconstructed with a gastric conduit and cervical anastomosis by either substernal or posterior mediastinal (PM) routes were included in the study...
December 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29307454/increased-variance-in-oral-and-gastric-microbiome-correlates-with-esophagectomy-anastomotic-leak
#7
Rishindra M Reddy, William B Weir, Shari Barnett, Brendan T Heiden, Mark B Orringer, Jules Lin, Andrew C Chang, Philip W Carrott, William R Lynch, David G Beer, J Christopher Fenno, Yvonne Kapila
BACKGROUND: Anastomotic leak after esophagectomy remains a significant source of morbidity and mortality. The gastrointestinal (GI) microbiome has been found to play a significant role in tumor oncogenesis and postoperative bowel anastomotic leak. We hypothesized that the GI microbiome could differentiate between esophageal cancer histologies and predict postoperative anastomotic leak. METHODS: A prospective study of esophagectomy patients was performed from May 2013 to August 2014, with the collection of oral saliva, intraoperative esophageal and gastric mucosa, and samples of postoperative infections (neck swab or sputum)...
January 4, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29302727/implications-of-stoma-formation-as-part-of-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#8
H Jacoby, Y Berger, L Barda, N Sharif, Y Zager, A Lebedyev, M Gutman, A Hoffman
BACKGROUND: Formation of protective stoma as part of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) may be an effective tool in reducing anastomotic leak incidence. Our aim was to evaluate the incidence and implications of stoma formation during CRS-HIPEC and to examine whether a creation of protective stoma reduces the postoperative morbidity. METHODS: A cohort retrospective analysis of all CRS-HIPEC procedures performed between 2004 and 2016 was conducted...
January 4, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29285681/outcomes-of-ileal-pouch-anal-anastomosis-without-primary-diverting-loop-ileostomy-if-postoperative-sepsis-develops
#9
O A Lavryk, T L Hull, L C Duraes, L Stocchi, J H Ashburn, D Liska, E Gorgun, H Kessler
BACKGROUND: The aim of the present study was to assess the short-term and long-term consequences of diverting loop ileostomy (DLI) omission in ileal pouch-anal anastomosis (IPAA) surgery complicated by postoperative pelvic sepsis. METHODS: This was a retrospective review of a prospectively maintained database. Of 4031 patients who underwent IPAA in 1983-2014, 357 developed IPAA-related pelvic sepsis with or without anastomotic dehiscence. Patients with Crohn's disease or cancer were excluded...
December 28, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29283083/the-risk-of-urinary-retention-following-robot-assisted-radical-prostatectomy-and-its-impact-on-early-continence-outcomes
#10
Mansour Alnazari, Marc Zanaty, Khaled Ajib, Assaad El-Hakim, Kevin C Zorn
INTRODUCTION: We aimed to evaluate the risk factors of acute urinary retention (AUR) following robot-assisted radical prostatectomy (RARP), as well as the relationship of AUR with early continence outcomes. METHODS: The records of 740 consecutive patients who underwent RARP by two experienced surgeons at our institution were retrospectively reviewed from a prospectively collected database. Multiple factors, including age, body mass index (BMI), international prostate symptom score (IPSS), prostate volume, presence of median lobe, nerve preservation status, anastomosis time, and catheter removal time (Day 4 vs...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/29282602/cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy-for-the-elderly-is-it-reasonable-a-meta-analysis
#11
Johan Gagnière, Julie Veziant, Bruno Pereira, Denis Pezet, Bertrand Le Roy, Karem Slim
BACKGROUND: Whether cytoreductive surgery (CRS) plus hyperthermic intraperitoneal chemotherapy (HIPEC) is safe and worthwhile for elderly patients remains unclear. This meta-analysis of outcomes after CRS plus HIPEC for the elderly aimed to generate a higher level of evidence and precise indications for these patients. METHODS: A systematic literature search for studies reporting postoperative outcomes after CRS plus HIPEC for elderly patients was performed in the MEDLINE, Cochrane Central Register of Controlled Trials, ClinicalTrials...
December 28, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29280460/preoperative-chemoradiation-therapy-does-not-increase-risk-of-anastomotic-leak-in-patients-with-gastric-cancer
#12
Naruhiko Ikoma, Prajnan Das, Mariela Blum, Jeannelyn S Estrella, Catherine E Devine, Xuemei Wang, Keith Fournier, Paul Mansfield, Bruce D Minsky, Jaffer Ajani, Brian D Badgwell
INTRODUCTION: We sought to determine whether preoperative chemoradiation therapy or chemotherapy increases the risk of anastomotic leak after gastrectomy in gastric cancer patients without gastroesophageal junction involvement. METHODS: We reviewed data from a prospectively maintained database of patients who underwent gastrectomy at our institution between 2001 and 2016. The incidence of anastomotic leak and symptomatic intra-abdominal fluid collection was determined and tested for associations with the type of preoperative therapy...
November 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29280120/-clinical-application-of-compound-anastomotic-device-in-protective-terminal-ileostomy-during-rectal-cancer-operation
#13
Qi Huang, Feng Cao, Jinzhe Zhou, Liming Liu, Bujun Ge
OBJECTIVE: To investigate the clinical effect of the application of "compound anastomotic device" on the high-risk colorectal anastomosis in rectal cancer patients undergoing protective ileostomy. METHODS: A total of 116 rectal cancer patients undergoing surgical procedure and prophylactic ileostomy in Tongji Hospital (90 cases) and The Third People's Hospital of Jingdezhen City (26 cases) from May 2011 to October 2016 were prospectively enrolled in the study. Paralleled control study and random digital table were applied...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29278753/intraoperative-endoscopy-prevents-technical-defect-related-leaks-in-laparoscopic-roux-en-y-gastric-bypass-a-randomized-control-trial
#14
Carlos Valenzuela-Salazar, Martin E Rojano-Rodríguez, Sujey Romero-Loera, Mario E Trejo-Ávila, Joseph Bañuelos-Mancilla, Roberto Délano-Alonso, Mucio Moreno-Portillo
BACKGROUND: Postoperative anastomotic leaks, bleeding and stenosis are major causes of morbidity after laparoscopic Roux-en-Y gastric bypass (LRYGB). Retrospective studies suggest that intraoperative endoscopy reduces the incidence of these complications. METHODS: We conducted a prospective randomized controlled trial in a single institution between March 2013 and January 2016. Patients were assigned to one of two groups: LRYGB with Intraoperative Endoscopy (IOE) or LRYGB without IOE...
December 23, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29277390/guiding-the-non-bariatric-surgeon-through-complications-of-bariatric-surgery
#15
N Contival, B Menahem, T Gautier, Y Le Roux, A Alves
Complications in bariatric surgery are varied; they are severe at times but infrequent. They may be surgical or non-surgical, and may occur early or late. The goal of this systematic review is to inform and help the attending physician, the emergency physician and the non-bariatric surgeon who may be called upon to manage surgical complications that arise after adjustable gastric band (AGB), sleeve gastrectomy (SG), or gastric bypass (GBP). Data from evidence-based medicine were extracted from the literature by a review of the Medline database and also of the most recent recommendations of the learned societies implicated...
December 22, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29273871/using-outcomes-data-to-justify-instituting-new-technology-a-single-institution-s-experience
#16
P M Starker, B Chinn
BACKGROUND: The PILLAR II trial demonstrated PINPOINT is safe, feasible to use with no reported adverse events and resulted in no anastomotic leaks in patients who had a change in surgical plan based on PINPOINT's intraoperative assessment of tissue perfusion during colorectal resection. Whether the cost savings associated with this reduction in anastomotic complications can offset the cost of investing in PINPOINT is unknown. METHODS: We performed a retrospective analysis of all patients (N = 347) undergoing colectomy with primary anastomosis from January 2015 to April 2016...
December 22, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29234924/a-new-direction-in-anastomotic-research-should-we-redesign-the-angle-of-sorrow
#17
Omar E Aly
INTRODUCTION: Despite advances in oncological outcomes in colo-rectal surgery, rates of anastomotic leak have not improved. The precise mechanisms of anastomotic leak remain poorly understood. Current research has focused on anastomotic reinforcement to tackle anastomotic leak with little success. The 'Angle of Sorrow', the corner of the anastomosis is prone to anastomotic leak, but remains a persistent feature in the gastrointestinal anastomosis. The tendency for stress forces to concentrate in the vulnerable 'Angle of Sorrow' prompts the need for anastomotic design research...
December 12, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29232658/a-meta-analysis-of-randomized-controlled-trials-on-the-use-of-suction-drains-following-rectal-surgery
#18
Francesco Guerra, Giuseppe Giuliani, Diego Coletta, Marcello Boni, Fabio Rondelli, Paolo Pietro Bianchi, Andrea Coratti
BACKGROUND: Anastomotic leakage is one of the most feared complications of rectal resections. The role of drains in limiting this occurrence or facilitating its early recognition is still poorly defined. We aimed to study whether the presence of prophylactic pelvic drains affects the surgical outcomes of patients undergoing rectal surgery with extraperitoneal anastomosis. METHODS: PubMed, EMBASE, and the Cochrane Library were systematically searched for randomized controlled trials comparing drained with undrained anastomoses following rectal surgery...
December 12, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/29230940/the-effects-of-recreational-ketamine-cystitis-on-urinary-tract-reconstruction-a-surgical-challenge
#19
Néha Sihra, Jeremy Ockrim, Dan Wood
OBJECTIVES: To identify the rate of post-operative complications in patients who require surgical reconstruction for ketamine-induced urinary tract dysfunction and to identify any predictors for poor post-operative outcome with subsequent management strategies. MATERIALS AND METHODS: A retrospective review of data collected between 2007 and 2017 was performed. Evaluation included CT urogram, cystoscopy and biopsy. Indications and outcomes for surgical intervention were assessed...
December 12, 2017: BJU International
https://www.readbyqxmd.com/read/29229157/long-term-outcomes-of-sigmoid-diverticulitis-a-single-center-experience
#20
Ido Mizrahi, Abbas Al-Kurd, Katya Chapchay, Yael Ag-Rejuan, Natalia Simanovsky, Ahmed Eid, Haggi Mazeh
BACKGROUND: During the last decade, guidelines for the treatment of sigmoid diverticulitis have dramatically changed. The aim of this study is to report the long-term outcomes of patients treated for diverticulitis at a nonspecialized single center. MATERIALS AND METHODS: After obtaining institutional review board approval, medical records of all patients admitted to our institution with the diagnosis of sigmoid diverticulitis between 1998 and 2008 were reviewed...
January 2018: Journal of Surgical Research
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