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https://www.readbyqxmd.com/read/28916892/precision-in-robotic-rectal-surgery-using-the-da-vinci-xi-system-and-integrated-table-motion-a-technical-note
#1
Sofoklis Panteleimonitis, Mick Harper, Stuart Hall, Nuno Figueiredo, Tahseen Qureshi, Amjad Parvaiz
Robotic rectal surgery is becoming increasingly more popular among colorectal surgeons. However, time spent on robotic platform docking, arm clashing and undocking of the platform during the procedure are factors that surgeons often find cumbersome and time consuming. The newest surgical platform, the da Vinci Xi, coupled with integrated table motion can help to overcome these problems. This technical note aims to describe a standardised operative technique of single docking robotic rectal surgery using the da Vinci Xi system and integrated table motion...
September 15, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28916858/an-endoscopic-mucosal-grading-system-is-predictive-of-leak-in-stapled-rectal-anastomoses
#2
Sarath Sujatha-Bhaskar, Mehraneh D Jafari, Mark Hanna, Christina Y Koh, Colette S Inaba, Steven D Mills, Joseph C Carmichael, Ninh T Nguyen, Michael J Stamos, Alessio Pigazzi
BACKGROUND: Anastomotic leak is a devastating postoperative complication following rectal anastomoses associated with significant clinical and oncological implications. As a result, there is a need for novel intraoperative methods that will help predict anastomotic leak. METHODS: From 2011 to 2014, patient undergoing rectal anastomoses by colorectal surgeons at our institution underwent prospective application of intraoperative flexible endoscopy with mucosal grading...
September 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28915206/laparoscopic-colorectal-surgery-in-patients-with-previous-abdominal-surgery-a-single-center-experience-and-literature-review
#3
Erdinc Kamer, Turan Acar, Fevzi Cengiz, Evren Durak, Mehmet Haciyanli
To present the outcomes of laparoscopic colorectal surgery in colorectal cancer patients with a previous history of abdominal surgery. Data of a total of 121 patients with primary colorectal cancer who underwent laparoscopic surgery were retrospectively analyzed. The patients were divided into 2 groups as those with previous abdominal surgery (PAS, n=34) and those without (non-PAS, n=87). Gastric and colonic surgeries were the most common procedures in the major PAS group, whereas gynecologic and obstetric surgeries and appendectomy were the most common procedures in the minor PAS group...
September 14, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28913968/risk-factors-for-unfavourable-postoperative-outcome-in-patients-with-crohn-s-disease-undergoing-right-hemicolectomy-or-ileocaecal-resection-an-international-audit-by-escp-and-s-ecco
#4
(no author information available yet)
BACKGROUND: Patient and disease-related factors, as well as operation technique all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. AIM: To investigate the effect of pre- and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. METHOD: International prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection...
September 15, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28905807/buttressing-hepaticojejunostomy-apos-s-with-hepatic-round-ligament-flap-may-be-beneficial
#5
Jayant Kumar Banerjee, Ramanathan Saranga Bharathi, Pankaj Purushotam Rao
BACKGROUND: Bile leaks and anastomotic strictures are important complications of hepaticojejunostomy (HJ). Evidence suggests that the use of hepatic round ligament (HRL) to buttress HJ may be beneficial. This study evaluates the feasibility of this approach. METHODS: HJs performed over 2 years (Jun 2014- May 2016), with HRL reinforcement, were analyzed. Operative outcomes measured included technical difficulty, blood loss, time necessary for flap harvest, and reinforcement of HJ...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28905801/the-impact-of-obesity-on-the-perioperative-clinicopathologic-and-oncologic-outcomes-of-robot-assisted-total-mesorectal-excision-for-rectal-cancer
#6
Ajit Pai, Fahad Alsabhan, John J Park, George Melich, Suela Sulo, Slawomir J Marecik
PURPOSE: To analyze the feasibility and outcomes of robotic rectal cancer surgery in obese patients. METHODS: From 2005 to 2012, 101 consecutive rectal cancers operated robotically were enrolled in a prospective database. Patients were stratified into obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) groups. Operative, perioperative parameters, and pathologic outcomes were compared. Data were analyzed using SPSS 22.0, while statistical significance was defined as a p value ≤ ...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28900830/transhiatal-vs-transthoracic-esophagectomy-a-nsqip-analysis-of-postoperative-outcomes-and-risk-factors-for-morbidity
#7
Francisco Schlottmann, Paula D Strassle, Marco G Patti
BACKGROUND: Both transhiatal esophagectomy (THE) and transthoracic esophagectomy (TTE) are accepted procedures for esophageal resection. We aimed to compare postoperative outcomes between these procedures and identify risk factors for morbidity. METHODS: A retrospective analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program database. Adult patients who underwent THE or TTE between 2005 and 2014 were included. Postoperative morbidity, length of stay, and 30-day mortality were compared...
September 12, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28895551/indocyanine-green-fluorescence-imaging-in-colorectal-surgery-overview-applications-and-future-directions
#8
REVIEW
Deborah S Keller, Takeaki Ishizawa, Richard Cohen, Manish Chand
Indocyanine green fluorescence imaging is a surgical tool with increasing applications in colorectal surgery. This tool has received acceptance in various surgical disciplines as a potential method to enhance surgical field visualisation, improve lymph node retrieval, and decrease the incidence of anastomotic leaks. In colorectal surgery specifically, small studies have shown that intraoperative fluorescence imaging is a safe and feasible method to assess anastomotic perfusion, and its use might affect the incidence of anastomotic leaks...
October 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28890650/economic-impact-of-laparoscopic-conversion-to-open-in-left-colon-resections
#9
Katherine Etter, Brad Davis, Sanjoy Roy, Iftekhar Kalsekar, Andrew Yoo
BACKGROUND AND OBJECTIVES: Studies have shown economic and clinical advantages of laparoscopic left-colon resections. Laparoscopic conversion to open is an important surgical outcome. We estimated conversion incidence, identified risk factors, and measured the clinical and economic impact. METHODS: In this retrospective study, we used the Premier Perspective database to analyze left-sided colectomies from 2009 to 2014. Operating room time (ORT), length of stay (LOS), total hospital cost (2014 U...
July 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28882772/early-elective-versus-delayed-elective-surgery-in-acute-recurrent-diverticulitis-a-systematic-review-and-meta-analysis
#10
REVIEW
Rao Muhammad Asaf Khan, Shahin Hajibandeh, Shahab Hajibandeh
OBJECTIVES: To investigate outcomes of early versus delayed surgery in patients with acute recurrent diverticulitis. METHODS: We performed a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards. We conducted a search of electronic information sources, including MEDLINE; EMBASE; CINAHL; the Cochrane Central Register of Controlled Trials (CENTRAL); the World Health Organization International Clinical Trials Registry; ClinicalTrials...
September 4, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28881894/outcomes-following-the-main-treatment-options-in-patients-with-a-leaking-esophagus-a-systematic-literature-review
#11
S Persson, I Rouvelas, T Irino, L Lundell
Leakage from the esophagus and gastroesophageal junction can be lethal due to uncontrolled contamination of the mediastinum. The most predominant risk factors for the subsequent clinical outcome are the patients' delay as well as the delay of diagnosis. Two major therapeutic concepts have been advocated: either prompt closure of the leakage by insertion of a self-expandable metal stent (SEMS) or more traditionally, surgical exploration. The objective of this review is to carefully scrutinize the recent literature and assess the outcomes of these two therapeutic alternatives in the management of iatrogenic perforation-spontaneous esophageal rupture as separated from those with anastomotic leak...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28880048/histopathological-changes-associated-to-an-absorbable-fibrin-patch-tachosil%C3%A2-covering-in-an-experimental-model-of-high-risk-colonic-anastomoses
#12
C García-Vásquez, S Gómez García de Las Heras, C Pastor Idoate, D De Pablo, M J Fernández-Aceñero
BACKGROUND: TachoSil® is a fibrin sponge that contains fibrinogen and thrombin and is a useful adjuvant to enhance control of air leaks in thoracic surgery and to control bleeding in vascular and general surgery. Its use in intestinal surgery to prevent suture dehiscence is currently under investigation. MATERIAL AND METHODS: We report the results of a prospective randomized experimental study on 33 large white pigs in which a high-risk suture was created by induction of ischemia...
September 7, 2017: Histology and Histopathology
https://www.readbyqxmd.com/read/28877811/resection-of-gastrointestinal-metastases-in-stage-iv-melanoma-correlation-with-outcomes
#13
Sangeetha Prabhakaran, William J Fulp, Ricardo J Gonzalez, Vernon K Sondak, Ragini R Kudchadkar, Geoffrey T Gibney, Jeffrey S Weber, Jonathan S Zager
The prognosis of patients with gastrointestinal (GI) melanoma metastases is poor. Surgery renders select patients disease free and/or palliates symptoms. We reviewed our single-institution experience of resection with GI melanoma metastases. A retrospective review was performed on patients who underwent surgery for GI melanoma metastases from 2007 to 2013. Fifty-four patients were identified and separated based on completeness of resection into curative 13 (24%) and palliative 41 (75.9%) groups. Thiry-six (63...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28871343/three-steps-and-a-join-a-simple-guide-to-right-and-left-sided-medial-to-lateral-laparoscopic-colorectal-surgery
#14
M J F X Rickard, A Keshava, J W T Toh
BACKGROUND: To provide a standardised 'medial to lateral' approach to laparoscopic colorectal surgery. METHODS: Both right- and left- sided laparoscopic colorectal procedures were simplified into three well-defined steps and a join. An instructional video and procedural guide provides the important pearls and pitfalls in performing laparoscopic colorectal surgery. RESULTS: During a 10-year period (2006-2016) at a single institution, 20 senior colorectal trainee surgeons and 20 general surgery registrars were trained in the 'three steps and a join' technique...
September 4, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28870964/incidence-and-oncological-implications-of-previously-undetected-tumor-multicentricity-following-pancreaticoduodenectomy-for-pancreatic-adenocarcinoma-in-patients-undergoing-salvage-pancreatectomy
#15
Andreas Andreou, Fritz Klein, Rosa B Schmuck, Daniela Lee, Marianne Sinn, Timm Denecke, Johann Pratschke, Marcus Bahra
BACKGROUND: The risk for multicentricity of pancreatic adenocarcinoma remains unclear and the question whether pancreaticoduodenectomy represents sufficient oncological treatment for patients with ductal adenocarcinoma of the head of the pancreas needs further investigation. PATIENTS AND METHODS: Clinicopathological data of patients who underwent pancreaticoduodenectomy for pancreatic adenocarcinoma between 2005 and 2015 were assessed and the incidence of tumor multicentricity among patients who required salvage pancreatectomy within 90 postoperative days was evaluated...
September 2017: Anticancer Research
https://www.readbyqxmd.com/read/28861269/defunctioning-stoma-a-prognosticator-for-leaks-in-low-rectal-restorative-cancer-resection-a-retrospective-analysis-of-stoma-database
#16
Haytham Abudeeb, Ahmed Hammad, Ajogwu Ugwu, Jamshid Darabnia, Lee Malcomson, Min Maung, Khurram Khan, Clare Mclaughlin, Arijit Mukherjee
AIMS: Low anterior resection (LAR) has higher risk of anastomotic leak with its attendant morbidity -mortality. De-functioning loop ileostomy (DLI), claimed to mitigate the consequences of anastomotic leak, has been questioned in recent years. This study aims to evaluate the impact of ileostomy on LAR. METHODS: A retrospective analysis of stoma database. 136 patients with stoma (March 2011-July 2015) were assessed. Data was analysed in respect to LAR anastomotic leak rate, impact on morbidity-mortality, short and long-term stoma complications, rate of ileostomy reversal and reasons for non-reversal...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28859398/component-analysis-of-enhanced-recovery-pathways-for-esophagectomy
#17
S R Markar, R Naik, G Malietzis, L Halliday, T Athanasiou, K Moorthy
The objective of this systematic review is to identify key components of enhanced recovery protocols (ERP) that lead to improved length of hospital stay (LOS) following esophagectomy. Relevant electronic databases were searched for studies comparing clinical outcome from esophagectomy followed by a conventional pathway versus ERP. Relevant outcome measures were compared and metaregression was performed to identify the key ERP components associated with reduced in LOS. Thirteen publications were included, ERP was associated with no changes in in-hospital mortality, total complications, anastomotic leak, or pulmonary complications compared with a conventional pathway, however LOS was reduced in the ERP group...
October 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28859370/management-of-recurrent-tracheoesophageal-fistula-after-esophageal-atresia-and-follow-up
#18
J Wang, M Zhang, W Pan, W Wu, W Yan, W Cai
Recurrent tracheoesophageal fistula (rTEF) is a complex complication after the repair of esophageal atresia (EA) and remains a challenge because of difficulties in preoperative management and the substantial rates of mortality and morbidity after reoperation. By reviewing a single institution's experience in the management of rTEF and assessing the outcome, we aimed to provide an optimal approach for managing rTEF and to evaluate growth and feeding problems after reoperations. The medical records of 35 patients with rTEF treated at a single institution from June 2012 to December 2015 were reviewed, and follow-up data were collected from all survivors...
September 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28859363/appropriate-timing-for-surgery-after-neoadjuvant-chemoradiation-for-esophageal-cancer
#19
J S Tsang, D K H Tong, K O Lam, B T T Law, I Y H Wong, D K K Chan, F S Y Chan, D Kwong, S Law
Optimal interval between neoadjuvant chemoradiotherapy (CRT) and surgery is not elucidated for esophageal squamous carcinoma. The aim of this study is to evaluate the impact of this time interval on patient outcome. Patients treated with neoadjuvant CRT followed by surgery between 2002 and 2009 were analyzed. Patients were divided into two groups based on the median interval to surgery (64 days): A </= 64 days (n = 54) and B > 64 days (n = 53). A second analysis was performed by re-classifying patients into three interval groups: A* ≤ 40 days (n = 16); B* 41-80 days (n = 60); C* > 80 days (n = 31)...
September 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28852961/late-anastomotic-breakdown-with-bevacizumab-in-colorectal-cancers-a-case-based-review
#20
REVIEW
T O'Hare, R McDermott, R Hannon
BACKGROUND: Bevacizumab is the first angiogenesis inhibitor to be approved for metastatic colorectal cancer. Unfortunately, bevacizumab treatment has been associated with a variety of complications including haemorrhage, poor wound healing and gastrointestinal perforation. Late anastomotic breakdown related to bevacizumab therapy however has rarely been described. CASE REPORT: Here, we present the case of a 56-year-old woman who had a bevacizumab-related anastomotic breakdown 17 months following her primary anastomosis...
August 29, 2017: Irish Journal of Medical Science
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