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Anastomotic leak

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https://www.readbyqxmd.com/read/28080215/laparoscopy-assisted-duhamel-z-anastomosis-for-total-colonic-aganglionosis-outcome-assessed-by-fecal-continence-evaluation
#1
Go Miyano, Hiroki Nakamura, Shogo Seo, Ryo Sueyoshi, Manabu Okawada, Takashi Doi, Hiroyuki Koga, Geoffrey J Lane, Tadaharu Okazaki, Atsuyuki Yamataka
BACKGROUND: A Z-shaped colorectal side-to-side anastomosis was introduced to improve the Duhamel procedure by eliminating the rectal blind pouch. We retrospectively reviewed all total colonic aganglionosis patients treated by laparoscopy-assisted Duhamel-Z (LapDZ) between 2009 and 2014 focusing on annual fecal continence evaluation scores (CES) as an indicator of outcome. METHODS: LapDZ was performed conventionally. Postoperatively, defecation was regulated with medications and enemas according to our standard protocol...
January 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28079244/preoperative-multidisciplinary-program-for-bariatric-surgery-a-proposal-for-the-brazilian-public-health-system
#2
Elinton Adami Chaim, José Carlos Pareja, Martinho Antonio Gestic, Murillo Pimentel Utrini, Everton Cazzo
BACKGROUND: - Bariatric surgery has become the gold standard treatment for morbid obesity, but access to surgery remains difficult and low compliance to postoperative follow-up is common. To improve outcomes, enable access and optimize follow-up, we developed a multidisciplinary preoperative approach for bariatric surgery. OBJECTIVE: - To determine the impact of this program in the outcomes of bariatric surgery in the Brazilian public health system. METHODS: - A prospective evaluation of the individuals who underwent a preoperative multidisciplinary program for bariatric surgery and comparison of their surgical outcomes with those observed in the prospectively collected historical database of the individuals who underwent surgery before the beginning of the program...
January 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28078465/non-inferiority-of-minimally-invasive-oesophagectomy-an-8-year-retrospective-case-series
#3
L Findlay, C Yao, D H Bennett, R Byrom, N Davies
BACKGROUND: The trend towards laparoscopic surgery seen in other specialties has not occurred at the same pace in oesophagectomy. This stems from concerns regarding compromised oncological clearance, and complications associated with gastric tube necrosis and anastomotic failure. We present our experience of minimally invasive oesophagectomy (MIO) compared to open and hybrid surgery. We aim to ascertain non-inferiority of MIO by evaluating impact on survival, oncological clearance by resection margin and lymph node harvest and post-operative complications...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28078463/endoscopic-vacuum-therapy-for-various-defects-of-the-upper-gastrointestinal-tract
#4
Florian Kuehn, Gunnar Loske, Leif Schiffmann, Michael Gock, Ernst Klar
BACKGROUND: Postoperative, iatrogenic or spontaneous upper gastrointestinal defects result in significant morbidity and mortality of the patients. In the last few years, endoscopic vacuum therapy (EVT) has been recognized as a new promising method for repairing upper gastrointestinal defects of different etiology. However, probably due to insufficient data and no commercially available system for EVT of the upper gastrointestinal tract, until the end of 2014, covering of esophageal defects with self-expanding metal stents (SEMS) were still the mainstay of endoscopic therapy...
January 11, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28078131/a-novel-management-of-post-oesophagectomy-gastro-pleural-fistula
#5
Javaid Ishtiaq, Jonathan Sutton, Waqar Ahmed
Oesophageal anastomotic leak and fistula are major and life-threatening complications of oesophagectomy with resultant increased mortality. Non-operative approach of such cases should be the initial strategy. Re-operative surgery and/or stent insertion are considered if conservative measures failed. Although oesophageal stenting is a safe option for the leaks, stent migration and failure to completely cover large anastomotic leaks are the main complications and pitfalls of the procedure. These can be overcome by using multiple or larger stents...
December 2016: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28067081/-relationship-of-consequences-of-anastomotic-insufficiency-and-bacterial-flora-of-oral-cavity-in-patients-with-esophageal-and-cardia-cancer
#6
Ákos Balázs, Beáta Winkler, Katalin Kristóf, László Harsányi, Lívia Bokor
INTRODUCTION: In the course of anastomotic insufficiency following resection of esophageal cancers the bacterial compound of the esophageal substance has a remarkable, presumable role in the outcome of complications. AIM: The purpose of this study is to compare the consequences of the anastomotic leak with the bacterial flora of patients' oral cavity. METHOD: In this prospective study a total of 131 patients were investigated directly before the surgical intervention taking a bacterial sample...
January 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28063681/is-fundoplication-required-after-the-foker-procedure-for-long-gap-esophageal-atresia
#7
Dylan Wanaguru, Catherine Langusch, Usha Krishnan, Vincent Varjavandi, Ashish Jiwane, Susan Adams, Guy Henry
BACKGROUND: Fundoplication has been performed almost universally in children treated with the Foker procedure (FP) for long gap esophageal atresia (LGEA). We report our experience with pharmacological management and endoscopic surveillance rather than early routine fundoplication in infants treated with the FP. METHODS: A retrospective chart review was performed of all children treated with the Foker procedure at our institution. RESULTS: Nine children have undergone the FP since 2007...
December 28, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28062891/surgical-techniques-for-esophageal-replacement-in-children
#8
REVIEW
Shilpa Sharma, Devendra K Gupta
PURPOSE: Surgical techniques for esophageal replacement (ER) in children include colon interposition, gastric tube, gastric transposition, and jejunal interposition. This review evaluates the merits and demerits of each. METHOD: Surgical techniques, complications, and outcome of ER are reviewed over last seven decades. RESULTS: Colon interposition is the time-tested procedure with minimal and less serious complications. Long-term complications include reflux, halitosis, colonic segment dilatation, and anastomotic stricture, sometimes requiring surgical interventions especially for dilatation and reflux...
January 6, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28059918/quality-improvement-initiatives-in-colorectal-surgery-value-of-physician-feedback
#9
Joshua A Waters, Todd Francone, Peter W Marcello, Patricia L Roberts, David J Schoetz, Thomas E Read, Caitlin Stafford, Rocco Ricciardi
BACKGROUND: The impact of process improvement through surgeon feedback on outcomes is unclear. OBJECTIVE: We sought to evaluate the effect of biannual surgeon-specific feedback on outcomes and adherence to departmental and Surgical Care Improvement Project process measures on colorectal surgery outcomes. DESIGN: This was a retrospective analysis of prospectively collected 100% capture surgical quality improvement data. SETTING: This study was conducted at the department of colorectal surgery at a tertiary care teaching hospital from January 2008 through December 2013...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059917/characterization-of-readmission-by-day-of-rehospitalization-after-colorectal-surgery
#10
Ahmed M Al-Mazrou, Kunal Suradkar, Christine M Mauro, Ravi P Kiran
BACKGROUND: Factors associated with readmission stratified by the day of postdischarge rehospitalization after colorectal surgery have not been characterized previously. OBJECTIVE: The purpose of this study was to identify factors leading to readmission on a day-to-day basis after discharge from colorectal surgery. DESIGN: This was a retrospective analysis of patients readmitted within 30-days after colorectal surgery. Reasons and factors associated with readmission each day after discharge were evaluated...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28041688/laparoscopic-surgical-treatment-of-ileocecal-crohn-s-disease-impact-of-obesity-on-short-term-results
#11
David Parés, Awad Shamali, Karen Flashman, Daniel O'Leary, Asha Senapati, John Conti, Amjad Parvaiz, Jim Khan
INTRODUCTION: The aim of our study was to analyse the short-term outcomes of laparoscopic surgery for a no medical responding ileocolic Cohn's disease in a single centre according to the presence of obesity. METHODS: A cross-sectional study was performed including all consecutive patients who underwent laparoscopic resection for ileocecal Crohn's disease from November 2006 to November 2015. Patients were divided according to body mass index ≥ 30 kg/m(2) in order to study influence of obesity in the short-term outcomes...
December 29, 2016: Cirugía Española
https://www.readbyqxmd.com/read/28039180/multimodality-treatment-for-esophageal-adenocaricnoma-multi-center-propensity-score-matched-study
#12
S R Markar, B J Noordman, H Mackenzie, J M Findlay, P R Boshier, M Ni, E W Steyerberg, A van der Gaast, M C C M Hulshof, N Maynard, M I van Berge Henegouwen, B P L Wijnhoven, J V Reynolds, J J B Van Lanschot, G B Hanna
BACKGROUND: The primary aim of this study was to compare survival from neoadjuvant chemoradiotherapy plus surgery (NCRS) versus neoadjuvant chemotherapy plus surgery (NCS) for the treatment of esophageal or junctional adenocarcinoma. The secondary aims were to compare pathological effects, short-term mortality and morbidity, and to evaluate the effect of lymph node harvest upon survival in both treatment groups. METHODS: Data were collected from 10 European centers from 2001 to 2012...
October 25, 2016: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28029449/perioperative-fluid-status-and-surgical-outcomes-in-patients-undergoing-cytoreductive-surgery-for-advanced-epithelial-ovarian-cancer
#13
M G Desale, E J Tanner, A K Sinno, A Africano Angarita, A N Fader, R L Stone, K L Levinson, R E Bristow, K Long Roche
OBJECTIVE: The objective of this study is to investigate the impact of fluid status on perioperative outcomes of patients undergoing cytoreductive surgery (CRS) for advanced epithelial ovarian cancer (EOC). METHODS: Patients undergoing CRS for stage III or IV EOC at a comprehensive cancer center from 12/2010 to 05/2015 were identified. Those who underwent upper abdominal procedures or colon resections were included. Demographic, perioperative, and 30-day complication data were collected...
October 28, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/28009740/surgeon-annual-and-cumulative-volumes-predict-early-postoperative-outcomes-after-rectal-cancer-resection
#14
Heather L Yeo, Jonathan S Abelson, Jialin Mao, Paul R A O'Mahoney, Jeffrey W Milsom, Art Sedrakyan
OBJECTIVE: To determine if 5-year surgeon cumulative and annual volumes predict improved early postoperative outcomes in patients with rectal cancer. BACKGROUND: Operative experience has been shown to effect surgical outcomes. The differential role of cumulative versus annual volume has not yet been explored for rectal surgery. METHODS: The Statewide Planning and Research Cooperative System database was used to capture patients undergoing surgery in New York State from 2000 to 2013...
January 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28000657/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#15
Morten Holt Thomsen, Henrik Ovesen, Jens Ravn Eriksen
INTRODUCTION: Incomplete specimens resulting in residual mesorectum in the patient and an increased risk of local recurrence remains a problem. We have introduced transanal-total mesorectal excision (Ta-TME) in our department to potentially overcome this problem due to more direct access to the lower pelvis in patients undergoing TME for rectal cancer and this article presents our initial experience with the new procedure. MATERIALS AND METHODS: Patients with a T1-T3 mid or low rectal cancer eligible for TME or intersphincteric abdominoperineal excision were selected for a combined transanal and transabdominal laparoscopic resection...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27999936/lack-of-evidence-for-tissue-hypoxia-as-a-contributing-factor-in-anastomotic-leak-following-colon-anastomosis-and-segmental-devascularization-in-rats
#16
B A Shakhsheer, B Lec, A Zaborin, K Guyton, A M Defnet, N Bagrodia, J J Kandel, O Zaborina, S L Hernandez, J Alverdy
PURPOSE: Current surgical dogma dictates that tissue ischemia and hypoxia are major contributing factors in anastomotic leak despite scant evidence. The aim of this study was to determine if tissue hypoxia is a feature of anastomotic leakage in rats following colon resection and segmental devascularization. METHODS: Rats were randomly assigned to undergo sham operation, segmental colon devascularization alone, colectomy alone, or segmental devascularization plus colectomy...
December 20, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27995450/prognostic-factors-and-significance-of-gastrointestinal-leak-after-cytoreductive-surgery-crs-with-heated-intraperitoneal-chemotherapy-hipec
#17
Konstantinos Chouliaras, Edward A Levine, Nora Fino, Perry Shen, Konstantinos I Votanopoulos
BACKGROUND: Gastrointestinal leak (GIL) after cytoreductive surgery with heated intraperitoneal chemotherapy (CRS/HIPEC) is associated with significant morbidity and mortality. This study aimed to identify GIL prognostic factors and its impact on overall survival. METHODS: A retrospective analysis of a prospectively maintained database comprising 1270 CRS/HIPEC procedures was performed. Type of GIL, functional and resection status, morbidity, mortality, and survival were reviewed...
December 19, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27995423/a-simple-web-based-risk-calculator-www-anastomoticleak-com-is-superior-to-the-surgeon-s-estimate-of-anastomotic-leak-after-colon-cancer-resection
#18
T Sammour, M Lewis, M L Thomas, M J Lawrence, A Hunter, J W Moore
BACKGROUND: Anastomotic leak can be a devastating complication, and early prediction is difficult. The aim of this study is to prospectively validate a simple anastomotic leak risk calculator and compare its predictive value with the estimate of the primary operating surgeon. METHODS: Consecutive patients undergoing elective or emergency colon cancer surgery with a primary anastomosis over a 1-year period were prospectively included. A recently published anastomotic leak risk nomogram was converted to an online calculator ( www...
December 19, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27994329/bypass-operation-for-unresectable-esophageal-cancer-postoperative-complications-after-thoracotomy-versus-no-thoracotomy
#19
Masahiro Kimura
Patients with unresectable esophageal cancer suffer from dysphagia, causing severe malnutrition and reduced quality of life (QOL). We elect to perform bypass because patients can have greater long-term survival with chemoradiation following this operation. We sought to compare complications in cases of bypass without thoracotomy versus those with thoracotomy. Thirty-four locally advanced esophageal cancer patients between 2007 and 2014 were studied. Eighteen patients underwent thoracotomy, and 16 patients did not have a thoracotomy...
October 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27993359/perioperative-management-and-outcomes-of-esophageal-atresia-and-tracheoesophageal-fistula
#20
Dave R Lal, Samir K Gadepalli, Cynthia D Downard, Daniel J Ostlie, Peter C Minneci, Ruth M Swedler, Thomas Chelius, Laura Cassidy, Cooper T Rapp, Katherine J Deans, Mary E Fallat, S Maria E Finnell, Michael A Helmrath, Ronald B Hirschl, Rashmi S Kabre, Charles M Leys, Grace Mak, Jessica Raque, Frederick J Rescorla, Jacqueline M Saito, Shawn D St Peter, Daniel von Allmen, Brad W Warner, Thomas T Sato
BACKGROUND/PURPOSE: Esophageal atresia/tracheoesophageal fistula (EA/TEF) is a rare congenital anomaly lacking contemporary data detailing patient demographics, medical/surgical management and outcomes. Substantial variation in the care of infants with EA/TEF may affect both short- and long-term outcomes. The purpose of this study was to characterize the demographics, management strategies and outcomes in a contemporary multi-institutional cohort of infants diagnosed with EA/TEF to identify potential areas for standardization of care...
December 5, 2016: Journal of Pediatric Surgery
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