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Anastomotic leak

Graeme C Hintz, Abdullah Alshehri, Carolyn M Bell, Sonia A Butterworth
BACKGROUND: Whereas the adult literature has demonstrated the acceptable safety profile of stapled anastomoses when compared to the hand-sewn alternative, the choice of intestinal anastomosis using sutures or staples remains inadequately investigated in children. The purpose of this study is to compare the anastomotic outcomes of both techniques in children under 5years of age. METHODS: A retrospective analysis of patients undergoing intestinal anastomosis at a single tertiary centre (2012-2016) was undertaken...
February 8, 2018: Journal of Pediatric Surgery
A Zarzavadjian Le Bian, C Denet, N Tabchouri, H Levard, R Besson, T Perniceni, R Costi, P Wind, D Fuks, B Gayet
BACKGROUND: Among the criteria used to diagnose metabolic syndrome (MS), obesity and diabetes mellitus (DM) are associated with poor postoperative outcomes following colectomy. MS is also associated with colorectal cancer (CRC) and diverticulosis, both of which may be treated with colectomy. However, the effect of MS on postoperative outcomes following laparoscopic colectomy has yet to be clarified. METHODS: In an academic tertiary hospital, data from all consecutive patients undergoing laparoscopic colectomy from 2005 to 2014 were prospectively recorded and analysed...
March 14, 2018: Techniques in Coloproctology
Ki Young Lee, Jung Kyoung Shin, Yoon Ah Park, Seong Hyeon Yun, Jung Wook Huh, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee
Purpose: This study aimed to compare short-term postoperative and oncologic outcomes of a transanal endoscopic total mesorectal excision (TME) to those of a transabdominal robotic TME. Methods: A total of 62 patients with rectal cancer underwent transanal (n = 26) or robotic (n = 36) TME between June 2013 and December 2014. After case-matching by tumor location and TNM stage, 45 patients were included for analysis. The median follow-up period was 21.3 months. Operative, histopathologic and postoperative outcomes and recurrences were analyzed...
February 2018: Annals of Coloproctology
Amit Surve, Daniel Cottam, Andres Sanchez-Pernaute, Antonio Torres, Joshua Roller, Yong Kwon, Joshua Mourot, Bleu Schniederjan, Bo Neichoy, Paul Enochs, Michael Tyner, Jon Bruce, Scott Bovard, Mitchell Roslin, Muhammad Jawad, Andre Teixeira, Myur Srikanth, Jason Free, Hinali Zaveri, David Pilati, Jamie Bull, LeGrand Belnap, Christina Richards, Walter Medlin, Rena Moon, Austin Cottam, Sarah Sabrudin, Samuel Cottam, Aneesh Dhorepatil
BACKGROUND: The single-anastomosis duodenal switch procedure is a type of duodenal switch that involves a loop anastomosis rather than traditional Roux-en-Y reconstruction. To date, there have been no multicenter studies looking at the complications associated with post-pyloric loop reconstruction. OBJECTIVES: The aim of the study was to report the incidence of complications associated with loop duodeno-ileostomy (DI) following single-anastomosis duodenal switch (SADS) procedures...
February 2, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
José Vicente Roig, Antonio Salvador, Matteo Frasson, Lucas García-Mayor, Javier Espinosa, Vicente Roselló, Juan Hernandis, María Dolores Ruiz-Carmona, Natalia Uribe, Rafael García-Calvo, Juan Carlos Bernal, Juan García-Armengol, Eduardo García-Granero
INTRODUCTION THE AIM: was to analyse the stoma reversal rate after surgery for complicated acute diverticulitis (CAD), and more specifically the end-stoma-reversal, as well as the delay, feasibility, complications and risk factors for stoma maintenance. METHODS: A multicentre retrospective study of patients who had undergone urgent surgery for CAD with stoma formation in ten hospitals during a period of 6 years. The frequency of reversal over time and the factors affecting the decision for reversal were analysed...
March 9, 2018: Cirugía Española
S Mejía-Rivera, S A Pérez-Marroquín, R Cortés-González, H Medina-Franco
INTRODUCTION AND AIMS: Esophagectomy is a highly invasive surgery and one of its postoperative complications is anastomotic leakage, occurring in 53% of cases. The aim of the present study was to determine the sensitivity of the contrast-enhanced swallow study as a method for diagnosing anastomotic leak in patients that underwent esophagectomy. MATERIAL AND METHODS: The present retrospective study included the case records of patients that underwent esophagectomy with reconstruction and cervical anastomosis at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán within the time frame of January 1, 2000 and May 31, 2006...
March 7, 2018: Revista de Gastroenterología de México
José Luis Muñoz, María Oliva Alvarez, Vicent Cuquerella, Elena Miranda, Carlos Picó, Raquel Flores, Marta Resalt-Pereira, Pedro Moya, Ana Pérez, Antonio Arroyo
BACKGROUND: C-reactive protein (CRP) and procalcitonin (PCT) have been described as good predictors of anastomotic leak after colorectal surgery, obtaining the highest diagnostic accuracy on the 5th postoperative day. However, if an enhanced recovery after surgery (ERAS) program is performed, early predictors are needed in order to ensure a safe and early discharge. The aim of this study was to investigate the efficacy of CRP, PCT, and white blood cell (WBC) count determined on first postoperative days, in predicting septic complications, especially anastomotic leak, after laparoscopic colorectal surgery performed within an ERAS program...
March 8, 2018: Surgical Endoscopy
Amador García Ruiz de Gordejuela, Almino Cardoso Ramos, Manoel Galvao Neto, Mario Nora, Antonio J Torres García, Andrés Sánchez Pernaute, Jordi Pujol Gebelli
INTRODUCTION: Live surgery is a topic of interest at every meeting or course in the field of surgery. The potential of laparoscopy for live broadcasting makes it an excellent tool in continuing medical education. Surgeons who participate in live surgeries are usually experienced, but several conditions may influence the results and safety of a procedure. OBJECTIVES: To analyze safety and outcomes in a series of patients who underwent surgery in the last 10 years in a live surgery course at our institution...
March 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Emanuele Asti, Gianluca Bonitta, Matteo Melloni, Stefania Tornese, Pamela Milito, Andrea Sironi, Elena Costa, Luigi Bonavina
BACKGROUND: Early detection of anastomotic leakage after esophagectomy has the potential to reduce morbidity and mortality. Prompt suspicion of leak may help to exclude patients from fast-track protocols, thereby avoiding early oral feeding and early hospital discharge which could aggravate the prognosis of a clinically occult leak. PATIENTS AND METHODS: Observational retrospective cohort study. Patients with diagnosis of esophageal cancer who underwent elective minimally invasive esophagectomy were included...
March 7, 2018: Langenbeck's Archives of Surgery
Rana Madani, Nigel Day, Lalit Kumar, Henry S Tilney, Andrew Mark Gudgeon
BACKGROUND: Individual trials comparing hand-sewn with stapled closure of loop ileostomy show different outcomes due to lack of statistical power. A systematic review, with a pooled analysis of results, might provide a more definitive answer. This review aimed to compare hand-sewn with stapled anastomotic technique for closure of a loop ileostomy and looked at the effect of bowel resection on the complication rates. METHODOLOGY: Relevant studies were identified from MEDLINE, EMBASE and the Cochrane database...
March 7, 2018: Digestive Surgery
Brian K P Goh, Lip-Seng Lee, Ser-Yee Lee, Pierce K H Chow, Chung-Yip Chan, Adrian K H Chiow
BACKGROUND: Presently, the adoption of laparoscopic hepatectomy is rapidly increasingly worldwide. However, the application of robotic hepatectomy (RH) remains limited and its role remains undefined today. METHODS: A retrospective review of 43 consecutive patients who underwent RH at two institutions in the Singapore Health Services Group. RESULTS: Forty-three consecutive patients underwent 48 resections during the study period. Seven (16...
March 7, 2018: ANZ Journal of Surgery
L Lee, S Liberman, P Charlebois, B Stein, P Kaneva, F Carli, L S Feldman
BACKGROUND: Despite the implementation of enhanced recovery pathways (ERP), morbidity following colorectal surgery remains high. The aim of the present study was to estimate the impact of postoperative complications on excess hospital length of stay (LOS) in patients undergoing elective colorectal resection. METHODS: A retrospective study of patients undergoing elective colorectal surgery at a single institution from 2003 to 2010 was performed. Patients managed by an ERP were compared to conventional care (CC), matched by propensity score radius matching...
March 5, 2018: Techniques in Coloproctology
M Rottoli, M P Di Simone, C Vallicelli, L Vittori, G Liguori, L Boschi, G Poggioli
BACKGROUND: Anastomotic leak after ileal pouch-anal anastomosis (IPAA) could lead to poor functional results and failure of the pouch. The aim of the present study was to analyze the outcomes of the vacuum-assisted closure therapy as the unique treatment for anastomotic leaks following IPAA without any additional surgical operations. METHODS: Consecutive patients with anastomotic leak after IPAA treated at our institution between March 2016 and March 2017 were prospectively enrolled...
March 3, 2018: Techniques in Coloproctology
Jared W Clouse, Chandrashekhar A Kubal, Jonathan A Fridell, Richard S Mangus
This study reports the clinical complication and infection rates of an active pediatric IT program that has never utilized bowel decontamination in either the donor or the recipient. All patients undergoing IT from 2003 to 2015 at a single pediatric IT center were reviewed. Post-transplant surgical, infectious, and immunosuppressive complications are reported. There were 52 patients who underwent IT during the study period. Among these patients, 4% developed a postoperative abscess, one developed an enteric fistula (2%), and one had an enteric or anastomotic leak (2%)...
March 2, 2018: Pediatric Transplantation
J Apers, R Wijkmans, E Totte, M Emous
BACKGROUND: Mini gastric bypass (MGB) is a promising and attractive alternative bariatric procedure. In 2011, we introduced MGB in our high-volume bariatric unit. Subsequently, we evaluated short- and midterm results of this procedure. METHODS: A prospective cohort of patients who underwent MGB between 2012 and 2013 was retrospectively evaluated. RESULTS: From 2012 to 2013, primary MGB was performed in 287 patients with a mean BMI of 42 kg/m2 (range 32-76 kg/m2 )...
February 28, 2018: Surgical Endoscopy
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...
February 27, 2018: Annals of the Royal College of Surgeons of England
J Trotter, L Onos, C McNaught, M Peter, M Gatt, K Maude, J MacFie
Introduction One of the most feared complications of colorectal surgery is anastomotic leak. Numerous techniques have been studied in the hope of decreasing leakage. This study was designed to assess the handling characteristics of a novel adhesive tissue patch (TissuePatch™; Tissuemed, Leeds, UK) applied to colorectal anastomoses in a pilot study. This was with a view to assessing its potential role in aiding anastomotic healing in subsequent trials. Methods A patch was applied to colorectal anastomoses after the surgeon had completed the anastomosis and prior to abdominal closure...
March 2018: Annals of the Royal College of Surgeons of England
Ephraim Katz, Ian White, Baruch Shpitz, Ronen Ghinea, Shmuel Avital
No abstract text is available yet for this article.
February 26, 2018: Techniques in Coloproctology
Wenjie Ma, Yongqiong Tan, Anuj Shrestha, Fuyu Li, Rongxing Zhou, Junke Wang, Haijie Hu, Qin Yang
Objective: To compare Roux-en-Y hepatico-jejunostomy with complete resection of the cyst or incomplete resection with 1-cm remnant proximal cyst wall in treating adult type I choledochal cyst (CC). Methods: The medical records of 267 adult patients with type I CC from January 1998 to December 2015 were reviewed retrospectively. Among them, 171 underwent Roux-en-Y hepatico-jejunostomy with complete resection (PBD 0-cm group) and 96 underwent Roux-en-Y hepatico-jejunostomy with 1-cm proximal cyst wall left (PBD 1-cm group)...
February 2018: Gastroenterology Report
Elisa Cassinotti, Stefano Costa, Stefano DE Pascale, Barbara Oreggia, Giorgio Palazzini, Luigi Boni
BACKGROUND: Anastomotic leakage (AL) is a serious complication in colorectal surgery leading to significant morbidity and mortality. Progressively lower anastomoses are associated with a greater leak rate. Adequate bowel perfusion has been stressed as one of the key elements for suture healing. Currently, there is no widespread method to assess and quantify the perfusion of gastrointestinal anastomoses intraoperatively, besides the subjective evaluation by the surgeon. The aim of this paper is to describe the basis of Indocyanine Green (ICG) fluorescence guided surgery applied to assessment of bowel perfusion and to highlight studies on the use of fluorescence angiography (FA) in laparoscopic rectal surgery...
February 21, 2018: Minerva Chirurgica
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