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Anastomotic leak

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https://www.readbyqxmd.com/read/28749112/serum-procalcitonin-predicts-anastomotic-leaks-in-colorectal-surgery
#1
Firdaus Hayati, Zairul Azwan Mohd Azman, Dian Nasriana Nasuruddin, Luqman Mazlan, Andee Dzulkarnaen Zakaria, Ismail Sagap
Background: Anastomotic leaks in colorectal surgery results in a high morbidity and mortality rate. Serum procalcitonin levels is known as a sensitive and specific marker of sepsis and could be use as a marker for early detection of a leak allowing early intervention. It may help a clinician decide to perform a CT scan even earlier especially when the diagnosis of a leak is uncertain. The aim of this study is to determine whether serum procalcitonin is a good predictor of anastomotic leak in colorectal surgery...
July 27, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28745410/short-and-medium-term-outcomes-following-primary-ileocaecal-resection-for-crohn-s-disease-in-two-specialist-centres
#2
A de Buck van Overstraeten, E J Eshuis, S Vermeire, G Van Assche, M Ferrante, G R D'Haens, C Y Ponsioen, A Belmans, C J Buskens, A M Wolthuis, W A Bemelman, A D'Hoore
BACKGROUND: Despite improvements in medical therapy, the majority of patients with Crohn's disease still require surgery. The aim of this study was to report safety, and clinical and surgical recurrence rates, including predictors of recurrence, after ileocaecal resection for Crohn's disease. METHODS: This was a cohort analysis of consecutive patients undergoing a first ileocaecal resection for Crohn's disease between 1998 and 2013 at one of two specialist centres...
July 26, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28744744/the-effect-of-neoadjuvant-chemoradiation-on-anastomotic-leak-and-additional-30-day-morbidity-and-mortality-in-patients-undergoing-total-gastrectomy-for-gastric-cancer
#3
Ivy N Haskins, Matthew D Kroh, Richard L Amdur, Jeffrey L Ponksy, John H Rodriguez, Khashayar Vaziri
INTRODUCTION: In addition to increased perioperative morbidity, anastomotic leak following gastric resection for gastric cancer can have detrimental effects on overall and disease-free survival. The risk of anastomotic leak following neoadjuvant therapy remains unknown. The purpose of this study is to investigate the association of preoperative chemotherapy and radiation therapy with postoperative anastomotic leak and additional 30-day morbidity and mortality outcomes following total gastrectomy with reconstruction for gastric cancer using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP)...
July 25, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28743178/multicenter-analysis-of-transanal-tube-placement-for-prevention-of-anastomotic-leak-after-low-anterior-resection
#4
Saori Goto, Koya Hida, Kenji Kawada, Ryosuke Okamura, Suguru Hasegawa, Takahisa Kyogoku, Shuichi Ota, Yukito Adachi, Yoshiharu Sakai
BACKGROUND: Anastomotic leak (AL) is a serious complication of low anterior resection (LAR). This study aimed to evaluate the effect of transanal tube placement for prevention of AL. METHODS: This multicenter retrospective cohort study enrolled 328 consecutive patients who underwent LAR for rectal cancer at participating hospitals from 2009 to 2014. Multivariate logistic regression was used to adjust for confounding factors. RESULTS: A transanal tube was placed in 205 patients (TA group) and not placed in 123 patients (non-TA group)...
July 25, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28739093/individual-surgeon-is-an-independent-risk-factor-for-leak-after-double-stapled-colorectal-anastomosis-an-institutional-analysis-of-800-patients
#5
Eduardo García-Granero, Francisco Navarro, Carlos Cerdán Santacruz, Matteo Frasson, Alvaro García-Granero, Franco Marinello, Blas Flor-Lorente, Alejandro Espí
BACKGROUND: Our aim was to assess whether the individual surgeon is an independent risk factor for anastomotic leak in double-stapled colorectal anastomosis after left colon and rectal cancer resection. METHODS: This retrospective analysis of a prospectively collected database consists of a consecutive series of 800 patients who underwent an elective left colon and rectal resection with a colorectal, double-stapled anastomosis between 1993 and 2009 in a specialized colorectal unit of a tertiary hospital with 7 participating surgeons...
July 21, 2017: Surgery
https://www.readbyqxmd.com/read/28738953/morbidity-associated-with-diverting-loop-ileostomies-weighing-diversion-in-rectosigmoid-resection
#6
Nathan Belkin, Liliana G Bordeianou, Paul C Shellito, Alexander T Hawkins
Anterior resection with primary anastomosis is the procedure of choice for patients with rectosigmoid cancers with good sphincter function. Surgeons may perform an associated diverting loop ileostomy (DLI) to minimize the likelihood and/or the severity of an anastomotic leak. To examine the morbidity of DLIs, we performed a review of a prospectively maintained database. Participants included all patients at the Massachusetts General Hospital who underwent anterior resection from January 2013 to July 2015 for rectosigmoid cancers and who subsequently underwent adjuvant chemotherapy...
July 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28738239/delayed-graft-duodenal-perforation-due-to-impacted-food-five-years-after-simultaneous-pancreas-kidney-transplantation-a-case-report
#7
Taizo Sakata, Hideki Katagiri, Tadao Kubota, Takashi Sakamoto, Kentaro Yoshikawa, Alan Kawarai Lefor, Cheol Woong Jung, Toru Kojima
INTRODUCTION: Pancreas transplantation is the best treatment option in selected patients with type 1 diabetes mellitus. Here we report a patient with a nonmarginal duodenal perforation five years after a simultaneous pancreas-living donor kidney transplantation (SPLKT). PRESENTATION OF CASE: A 31-year old male who underwent SPLKT five years previously presented with severe abdominal pain. He had a marginal duodenal perforation four years later, treated by primary closure and drainage...
July 14, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28736640/systematic-review-and-a-meta-analysis-of-hospital-and-surgeon-volume-outcome-relationships-in-colorectal-cancer-surgery
#8
Ya Ruth Huo, Kevin Phan, David L Morris, Winston Liauw
BACKGROUND: Numerous hospitals worldwide are considering setting minimum volume standards for colorectal surgery. This study aims to examine the association between hospital and surgeon volume on outcomes for colorectal surgery. METHODS: Two investigators independently reviewed six databases from inception to May 2016 for articles that reported outcomes according to hospital and/or surgeon volume. Eligible studies included those in which assessed the association hospital or surgeon volume with outcomes for the surgical treatment of colon and/or rectal cancer...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#9
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC).. METHOD: Patients were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
July 22, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28732747/shorter-overall-operative-time-when-barbed-suture-is-used-in-primary-laparoscopic-gastric-bypass-a-cohort-study-of-25-006-cases
#10
Bjarni Vidarsson, Magnus Sundbom, David Edholm
BACKGROUND: Closing the remaining opening in a linear stapled anastomosis, for example in laparoscopic Roux-en-Y gastric bypass (LRYGB), can be challenging. OBJECTIVES: To evaluate if the novel unidirectional barbed suture (BS) is of value in LRYGB compared with polyfilament (PS) suture. We have compared operative time, early complications, and length of stay, as well as anastomotic strictures and small bowel obstruction during the first year. SETTING: Retrospective study from the Scandinavian Obesity Surgery Registry (SOReg)...
April 25, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#11
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726145/robotic-gastric-bypass-may-lead-to-fewer-complications-compared-with-laparoscopy
#12
Dimitrios Stefanidis, Savannah B Bailey, Timothy Kuwada, Connie Simms, Keith Gersin
BACKGROUND: Robotic technology leads to improved visualization and precision over laparoscopy but also higher cost of care. The benefits of this technology to patient outcomes are controversial. Our objective was to assess whether the application of robotic surgery to Roux-en-Y gastric bypass (RYGB) would lead to improved patient outcomes. METHODS: A prospectively collected database at a bariatric center of excellence was reviewed for all RYGB procedures performed by one surgeon between 2007 and 2015...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28723752/full-covered-self-expandable-metal-stents-for-the-treatment-of-anastomotic-leak-using-a-silk-thread
#13
Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Su Jin Kim, Sun Hwi Hwang, Si Hak Lee
To evaluate the safety and effectiveness of fixation of the fully covered self-expandable metal stent (SEMS) placement using a silk thread for complete closure of an anastomotic leak. An anastomotic leak is a life-threatening complication after gastrectomy. Although the traditional treatment of choice was surgical re-intervention, an endoscopic SEMS can be used alternatively.During the study period, we retrospectively reviewed consecutive patients who received a modified covered SEMS capable of being fixed using a silk thread (Shim technique) due to an anastomotic leak after gastrectomy to prevent stent migration...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723230/retrograde-endourological-management-of-upper-urinary-tract-abnormalities-in-patients-with-ileal-conduit-urinary-diversion-a-dual-center-experience
#14
Louise Olson, Hywel Satherley, Paul Cleaveland, Bachar Zelhof, Max Mokete, Donald Neilson, Shalom Srirangam
INTRODUCTION: Patients with ileal conduit urinary diversions are at an increased risk of long-term upper urinary tract (UUT) complications, including anastomotic strictures, infections, and urolithiasis. The reconstructed urinary system poses challenges for endoscopic manipulation. We present and describe our dual-center experience in performing retrograde ureteroscopy to treat or diagnose UUT abnormalities in patients with ileal conduit incontinent diversion. PATIENT AND METHODS: We performed a retrospective analysis of medical records for all patients with previous urinary diversion who underwent retrograde ureteroscopic procedures via the ileal loop in our institutions over a 9 year period (between June 2007 and August 2016)...
July 19, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28721194/successful-laparoscopic-repair-of-gastro-gastric-fistula-following-roux-en-y-gastric-bypass-at-harlem-community-hospital
#15
Saqib Saeed, Sara Alothman, Amrita Persaud, Sanjiv Gray, Leaque Ahmed
Gastro-gastric fistula is a communication between the gastric remnant and gastric pouch. It is a rare complication of Roux-en-Y gastric bypass. It is caused by anastomotic leak, marginal ulcers, distal obstruction or erosion from foreign body. In this case report, we are presenting a successful laparoscopic repair of gastro-gastric fistula in a patient who presented with weight gain after initial loss.
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28718940/changes-in-treatment-and-outcome-of-oesophageal-cancer-in-denmark-between-2004-and-2013
#16
D W Kjaer, H Larsson, L B Svendsen, L S Jensen
BACKGROUND: Since 2003, care for patients with oesophageal cancer has been centralized in a few dedicated centres in Denmark. The aim of this study was to assess changes in the treatment and outcome of patients registered in a nationwide database. METHODS: All patients diagnosed with oesophageal cancer or cancer of the gastro-oesophageal junction who underwent oesophagectomy in Denmark between 2004 and 2013, and who were registered in the Danish clinical database of carcinomas in the oesophagus, gastro-oesophageal junction and stomach (DECV database) were included...
July 18, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28717916/colon-perfusion-patterns-during-colorectal-resection-using-visible-light-spectroscopy
#17
Henry Hoffmann, Tarik Delko, Philipp Kirchhoff, Rachel Rosenthal, Juliane Schäfer, Marko Kraljević, Christoph Kettelhack
BACKGROUND: The impact of blood supply to the anastomosis on development of anastomotic leakage is still a matter of debate. Considering that bowel perfusion may be affected by manipulation during surgery, perfusion assessment of the anastomosis alone may be of limited value. We propose perfusion assessment at different time points during surgery to explore the dynamics of bowel perfusion during colorectal resection and its impact on outcome. METHODS: In this prospective cohort study, patients undergoing elective colorectal resection were eligible...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28710609/laparoscopic-colectomy-in-the-obese-morbidly-obese-and-super-morbidly-obese-when-does-weight-matter
#18
Bradley J Champagne, Madhuri Nishtala, Justin T Brady, Benjamin P Crawshaw, Morris E Franklin, Conor P Delaney, Scott R Steele
PURPOSE: Previous studies have demonstrated that obese patients (BMI >30) undergoing laparoscopic colectomy have longer operative times and increased complications when compared to non-obese cohorts. However, there is little data that specifically evaluates the outcomes of obese patients based on the degree of their obesity. The aim of this study was to evaluate the impact of increasing severity of obesity on patients undergoing laparoscopic colectomy. METHODS: A retrospective review was performed of all patients undergoing laparoscopic colectomy between 1996 and 2013...
July 14, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28702861/outcomes-of-a-single-surgeon-based-transanal-total-mesorectal-excision-tatme-for-rectal-cancer
#19
Antonio Caycedo-Marulanda, Henry Y Jiang, Erica L Kohtakangas
BACKGROUND: Several studies have shown the transanal total mesorectal excision (TATME) is emerging as a safe and effective technique for proctectomy. The majority of these studies to date, however, is based on procedures done in centers with teams of two surgeons working simultaneously. Few were performed by single-surgeon teams with sizeable case load. The objective of our study was to identify the feasibility and safety of a single-surgeon TATME. METHODS: Chart review of prospectively collected data on 27 patients who underwent TATME at our institution from June 2015 to September 2016 were included in this study...
July 13, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28700005/fluorescent-test-accurately-predicts-leak-of-ischemic-colon-anastomosis-in-rats
#20
Laura Moschetti, Tiago Leal Ghezzi, Belisa Gomes Müller, Adriano Basso Dias, Oly Campos Corleta
Purpose: To investigate if fluorescein fluorescent test can predict dehiscence in a model of ischemic colonic anastomosis in rats. Methods: This experimental controlled trial randomly assigned 55 rats to four groups. Anastomoses were performed in non-ischemic colon segments (control group) and in ischemic colon segments measuring 1, 2 or 3 cm long (groups 1, 2 and 3, respectively). Fluorescein was injected and the tissues were examined under ultraviolet light. Seven days later, a second-look surgery was performed to check for the presence or absence of anastomosis dehiscence...
June 2017: Acta Cirúrgica Brasileira
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