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Anastomotic leak colon

Charbel Karam, Sally Lord, Rohan Gett, Alan P Meagher
BACKGROUND: Leak rates of over 5% following anastomoses between the ileum and colon continue to be reported in large series and are associated with substantial morbidity and with mortality rates of 10-20%. In 1994, we began performing circumferentially oversewn inverted stapled anastomoses in patients undergoing ileo-colic anastomoses or ileostomy closure. It has become increasingly apparent that this method is associated with a low risk of leakage, which we should report. METHODS: The anastomotic technique described was used in all patients undergoing ileo-colic anastomosis or closure of ileostomy by surgeon 1 (1994-2015) and in all ileo-colic anastomoses by surgeon 2 (2007-2015)...
October 20, 2016: ANZ Journal of Surgery
Shunji Morita, Kimimasa Ikeda, Takamichi Komori, Tsukasa Tanida, Hisanori Hatano, Yoshito Tomimaru, Hiroshi Imamura, Keizo Dono
BACKGROUND: Emergency surgery for obstructing colorectal cancer is associated with high mortality and morbidity rates. OBJECTIVE: The purpose of this study was to assess outcomes of emergency surgery for obstructing colorectal cancer in a single hospital, where care was primarily provided by colorectal surgeons. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at the Toyonaka Municipal Hospital...
November 2016: Diseases of the Colon and Rectum
David R Rosen, Grace S Hwang, Glenn T Ault, Adrian E Ortega, Kyle G Cologne
BACKGROUND: Diverticulitis has become a medically managed disease process; the indications and timing of surgical intervention have evolved. METHODS: We retrospectively reviewed all patients who underwent surgical intervention due to diverticular disease by the Division of Colon and Rectal Surgery from 2012 to 2014. RESULTS: Ninety-eight surgeries were performed. Indications included colovesicular fistula, multiple recurrences of diverticulitis, medically refractory diverticulitis, stricture, abscess, colocutaneous fistula, and colovaginal fistula...
August 3, 2016: American Journal of Surgery
Kristina Guyton, John C Alverdy
Surgery involving the gastrointestinal tract continues to prove challenging because of the persistence of unpredictable complications such as anastomotic leakage and life-threatening infections. Removal of diseased intestinal segments results in substantial catabolic stress and might require complex reconstructive surgery to maintain the functional continuity of the intestinal tract. As gastrointestinal surgery necessarily involves a breach of an epithelial barrier colonized by microorganisms, preoperative intestinal antisepsis is used to reduce infection-related complications...
October 12, 2016: Nature Reviews. Gastroenterology & Hepatology
Christoph A Maurer, Daniel Dietrich, Martin K Schilling, Urs Metzger, Urban Laffer, Peter Buchmann, Bruno Lerf, Peter Villiger, Gian Melcher, Christian Klaiber, Christian Bilat, Peter Brauchli, Luigi Terracciano, Katharina Kessler
PURPOSE: This study aimed to investigate in a multicenter cohort study the radicality of colorectal cancer resections, to assess the oncosurgical quality of colorectal specimens, and to compare the performance between centers. METHODS: One German and nine Swiss hospitals agreed to prospectively register all patients with primary colorectal cancer resected between September 2001 and June 2005. The median number of eligible patients with one primary tumor included per center was 95 (range 12-204)...
October 7, 2016: International Journal of Colorectal Disease
Ivy N Haskins, James W Fleshman, Richard L Amdur, Samir Agarwal
BACKGROUND AND OBJECTIVES: The routine use of preoperative bowel preparation (BP) is heavily debated in the colorectal surgery literature. To date, no study has investigated the effect preoperative BP has on patients with an established anastomotic leak. We therefore seek to compare the severity of patient morbidity and mortality in patients with a known anastomotic leak based on type of preoperative BP using the Targeted Colectomy American College of Surgeons National Surgery Quality Improvement Program (ACS-NSQIP)...
September 16, 2016: Journal of Surgical Oncology
M Raithel, H Albrecht, W Scheppach, M Farnbacher, W Haupt, A F Hagel, V Schellerer, F Vitali, M F Neurath, H T Schneider
BACKGROUND: Acute gastrointestinal (GI) wall defects contain a high risk of morbidity and mortality and may be closed endoscopically by a full-thickness over-the-scope clip (OTSC). METHODS: Unselected consecutive patients presenting with acute non-surgical perforations or postoperative anastomotic leaks or perforations underwent attempted OTSC placement as primary closure method after interdisciplinary consensus in three tertiary referral centres. Their clinical data and intervention characteristics were evaluated in an intention to treat analysis during a 24-month period to assess closure rates, 30-day mortality, hospitalization and comorbidity...
September 15, 2016: Surgical Endoscopy
Masayoshi Nakanishi, Yoshiaki Kuriu, Yasutoshi Murayama, Tomohiro Arita, Hiroshi Ito, Toshiyuki Kosuga, Ryo Morimura, Hirotaka Konishi, Syuhei Komatsu, Atsushi Shiozaki, Hisashi Ikoma, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Eigo Otsuji
AIM: Although laparoscopic surgery has made minimally invasive treatment available for colon cancer, various innovations aimed at developing even more minimally invasive treatment modalities have been reported in recent years. Needlescopic surgery, in which forceps with a small-diameter shaft are used to safely reduce invasiveness without increasing surgeons' stress, has been reported. We introduced the reduced-port surgery (RPS) technique by using needle forceps for the treatment of sigmoidal colon cancer and cancer of the rectosigmoidal region, with the aim of safely reducing invasiveness while maintaining curability...
September 2016: Anticancer Research
Luigi Boni, Abe Fingerhut, Alessandro Marzorati, Stefano Rausei, Gianlorenzo Dionigi, Elisa Cassinotti
INTRODUCTION: Colorectal anastomoses after anterior resection for cancer carry a high risk of leakage. Different factors might influence the correct healing of anastomosis, but adequate perfusion of the bowel is highlighted as one of the most important elements. Fluorescence angiography (FA) is a new technique that allows the surgeon to perform real-time intraoperative angiography to evaluate the perfusion of the anastomosis and hence, potentially, reduce leak rate. AIM: The aim of this study was to evaluate the impact of FA of the bowel on postoperative complications and anastomotic leakage after laparoscopic anterior resection with total mesorectal excision (TME)...
August 23, 2016: Surgical Endoscopy
Baddr A Shakhsheer, Luke A Versten, James N Luo, Jennifer R Defazio, Robin Klabbers, Scott Christley, Alexander Zaborin, Kristina L Guyton, Monika Krezalek, Daniel P Smith, Nadim J Ajami, Joseph F Petrosino, Irma D Fleming, Natalia Belogortseva, Olga Zaborina, John C Alverdy
BACKGROUND: Despite ever more powerful antibiotics, newer surgical techniques, and enhanced recovery programs, anastomotic leaks remain a clear and present danger to patients. Previous work from our laboratory suggests that anastomotic leakage may be caused by Enterococcus faecalis strains that express a high collagenase phenotype (i.e., collagenolytic). Yet the mechanisms by which the practice of surgery shifts or selects for collagenolytic phenotypes to colonize anastomotic tissues remain unknown...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Svetozar Antovic, Aleksandar Mitevski, Aleksandar Karagozov, Biljana Kuzmanovska, Nikola Jankulovski
AIM: Clinical evaluation of the safety and effectiveness of compression anastomosis with ColonRing™ for large-bowel end-to-end anastomosis for rectal cancer and explanation of the procedure and the device itself since this device is used for the first time in our clinic. MATERIAL AND METHODS: In November, 2012, a team of surgeons from our clinic attended the Clinical practice workshop in Belgrade, Serbia which was organized by the World Congress of Compression Anastomosis (WCCA) and held by its President Prof...
2016: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
Emilio Maseda, Alejandro H Rodríguez, Gerardo Aguilar, Javier Pemán, Rafael Zaragoza, Ricard Ferrer, Pedro Llinares, Santiago Grau
BACKGROUND: Although in the last decade the management of invasive fungal infections has improved, a number of controversies persist regarding the management of complicated intra-abdominal infection and surgical extended length-of-stay (LOS) patients in intensive care unit (ICU). AIMS: To identify the essential clinical knowledge and elaborate a set of recommendations, with a high level of consensus, necessary for the management of postsurgical patients with complicated intra-abdominal infection and surgical patients with ICU extended stay...
July 13, 2016: Revista Iberoamericana de Micología
Carrie E Ryan, Alessandro Paniccia, Robert A Meguid, Martin D McCarter
INTRODUCTION: Leaks from intrathoracic esophagogastric anastomosis are thought to be associated with higher rates of morbidity and mortality than leaks from cervical anastomosis. We challenge this assumption and hypothesize that there is no significant difference in mortality based on the location of the esophagogastric anastomosis. METHODS: A systematic literature search was conducted using PubMed and Embase databases on all studies published from January 2000 to June 2015, comparing transthoracic (TTE) and transhiatal (THE) esophagectomies...
July 12, 2016: Annals of Surgical Oncology
Anass Mohammed Majbar, Mourad Abid, Mouna Alaoui, Farid Sabbah, Mohamed Raiss, Mohamed Ahallat, Abdelmalek Hrora
BACKGROUND: The impact of conversion to open surgery after a laparoscopic resection for rectal adenocarcinoma on postoperative morbidity is still unclear. Most previous studies included colon and rectal carcinomas and produced conflicting results. The aim of this study was to investigate the impact of conversion to open surgery on early postoperative morbidity in patients who underwent a laparoscopic resection for rectal adenocarcinoma. METHODS: This was a retrospective bicentric study...
September 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Giampiero Soccorso, Dakshesh H Parikh
Replacement of a nonexistent or damaged esophagus continues to pose a significant challenge to pediatric surgeons. Various esophageal replacement grafts and techniques have not produced consistently good outcomes to emulate normal esophagus. Therefore, many techniques are still being practiced and recommended with no clear consensus. We present a concise literature review of the currently used techniques and with discussions on the advantages and anticipated morbidity. There are no randomized controlled pediatric studies to compare different types of esophageal replacements...
July 2016: Journal of Indian Association of Pediatric Surgeons
Philip Blasto Ooko, Seno Saruni, Mark Oloo, Hillary Mariko Topazian, Russell White
INTRODUCTION: Ileo-sigmoid knotting (ISK) is a rare cause of bowel obstruction in which the ileum twists around the sigmoid colon. It is associated with rapid bowel gangrene and a high mortality rate. Little has been published about this condition in Kenya. The objective was to determine the presentation, management, and outcome of patients with ISK. METHODS: A seven year (January 2008-December 2014) retrospective chart review of patients managed for ISK at Tenwek Hospital in Bomet, Kenya...
2016: Pan African Medical Journal
Monika A Krezalek, John C Alverdy
PURPOSE OF REVIEW: The purpose of this review is to highlight new research findings in the complex bidirectional crosstalk that occurs between the intestinal microbiome and the host immune system in the context of surgical recovery and outcomes. RECENT FINDINGS: Significant evidence has been generated emphasizing the central role of the intestinal microbiome on surgical outcomes such as wound healing, surgical site infections and anastomotic leak. Current preventive strategies, including the use of some parenteral antibiotics, may actually exacerbate the problem by selecting for drug-resistant pathogens...
June 23, 2016: Current Opinion in Clinical Nutrition and Metabolic Care
Zoltan H Nemeth, Eric L Lazar, Samantha R Paglinco, Addison S Hicks, Jason Lei, Patricia A Barratt-Stopper, Rolando H Rolandelli
BACKGROUND: With the introduction of stapling devices (SDs), the proportion of hand-sewn (HS) intestinal anastomoses (IAs) has declined. As more IAs are constructed with SDs, there are fewer opportunities for general surgery residents (GSRs) to acquire the skills for HS techniques during their training. STUDY DESIGN: Data for this study were extracted from an existing database of all IAs performed at the Department of Surgery of the Morristown Medical Center since 2003...
September 2016: Journal of Surgical Education
Jill H Tseng, Rudy S Suidan, Oliver Zivanovic, Ginger J Gardner, Yukio Sonoda, Douglas A Levine, Nadeem R Abu-Rustum, William P Tew, Dennis S Chi, Kara Long Roche
OBJECTIVE: To examine the use, as well as postoperative and long-term oncologic outcomes of diverting loop ileostomy (DI) during primary debulking surgery (PDS) for ovarian cancer. METHODS: Patients with stage II-IV ovarian, fallopian tube, or primary peritoneal carcinoma who underwent colon resection during PDS from 1/2005-1/2014 were identified. Demographic and clinical data were analyzed. RESULTS: Of 331 patients, 320 (97%) had stage III/IV disease and 278 (84%) had disease of high-grade serous histology...
August 2016: Gynecologic Oncology
Tarik Sammour, Ian P Hayes, Ian T Jones, Malcolm C Steel, Ian Faragher, Peter Gibbs
BACKGROUND: There is conflicting evidence regarding the oncological impact of anastomotic leak following colorectal cancer surgery. This study aims to test the hypothesis that anastomotic leak is independently associated with local recurrence and overall and cancer-specific survival. METHODS: Analysis of prospectively collected data from multiple centres in Victoria between 1988 and 2015 including all patients who underwent colon or rectal resection for cancer with anastomosis was presented...
June 3, 2016: ANZ Journal of Surgery
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