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Anastomotic leak colon

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https://www.readbyqxmd.com/read/28342119/returns-to-operating-room-after-colon-and-rectal-surgery-in-a-tertiary-care-academic-medical-center-a-valid-measure-of-surgical-quality
#1
Amy L Lightner, Amy E Glasgow, Elizabeth B Habermann, Robert R Cima
INTRODUCTION: Returns to the operating room (ROR) have been suggested as a marker of surgical quality. Increasingly, quality and value metrics are utilized for reimbursement as well as public reporting to inform health care consumers. We sought to understand the etiology of ROR and assess the validity of simple ROR as a quality metric. METHODS: This was a single referral center retrospective review of all colon and rectal operations between January 1, 2014 and December 31, 2014...
March 24, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28332129/development-of-an-enhanced-recovery-after-surgery-eras-protocol-in-laparoscopic-colorectal-surgery-results-of-the-first-120-consecutive-cases-from-a-university-hospital
#2
Antonio Brescia, Federico Tomassini, Giammauro Berardi, Carola Sebastiani, Massimo Pezzatini, Anna Dall'Oglio, Giovanni Guglielmo Laracca, Fabrizio Apponi, Marcello Gasparrini
The ERAS(®) represents a dynamic culmination of upon perioperative care elements, successfully applied to different surgical specialties with shorter hospital stay and lower morbidity rates. The aim of this study is to describe the introduction of the ERAS protocol in colorectal surgery in our hospital analysing our first series. Between September 2014 and June 2016, 120 patients suffering from colorectal diseases were included in the study. Laparoscopic approach was used in all patients if not contraindicated...
March 22, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28332057/the-impact-of-operative-approach-on-postoperative-complications-following-colectomy-for-colon-caner
#3
Benedetto Mungo, Christina M Papageorge, Miloslawa Stem, Daniela Molena, Anne O Lidor
BACKGROUND: Colectomy is one of the most common major abdominal procedures performed in the USA. A better understanding of risk factors and the effect of operative approach on adverse postoperative outcomes may significantly improve quality of care. METHODS: Adult patients with a primary diagnosis of colon cancer undergoing colectomy were selected from the National Surgical Quality Improvement Program 2013-2015 targeted colectomy database. Patients were stratified into five groups based on specific operative approach...
March 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28320053/management-of-colorectal-trauma-a-review
#4
REVIEW
Ju Yong Cheong, Anil Keshava
Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28263043/the-relationship-between-method-of-anastomosis-and-anastomotic-failure-after-right-hemicolectomy-and-ileo-caecal-resection-an-international-snapshot-audit
#5
(no author information available yet)
BACKGROUND: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified definition...
March 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28166091/oral-polyphosphate-suppresses-bacterial-collagenase-production-and-prevents-anastomotic-leak-due-to-serratia-marcescens-and-pseudomonas-aeruginosa
#6
Sanjiv K Hyoju, Robin E Klabbers, Melissa Aaron, Monika A Krezalek, Alexander Zaborin, Mara Wiegerinck, Neil H Hyman, Olga Zaborina, Harry Van Goor, John C Alverdy
OBJECTIVE: The objective of this study was to determine the effect of polyphosphate on intestinal bacterial collagenase production and anastomotic leak in mice undergoing colon surgery. BACKGROUND: We have previously shown that anastomotic leak can be caused by intestinal pathogens that produce collagenase. Because bacteria harbor sensory systems to detect the extracellular concentration of phosphate which controls their virulence, we tested whether local phosphate administration in the form of polyphosphate could attenuate pathogen virulence and prevent leak without affecting bacterial growth...
February 3, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28080215/laparoscopy-assisted-duhamel-z-anastomosis-for-total-colonic-aganglionosis-outcome-assessed-by-fecal-continence-evaluation
#7
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...
March 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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/28029449/perioperative-fluid-status-and-surgical-outcomes-in-patients-undergoing-cytoreductive-surgery-for-advanced-epithelial-ovarian-cancer
#9
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/27999936/lack-of-evidence-for-tissue-hypoxia-as-a-contributing-factor-in-anastomotic-leak-following-colon-anastomosis-and-segmental-devascularization-in-rats
#10
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/27995423/a-simple-web-based-risk-calculator-www-anastomoticleak-com-is-superior-to-the-surgeon-s-estimate-of-anastomotic-leak-after-colon-cancer-resection
#11
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...
January 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27926773/associations-of-specific-postoperative-complications-with-outcomes-after-elective-colon-resection-a-procedure-targeted-approach-toward-surgical-quality-improvement
#12
John E Scarborough, Jessica Schumacher, K Craig Kent, Charles P Heise, Caprice C Greenberg
Importance: Numerous quality initiatives have been implemented in an effort to minimize the onus of postoperative complications on clinical and economic outcomes after major surgery. It is unknown which complications have the greatest overall effect on these outcomes. Objective: To quantify the associations of specific postoperative complications with outcomes after elective colon resection. Design, Setting, and Participants: Patients undergoing elective colon resection between January 1, 2012, and December 31, 2013, who were included in the Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program were assessed for the development of specific types of postoperative complications...
February 15, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/27921277/surgery-for-acute-exacerbation-of-chronic-mesenteric-ischemia-a-case-report
#13
Shinji Abe, Tomoji Yamakawa, Hideaki Kawashima, Makoto Yoshida, Setsuji Takanashi, Motoya Kashiyama, Masahiro Ishigooka, Yasushige Shingu, Yoshiro Matsui
BACKGROUND: Chronic mesenteric ischemia (CMI) is a rare disease; however, symptomatic CMI has a risk of acute exacerbation without timely revascularization. CASE PRESENTATION: A 54-year-old man who had had postprandial pain for 6 months was admitted to our hospital because of vomiting and diarrhea. Although the celiac and superior mesenteric arteries were occluded at the proximal portion, contrast enhancement of the bowel wall was good in contrast-enhanced computed tomography (CECT)...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27918375/treatments-and-other-prognostic-factors-in-the-management-of-the-open-abdomen-a-systematic-review
#14
Adam T Cristaudo, Scott B Jennings, Kerry Hitos, Ronny Gunnarsson, Alan DeCosta
BACKGROUND: The open abdomen (OA) is an important approach for managing intra-abdominal catastrophes and continues to be the standard of care. Despite this, challenges remain with it associated with a high incidence of complications and poor outcomes. The objective of this article is to perform a systematic review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to identify prognostic factors in OA patients in regard to definitive fascial closure (DFC), mortality and intra-abdominal complications...
February 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27916194/standard-outcome-indicators-after-colon-cancer-resection-creation-of-a-nomogram-for-autoevaluation
#15
Jorge Sancho-Muriel, Matteo Frasson, David Hervás, Blas Flor-Lorente, José Luis Ramos Rodriguez, Manuel Romero Simó, Jordi Escoll Rufino, Marta Santamaría Olabarrieta, José Viñas Martinez, Manolo López Bañeres, Eduardo García-Granero
INTRODUCTION: Lately there has been an increasing interest in identifying quality standards in different pathologies, among them colon cancer due to its great prevalence. The main goal of this study is to define the quality standards of colon cancer surgery based on a large prospective national study dataset. METHODS: Data from the prospective national study ANACO were used. This study included a consecutive series of patients operated on for colon cancer in 52 Spanish hospitals (2011-2012)...
December 1, 2016: Cirugía Española
https://www.readbyqxmd.com/read/27916080/-clinical-effect-of-preservation-of-the-left-colonic-artery-in-laparoscopic-anterior-resection-for-rectal-cancer
#16
J W Niu, W Ning, W Y Wang, D P Pei, F Q Meng, Z Z Liu, D G Cai
Objective: To evaluate the value and feasibility of preservation of the left colonic artery (LCA) in laparoscopic anterior resection for rectal cancer. Methods: The clinical data of 97 patiens who received laparoscopic anterior resection of rectal cancer from 2009.3 to 2015.3 were randomly divided into two groups, including 52 cases with preservation of LCA and 45 cases without preservation of LCA. The operation time, quantity of bleeding, number of lymph nodes removed around the root of inferior mesenteric artery (IMA), the rate of lymph node metastasis around the root of IMA, the incidence of transverse colostomy and anastomotic leak were compared between the two groups...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27899040/clinical-role-of-fluorescence-imaging-in-colorectal-surgery-a-review
#17
REVIEW
Ido Mizrahi, Steven D Wexner
Anastomotic leak (AL) after colorectal surgery is a devastating complication; decreased blood perfusion is an important risk factor. Surgeons rely on subjective measures to assess bowel perfusion. Fluorescence imaging (FI) with indocyanine green (ICG) provides a real-time objective assessment of intestinal perfusion. Areas covered: A PubMed search using the terms 'fluorescence imaging', 'indocyanine green', 'colon and rectal surgery' was undertaken. Sixteen articles between 2010 to present were identified. Main outcomes were leak rate reduction, change in surgical plan, and technical feasibility...
January 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27896159/intestinal-atresia-experience-at-a-busy-center-of-north-west-india
#18
Shilpi Gupta, Rahul Gupta, Soumyodhriti Ghosh, Arun Kumar Gupta, Arvind Shukla, Vinita Chaturvedi, Praveen Mathur
Objective: To evaluate the presentation, management, complications and outcome of intestinal atresia (IA) managed at our center over a period of 1 year. Materials and methods: Records of patients of IA admitted in our center from January 2015 to December 2015 were retrospectively analyzed. Demographic data, antenatal history, presenting complaints, location (duodenal, jejunoileal, colonic) of atresia, surgery performed and peri-operative complications were noted. Results: Total 78 cases of IA were included in the analyses...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27896157/congenital-neonatal-intestinal-obstruction-retrospective-analysis-at-tertiary-care-hospital
#19
Vijay Singh, Manish Pathak
BACKGROUND: The purpose of this study is to analyze the etiology, clinical presentation and outcome of neonatal intestinal obstruction at our institute. MATERIALS AND METHODS: The medical record of all the patients, presented with intestinal obstruction in neonatal period during 2014 and 2015 was reviewed retrospectively for etiology, clinical features, investigations, management, and outcome. RESULTS: Out of total 53 cases of neonatal intestinal obstruction, 27 were of intestinal atresia (9 cases (17%) were of duodenal atresia, 7 (13%) were of jejunal atresia and 8 (13%) were ileal atresias and 3 cases were found with colonic atresia); 7 were malrotation, 17 were Hirschsprung's disease (HD)...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27893300/the-use-of-robotic-and-laparoscopic-surgical-stapling-devices-during-minimally-invasive-colon-and-rectal-surgery-a-comparison
#20
Jeremy L Holzmacher, Samuel Luka, Madiha Aziz, Richard L Amdur, Samir Agarwal, Vincent Obias
PURPOSE: To date there exists no published study examining the safety and efficacy of the EndoWrist 45 (Intuitive Surgical, Inc.) robotic stapler. We compared outcomes between the robotic and comparable laparoscopic stapler in robotic-assisted colorectal procedures. MATERIALS AND METHODS: We conducted a retrospective review of 93 patients who underwent robotic-assisted colorectal surgery at our institution from 2012 to 2014. Surgeries included left, sigmoid, subtotal and total colectomies, and low anterior rectal resections...
February 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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