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Anastomotic leak colon

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
Alexandros Charalabopoulos, Ali Kordzadeh, Elias Sdralis, Bruno Lorenzi, Fateh Ahmad
BACKGROUND: Esophagectomy in situs inversus is challenging. With long-segment supercharged reconstruction, it becomes more perplexing and multidisciplinary surgical skills are needed. Challenges met and the surgical technique used is presented in this case report. METHODS: The case of a 49-year old patient with situs inversus abdominus and a locally advanced distal esophageal adenocarcinoma extending to the stomach is presented. RESULTS: Following neoadjuvant chemotherapy and due to inability to use the stomach as a conduit, a thoracoscopic total esophagogastrectomy with long-segment reconstruction was performed...
February 13, 2018: Acta Chirurgica Belgica
Makoto Aoki, Hiroyuki Fukunari, Yosuke Kawai, Akemi Watanabe, Yuya Umebayashi, Toshifumi Saito, Kenji Shitara, Tetsuji Hayashi
A 67-year-old woman underwent laparoscopy-assisted left hemicolectomy for early descending colon cancer(pTis, pN0, cH0, cM0, Stage 0).Her postoperative course was uneventful, without fever and/or tenderness at the anastomotic site.A month following discharge from the hospital, enhanced computed tomography revealed a liver abscess measuring 80mm in diameter at the lateral segment and a left adrenal abscess measuring 30mm in diameter.Although some free air and fluid collection was noted near the anastomotic site, there was no tenderness, and a gastrografin enema did not reveal leakage and/or pooling of the contrast agent near the anastomotic site...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Johannes M Salusjärvi, Monika A Carpelan-Holmström, Johanna M Louhimo, Olli Kruuna, Tom M Scheinin
BACKGROUND: An anastomotic leak is a fairly common and a potentially lethal complication in colorectal surgery. Objective methods to assess the viability and blood circulation of the anastomosis could help in preventing leaks. Intraoperative pulse oximetry is a cheap, easy to use, fast, and readily available method to assess tissue viability. Our aim was to study whether intraoperative pulse oximetry can predict the development of an anastomotic leak. METHODS: The study was a prospective single-arm study conducted between the years 2005 and 2011 in Helsinki University Hospital...
January 26, 2018: International Journal of Colorectal Disease
C E Munro, Gfw Stamp, A W Phillips, S M Griffin
The use of endoluminal stents to treat anastomotic leaks post oesophagogastric resection remains controversial. While some advocate stents to expedite recovery, others advise caution due to the risk of major morbidity and mortality. We describe a case of anastomotic leak following total gastrectomy for adenocarcinoma treated with a self-expanding metallic stent. Complications with the initial stent were treated with a further stent, which compromised the function of the oesophagus and eroded into the aorta, necessitating a colonic reconstruction and endovascular aortic stenting...
January 24, 2018: Annals of the Royal College of Surgeons of England
Mas Khan, D Jayne, R Saunders
Introduction Total colectomy and ileorectal anastomosis can result in significant defecatory frequency and poor bowel function. The aim of this study was to assess whether a laparoscopic approach is associated with any improvement in this regard. Methods A single institution retrospective review was undertaken of patients undergoing elective total colectomy and ileorectal anastomosis between 2000 and 2011. Those undergoing emergency surgery and paediatric surgery were excluded. The primary outcome measure was satisfactory defecatory function after surgery...
January 24, 2018: Annals of the Royal College of Surgeons of England
Jiaming Zhou, Shuyun Zhang, Jun Huang, Pinzhu Huang, Shaoyong Peng, Jinxin Lin, Tuoyang Li, Jianping Wang, Meijin Huang
OBJECTIVE: To explore the feasibility and clinical significance of precision low inferior mesenteric artery (IMA) ligation with the left colonic artery (LCA) preservation and root lymph node dissection in laparoscopic radical resection for rectal cancer, according to the inferior mesenteric artery (IMA) types. METHODS: One Hundred and fore cases of rectal cancer patients who underwent laparoscopic resection in The Sixth Affiliated Hospital of Sun Yat-sen University from October 2015 to June 2016 were selected and divided into study group and control group according to different surgical methods...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
S Gaines, C Shao, N Hyman, J C Alverdy
BACKGROUND: The pathogenesis of colorectal cancer recurrence after a curative resection remains poorly understood. A yet-to-be accounted for variable is the composition and function of the microbiome adjacent to the tumour and its influence on the margins of resection following surgery. METHODS: PubMed was searched for historical as well as current manuscripts dated between 1970 and 2017 using the following keywords: 'colorectal cancer recurrence', 'microbiome', 'anastomotic leak', 'anastomotic failure' and 'mechanical bowel preparation'...
January 2018: British Journal of Surgery
L Martinek, K You, S Giuratrabocchetta, M Gachabayov, K Lee, R Bergamaschi
AIM: Foreshortened mesentery or thick abdominal wall constitutes a rationale for laparoscopic intracorporeal ileocolic anastomoses (ICA). The aim of this study was to compare intracorporeal to extracorporeal ICA in terms of surgical site infections in patients with Crohn's ileitis and overweight patients with right colon tumors. METHOD: This was a prospective propensity score-matched cohort study enrolling consecutive patients with Crohn's terminal ileitis and overweight patients with right colon tumors undergoing elective laparoscopic right colon resection with intracorporeal or extracorporeal ICA...
January 11, 2018: International Journal of Colorectal Disease
Santiago A Endara, Fernando J Terán, Armando J Serrano, Manuela J Castillo, Gabriel A Molina
Esophageal fistulas in the cervical region are usually difficult to manage and carry a high morbidity. We report a case of an esophago-colonic fistula after colonic interposition, successfully managed with vacuum-assisted closure 'V.A.C. system', (Kinetic Concepts Inc., San Antonio, TX, USA). The patient initially presented with purulent fluid from the cervical wound 13 days after surgery. Esophagogram confirmed a leak. Since the patient had a history of anastomotic leaks, a surgical intervention was not the treatment of choice...
January 2018: Journal of Surgical Case Reports
Qi Huang, Feng Cao, Jinzhe Zhou, Liming Liu, Bujun Ge
OBJECTIVE: To investigate the clinical effect of the application of "compound anastomotic device" on the high-risk colorectal anastomosis in rectal cancer patients undergoing protective ileostomy. METHODS: A total of 116 rectal cancer patients undergoing surgical procedure and prophylactic ileostomy in Tongji Hospital (90 cases) and The Third People's Hospital of Jingdezhen City (26 cases) from May 2011 to October 2016 were prospectively enrolled in the study. Paralleled control study and random digital table were applied...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
P M Starker, B Chinn
BACKGROUND: The PILLAR II trial demonstrated PINPOINT is safe, feasible to use with no reported adverse events and resulted in no anastomotic leaks in patients who had a change in surgical plan based on PINPOINT's intraoperative assessment of tissue perfusion during colorectal resection. Whether the cost savings associated with this reduction in anastomotic complications can offset the cost of investing in PINPOINT is unknown. METHODS: We performed a retrospective analysis of all patients (N = 347) undergoing colectomy with primary anastomosis from January 2015 to April 2016...
December 22, 2017: Surgical Endoscopy
Stacy J Kowalsky, Mazen S Zenati, Jennifer Steve, Kenneth K Lee, Melissa E Hogg, Herbert J Zeh, Amer H Zureikat
BACKGROUND: Ketorolac (Toradol), a commonly used nonselective nonsteroidal anti-inflammatory drug (NSAID) in the postoperative period, has been associated with increased risk of anastomotic leak after colon resection. The effect of postoperative NSAID and ketorolac use on postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) is unknown. METHODS: Retrospective review of consecutive PDs at a high-volume pancreas center from 2012 to 2015. POPF was identified and graded using International Study Group on Pancreatic Fistula criteria...
January 2018: Journal of Surgical Research
Kristian Eeg Storli, Kristin Bentung Lygre, Knut Børge Iversen, Maria Decap, Geir Egil Eide
AIM: To analyse clinical and long-term oncologic results after laparoscopic complete mesocolic excision (CME) for colonic cancer over a 10-year period. METHODS: Consecutive patients who received laparoscopic CME at our hospital from 2007 to 2017 were prospectively registered and retrospectively analysed. In total, 341 patients were included with tumour-nodal-metastasis (TNM) stages 0-III. RESULTS: The mean age of the patients was 71.9 years...
November 27, 2017: World Journal of Gastrointestinal Surgery
Leonardo Solaini, Francesca Bazzocchi, Davide Cavaliere, Andrea Avanzolini, Alessandro Cucchetti, Giorgio Ercolani
BACKGROUND: In the right colon surgery, there is a growing literature comparing the safety of robotic right colectomy (RRC) to that of laparoscopic right colectomy (LRC). With this paper we aim to systematically revise and meta-analyze the latest comparative studies on these two minimally invasive procedures. METHODS: A systematic review of studies published from 2000 to 2017 in the PubMed, Scopus, and Embase databases was performed. Primary endpoints were postoperative morbidity and mortality...
March 2018: Surgical Endoscopy
Ahmad Sakr, Sameh Hany Emile, Emad Abdallah, Waleed Thabet, Wael Khafagy
Anastomotic leak (AL) is a serious complication of intestinal surgery with various predisposing factors. This study aims to assess several risk factors associated with AL after small intestinal and colonic anastomoses through a multivariate analysis. Two hundred twenty-four patients (126 males) with intestinal anastomosis of a median age of 44 years were reviewed. Independent factors associated with AL were male gender (OR = 2.59, P  = 0.02), chronic liver disease (CLD) (OR = 8.03, P  < 0.0001), more than one associated comorbidity (OR = 5...
December 2017: Indian Journal of Surgery
Emily F Midura, Andrew D Jung, Dennis J Hanseman, Vikrom Dhar, Shimul A Shah, Janice F Rafferty, Bradley R Davis, Ian M Paquette
BACKGROUND: Before elective colectomy, many advocate mechanical bowel preparation with oral antibiotics, whereas enhanced recovery pathways avoid mechanical bowel preparations. The optimal preparation for right versus left colectomy is also unclear. We sought to determine which strategy for bowel preparation decreases surgical site infection (SSI) and anastomotic leak (AL). METHODS: Elective colectomies from the National Surgical Quality Improvement Program colectomy database (2012-2015) were divided by (1) type of bowel preparation: no preparation (NP), mechanical preparation (MP), oral antibiotics (PO), or mechanical and oral antibiotics (PO/MP); and (2) type of colonic resection: right, left, or segmental colectomy...
March 2018: Surgery
Iosief Abraha, Gian A Binda, Alessandro Montedori, Alberto Arezzo, Roberto Cirocchi
BACKGROUND: Diverticular disease is a common condition in Western industrialised countries. Most individuals remain asymptomatic throughout life; however, 25% experience acute diverticulitis. The standard treatment for acute diverticulitis is open surgery. Laparoscopic surgery - a minimal-access procedure - offers an alternative approach to open surgery, as it is characterised by reduced operative stress that may translate into shorter hospitalisation and more rapid recovery, as well as improved quality of life...
November 25, 2017: Cochrane Database of Systematic Reviews
R Cirocchi, F Cesare Campanile, S Di Saverio, G Popivanov, L Carlini, D Pironi, R Tabola, N Vettoretto
BACKGROUND: Hemicolectomy is the treatment of choice for intestinal obstruction from right colon cancer. This review compares the laparoscopic vs open access in hemicolectomy for patients with right colon cancer. METHODS: A systematic review and meta-analysis of clinical studies published after January 2017 was performed according to the Prisma guidelines. The study has been recorded on the Prospero register (CRD42016044108). RESULTS: Five studies were included for review...
December 2017: Journal of Visceral Surgery
Jacqueline van den Bos, Mahdi Al-Taher, Rutger M Schols, Sander van Kuijk, Nicole D Bouvy, Laurents P S Stassen
PURPOSE: The aims of this review are to determine the feasibility of near-infrared fluorescence (NIRF) angiography in anastomotic colorectal surgery and to determine the effectiveness of the technique in improving imaging and quantification of vascularization, thereby aiding in decision making as to where to establish the anastomosis. METHODS: A systematic literature search of PubMed and EMBASE was conducted. Searching through the reference lists of selected articles identified additional studies...
November 6, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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