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Bowel anastomosis

Rishabh Sehgal, Cherry X Cheung, Tristram Hills, Aqueel Waris, Donagh Healy, Tahir Khan
Jejunal pseudo-diverticulosis is a rare acquired herniation of the mucosa and submucosa through weakened areas of the muscularis mucosa of the mesenteric aspect of the bowel. They are asymptomatic in the majority of cases; however, they can present with a wide spectrum of non-specific symptoms such as chronic abdominal discomfort, postprandial flatulence, diarrhoea, malabsorption and steattorhoea. In up to 15% of cases, more serious acute complications may arise such as the development of intestinal obstruction, haemorrhage or as in our case, localized peritonitis secondary to perforation...
October 7, 2016: Journal of Surgical Case Reports
Carmit K McMullen, Joanna E Bulkley, Andrea Altschuler, Christopher S Wendel, Marcia Grant, Mark C Hornbrook, Virginia Sun, Robert S Krouse
BACKGROUND: Eliciting the priorities of cancer survivors is essential to address the specific needs of cancer survivor subgroups. OBJECTIVE: The purpose of this study was to describe the greatest challenges related to treatment for long-term rectal cancer survivors. DESIGN: This was an observational study with a cross-sectional survey. SETTINGS: The study included members of Kaiser Permanente Northern California and Northwest health plans...
November 2016: Diseases of the Colon and Rectum
Tina T Thomas, Daniel H Teitelbaum, Ethan A Smith, Jonathan R Dillman, Ranjith Vellody, Marcus D Jarboe
PURPOSE: Surgical procedures for high imperforate anus have ranged from the posterior sagittal anorectoplasty (PSARP) to laparoscopic-assisted anorectoplasty (LAARP). PSARP bisects the sphincter muscle complex, introducing muscle injury and scarring. LAARP uses a straight trocar to traverse an often non-linear sphincter muscle complex. MRI-assisted LAARP (MRI-LAARP) guides the neorectum precisely through the middle of the entire sphincter complex along its trajectory. We present our experience utilizing MRI intraoperatively during LAARP...
October 8, 2016: Pediatric Surgery International
Mikael L Soucisse, Kerianne Boulva, Lucas Sideris, Pierre Drolet, Michel Morin, Pierre Dubé
BACKGROUND: As surgical training is evolving and operative exposure is decreasing, new, effective, and experiential learning methods are needed to ensure surgical competency and patient safety. Video coaching is an emerging concept in surgery that needs further investigation. DESIGN: In this randomized controlled trial conducted at a single teaching hospital, participating residents were filmed performing a side-to-side intestinal anastomosis on cadaveric dog bowel for baseline assessment...
October 5, 2016: Journal of Surgical Education
E Zittan, Grace W Ma, N Wong-Chong, R Milgrom, R S McLeod, M Silverberg, Z Cohen
BACKGROUND: We aimed to summarize the outcomes of ulcerative colitis (UC) patients receiving an ileal pouch-anal anastamosis (IPAA) over an 11-year period at a high-volume Canadian inflammatory bowel disease (IBD) center. METHODS: A retrospective chart review was performed for subjects with UC who underwent IPAA between 2002 and 2013. Patient charts were reviewed for demographic data, clinical characteristics, preoperative medical treatment, and surgical outcomes...
October 4, 2016: International Journal of Colorectal Disease
Adam Bobkiewicz, Adam Studniarek, Lukasz Krokowicz, Krzysztof Szmyt, Maciej Borejsza-Wysocki, Jacek Szmeja, Ryszard Marciniak, Michal Drews, Tomasz Banasiewicz
PURPOSE: Biofragmentable anastomosis ring (BAR) is an alternative to manual and stapled anastomoses performed within the upper and lower gastrointestinal (GI) tract. The aim of this study was to evaluate the effectiveness of BAR utility for bowel anastomoses based on our own material. METHODS: A retrospective analysis was performed to a total of 203 patients who underwent bowel surgery with the use of BAR anastomosis within upper and lower gastrointestinal tract between 2004 and 2014...
September 30, 2016: International Journal of Colorectal Disease
Marc Dilauro, Matthew D F McInnes, Nicola Schieda, Ania Z Kielar, Raman Verma, Cynthia Walsh, Andrey Vizhul, William Petrcich, Joseph Mamazza
Purpose To evaluate the accuracy of computed tomography (CT) for diagnosis of internal hernia (IH) in patients who have undergone laparoscopic Roux-en-Y gastric bypass and to develop decision tree models to optimize diagnostic accuracy. Materials and Methods This was a retrospective, ethics-approved study of patients who had undergone laparoscopic Roux-en-Y gastric bypass with surgically confirmed IH (n = 76) and without IH (n = 78). Two radiologists independently reviewed each examination for the following previously established CT signs of IH: mesenteric swirl, small-bowel obstruction (SBO), mushroom sign, clustered loops, hurricane eye, small bowel behind the superior mesenteric artery, and right-sided anastomosis...
September 30, 2016: Radiology
Lars Nelson, Rena C Moon, Andre F Teixeira, Manoel Galvão, Almino Ramos, Muhammad A Jawad
Background: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was introduced into bariatric surgery by Sanchez-Pernaute et al. as an advancement of the biliopancreatic diversion with duodenal switch. Aim: To evaluate the SADI-S procedure with regard to weight loss, comorbidity resolution, and complication rate in the super obese population. Methods: A retrospective chart review was performed on initial 72 patients who underwent laparoscopic or robot-assisted laparoscopic SADI-S between December 17th, 2013 and July 29th, 2015...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Eduardo Arevalo Vidal, Francisco Abarca Rendon, Trino Andrade Zambrano, Yudoco Andrade García, Mario Ferrin Viteri, Josemberg Marins Campos, Manoela Galvão Ramos, Almino Cardoso Ramos
Background: Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. Aim: To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Methods: Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Frederick H Koh, Ker-Kan Tan
BACKGROUND: Anastomotic leakage after gastrointestinal surgery is associated with significant morbidity and mortality.1 Insufficient vascular supply is one cause.2 Recent reports of using intraoperative indocyanine green (ICG) fluorescent angiography to evaluate whether perfusion of the anastomosis is adequate has yielded positive outcomes.3 (-) 6 The authors describe their use of ICG-enhanced fluorescence angiography in a laparoscopic anterior resection. METHODS: The patient was an 80-year-old with an upper rectal adenocarcinoma and significant cardiovascular risk factors...
September 28, 2016: Annals of Surgical Oncology
Keisuke Hata, Soichiro Ishihara, Hiroaki Nozawa, Kazushige Kawai, Tomomichi Kiyomatsu, Toshiaki Tanaka, Junko Kishikawa, Hiroyuki Anzai, Toshiaki Watanabe
Restorative proctocolectomy with ileal pouch-anal anastomosis has been the surgical treatment of choice for patients with ulcerative colitis who require surgery. The quality of life after this procedure is satisfactory in most cases; however, pouchitis is a troublesome condition involving inflammation of the ileal pouch. When a patient presents with symptoms of pouchitis, such as increased bowel movements, mucous and/or bloody exudates, abdominal cramps, and fever, endoscopy is essential for a precise diagnosis...
September 28, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Sebastien Pesenti, Benjamin Blondel, Alice Faure, Emilie Peltier, Franck Launay, Jean-Luc Jouve
Paediatric Chance fracture are rare lesions but often associated with abdominal injuries. We herein present the case of a seven years old patient who sustained an entrapment of small bowel and an ureteropelvic disruption associated with a Chance fracture and spine dislocation following a traffic accident. Initial X-rays and computed tomographic (CT) scan showed a Chance fracture with dislocation of L3 vertebra, with an incarceration of a small bowel loop in the spinal canal and a complete section of the left lumbar ureter...
September 16, 2016: World Journal of Clinical Cases
Ganglei Liu, Xianrui Wu, Yi Li, Yuanyi Rui, Luca Stocchi, Feza H Remzi, Bo Shen
BACKGROUND: There are no published studies on the impact of visceral adipose tissue (VAT) change on outcomes of restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA). The aim of this historic cohort study was to evaluate the impact of excessive VAT gain on the outcomes of inflammatory bowel disease (IBD) patients with IPAA. METHODS: We evaluated all eligible patients with at least two sequential CT scans after pouch construction from our prospectively maintained Pouchitis Registry between 2002 and 2014...
September 25, 2016: Gastroenterology Report
Mark-Bram Bouman, Marlon E Buncamper, Wouter B van der Sluis, Wilhelmus J H J Meijerink
OBJECTIVE: To demonstrate step by step our technique for total laparoscopic sigmoid vaginoplasty. DESIGN: Surgical video tutorial. SETTING: Academic medical center. PATIENT(S): Transgender women with penile hypoplasia or with a failed primary vaginoplasty and biological women with either acquired or congenital absence of a functional vagina. INTERVENTION(S): An original technique for total laparoscopic sigmoid vaginoplasty is shown on video...
September 22, 2016: Fertility and Sterility
Asser Mathiassen Oppfeldt, Jens F Dahlerup, Lisbet A Christensen, Christian L Hvas
Faecal microbiota transplantation (FMT) is increasingly being used to treat refractory and recurring Clostridium difficile infection (CDI). Although FMT appears to be safe and highly effective in patients with a preserved colon and immunocompetence, its use in patients with inflammatory bowel disease (IBD) who are on immunomodulating therapies is controversial. In particular, patients who have undergone colectomy may have different treatment responses to FMT. In this case report, we describe the successful use of FMT in a female patient aged 19 years with Crohn's disease who underwent ileorectal anastomosis following colectomy...
2016: BMJ Case Reports
Danny Huynh, Alex Henderson, Tyler Haden, Alexander Jones, Naveen Pokala
Robot-assisted laparoscopic radical cystectomy (RALRC) is increasingly being performed for the treatment of muscle-invasive bladder cancer. There is increased tension while performing the ureteroileal anastomosis through a small incision. Patients are at risk to suffer wound and skin complications perioperatively due to possible contamination with bowel contents. The Alexis(®) retractor helps with retraction of small incisions potentially reducing tension and also reduces wound infection rates as reported in the colorectal literature...
September 17, 2016: Journal of Robotic Surgery
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
Bo Shen
Restorative proctocolectomy with ileal pouch-anal anastomosis has become the standard surgical treatment modality for patients with ulcerative colitis or familial adenomatous polyposis who require colectomy. Normally staged pouch surgery is performed. Endoscopy plays an important role in postoperative monitoring of disease status and delivery of therapy, if necessary. Therefore, ileal pouch surgery significantly alters bowel anatomy, with new organ structures being created. Endoscopy of the altered bowel includes the evaluation of end ileostomy, Hartmann pouch or diverted rectum, loop ileostomy, diverted pouch, and pouchoscopy...
October 2016: Gastrointestinal Endoscopy Clinics of North America
Isaac Assam Udo, Emmanuel K Abudu, Felix Uduma
BACKGROUND: Intussusception is a rare cause of intestinal obstruction in adults. Its diagnosis could be elusive based solely on clinical features because of protean presentation. Supplementary imaging allows for preoperative diagnosis, early institution of definitive management, and a better clinical outcome. PATIENTS AND METHODS: Records of adults managed for intestinal obstruction by laparotomy in a surgical unit of a tertiary health facility were retrospectively examined...
July 2016: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Nermin Lojo, Zarko Rasic, Anita Zenko Sever, Danijela Kolenc, Darko Vukusic, Domagoj Drmic, Ivan Zoricic, Marko Sever, Sven Seiwerth, Predrag Sikiric
Stable gastric pentadecapeptide BPC 157 was previously used to ameliorate wound healing following major surgery and counteract diclofenac toxicity. To resolve the increasing early risks following major massive small bowel resectioning surgery, diclofenac combined with nitric oxide (NO) system blockade was used, suggesting therapy with BPC 157 and the nitric oxide synthase (NOS substrate) L-arginine, is efficacious. Immediately after anastomosis creation, short-bowel rats were untreated or administered intraperitoneal diclofenac (12 mg/kg), BPC 157 (10 μg/kg or 10 ng/kg), L-NG-nitroarginine methyl ester (L-NAME, 5 mg/kg), L-arginine (100 mg/kg) alone or combined, and assessed 24 h later...
2016: PloS One
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