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Bowel anastomosis

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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
#1
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/28738080/effects-of-exogenous-glucagon-like-peptide-2-and-distal-bowel-resection-on-intestinal-and-systemic-adaptive-responses-in-rats
#2
Sarah W Lai, Elaine de Heuvel, Laurie E Wallace, Bolette Hartmann, Jens J Holst, Mary E Brindle, Prasanth K Chelikani, David L Sigalet
OBJECTIVE: To determine the effects of exogenous glucagon-like peptide-2 (GLP-2), with or without massive distal bowel resection, on adaptation of jejunal mucosa, enteric neurons, gut hormones and tissue reserves in rats. BACKGROUND: GLP-2 is a gut hormone known to be trophic for small bowel mucosa, and to mimic intestinal adaptation in short bowel syndrome (SBS). However, the effects of exogenous GLP-2 and SBS on enteric neurons are unclear. METHODS: Sprague Dawley rats were randomized to four treatments: Transected Bowel (TB) (n = 8), TB + GLP-2 (2...
2017: PloS One
https://www.readbyqxmd.com/read/28735511/infrared-thermal-imaging-a-potential-tool-used-in-open-colorectal-surgery
#3
Vladan Bernard, Vladimír Čan, Erik Staffa, Martina Farkašová, Michaela Němcová, Marek Dostál, Zdeněk Kala, Vojtěch Mornstein
Aim of this pilot study was to assess blood perfusion of bowel in resection lines by means of the infrared thermal imaging in order to choose the best place for anastomosis. The paper brings a first experience with infrared thermal imaging used in colorectal surgery operation from initial observation of the patient with T3 adenomatous carcinoma with no lymph node metastasis. The obtained infrared images show a clear boundary between parts of the intestine with blood perfusion and without it. The proposed position of resection of colon identified by infrared camera is in accordance with routinely designated position...
October 2017: Minerva Chirurgica
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
#4
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/28726144/anastomotic-stricture-after-ultralow-anterior-resection-or-intersphincteric-resection-for-very-low-lying-rectal-cancer
#5
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
BACKGROUND: Anastomotic stricture following colorectal cancer surgery is not a rare complication, but proper management of anastomotic stricture located close to the anal verge is uncertain. This study aimed to investigate risk factors and management strategies for anastomotic stricture after ultralow anterior resection (ULAR). METHODS: We retrospectively reviewed a database of patients with rectal cancer who underwent surgery between January 2007 and June 2015, and included patients with an anastomosis within 4 cm from the anal verge...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28724302/efficacy-and-safety-of-vedolizumab-as-a-treatment-option-for-moderate-to-severe-refractory-ulcerative-colitis-in-two-patients-after-liver-transplant-due-to-primary-sclerosing-cholangitis
#6
Raúl Vicente Olmedo Martín, Víctor Amo Trillo, Rocío González Grande, Miguel Jiménez Pérez
Vedolizumab is a humanized IgG1 monoclonal antibody that selectively blocks the lymphocyte integrin α4β7 and prevents its interaction with endothelial adhesion molecules and subsequent transmigration to the gastrointestinal tract. The drug was approved in 2014 for the induction and maintenance treatment of ulcerative colitis and moderate to severe Crohn's disease that is refractory or intolerant to conventional treatment with corticoids and immunosuppressants and/or anti-TNFα drugs. However, inflammatory bowel disease has a variable behavior following liver transplant...
July 14, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28719764/surgical-anatomy-does-not-affect-the-progression-of-intestinal-failure-associated-liver-disease-in-neonatal-piglets
#7
Celeste M Lavallee, Pamela R Wizzard, Marihan Lansing, Donna F Vine, Patrick N Nation, Jason Y Yap, Benjamin P Willing, Paul W Wales, Justine M Turner
BACKGROUND: Intestinal failure-associated liver disease (IFALD) causes significant morbidity in neonates with short bowel syndrome (SBS) dependent on parenteral nutrition (PN). Resected ileum, with loss of the ileocecal valve (ICV), is the most common anatomy in SBS, yet its impact on IFALD has not been adequately studied. METHODS: Neonatal piglets were randomized to 75% intestinal resection with jejunocolic anastomosis (JC, n = 12), 75% resection with jejunoileal anastomosis and intact ICV (JI, n = 13), PN-fed sham (sham, n = 14), or sow-fed control (SF, n = 8)...
July 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28717916/colon-perfusion-patterns-during-colorectal-resection-using-visible-light-spectroscopy
#8
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/28716313/telemedicine-for-management-of-inflammatory-bowel-disease-myibdcoach-a-pragmatic-multicentre-randomised-controlled-trial
#9
Marin J de Jong, Andrea E van der Meulen-de Jong, Mariëlle J Romberg-Camps, Marco C Becx, Jeroen P Maljaars, Mia Cilissen, Ad A van Bodegraven, Nofel Mahmmod, Tineke Markus, Wim M Hameeteman, Gerard Dijkstra, Ad A Masclee, Annelies Boonen, Bjorn Winkens, Astrid van Tubergen, Daisy M Jonkers, Marie J Pierik
BACKGROUND: Tight and personalised control of inflammatory bowel disease in a traditional setting is challenging because of the disease complexity, high pressure on outpatient clinics, and rising incidence. We compared the effects of self-management with a telemedicine system, which was developed for all subtypes of inflammatory bowel disease, on health-care utilisation and patient-reported quality of care versus standard care. METHODS: We did this pragmatic, randomised trial in two academic and two non-academic hospitals in the Netherlands...
July 14, 2017: Lancet
https://www.readbyqxmd.com/read/28705784/laparoscopic-proctocolectomy-with-ileal-j-pouch-anal-anastomosis-in-children
#10
Ufuk Ateş, Ergun Ergün, Gülnur Göllü, Gönül Küçük, Aydın Yağmurlu
BACKGROUND/AIMS: We aimed to evaluate postoperative fecal incontinence scales of children who underwent laparoscopic proctocolectomy and ileal J-pouch anastomosis for familial adenomateous polyposis (FAP) and inflammatory bowel disease (IBD). MATERIALS AND METHODS: Fecal incontinence scores were collected at 3 months post-surgery. A retrospective chart review was also performed to obtain the demographic data and operative technical details. RESULTS: The postoperative Wexner Fecal Incontinence Score was 0 in 9 of 11 patients and satisfactory in the remaining two...
July 13, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28705638/laparoscopic-assisted-duhamel-procedure-with-ex-anal-rectal-transection-for-total-colonic-aganglionosis
#11
Xi Zhang, Guo-Qing Cao, Shao-Tao Tang, Xiao-Pan Chang, Shuai Li, Li Yang, Kang Li, Ying Zhou, De-Hua Yang
PURPOSE: Laparoscopic-assisted Duhamel procedure has a larger anastomosis and a reservoir which allows early recovery of defecation frequency, but concerns have been raised regarding the long operative time, high incidence of pouchitis and Hirschsprung associated enterocolitis (HAEC). The purpose of this study was to evaluate the postoperative complications and functional outcomes for patients with TCA undergoing modified laparoscopic-assisted Duhamel procedure (MLDP) with ex-abdominal partial colectomy and ex-anal rectal transection...
June 27, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28694670/new-totally-intracorporeal-reconstructive-approach-after-robotic-total-gastrectomy-technical-details-and-short-term-outcomes
#12
Amilcare Parisi, Francesco Ricci, Alessandro Gemini, Stefano Trastulli, Roberto Cirocchi, Giorgio Palazzini, Vito D'Andrea, Jacopo Desiderio
AIM: To show outcomes of our series of patients that underwent a total gastrectomy with a robotic approach and highlight the technical details of a proposed solution for the reconstruction phase. METHODS: Data of gastrectomies performed from May 2014 to October 2016, were extracted and analyzed. Basic characteristics of patients, surgical and clinical outcomes were reported. The technique for reconstruction (Parisi Technique) consists on a loop of bowel shifted up antecolic to directly perform the esophago-enteric anastomosis followed by a second loop, measured up to 40 cm starting from the esojejunostomy, fixed to the biliary limb to create an enteroenteric anastomosis...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28694653/attenuated-adenomatous-polyposis-of-the-large-bowel-present-and-future
#13
EDITORIAL
Luca Roncucci, Monica Pedroni, Francesco Mariani
Attenuated adenomatous polyposis (AAP) is a poorly understood syndrome, that can be defined as the presence of 10-99 synchronous adenomas in the large bowel, and it is considered a phenotypic variant of familial adenomatous polyposis (FAP). This definition has the advantage of simplicity, but it may include sporadic multiple adenomas of the large bowel at an extreme, or FAP cases on the other side. AAP shows a milder phenotype than FAP, with an older age of onset of adenomas and cancer, and less frequent extracolonic manifestations...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28689778/urinary-diversion-with-versus-without-bowel-anastomosis-in-patients-with-existing-colostomy-a-multi-institutional-study
#14
Katherine J Cotter, Ronak A Gor, Mary R Kwaan, Yunhua Fan, Piyush Pathak, Jeremy B Myers, Sean P Elliott
OBJECTIVE: To describe the short-term outcomes with the bowel anastomosis vs. no bowel anastomosis approach in adult patients undergoing urinary diversion. METHODS: Chart review was performed of adults undergoing urinary diversion from 2006-2015. Patients with a pre-existing colostomy were divided into a no bowel anastomosis (NBA) and bowel anastomosis (BA) group. Post-operative complications were recorded per the Clavien-Dindo system. Variables were compared using the bowel anastomosis group as a control...
July 6, 2017: Urology
https://www.readbyqxmd.com/read/28686923/rare-case-of-incarcerated-obturator-hernia-case-report-and-review-of-literature
#15
N C Sá, V C M Silva, P R L Carreiro, A S Matos Filho, I A Lombardi
INTRODUCTION: Obturator hernia is a rare condition accounting for less than 1% of all intra abdominal hernias. Clinical diagnosis is considered a challenge for most surgeons. It usually appears as an intestinal obstruction. Confirmation of diagnosis is carried out by means of imaging or during surgery. CASE REPORT: An 85-year-old female patient, with symptoms of intestinal obstruction of 24h duration was admitted to the emergency room of Unimed Hospital - Belo Horizonte...
June 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28684935/the-role-of-temporary-fecal-diversion
#16
REVIEW
Amy L Lightner, John H Pemberton
The use of temporary fecal diversion is of great importance to tenuous anastomosis, immunosuppressed patient, or actively infected patient. Its use protects newly constructed intestinal anastomoses from being the culprit of pelvic sepsis or systemic illness. Thus, potential morbidity and mortality can be averted. However, its appropriate or optimal use is often debated. We herein discuss the evidence for when to best use a diverting stoma for colorectal, coloanal, and ileoanal anastomoses. We also discuss the importance of considering a temporary diverting stoma in the setting of high-dose immunosuppression (e...
July 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28684934/considerations-in-stoma-reversal
#17
REVIEW
Karen L Sherman, Steven D Wexner
Temporary stomas are frequently used in the management of diverticulitis, colorectal cancer, and inflammatory bowel disease. These temporary stomas are used to try to mitigate septic complications from anastomotic leaks and to avoid the need for reoperation. Once acute medical conditions have improved and after the anastomosis has been proven to be healed, stomas can be reversed. Contrast enemas, digital rectal examination, and endoscopic evaluation are used to evaluate the anastomosis prior to reversal. Stoma reversal is associated with complications including anastomotic leak, postoperative ileus, bowel obstruction, enterocutaneous fistula, and, most commonly, surgical site infection...
July 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28682966/management-of-low-colorectal-anastomotic-leakage-in-the-laparoscopic-era-more-than-a-decade-of-experience
#18
Stephen Alexander Boyce, Craig Harris, Andrew Stevenson, John Lumley, David Clark
BACKGROUND: Anastomotic leak after colorectal surgery increases postoperative mortality, cancer recurrence, permanent stoma formation, and poor bowel function. Anastomosis between the colon and rectum is a particularly high risk. Traditional management mandates laparotomy, disassembly of the anastomosis, and formation of an often-permanent stoma. After laparoscopic colorectal surgery it may be possible to manage anastomotic failure with laparoscopy, thus avoiding laparotomy. OBJECTIVE: The purpose of this study was to determine the feasibility of the laparoscopic management of failed low colorectal anastomoses...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28682964/subtotal-colectomy-for-colon-cancer-reduces-the-need-for-subsequent-surgery-in-lynch-syndrome
#19
Laura Renkonen-Sinisalo, Toni T Seppälä, Heikki J Järvinen, Jukka-Pekka Mecklin
BACKGROUND: The risk of metachronous colorectal cancer is high after surgical resection for first colon cancer in Lynch syndrome. OBJECTIVE: This study aimed to examine whether extended surgery decreases the risk of subsequent colorectal cancer and improves long-term survival. DESIGN: This was a retrospective study. SETTING: Data were collected from a nationwide registry. PATIENTS: Two hundred forty-two Lynch syndrome pathogenic variant carriers who underwent surgery for a first colon cancer from 1984 to 2009 were included...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28670610/in-vivo-characterization-of-abnormalities-in-small-bowel-diseases-using-probe-based-confocal-laser-endomicroscopy
#20
Naoki Ohmiya, Noriyuki Horiguchi, Tomomitsu Tahara, Mitsuo Nagasaka, Yoshihito Nakagawa, Tomoyuki Shibata, Tetsuya Tsukamoto, Makoto Kuroda
BACKGROUND AND STUDY AIMS:  Probe-based confocal laser endomicroscopy (pCLE) enables real-time optical biopsy. Little is known about pCLE imaging deep inside the small bowel, therefore the aim of this study was to determine its usefulness. PATIENTS AND METHODS:  Between April 2014 and January 2016, we performed 38 pCLE examinations during double-balloon enteroscopy with intravenous fluorescein in 37 patients with: tumors (n = 10), vascular disorders (n = 6), inflammatory diseases and drug injuries (n = 13), other disorders (n = 4), and normal findings (n = 4)...
July 2017: Endoscopy International Open
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