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Bowel anastomosis

Nauman Ahmed, Hammad Naeem Rana
Primary Small bowel adenocarcinoma, a rare entity and having varied clinical presentation, makes its clinical detection a diagnostic challenge. Moreover, its true prevalence in sub-continent population has not yet been established, which makes it more difficult for its detection. We present the case of a 60 year old male who came with abdominal pain and weight loss for two years as the only symptoms. A series of tests in the two year period remained inconclusive. Later Computed tomography showed a suspicious mass at the terminal ileum...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Matthew C Hernandez, Brandon R Bruns, Nadeem Haddad, Margaret Lauerman, David S Morris, Kristen Arnold, Herb A Phelan, David Turay, Jason Murry, John S Oh, Toby Enniss, Matthew M Carrick, Thomas M Scalea, Martin Zielinski
INTRODUCTION: Threatened, perforated, and infarcted bowel is managed with conventional resection and anastomosis (hand sewn (HS) or stapled (ST)). The SHAPES analysis demonstrated equivalence between HS and ST techniques, yet surgeons appeared to prefer (HS) for the critically ill. We hypothesized that HS is more frequent in patients with higher disease severity as measured by the AAST EGS grading system. METHODS: We performed a post hoc analysis of the SHAPES database...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Igors Iesalnieks, Melanie Hoene, Theresa Bittermann, Hans J Schlitt, Christina Hackl
Background: Studies addressing the role of mechanical bowel preparation (MBP) in Crohn's disease (CD) patients are lacking. Methods: Consecutive elective colorectal resections for CD have been included in the present analysis. Exclusion criteria were small bowel resections not including colon, urgent surgeries, surgeries for cancer, and abdominoperineal resections for perianal disease. MBP was performed routinely between 1992 and 2004, omitted between 2005 and 2015, and reintroduced in 2016...
February 24, 2018: Inflammatory Bowel Diseases
H Roman, M Ballester, J Loriau, M Canis, P A Bolze, J Niro, S Ploteau, C Rubod, C Yazbeck, P Collinet, B Rabischong, B Merlot, X Fritel
The article presents French guidelines for surgical management of endometriosis. Surgical treatment is recommended for mild to moderate endometriosis, as it decreases pelvic painful complaints and increases the likelihood of postoperative conception in infertile patients (A). Surgery may be proposed in symptomatic patients with ovarian endometriomas which diameter exceeds 20mm. Cystectomy allows for better postoperative pregnancy rates when compared to ablation using bipolar current, as well as for lower recurrences rates when compared to ablation using bipolar current or CO2 laser...
March 8, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Lindsey M Charo, Adam M Burgoyne, Paul T Fanta, Hitendra Patel, Juliann Chmielecki, Jason K Sicklick, Michael T McHale
Gastrointestinal stromal tumors (GISTs) are rare in pregnancy, with only 11 reported cases. Adjuvant imatinib therapy, which targets the most common driver mutations in GIST ( KIT and PDGFRA) , is recommended for patients with high-risk GIST, but it has known teratogenicity in the first trimester. A 34-year-old G3P2 woman underwent exploratory laparotomy at 16 weeks' gestation for a presumed adnexal mass. Surgical findings included normal adnexa and a 14-cm solid small bowel mass. The mass was resected en bloc with a segment of jejunum followed by a primary anastomosis...
March 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Praneet Wander, Daniel Castaneda, Lionel D'Souza, Simi Singh, Sam Serouya, Ana I Velazquez, Rifat Mamun, Rebecca Voaklander, Petros Benias, David L Carr-Locke
BACKGROUND: To assess the safety and efficacy of the Instinct clip in the acute endoscopic treatment of upper gastrointestinal bleeding (UGIB). MATERIALS AND METHODS: This is the first large series reporting this clip in achieving hemostasis. A retrospective descriptive chart review was performed on patients presenting with recent overt GI bleeding treated with endoclip therapy at Mount Sinai Beth Israel Medical Center between May 2013 and January 2016. Results are expressed in absolute numbers, percentages, and trends...
April 2018: Journal of Clinical Gastroenterology
Rana Madani, Nigel Day, Lalit Kumar, Henry S Tilney, Andrew Mark Gudgeon
BACKGROUND: Individual trials comparing hand-sewn with stapled closure of loop ileostomy show different outcomes due to lack of statistical power. A systematic review, with a pooled analysis of results, might provide a more definitive answer. This review aimed to compare hand-sewn with stapled anastomotic technique for closure of a loop ileostomy and looked at the effect of bowel resection on the complication rates. METHODOLOGY: Relevant studies were identified from MEDLINE, EMBASE and the Cochrane database...
March 7, 2018: Digestive Surgery
Stefano Scaringi, Annamaria Di Bella, Luca Boni, Francesco Giudici, Carmela Di Martino, Daniela Zambonin, Ferdinando Ficari
BACKGROUND AND AIMS: Surgical management of Crohn's colitis represents one of the most complex situations in colorectal surgery. Segmental colectomy (SC) and total abdominal colectomy with ileorectal anastomosis (TAC-IRA) are the most common procedures, but there are few available data on their long-term outcome. The aim of the present study was to analyze the long-term outcome of patients who underwent segmental colectomy for Crohn's colitis, with regard to the risk for total abdominal colectomy...
March 6, 2018: International Journal of Colorectal Disease
Abdullah Alfawaz, Jun Tashiro, Danny Sleeman, Keith Jones, Jorge Rey
Aorto-enteric fistulae pose a challenging negative outcome of aortic intervention. Treatment involves graft excision, and recently, more enthusiasm has met in situ revascularization over extra-anatomic bypass. This has been traditionally performed through the transperitoneal approach via a midline abdominal incision. We propose an exclusively total retroperitoneal technique in managing this complication with regard to both the vascular and alimentary tract technical aspects of the procedure. This involves exclusion and bypass of the affected segment followed by en-mass resection of the affected segment with the duodenum, and finally, bowel anastomosis...
2018: SAGE Open Medical Case Reports
Lei Lian, Emmanuel Obusez, Erick M Remer, Manoj Monga, Bo Shen
Background: Enlarged prostate is often noticed in patients with ileal pouch-anal anastomosis (IPAA) in our clinical practice. The aims were to identify the factors associated with enlarged prostate and to investigate its clinical implications. Methods: IPAA patients with available prostate imaging after IPAA were included. Prostate length and width were measured in the axial plane and height in coronal plane. Prostate volume was calculated with the formula (length × width × height) × π/6...
February 2018: Gastroenterology Research
Frederikke Schønfeldt Troelsen, Anders Tøtterup
Post-operative bowel perforation is often a consequence of an anastomotic leakage. In most cases of major anastomotic leakage with generalised peritonitis a stoma formation at the point of perforation is recommended. In some cases, however, stoma formation is not possible. In this case report an artificial fistula was made. The edge of the defect in the anastomosis was sutured to an incision in the iliac fossa to provide source control in a difficult case of anastomotic leakage. The abdominal cavity was found without faecal contamination on the fourth post-operative day...
February 26, 2018: Ugeskrift for Laeger
Stuart K Amateau, Chin Hong Lim, Nicholas M McDonald, Mustafa Arain, Sayeed Ikramuddin, Daniel B Leslie
Traditionally, restoration of normal bowel continuity after resection and bypass of a diseased or obstructed gastrointestinal tract can only be achieved through surgery, which can be technically challenging and comes with a risk of adverse events. Here, we describe our institutions' experience with endoscopic-guided gastroenterostomy or enteroenterostomy with lumen-apposing metal stent (LAMS) from March 2015 to August 2016. Ten patients had gastrogastrostomy (gastric pouch to gastric remnant) and three patients had jejunogastrostomy (Roux limb to gastric remnant) for the reversal of Roux-en-Y bariatric surgery...
March 2, 2018: Obesity Surgery
P Loertzer, S Siemer, M Stöckle, C H Ohlmann
PURPOSE: To analyze the feasibility and perioperative results of patients undergoing robot-assisted cystectomy with intracorporeal urinary diversion and robot-sewn ileoileal anastomosis. METHODS: This is a mono-centric analysis of perioperative data from 48 consecutive patients undergoing robot-assisted cystectomy with intracorporeal urinary diversion and robot-sewn ileoileal anastomosis. Data include the preoperative variables, operative and postoperative course and complication rates related to bowel anastomosis...
March 2, 2018: World Journal of Urology
Gisele Aaltonen, Monika Carpelan-Holmström, Ilona Keränen, Anna Lepistö
PURPOSE: To compare recurrence frequency and location between different types of bowel resections in Crohn's disease patients. METHODS: This was a retrospective study of consecutive patients undergoing bowel resection for Crohn's disease between 2006 and 2016. Type of primary operation was recorded and grouped as ileocolic resection, small bowel resection, segmental colon resection with colocolic anastomosis or colorectal anastomosis, colectomy with ileorectal anastomosis, or end stoma operation...
February 28, 2018: International Journal of Colorectal Disease
Qingjuan Shang, Qiankun Geng, Xuebing Zhang, Hongfang Xu, Chunbao Guo
This study was conducted to assess the clinical advantages of early enteral nutrition (EEN) in pediatric patients who underwent surgery with gastrointestinal (GI) anastomosis.EEN has been associated with clinical benefits in various aspect of surgical intervention, including GI function recovery and postoperative complications reduction. Evaluable data documenting clinical advantages with EEN for pediatric patients after surgery with GI anastomosis are limited.We retrospectively reviewed the medical records of 575 pediatric patients undergoing surgical intervention with GI anastomosis...
March 2018: Medicine (Baltimore)
Pietro Calcagno, Matteo Viti, Alessandro Cornelli, Davide Galli, Corrado D'Urbano
INTRODUCTION: Endometriosis is the growth of endometrium outside the uterine cavity. In 5-15% of cases the disease can affect the colon and small bowel, causing complete obstruction and requiring resection in about 1% of cases. CASE SUMMARY: We describe a case of sigmoid obstruction due to endometriosis in a 38 years old woman with personal history of endometriosis. She was admitted for abdominal pain and constipation. The patient was treated with endoscopic stenting and subsequent laparoscopic sigmoidectomy...
February 14, 2018: International Journal of Surgery Case Reports
Pablo Stringa, Nidia Monserrat Arreola, Ane M Andres Moreno, Carlota Largo, Martín Rumbo, Francisco Hernandez
BACKGROUND:  Modified multivisceral transplantation (MMVTx) refers to the use of a graft that includes all abdominal organs except the liver. The use of this type of transplant in children and adults expanded over the last years with good results. However, long-term survival in experimental models has not been reported. Our aim is to describe in detail some technical modifications of MMVTx to obtain long-term survival. MATERIALS AND METHODS:  Syngeneic (Lewis-Lewis) heterotopic MMVTx was performed in 16 male rats (180-250 g)...
February 23, 2018: European Journal of Pediatric Surgery
Fabio Rondelli, Roberto Santinelli, Paolo Stella, Walter Bugiantella, Graziano Ceccarelli, Ruben Carlo Balzarotti, Michele De Rosa, Nicola Avenia
BACKGROUND: Colorectal cancer is the fourth most diffuse cause of death in the world and local recurrence is associated with a reduced long-term life expectancy, with a reduced quality of life. Rectal washout at the anastomosis site leads to a statistically significant reduction of local recurrences. METHODS: We developed the idea of a new laparoscopic stapler with an integrated washout system that could decontaminate the rectal stump before resection, without the need to enlarge the standard surgical incision or even to distort the incision site, closing the rectal stump just below the inferior part of the cancer, and then proceeding with the resection and stapling of the distal part of the tumor...
February 1, 2018: Surgical Innovation
Elisa Cassinotti, Stefano Costa, Stefano DE Pascale, Barbara Oreggia, Giorgio Palazzini, Luigi Boni
BACKGROUND: Anastomotic leakage (AL) is a serious complication in colorectal surgery leading to significant morbidity and mortality. Progressively lower anastomoses are associated with a greater leak rate. Adequate bowel perfusion has been stressed as one of the key elements for suture healing. Currently, there is no widespread method to assess and quantify the perfusion of gastrointestinal anastomoses intraoperatively, besides the subjective evaluation by the surgeon. The aim of this paper is to describe the basis of Indocyanine Green (ICG) fluorescence guided surgery applied to assessment of bowel perfusion and to highlight studies on the use of fluorescence angiography (FA) in laparoscopic rectal surgery...
February 21, 2018: Minerva Chirurgica
James Chi-Yong Ngu, Yvonne Ying-Ru Ng
Comparisons between robotic and laparoscopic right hemicolectomy have been confounded by variations in operative technique. This study evaluates the two procedures after standardizing the intraoperative steps and perioperative management. Patients who underwent robotic right hemicolectomy with intracorporeal bowel anastomosis between July 2015 and June 2017 were matched with a laparoscopic group. Perioperative management was in accordance to an enhanced recovery protocol. Outcomes and histopathological data were compared...
February 22, 2018: Journal of Robotic Surgery
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