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gastrointestinal anastomosis

Manuel Guerrero-Hernandez, Carlos A Hinojosa, Javier E Anaya-Ayala, Erika Elenes, Aldo Torre
Portal vein (PV) thrombosis (PVT) in the absence of liver disease or thrombophilia is rare. We report a 57-year-old male with a history of stage 3 chronic kidney disease who presented at the emergency department 18 months after abdominal surgery with progressive abdominal pain and distention. Computed tomography revealed PVT with multiple collaterals and moderate ascites. He had undergone partial gastrectomy and gastrojejunal anastomosis at an outside facility for gastrointestinal stromal tumors that caused an iatrogenic stenotic lesion in the PV...
October 20, 2016: Vascular and Endovascular Surgery
Sarah Wills, Hugues Beaufrère, Gwyneth Watrous, Michelle L Oblak, Dale A Smith
CASE DESCRIPTION A 13-year-old female green iguana (Iguana iguana) was examined because of a 6-day history of vomiting, anorexia, and lethargy and a 4-day history of decreased fecal and urate output. CLINICAL FINDINGS Physical examination revealed a distended abdomen, signs of depression, pallor, tachycardia, harsh lung sounds, and vomiting. Abdominal radiographs revealed gas distention of the stomach and small intestine with fluid lines evident on the lateral view. Plasma biochemical analysis indicated hypochloremic metabolic alkalosis, hyperglycemia, and hyperuricemia...
November 1, 2016: Journal of the American Veterinary Medical Association
Yuqin Huang, Sen Wang, Dong Tang, Youquan Shi, Wei Wang, Yang Chong, Huaicheng Zhou, Qingquan Xiong, Jie Wang, Daorong Wang
Uncut Roux-en-Y gastrojejunostomy is a modification of the Billroth II procedure with Braun anastomosis, in which a jejunal occlusion is fashioned to avoid the Roux Stasis Syndrome. This review aimed to summarize the current knowledge about the uncut Roux-en-Y anastomosis operation, so that surgeons may be able to make informed decisions about its clinical application. Additionally, we hope that our findings will guide future research on this topic. Areas covered: The original uncut technique was associated with dehiscence or recanalization of the jejunal occlusion, and was therefore not widely applied...
October 17, 2016: Expert Review of Gastroenterology & Hepatology
Munetaka Hashimoto, Hitoshi Goto, Daijirou Akamatsu, Takuya Shimizu, Ken Tsuchida, Keiichiro Kawamura, Yuta Tajima, Michihisa Umetsu
Objectives: The optimal surgical management for secondary aorto-enteric fistula (sAEF) is controversial. Here, we report the long-term outcomes of a surgical treatment with in situ graft reconstruction for sAEF that was performed at our hospital. Methods: Between 2009 and 2012, 10 consecutive patients (8 males, 2 females, mean age 75.9 years) with sAEF were surgically treated with in situ graft reconstruction. Perioperative and long-term outcomes were reviewed retrospectively by medical records. Results: Clinical manifestations, including gastrointestinal bleeding, shock, sepsis, and back and abdominal pain, were observed during the treatment of the patients...
2016: Annals of Vascular Diseases
Basak Erginel, Feryal Gun Soysal, Huseyin Ozbey, Erbug Keskin, Alaattin Celik, Aslıhan Karadag, Tansu Salman
PURPOSE: The purpose of the study was to evaluate our experience with enteric duplication cysts in 40 children during the past 26 years, while assessing the variability of their presentations and to propose an algorithm for surgical management. METHODS: We retrospectively analysed sex, age, clinical presentations, duplication site, surgical treatment, presence of ectopic tissue, complications, associated anomalies, and prognosis of 40 patients with gastrointestinal tract duplications who were surgically treated in our clinic...
October 12, 2016: World Journal of Surgery
Ri-Xing Bai, Wen-Mao Yan, You-Guo Li, Jun Xu, Zhi-Qiang Zhong, Ming Yan
AIM: To evaluate the feasibility of side-to-side anastomosis of the lesser curvature of stomach and jejunum in laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: Seventy-seven patients received side-to-side anastomosis of the lesser curvature of stomach and jejunum by utilization of linear stapler in LRYGB from April 2012 to July 2015 were retrospectively analyzed. RESULTS: All patients were successfully completed laparoscopic gastric bypass with the side-to-side anastomosis of the lesser curvature of stomach and jejunum...
October 7, 2016: World Journal of Gastroenterology: WJG
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
Mariano Palermo, Edgardo Serra
Background: Gastric bypass is a restrictive and malabsorptive surgery. The restrictive part consists in the creation of a small gastric pouch. The gastrointestinal bypass serves as the malabsorptive element. Aim: To describe a simplified gastric bypass approach for morbid obese patients, showing our results, and also remarking the importance of this technique for reducing the learning curve. Method: The patient is positioned in a split legs position and carefully strapped to the operating room table, with the surgeon between the patient's legs...
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
Yin Li
Enhanced recovery after surgery (ERAS) is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition and psychology. It aims to minimize surgical stress and maintain physiological function in perioperative care, thereby expediting recovery. ERAS theory has been clinically applied for nearly 20 years and it is firstly used in colorectal surgery, then widely used in other surgical fields. However, ERAS is not used commonly in esophagectomy because of its surgical complexity and high morbidity of postoperative complications, which limits the application of ERAS in the field of esophagectomy...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Frans van Workum, Jolijn van der Maas, Frits J H van den Wildenberg, Fatih Polat, Ewout A Kouwenhoven, Marc J van Det, Grard A P Nieuwenhuijzen, Misha D Luyer, Camiel Rosman
BACKGROUND: Both cervical esophagogastric anastomosis (CEA) and intrathoracic esophagogastric anastomosis (IEA) are used to restore gastrointestinal integrity following minimally invasive esophagectomy (MIE). No prospective randomized data on functional outcome, postoperative morbidity, and mortality between these techniques are currently available. METHODS: A comparison was conducted including all consecutive patients with esophageal carcinoma of the distal esophagus or gastroesophageal junction undergoing MIE with CEA or MIE with IEA from October 2009 to July 2014 in 3 high-volume esophageal cancer centers...
September 24, 2016: Annals of Thoracic Surgery
Pietro Addeo, Gennaro Nappo, Emanuele Felli, Constantin Oncioiu, François Faitot, Philippe Bachellier
Nowadays, pancreaticoduodenectomies (PD) with an "en-bloc" resection of the spleno-mesenterico-portal (SMP) venous axis are safely performed at tertiary centers for patients presenting venous invasion. However, for tumors infiltrating the SMP confluence optimal management of the splenic vein (SV) remains a matter of debate. Simple SV ligation has been associated with the development of sinistral portal hypertension, gastrointestinal bleeding and hypersplenism over the long term. To avoid these complications, reconstructive methods such as the direct implantation of the SV into a SMP "neoconfluence", the inferior mesenteric vein-SV anastomosis and the distal spleno-renal shunt have been reported...
September 20, 2016: Updates in Surgery
Sami A Chadi, Abe Fingerhut, Mariana Berho, Steven R DeMeester, James W Fleshman, Neil H Hyman, David A Margolin, Joseph E Martz, Elisabeth C McLemore, Daniela Molena, Martin I Newman, Janice F Rafferty, Bashar Safar, Anthony J Senagore, Oded Zmora, Steven D Wexner
Anastomotic leaks represent one of the most alarming complications following any gastrointestinal anastomosis due to the substantial effects on post-operative morbidity and mortality of the patient with long-lasting effects on the functional and oncologic outcomes. There is a lack of consensus related to the definition of an anastomotic leak, with a variety of options for prevention and management. A number of patient-related and technical risk factors have been found to be associated with the development of an anastomotic leak and have inspired the development of various preventative measures and technologies...
September 16, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Shayan Irani, Sujai Jalaj, Andrew Ross, Michael Larsen, Ian S Grimm, Todd H Baron
BACKGROUND AND AIMS: Benign gastrointestinal strictures occur typically in the esophagus and pyloric channel, but can occur anywhere in the GI tract and at anastomotic sites. Such strictures can be treated with dilation, incisional therapy, steroid injection and stents. Our aim was to describe the use of a lumen-apposing metal stent (LAMS) to treat short, benign gastrointestinal strictures. PATIENTS AND METHODS: Retrospective review of consecutive patients who underwent LAMS placement for various benign strictures at 2 tertiary care centers from August 2014 to November 2015...
September 12, 2016: Gastrointestinal Endoscopy
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
Dan Xie, Kunpeng Hu, Ying Xian, Ying Wang, Xiaofeng Yuan, Mingliang Li, Xiaogang Bi, Kouxing Zhang
Peptic ulcer bleeding due to primary hyperparathyroidism is extremely rare. We report a case of a 42-year-old male with life-threatening acute upper gastrointestinal bleeding secondary to a duodenal ulcer and a history of kidney stones. Gastroscopic therapy, Billroth II gastrointestinal anastomosis and angiographic embolization were sequentially conducted to arrest the hemorrhage. A complete investigative work-up revealed that the duodenal ulcer bleeding was due to primary hyperparathyroidism coexisting with a parathyroid adenoma...
September 10, 2016: Gastroenterology Report
Renata Tabola, Katarzyna Augoff, Andrzej Lewandowski, Piotr Ziolkowski, Piotr Szelachowski, Krzysztof Grabowski
A two-stage esophagectomy with an interval for reconstruction of the esophagus creates an opportunity for the esophageal stump to recover from vessel injury and allows the formation of granulation tissue rich in proangiogenic factors, including transforming growth factor β (TGF-β) and vascular endothelial growth factor A (VEGF-A), which may have an impact on anastomosis healing. The present study comprised 25 patients (27 in total, 2 succumbed to complications following surgery) who underwent two-stage esophagectomy for squamous cell carcinoma in the Department of Gastrointestinal and General Surgery, Wrocław Medical University (Wrocław, Poland) between January 2007 and December 2012...
September 2016: Oncology Letters
Seung Koo Yang, Chang Jin Yoon
Stenosis of the pancreatico-enteric anastomosis is one of the major complications of pancreaticoduodenectomy (PD). Endoscopic stent placement, has limited success rate as a nonsurgical treatment due to altered gastrointestinal anatomy. Percutaneous treatment is rarely attempted due to the technical difficulty in accessing the pancreatic duct. We reported a case of pancreaticojejunostomy stenosis after PD, in which a pancreatic stent was successfully placed using a rendezvous technique with a dual percutaneous approach...
September 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
M Atie, O Khoma, G Dunn, G L Falk
Oedema can occur in handled tissues following upper gastrointestinal surgery with anastomosis formation. Obstruction of the lumen may result in delayed return of enteric function. Intravenous steroid use may be beneficial. Three cases of delayed emptying following fundoplication, gastro-enteric and entero-enteric anastomoses are reviewed. Conservative management with supportive measures failed. Dexamethasone was administered to treat the oedematous obstruction. A literature review in PubMed, Cochrane database and Medline for English language publications on the use of dexamethasone in the treatment of acute post surgical oedema of the upper gastrointestinal was conducted...
2016: Journal of Surgical Case Reports
Minhua Zheng, Junjun Ma
With the development in past 20 years, the utilization of the laparoscopic surgery, which is the main trend in minimally invasive surgery for colorectal cancer, has tremendously changed. Minimally invasive surgery for colorectal cancer is now at a high level platform after going through the exploration at the very beginning and rapid development in the period of standardizing and promoting the regulations. Nowadays, the unique advantage that the laparoscopy owns is high definition and enlargement of the image, along with the establishment of the key note in series of laparoscopic complete mesocolic excision and the improvement of surgical instruments and methods make the operation skills accurate and normative in exploration of correct plane, high ligation of vessels and protection of nerve during the lymph node dissection of colorectal surgery...
August 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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