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https://www.readbyqxmd.com/read/29682708/-early-diagnosis-and-treatment-of-anastomotic-leak-after-rectal-cancer-surgery
#1
Tinghan Yang, Ziqiang Wang
Anastomotic leakage is the most common major complication after mid-low rectal cancer surgery. Due to lack of knowledge regarding the virtual mechanisms of anastomotic leakage, not much can be done to prevent its development. The aim of the present review was to discuss the prevention, early diagnosis, and treatment of anastomotic leakage after rectal cancer surgery. For patients with risk factors, such as anastomotic site within 4 cm from anus, obese men, lack of blood supply of the anastomotic site, neoadjuvant chemo radiotherapy, or patients with severe co-morbidity, aggressive preventive strategy should be adopted...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29670882/stomal-closure-strategies-to-prevent-incisional-hernia
#2
Rhiannon L Harries, Jared Torkington
Incisional hernias following ostomy reversal occur frequently. Incisional hernias at the site of a previous stoma closure can cause significant morbidity, impaired quality of life, lead to life-threatening hernia incarceration or strangulation and result in a significant financial burden on health care systems Despite this, the evidence base on the subject is limited. Many recognised risk factors for the development of incisional hernia following ostomy reversal are related to patient factors such as age, malignancy, diabetes, COPD, hypertension and obesity, and are not easily correctable...
2018: Frontiers in Surgery
https://www.readbyqxmd.com/read/29614542/-gastrointestinal-bleeding-update
#3
Jonel Trebicka, Martin Götz
PREENDOSCOPIC MANAGEMENT:  In suspected gastrointestinal bleeding (GIB), standard operating procedures help in risk stratification, early patient management and endoscopy. If variceal bleeding is suspected, specific medication (vasoconstrictors, antimicrobial therapy) are additive to standard pharmacological management (PPI, erythromycin) prior to endoscopy. COAGULATION REQUIRMENTS:  An emergency endoscopy can be performed independent of the patient's current coagulation status...
April 2018: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29564651/effectiveness-of-mechanical-bowel-preparation-versus-no-preparation-on-anastomotic-leakage-in-colorectal-surgery-a-systematic-review-and-meta-analysis
#4
REVIEW
Jobbe P L Leenen, Judith E K R Hentzen, Henrietta D L Ockhuijsen
It has been a standard practice to perform mechanical bowel preparation (MBP) prior to colorectal surgery to reduce the risk of colorectal anastomotic leakages (CAL). The latest Cochrane systematic review suggests there is no benefit for MBP in terms of decreasing CAL, but new studies have been published. The aim of this systematic review and meta-analysis is to update current evidence for the effectiveness of preoperative MBP on CAL in patients undergoing colorectal surgery. Consequently, PubMed, MEDLINE, Embase, CENTRAL and CINAHL were searched from 2010 to March 2017 for randomised controlled trials (RCT) that compared the effects of MBP in colorectal surgery on anastomotic leakages...
March 21, 2018: Updates in Surgery
https://www.readbyqxmd.com/read/29529206/mechanical-bowel-preparation-mbp-prior-to-elective-colorectal-resections-in-crohn-s-disease-patients
#5
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
https://www.readbyqxmd.com/read/29435308/complementary-and-alternative-treatment-in-functional-dyspepsia
#6
REVIEW
Giuseppe Chiarioni, Marcella Pesce, Alberto Fantin, Giovanni Sarnelli
Introduction and aim: The popularity of complementary and alternative medicine (CAM) in treating functional gastrointestinal disorders (FGIDs) has steadily increased in Western countries. We aimed at analyzing available data on CAM effectiveness in functional dyspepsia (FD) patients. Methods: A bibliographical search was performed in PubMed using the following keywords: "complementary/alternative medicine," "hypnosis," "acupuncture" and/or "functional dyspepsia...
February 2018: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29421814/herbal-preparation-stw-5-for-functional-gastrointestinal-disorders-clinical-experience-in-everyday-practice
#7
Tatiana L Lapina, Alexander S Trukhmanov
BACKGROUND: The most common functional gastrointestinal disorders (FGID) are functional dyspepsia (FD) and irritable bowel syndrome (IBS), with a prevalence in the general population of 15-20% (FD) and 10% (IBS), respectively. The complexity of pathophysiologic mechanisms and limitations in therapeutic options make the management of FD and IBS patients a challenge in routine clinical practice. SUMMARY: Syndromes classified as FGID frequently overlap, and coexist with gastroesophageal reflux disease (GERD)...
February 8, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29421789/mechanism-of-action-of-stw-5-in-functional-dyspepsia-and-ibs-the-origin-of-multi-target
#8
Hans-Dieter Allescher, Heba Abdel-Aziz
BACKGROUND: STW 5 is a complex herbal combination preparation composed of 9 different herbal extracts. As an herbal medicinal product, this preparation is indicated for treating functional dyspepsia (FD) and irritable bowel syndrome (IBS). Its efficacy and practical applicability was demonstrated in several clinical studies. SUMMARY: Each herbal constituent of STW 5 has distinct effects on the gastrointestinal tract, and each shows activity through different mechanisms of action: among others, the single extracts have effects on nerves, smooth muscles, epithelial, and inflammatory cells...
February 8, 2018: Digestive Diseases
https://www.readbyqxmd.com/read/29417737/drug-induced-enterocolitis-prevention-and-management-in-primary-care
#9
Ignazio Grattagliano, Enzo Ubaldi, Piero Portincasa
Drug-induced enterocolitis is an increasing diagnosed condition which includes a variety of morphological and functional alterations of the small and large intestine as a consequence of the exposure to pharmacological active compounds. A number of factors play a major role or participate to the onset of enterocolitis which is the result of an interplay between the effect of the drug molecule and the tolerance of the bowel toward damaging insults. Age, sex, dose of drug, time of exposure, pharmaceutical preparation, drug-drug and drug-food interactions, gut barrier integrity, underlying intestinal conditions, gut microbiota composition are all involved in the appearance and extent of the injury...
February 8, 2018: Journal of Digestive Diseases
https://www.readbyqxmd.com/read/29415338/a-statewide-program-providing-colorectal-cancer-screening-to-the-uninsured-of-south-carolina
#10
Jan M Eberth, Annie Thibault, Renay Caldwell, Michele J Josey, Beidi Qiang, Edsel Peña, Delecia LaFrance, Franklin G Berger
BACKGROUND: Cancer screening rates are lowest in those without insurance or a regular provider. Since 2008, the Colorectal Cancer Prevention Network (CCPN) has provided open access colonoscopy to uninsured residents of South Carolina through established, statewide partnerships and patient navigation. Herein, we describe the structure, implementation, and clinical outcomes of this program. METHODS: The CCPN provides access to colonoscopy screening at no cost to uninsured, asymptomatic patients aged 50-64 years (African Americans age 45-64 years are eligible) who live at or below 150% of the poverty line and seek medical care in free medical clinics, federally qualified health centers, or hospital-based indigent practices in South Carolina...
February 7, 2018: Cancer
https://www.readbyqxmd.com/read/29398873/impact-of-mechanical-bowel-preparation-in-elective-colorectal-surgery-a-meta-analysis
#11
Katie E Rollins, Hannah Javanmard-Emamghissi, Dileep N Lobo
AIM: To analyse the effect of mechanical bowel preparation vs no mechanical bowel preparation on outcome in patients undergoing elective colorectal surgery. METHODS: Meta-analysis of randomised controlled trials and observational studies comparing adult patients receiving mechanical bowel preparation with those receiving no mechanical bowel preparation, subdivided into those receiving a single rectal enema and those who received no preparation at all prior to elective colorectal surgery...
January 28, 2018: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29372693/small-bowel-transanal-evisceration-mimicking-a-rectal-prolapse-a-case-report-and-review-of-literature
#12
Giuseppe Pisano, Enrico Erdas, Fabio Medas, Umberto Pisano, Pietro Giorgio Calò
Transanal intestinal evisceration is a very uncommon and dramatic occurrence, linked most frequently to rectal prolapse rupture or, very rarely, to traumatic pathology. The Authors describe a case of a 74-year-old female patient who required urgent hospital admission because of a seemingly strangulated rectal prolapse. During surgical preparation the protruding mass was recognized as small bowel loops herniating from the anus. Evisceration was due to spontaneous rectal wall rupture, most likely caused by increased abdominal pressure and consequent breach through the weakened rectum...
November 20, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29359030/role-of-oral-antibiotics-for-prophylaxis-against-surgical-site-infections-after-elective-colorectal-surgery
#13
REVIEW
Shamir O Cawich, Sachin Teelucksingh, Samara Hassranah, Vijay Naraynsingh
Over the past few decades, surgeons have made many attempts to reduce the incidence of surgical site infections (SSI) after elective colorectal surgery. Routine faecal diversion is no longer practiced in elective colonic surgery and mechanical bowel preparation is on the verge of being eliminated altogether. Intravenous antibiotics have become the standard of care as prophylaxis against SSI for elective colorectal operations. However, the role of oral antibiotics is still being debated. We review the available data evaluating the role of oral antibiotics as prophylaxis for SSI in colorectal surgery...
December 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29341151/gut-microbiome-influences-on-anastomotic-leak-and-recurrence-rates-following-colorectal-cancer-surgery
#14
REVIEW
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
https://www.readbyqxmd.com/read/29337786/mechanical-bowel-preparation-before-colorectal-surgery-in-enhanced-recovery-programs-discrepancy-between-the-american-and-european-guidelines
#15
Karem Slim, Alex Kartheuser
No abstract text is available yet for this article.
February 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29288776/predictive-factors-for-early-and-late-onset-surgical-site-infections-in-patients-undergoing-elective-colorectal-surgery-a-multicentre-prospective-cohort-study
#16
A Gomila, J Carratalà, S Biondo, J M Badia, D Fraccalvieri, E Shaw, V Diaz-Brito, L Pagespetit, N Freixas, M Brugués, L Mora, R Perez, C Sanz, N Arroyo, S Iftimie, E Limón, F Gudiol, M Pujol
BACKGROUND: Surgical site infections (SSIs) are the leading cause of healthcare-associated infections in acute care hospitals in Europe. However, the risk factors for the development of early-onset (EO) and late-onset (LO) SSI have not been elucidated. AIM: This study investigated the predictive factors for EO-SSI and LO-SSI in a large cohort of patients undergoing colorectal surgery. METHODS: We prospectively followed-up adult patients undergoing elective colorectal surgery in 10 hospitals (2011-2014)...
December 28, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29225733/colorectal-surgeon-consensus-with-diverticulitis-clinical-practice-guidelines
#17
Javariah Siddiqui, Assad Zahid, Jonathan Hong, Christopher John Young
AIM: To determine the application of clinical practice guidelines for the current management of diverticulitis and colorectal surgeon specialist consensus in Australia and New Zealand. METHODS: A survey was distributed to 205 colorectal surgeons in Australia and New Zealand, using 22 hypothetical clinical scenarios. RESULTS: The response rate was 102 (50%). For 19 guideline-based scenarios, only 11 (58%) reached consensus (defined as > 70% majority opinion) and agreed with guidelines; while 3 (16%) reached consensus and did not agree with guidelines...
November 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29198768/combination-oral-and-mechanical-bowel-preparations-decreases-complications-in-both-right-and-left-colectomy
#18
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
https://www.readbyqxmd.com/read/29134293/medicinal-foods-for-functional-gi-disorders
#19
REVIEW
Brent W Acker, Brooks D Cash
PURPOSE OF REVIEW: Over the past 10 years, there has been a dramatic increase in basic and clinical research involving functional gastrointestinal disorders (FGIDs). New diagnostic and biomarker procedures are helping to identify physiologic disruptions associated with FGIDs on cellular and molecular levels. Simultaneously, clinicians are using new approaches to help manage patients with FGIDs. Among these, an important component of care has been the use of medical foods. These include probiotics, prebiotics, synbiotics, peppermint oil, caraway oil, curcumin, bovine immunoglobulin and many others...
November 13, 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/29119289/local-antibiotic-decontamination-to-prevent-anastomotic-leakage-short-term-outcome-in-rectal-cancer-surgery
#20
Ulrich Wirth, Susanne Rogers, Kristina Haubensak, Stefan Schopf, Thomas von Ahnen, Hans Martin Schardey
PURPOSE: Anastomotic leakage still presents an issue in rectal cancer surgery with rates of about 11%. As bacteria play a critical role, there is the concept of perioperative local decontamination to prevent anastomotic leakage. METHODS: To ascertain the effectiveness of this treatment, we performed a retrospective analysis on 206 rectal resections with primary anastomosis and routine use of a selective decontamination of the digestive tract (SDD) regimen for local decontamination...
January 2018: International Journal of Colorectal Disease
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