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Anastomatic leak

David Lalezari, Inder Singh, Sofiya Reicher, Viktor Ernst Eysselein
AIM: To investigate the use of fully covered metal stents in benign biliary strictures (BBS) and bile leaks. METHODS: We studied 17 patients, at Harbor-UCLA Medical center (Los Angeles), with BBS (n = 12) and bile leaks (n = 5) from July 2007 to February 2012 that had received placement of fully covered self-expanding metal stents (FCSEMs). Fourteen patients had endoscopic placement of VIABIL(®) (Conmed, Utica, New York, United States) stents and three had Wallflex(®) (Boston Scientific, Mass) stents...
July 16, 2013: World Journal of Gastrointestinal Endoscopy
Abdul-Wahed N Meshikhes, Mokhtar El Tair, Thabit Al Ghazal
BACKGROUND/AIM: As totally laparoscopic colorectal surgery is considered challenging and technically demanding with a long steep learning curve, we adopted hand-assisted laparoscopic colorectal surgery as a bridge to totally laparoscopic assisted colorectal surgery. This prospective study aims to highlight the initial experience of a single surgeon with this technique. MATERIALS AND METHODS: A prospective analysis of the first 25 cases of hand-assisted laparoscopic colorectal resections which were performed by a single surgeon over a 15-month period...
January 2011: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
E H Raboei, R Luoma
BACKGROUND: Resistant benign esophageal strictures (ES) are likely to require esophageal replacement. The use of colon patch esophagoplasty (CPE) was originally described for the correction of long segment esophageal stenosis, however it was thought that the length of the stricture would limit the use of the patch technique. We performed CPE on 3- to 4-inch strictures with a good outcome. AIM: We report here on our results of the use of CPE for long and short ES...
August 2008: European Journal of Pediatric Surgery
Paul A Lucha, James E Fticsar, Michael J Francis
Clinically significant anastomotic strictures usually only occur with very low colorectal anastomoses below the level of the peritoneal reflection. The reported rate averages 8 percent and has been attributed to tissue ischemia, localized sepsis, anastomotic leak, proximal fecal diversion, radiation injury, inflammatory bowel disease, and recurrent rectal cancer. Most patients will have symptoms of obstipation, frequent small bowel movements, and bloating. Symptomatic strictures are often approached by dilation (balloon or Hegar) or less often repeat resection...
April 2005: Diseases of the Colon and Rectum
Thomas Koperna
HYPOTHESIS: Anastomotic leakage is the most important cost driver in patients who undergo low anterior resection (LAR) for rectal cancer. Creating defunctioning stomas to protect colorectal anastomoses may also have a major effect on the overall costs. Unselected creation of defunctioning stomas in most of these patients may be associated with higher overall costs compared with a program that has a low rate of defunctioning stomas and an acceptable anastomotic leakage rate. DESIGN: Cost-effectiveness analysis...
December 2003: Archives of Surgery
Joyce A Wilson, Jan J Clark
Intrinsic and extrinsic factors affect wound healing. High risk factors for the obese patients include infection, seromas, anastomatic leaks, and incision dehiscence. Tissue perfusion is an issue of great concern and is a key factor in most assessments. Obesity adds another dimension to the needs of the patient and presents challenges to nurses. From routine evaluations to specialized assessments with attention to bariatric equipment needs, a thorough understanding of wound healing and potential problems of obese patients, and knowledge of interventions is needed...
April 2003: Critical Care Nursing Quarterly
Han-Lei Dan, Yang Bai, Hui Meng, Cong-Lin Song, Jie Zhang, Yong Zhang, Lei-Chi Wan, Ya-Li Zhang, Zhen-Shu Zhang, Dian-Yuan Zhou
AIM: To reduce the incidence of postoperative anastomotic leak, stenosis, gastroesophageal reflux (GER) for patients with esophageal carcinoma, and to evaluate the conventional method of esophagectomy and esophagogastroplasty modified by a new three-layer-funnel-shaped (TLF) esophagogastric anastomotic suturing technique. METHODS: From January 1997 to October 1999, patients with clinical stage I and II (IIa and IIb) esophageal carcinoma, which met the enrollment criteria, were surgically treated by the new method (Group A) and by conventional operation (Group B)...
January 2003: World Journal of Gastroenterology: WJG
F Marinaccio, M Nobili, F Niglio, D Magistro, M Marinaccio
From January 1988 to December 1999, 21 new born babies, 13 boys and 8 girls, with esophageal atresia (EA) and tracheosophageal fistula (TEF) were treated at Division of Pediatric Surgery in Foggia (Italy). At birth their weight ranged from 1.600 to 3.000 g, the gestional age ranged from 36 to 41 weeks. Five (23%) of them were premature, seven (58%) SGA, seventeen (80%) associated congenital anomalies. Complete surgical correction was performed in all patients. In three AE cases with wide-gap an azygos vein flap was used to strengthen the anastomosis under excessive tension...
January 2002: Il Giornale di Chirurgia
G B Zibari, D F Aultman, K D Abreo, M L Lynn, E Gonzalez, R W McMillan, D Dies, J Work, J C McDonald
INTRODUCTION: Pancreatic transplantation (PTx) with portal venous delivery of insulin and enteric drainage of the exocrine secretion is more physiologic than bladder-systemic (BS) drainage. With portal-enteric (PE) PTx, the diagnosis of acute rejection (AR) requires a percutaneous biopsy. The roux-en-y (RNY) venting jejunostomy in patients with PEPTx offers a novel approach to monitor rejection and prevent anastomatic leaks. METHODS: From January 1996 to December 1998, we performed 17 simultaneous kidney/pancreas transplants (SKPTx)...
August 2000: Clinical Transplantation
P Luna-Perez, D F Rodriguez, D Flores, S Delgado, S Labastida
BACKGROUND: Pelvic exenteration, the standard treatment for patients with locally advanced rectal adenocarcinoma infiltrating neighbouring pelvic visceras, carried a significant morbidity and mortality rate. AIMS: The aim of this study was to determine the morbidity and mortality rates in a group of patients who were treated with preoperative radiation therapy and total pelvic exenteration. METHODS: Between January 1980 and January 1995, we treated 18 patients...
1995: Surgical Oncology
P R Dottino, R A Segna, T S Jennings, A M Beddoe, C J Cohen
Total cystectomy at the time of radical pelvic surgery for gynecologic malignancies is not uncommon. Many techniques have been developed for urinary diversion including the continent ileocecal urinary reservoir. Twenty-nine patients underwent construction of a continent ileocecal urinary reservoir during the reconstructive phase of an exenterative procedure or for the relief of urinary tract fistula between 1990 and 1993. All procedures were performed using the mechanical stapling devices using metal staples...
November 1994: Gynecologic Oncology
S A Pradhan, R M Rajpal
Twenty-five cases of squamous cancer of the hypopharynx and cervical esophagus treated with laryngopharyngoesophagectomy and pharyngogastric anastomosis are presented. In all cases the lesion was such that a complete circumferential pharyngectomy was necessitated. Twelve patients had received full radiation therapy and surgery was undertaken for residual and recurrent disease. Eleven patients had a concurrent unilateral radical neck dissection and two patients a concurrent bilateral neck dissection. Five patients died within 1 month following surgery...
June 1984: Journal of Surgical Oncology
R K Newman, F L Weiland, J T Johnson, P R Rosen, L W Gumerman
Patients with carcinoma of the head and neck undergoing major ablative and reconstructive procedures following periods of prolonged debilitation, chemotherapy, and/or radiation therapy have been identified as having a high risk for postoperative wound complication, most often infection. Does postoperative wound infection arise de novo, does infection result from failure of prophylactic antibiotic coverage, or is it the result of anastomatic salivary leak? To investigate the incidence of unrecognized salivary leak into the neck, 24 patients underwent salivary radioisotope studies using technetium 99m sodium pertechnetate from three to six days postoperatively...
July 1983: Annals of Otology, Rhinology, and Laryngology
S K Murthy, P S Prabhakaran, M Chandrashekar, R Deshpande, D C Doval, K S Gopinath
We are analysing the results of 80 patients who underwent surgery during 1983-84 for esophageal cancer. Forty patients who received pre-operative single agent Cis-DDP were grouped under "A" and 40 patients who went for surgery directly were grouped under "B". Twenty-two patients (55%) of Group A showed tumor necrosis. Both groups underwent resection and hand-sewn anastamosis of the esophagus. There were 10 post-operative deaths among 80 resected cases, 9 of them being from anastomatic leak. Cis-DDP has induced negligible side effects...
November 1990: Journal of Surgical Oncology
C S Cheng
105 cases of esophageal cancer and 46 cases of gastric cardia carcinoma were resected and the continuity of alimentary canal was resumed by planting esophagus into the stomach. This procedure had been designed by authors. There is neither anastomotic leakage nor stricture. Only 1 case died perioperatively. The anastomosis start by suturing the whole thickness of esophageal wall to the mucous membrane of stomach. Then the esophageal stump was telescoped into the stomach by suturing the secomuscular layer of stomach to the outer layer of esophageal muscles, with a distance of about 3 cm from the inner anastomatic line...
May 1990: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
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