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Anastomotic leaks

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https://read.qxmd.com/read/32219810/transanal-minimally-invasive-surgery-a-multi-purpose-operation
#1
Giovanni Dapri
BACKGROUND: Minimally Invasive Colorectal Surgery (MICS) is continually evolving. The recognition of the anus as a natural orifice to perform MICS has contributed to the development of a new philosophy of treatment called TransAnal Minimally Invasive Surgery (TAMIS). Transanal total mesorectal excision (TaTME) is one of the most common forms of TAMIS. Other indications include benign diseases and early malignant rectal adenocarcinoma. This report presents the author's experience with TAMIS as a multi-purpose operation...
March 27, 2020: Surgical Technology International
https://read.qxmd.com/read/32206962/anastomotic-leak-and-cancer-specific-outcomes-after-curative-rectal-cancer-surgery-a-systematic-review-and-meta-analysis
#2
REVIEW
A Karim, V Cubas, S Zaman, S Khan, H Patel, P Waterland
BACKGROUND: The aim of the present study was to perform a systematic review and meta-analysis of cancer-specific outcomes after curative rectal cancer surgery comparing anastomotic leak (AL) with no leak. METHODS: PubMed, Medline and Embase databases were searched to identify studies comparing cancer-specific outcomes after rectal cancer surgery in patients with AL and without. A meta-analysis with a random-effects model was used to calculate pooled odds ratios (OR) and confidence intervals (CI) for each outcome measure...
March 23, 2020: Techniques in Coloproctology
https://read.qxmd.com/read/32206808/enteral-immunonutrition-versus-enteral-nutrition-for-patients-undergoing-oesophagectomy-a-systematic-review-and-meta-analysis
#3
Xiao-Kun Li, Hai Zhou, Yang Xu, Zhuang-Zhuang Cong, Wen-Jie Wu, Jing Luo, Zhi-Sheng Jiang, Yi Shen
OBJECTIVES: According to retrospective studies, oesophageal carcinoma is the second deadliest gastrointestinal cancer after gastric cancer. Enteral immunonutrition (EIN) has been increasingly used to enhance host immunity and relieve the inflammatory response of patients undergoing oesophagectomy; however, conclusions across studies remain unclear. We aimed to evaluate the effect of EIN on the clinical and immunological outcomes of patients undergoing oesophagectomy. METHODS: Four electronic databases (MEDLINE, Embase, Web of Science and Cochrane Library) were used to search articles in peer-reviewed, English-language journals...
March 24, 2020: Interactive Cardiovascular and Thoracic Surgery
https://read.qxmd.com/read/32198097/critical-appraisal-of-gastric-conduit-ischaemic-conditioning-gic-prior-to-oesophagectomy-a-systematic-review-and-meta-analysis
#4
REVIEW
Sivesh K Kamarajah, Charlie Boyle, James R Bundred, Benjamin Hl Tan
INTRODUCTION: Anastomotic leaks remain a major complication following oesophagectomy, accounting for high morbidity and mortality. Recently, gastric ischaemic conditioning (GIC) has been proposed to improve anastomotic integrity through neovascularisation of the gastric conduit. This systematic review and meta-analysis aim to determine the impact of GIC on postoperative outcomes following oesophagectomy. METHODS: A systematic literature search was performed to identify studies reporting GIC for any indication of oesophageal resection up to 25th April 2019...
March 17, 2020: International Journal of Surgery
https://read.qxmd.com/read/32193667/initial-clinical-experience-with-a-powered-circular-stapler-for-colorectal-anastomosis
#5
S Atallah, S Kural, N Banda, A Banda, F Bawaney, F Cabral, V Neychev, C Patel, S Larach
BACKGROUND: The Echelon circular™ powered stapler (ECP stapler) obviates the need for manual firing of conventional circular staplers during the construction of a colorectal anastomosis, but has not been evaluated clinically. The aim of this study was to perform a clinical evaluation of this stapler. METHODS: A retrospective review of the initial clinical experience of a single surgeon using the ECP stapler for left-sided colorectal anastomosis construction during elective colorectal resections for benign and malignant disease was conducted by analyzing results from a prospectively maintained study database...
March 19, 2020: Techniques in Coloproctology
https://read.qxmd.com/read/32193534/treatment-protocol-for-secondary-esophageal-reconstruction-using-supercharged-colon-interposition-flaps
#6
N Esmonde, W Rodan, K R Haisley, N Joslyn, J Carboy, J G Hunter, P H Schipper, B H Tieu, J Hansen, J P Dolan
Locoregional esophageal cancer is currently treated with induction chemoradiotherapy, followed by esophagectomy with reconstruction, using a gastric conduit. In cases of conduit failure, patients are temporized with a cervical esophagostomy and enteral nutrition until gastrointestinal continuity can be established. At our institution, we favor reconstruction, using a colon interposition with a 'supercharged' accessory vascular pedicle. Consequently, we sought to examine our technique and outcomes for esophageal reconstruction, using this approach...
March 20, 2020: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/32193528/the-impact-of-preoperative-sarcopenia-on-postoperative-complications-following-esophagectomy-for-esophageal-neoplasia-a-systematic-review-and-meta-analysis
#7
Dimitrios Papaconstantinou, Konstantina Vretakakou, Anna Paspala, Evangelos P Misiakos, Anestis Charalampopoulos, Constantinos Nastos, Paul Patapis, Emmanouil Pikoulis
Esophageal cancer is characterized by profound changes in body composition due to dysphagia and generalized cachexia. Sarcopenia or muscle wasting is a component of cachexia associated with poor postoperative performance status. The skeletal muscle index (SMI) calculated by computed tomography scans at the level of the third lumbar vertebra is an easily quantifiable and reproducible measure of sarcopenia. The aim of this meta-analysis is to investigate the impact of preoperative sarcopenia (low SMI) on postoperative complications after esophagectomy for neoplastic lesions...
March 20, 2020: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://read.qxmd.com/read/32192850/robotic-hepaticojejunostomy-surgical-technique-and-risk-factor-analysis-for-anastomotic-leak-and-stenosis
#8
Roberto Bustos, Eduardo Fernandes, Alberto Mangano, Gabriela Aguiluz, Valentina Valle, Mario Masrur, Francesco Bianco, Pier C Giulianotti
BACKGROUND: A variety of techniques have been described for the construction of the HJ (hepaticojejunostomy). Due to its technical challenges, HJ is rarely performed in a pure laparoscopic setting. In stark contrast, the increasing availability of the robotic platform has sparked new interest in pursuing this procedure in a minimally invasive fashion. The aim of our study was to describe our surgical technique and to identify risk factors for anastomotic leak and stenosis following robotic surgery...
March 16, 2020: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://read.qxmd.com/read/32191004/-a-comparison-of-knot-free-and-interrupted-suturing-of-vesicourethral-anastomosis-during-learning-curve-of-radical-prostatectomy
#9
S V Popov, I N Orlov, I V Sushina, P V Vjazovcev, E A Grin, T M Topuzov, S M Malevich
BACKGROUND: Laparoscopic radical prostatectomy (LRP) is the most popular treatment method for localized prostate cancer worldwide. This is a technically-demanding procedure with a long learning curve. Therefore, an improvement of the surgical technique is very important in order to simplify training for LRP. Dorsal vein ligation and vesicourethral anastomosis (VUA) are two major problems for surgeons with insufficient experience in LRP. Previous studies have shown that between 50 and 250 procedures are required in order to get necessary skills...
March 2020: Urologii︠a︡
https://read.qxmd.com/read/32189424/a-study-investigating-the-perfusion-of-colorectal-anastomoses-using-fluorescence-angiography-results-of-flag-randomized-trial
#10
Mikhail Alekseev, Evgeny Rybakov, Yuri Shelygin, Stanislav Chernyshov, Irina Zarodnyuk
AIM: To evaluate the efficacy of indocyanine-green (ICG) fluorescence angiography (FA) in reducing the incidence of anastomotic leak (AL) following colorectal anastomoses. METHODS: A single center randomized trial was undertaken between 2018 and 2019. Those patients who underwent a stapled colorectal anastomosis were randomized 1:1 for ICG FA vs. visual clinical assessment of blood perfusion of the anastomosed colon and rectal stump (non-ICG FA group). The primary end-point was to assess whether ICG FA was associated with a reduction in the incidence of AL ...
March 18, 2020: Colorectal Disease
https://read.qxmd.com/read/32189067/how-to-reduce-anastomotic-leakage-in-colorectal-surgery-report-from-german-expert-meeting
#11
Andreas D Rink, Peter Kienle, Felix Aigner, Alexis Ulrich
AIMS: Anastomotic leakage is one of the most worrisome complications in colorectal surgery. An expert meeting was organized to discuss and find a consensus on various aspects of the surgical management of colorectal disease with a possible impact on anastomotic leakage. METHODS: A three-step Delphi-method was used to find consensus recommendations. RESULTS: Strong consensus was achieved for the use of mechanical bowel preparation and oral antibiotics prior to colorectal resections, the abundance of non-selective NSAIDs, the preoperative treatment of severe iron deficiency anemia, and for attempting to improve the patients' general performance in the case of frailty...
March 18, 2020: Langenbeck's Archives of Surgery
https://read.qxmd.com/read/32185679/intraoperative-endoscopy-with-immediate-suture-reinforcement-of-the-defect-in-colorectal-anastomosis-a-pilot-study
#12
Carlo Vallicelli, Basilio Pirrera, Vincenzo Alagna, Enrico Fantini, Gian Marco Palini, Nicola Zanini, Gianluca Garulli
Colorectal anastomosis is the one at higher risk of complication in alimentary tract surgery. Several techniques have been used to intraoperatively check a colorectal anastomosis, without reaching a clear consensus. The aim of the present study is to evaluate the addition of intraoperative flexible endoscopy to indocyanine green fluorescence in detecting colorectal anastomotic defects in a consecutive series of patients. This was a pilot study conducted over a 15-month period. Patients were scheduled for an elective laparoscopic left colectomy or anterior resection with a planned stapled colorectal anastomosis...
March 17, 2020: Updates in Surgery
https://read.qxmd.com/read/32179999/laparoscopic-versus-open-surgery-for-the-management-of-post-cholecystectomy-benign-biliary-strictures
#13
Amit Javed, B D Shashikiran, P S Aravinda, Anil K Agarwal
BACKGROUND AND AIM: Surgical management by a bilioenteric anastomosis is the standard for the repair of post-cholecystectomy benign biliary strictures (BBS). This is traditionally done as an open operation. There are a few reports describing the procedure by a laparoscopic technique. The aim of the present study was to describe our experience of laparoscopic bilio-enteric anastomosis [Roux-en-Y hepaticojejunostomy (LRYHJ)/laparoscopic hepaticoduodenostomy (LHD)] in the management of post-cholecystectomy BBS and compare the outcomes with our patients operated by the open approach...
March 16, 2020: Surgical Endoscopy
https://read.qxmd.com/read/32168095/locally-transplanted-adipose-stem-cells-reduce-anastomotic-leaks-in-ischemic-colorectal-anastomoses-a-rat-model
#14
Andrew Morgan, Andrew Zheng, Kimberly Linden, Ping Zhang, Spencer Brown, Jeffrey Carpenter, Francis Spitz, Michael Kwiatt
BACKGROUND: Anastomotic leakage remains a dreaded complication after colorectal surgery. Stem-cell-based therapies have been shown to increase angiogenesis and cell proliferation. OBJECTIVE: To investigate the use of adipose-derived stem cells on the healing of ischemic colonic anastomoses in a rat model. DESIGN: This is an animal research study using xenotransplantation. SETTINGS: Male Wistar rats (300-400g, n=48) were purchased from a licensed breeder...
March 9, 2020: Diseases of the Colon and Rectum
https://read.qxmd.com/read/32167712/modified-wallace-anastomotic-technique-reduces-ureteroenteric-stricture-rates-after-ileal-conduit-urinary-diversion
#15
Petar Kavaric, Sabovic Eldin, Radovic Nenad, Pratljacic Dragan, Marko Vukovic
PURPOSE: To compare perioperative outcomes, complications and anastomotic stricture rate in a contemporary series of patients who underwent open radical cystectomy (RC) with modified Wallace anastomotic technique versus traditional ileal conduit. MATERIALS AND METHODS: Study enrolled 180 patients, of whom 140 were randomized and underwent RC; seventy were randomized to group I and the seventy to the group II. For the primary objective, we hypothesized that the rate of ureteroenteric strictures would be at least 20 % lower in the second group...
May 2020: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://read.qxmd.com/read/32166547/two-stage-hybrid-ivor-lewis-esophagectomy-as-surgical-strategy-to-reduce-postoperative-morbidity-for-high-risk-patients
#16
I Bartella, S Brinkmann, H Fuchs, J Leers, H A Schlößer, C J Bruns, W Schröder
BACKGROUND: Ivor-Lewis esophagectomy (ILE) is the standard surgical care for esophageal cancer patients but postoperative morbidity impairs quality of life and reduces long-term oncological outcome. Two-stage ILE separating the abdominal and thoracic phase into two distinct surgical procedures has proven to enhance microcirculation of the gastric conduit and therefore most likely reduces complications. However, two-stage ILE has not been evaluated systematically in selected groups of patients scheduled for this procedure...
March 12, 2020: Surgical Endoscopy
https://read.qxmd.com/read/32161727/-double-lumen-valve-controlled-intra-operative-pyeloplasty-stent-vips-a-new-technology-for-post-pyeloplasty-stenting-proof-of-concept-study-in-a-preclinical-large-animal-model
#17
Tariq O Abbas, Mansour Ali, Raphael Moog
Background: Pyeloplasty is a common surgical operation with a high success rate. However, significant challenges are to be optimized in the design of stenting systems in order to improve perioperative monitoring of urine drainage and enhance patient and family comfort through easier post-operative care. Materials and Methods: In a preliminary study in six pigs, handling, mechanical and functional features of this stent system were tested. In our main study, six double-lumen stents (230 mm long each) and 6F/9F external diameter were implanted through the ureteric walls of six domestic pigs to allow postoperative drainage and monitoring following ureteroureterostomy...
2020: Research and Reports in Urology
https://read.qxmd.com/read/32159273/intraoperative-indocyanine-green-fluorescence-angiography-to-prevent-anastomotic-leak-after-low-anterior-resection-for-rectal-cancer-a-meta-analysis
#18
REVIEW
Yu Shen, Tinghan Yang, Jinliang Yang, Wenjian Meng, Ziqiang Wang
BACKGROUND: Anastomotic leakage (AL) is one of the most dreadful complications after rectal cancer surgery. Indocyanine green fluorescence angiography (ICG FA) is now being used to evaluate blood supply at the anastomotic site. The aim of this study is to conduct a meta-analysis of the available literature to evaluate whether ICG FA could prevent AL after low anterior resection (LAR) for rectal cancer. METHODS: Databases including PubMed, Web of Science, Google Scholar databases, Cochrane Library and China National Knowledge Infrastructure were searched to find out potential comparative studies comparing AL rates after LAR between intraoperative use and non-use of ICG FA...
March 11, 2020: ANZ Journal of Surgery
https://read.qxmd.com/read/32159065/-enterobacter-cloacae-periprosthetic-joint-infection-after-bariatric-surgical-anastomotic-leak
#19
Justin T DesLaurier, Joyce J Chung, Awais K Hussain, Michael J Patetta, Mark H Gonzalez, Menachem M Meller
Four weeks after a bilateral total knee arthroplasty (TKA), an immunocompetent, 61-year-old, Caucasian man presented with a periprosthetic joint infection (PJI) of the left knee by Enterobacter cloacae (an enteric bacteria). The most likely source of his infection was due to an anastomotic leak after a bariatric surgery done 6 months before TKA. There is a growing focus on stratifying the risk of PJI after TKA. Hematogenous seeding of enteric bacteria leading to PJI is an unexplored risk that will become more prevalent as bariatric procedures before TKA continue to increase in frequency...
January 2020: Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
https://read.qxmd.com/read/32159062/-enterobacter-cloacae-periprosthetic-joint-infection-after-bariatric-surgical-anastomotic-leak
#20
Justin T DesLaurier, Joyce J Chung, Awais K Hussain, Michael J Patetta, Mark H Gonzalez, Menachem M Meller
Four weeks after a bilateral total knee arthroplasty (TKA), an immunocompetent, 61-year-old, Caucasian man presented with a periprosthetic joint infection (PJI) of the left knee by Enterobacter cloacae (an enteric bacteria). The most likely source of his infection was due to an anastomotic leak after a bariatric surgery done 6 months before TKA. There is a growing focus on stratifying the risk of PJI after TKA. Hematogenous seeding of enteric bacteria leading to PJI is an unexplored risk that will become more prevalent as bariatric procedures before TKA continue to increase in frequency...
January 2020: Journal of the American Academy of Orthopaedic Surgeons. Global Research & Reviews
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