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Fast Track Anastomosis

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
P A Cascales-Campos, P A Sánchez-Fuentes, J Gil, E Gil, V López-López, N Rodriguez Gomez-Hidalgo, D Fuentes, P Parrilla
BACKGROUND: The aim of this study was to analyze the results short term perioperative of patients with peritoneal surface malignancies undergoing cytoreduction with peritonectomy and HIPEC under a controlled fast track protocol and evaluate the factors related to the failure of implementation of the protocol. PATIENTS AND METHOD: We prospectively analyzed a consecutive series of patients (N = 156) with peritoneal surface malignancies treated by cytoreductive surgery with peritonectomy procedures and HIPEC from September 2008 until December 2014, in whom a fast track protocol was implemented...
December 2016: Surgical Oncology
Gijs H K Berkelmans, Bas J W Wilts, Ewout A Kouwenhoven, Koshi Kumagai, Magnus Nilsson, Teus J Weijs, Grard A P Nieuwenhuijzen, Marc J van Det, Misha D P Luyer
INTRODUCTION: Early start of an oral diet is safe and beneficial in most types of gastrointestinal surgery and is a crucial part of fast track or enhanced recovery protocols. However, the feasibility and safety of oral intake directly following oesophagectomy remain unclear. The aim of this study is to investigate the effects of early versus delayed start of oral intake on postoperative recovery following oesophagectomy. METHODS AND ANALYSIS: This is an open-label multicentre randomised controlled trial...
August 5, 2016: BMJ Open
Yan Zheng, Yin Li, Zongfei Wang, Haibo Sun, Ruixiang Zhang
The main obstacle of fast track surgery for esophagectomy is early oral feeding. The main concern of early oral feeding is the possibility of increasing the incidence of anastomotic leakage. Dr. Yin Li used the Li's anastomosis to ensure oral feeding at will the first day after esophagectomy. This safe and efficient anastomosis method significantly reduced the anastomotic leak rate, the number of post-operative days and stricture. Importantly, the "non-tube no fasting" fast track program for esophageal cancer patients was conducted smoothly with Li's anastomosis...
July 2015: Journal of Thoracic Disease
Sastha Ahanatha Pillai, Ravichandran Palaniappan, Anbalagan Pichaimuthu, Kamala Kannan Rajendran, Jeswanth Sathyanesan, Manoharan Govindhan
INTRODUCTION: Fast track programmes have been introduced in pancreatic surgery, but the data are sparse. The aim of this prospective study was to analyse the feasibility of implementing fast track rehabilitation protocol in PD with pancreaticogastrostomy, using historical control for comparison. MATERIALS AND METHODS: Between April 2012 and December 2012, twenty patients who underwent PD (with pancreaticogastrostomy) were managed by a fast-track rehabilitation protocol...
2014: International Journal of Surgery
Keiko Nakazato, Atsuhiro Sakamoto
Off-pump coronary artery bypass grafting (OPCAB) has some advantages in reduction of postoperative complications including systematic inflammatory response, myocardial injury, renal injury and cerebral injury, compared to on-pump coronary artery bypass grafting. It is important to reduce myocardial oxygen consumption during anesthesia for OPCAB. The anesthesiologists should collaborate with the cardiac surgeons and plan the best perioperative strategy for rapid recovery. The anesthesiologists should pay attention to hemodynamic instability and myocardial ischemia during anastomosis...
May 2014: Masui. the Japanese Journal of Anesthesiology
M Duda, L Adamčík, M Škrovina, T Jínek
INTRODUCTION: The aim of the work is to evaluate acceptable mortality and morbidity associated with the esophageal resections for carcinoma. METHOD: The work analyses the data of patients with esophageal cancer from the Czech National Cancer Registry and it compares personal experience with complications and risks associated with the esophagectomy for carcinoma with the data from specialized literature published in recent years. RESULTS: Despite improvements in the surgical technique and the perioperative intensive care, the esophagectomy maintains a relatively high morbidity and mortality...
September 2013: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Vanessa Hui, Neil Hyman, Christopher Viscomi, Turner Osler
BACKGROUND: Multimodality fast-track protocols have been shown to enhance recovery after bowel resection. However, it remains unclear which of the components impact outcomes and whether processes actually occur as intended. METHODS: Consecutive patients who underwent elective bowel resection at a university teaching hospital under a standardized fast-track recovery protocol were compared with patients who underwent similar procedures before protocol initiation. Compliance was measured with the 7 major elements of the protocol: administration of nonopioid analgesia, perioperative lidocaine, nasogastric tube removal, early feeding, early ambulation, and fluid restriction...
August 2013: American Journal of Surgery
Stefan K Burgdorf, Jacob Rosenberg
Purpose. Short hospital stay and equal or reduced complication rates have been demonstrated after fast track open colonic surgery. However, fast track principles of perioperative care can be difficult to implement and often require increased nursing staff because of more concentrated nursing tasks during the shorter hospital stay. Specific data on nursing requirements after laparoscopic surgery are lacking. The purpose of the study was to evaluate the effect of operative technique (open versus laparoscopic operation), but without changing nurse staffing or principles for peri- or postoperative care, that is, without implementing fast track principles, on length of stay after colorectal resection for cancer...
2012: Minimally Invasive Surgery
Zhi-wei Jiang, Jie-shou Li
Laparoscopic gastrectomy has not become a common procedure for gastric cancer due to the difficulties of performing D2 lymphadenectomy and reconstruction of digestive tract by the conventional laparoscopic instruments. The da Vinci system provides 3D visualization, enhanced magnification, and seven degrees of freedom of the instruments to suture and knot in the narrow surgical space, so it can perform totally robotic gastrectomy with D2 lymphadenectomy and robot-sewing anastomosis for reconstruction. Application of robotic system can expand the indications of minimally invasive surgery in treatment of gastric cancer...
August 2012: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Massimo Maffezzini, Fabio Campodonico, Giacomo Capponi, Egi Manuputty, Guido Gerbi
OBJECTIVES: With the purpose to reduce the complications of radical cystectomy and intestinal urinary reconstruction a perioperative protocol based on fast-track surgery principles and technical modifications of the original surgical technique was applied to patient candidates for etherotopic bladder substitution. Our protocol included pre-, intra-, and postoperative interventions. The technical variations of the modified Indiana pouch technique were focused on intestinal anastomosis to restore bowel continuity, uretero-colonic anastomoses, and capacity of the reservoir...
September 2012: Surgical Oncology
K J Gorissen, D Benning, T Berghmans, M G Snoeijs, M N Sosef, K W E Hulsewe, M D P Luyer
BACKGROUND: With the implementation of multimodal analgesia regimens in fast-track surgery programmes, non-steroidal anti-inflammatory drugs (NSAIDs) are being prescribed routinely. However, doubts have been raised concerning the safety of NSAIDs in terms of anastomotic healing. METHODS: Data on patients who had undergone primary colorectal anastomosis at two teaching hospitals between January 2008 and December 2010 were analysed retrospectively. Exact use of NSAIDs was recorded...
May 2012: British Journal of Surgery
Daniel Antoni F Morończyk, Ireneusz Wojciech Krasnodębski
A perioperative care in the colorectal surgery has been considerably changed recently. The fast track surgery decreases complications rate, shortens length of stay, improves quality of life and leads to cost reduction. It is achieved by: resignation of a mechanical bowel preparation before and a nasogastric tube insertion after operation, optimal pain and intravenous fluid management, an early rehabilitation, enteral nutrition and removal of a vesical catheter and abdominal drain if used.The aim of the study was to compare the results of an implementation the fast track surgery protocol with results achieving in the conventional care regimen...
September 2011: Polski Przeglad Chirurgiczny
Paul M Verheijen, Anthony W H Vd Ven, Paul H P Davids, Bryan J M Vd Wall, Apollo Pronk
INTRODUCTION: An accelerated multi-modal rehabilitation programme may improve the recuperation and reduce the complication rate in patients undergoing colorectal surgery. The aim of this study was to see whether fast-track recovery is feasible in various patient groups. PATIENTS AND METHODS: Data on all patients operated for intestinal pathology from July 2006-April 2008 were prospectively collected for this prospective study. All included patients entered a multi-modal rehabilitation programme...
April 2012: International Journal of Colorectal Disease
Ka Li, Zongguang Zhou, Zengrong Chen, Yi Zhang, Cun Wang
This study evaluates the application of fast track (FT) nasogastric decompression in patients who underwent anterior resection of rectal cancer. A randomized control trial was performed comparing the group with the fast track treatment (n = 57) and the group with traditional nasogastric decompression (n = 84). Preoperative characteristics and postoperative recovery indices were recorded and analyzed. The results indicate no significant differences in gender (P = 0.614), age (P = 0.653), tumor location (P = 0...
September 2011: Frontiers of Medicine
Francesco Feroci, Katrin C Kröning, Elisa Lenzi, Luca Moraldi, Stefano Cantafio, Marco Scatizzi
BACKGROUND: Whether laparoscopic colorectal resection improved recovery within an enhanced recovery program was investigated. METHODS: This study was designed as a query of a prospectively maintained colorectal database to identify 350 patients who underwent elective colorectal resection with primary anastomosis for colorectal cancer between January 1, 2005 and December 31, 2009. Patients were categorized into two groups (laparoscopic and open resection), and demographic, treatment, and outcome variables were independently reviewed for accuracy...
September 2011: Surgical Endoscopy
P A Cascales Campos, J Gil Martínez, P J Galindo Fernández, E Gil Gómez, I M Martínez Frutos, P Parrilla Paricio
INTRODUCTION: Diffuse peritoneal dissemination in advanced ovarian cancer can be treated using optimal effort surgery involving peritonectomy procedures and the administration of hyperthermic intraoperative intraperitoneal chemotherapy (HIPEC). OBJECTIVE: To report on our experience in the treatment of advanced ovarian cancer using peritonectomy procedures and HIPEC through the fast track program. PATIENTS AND METHOD: From September 2008 until May 2010, forty-six patients with primary advanced (stage III-C) or recurrent ovarian cancer have been included in the fast track protocol if they had optimal cytoreduction CC-0 or CC-1 accompanied by HIPEC and there had no more than one digestive anastomosis...
June 2011: European Journal of Surgical Oncology
Giuseppe Pappalardo, Domenico Spoletini, Aldo Nunziale, Elena Manna, Francesca De Lucia, Fabrizio Maria Frattaroli
AIM: To value the results of "open" surgery with sphincter preservation, TME nerve-sparing, fast-track, without a protective stoma in a consecutive series of patients with subperitoneal rectal cancer (s.p.r.c.). MATERIALS AND METHODS: In January 1989, we started a prospective, non-randomized study designed to assess when a primary derivative stoma was warranted in a series of consecutive patients electively treated with open low and ultralow AR. The inclusion criteria were: all patients with middle and low rectal cancer who underwent elective low and ultralow AR, including those treated with neoadjuvant therapy...
July 2010: Annali Italiani di Chirurgia
K J Gash, A C Goede, W Chambers, G L Greenslade, A R Dixon
BACKGROUND: Fast-track surgery accelerates recovery, reduces morbidity, and shortens hospital stay. However, the benefits of laparoscopic versus open surgery remain unproven within a fast-track program. Case reports of laparoendoscopic single-site (LESS) colectomies are appearing with claims of cosmetic advantage and decreased parietal trauma. This report describes the largest case series of LESS colorectal surgery and its effects on recovery. METHODS: In this series, 20 consecutive unselected patients underwent LESS colorectal surgery including right hemicolectomy (n = 3), extended right hemicolectomy, high anterior resection (n = 2), low anterior resection involving total mesorectal excision (TME; n = 3), ileocolic anastomosis (n = 2, including 1 redo surgery), colectomy and ileorectal anastomosis (n = 4, including 1 with ventral mesh rectopexy), panproctocolectomy (n = 2), proctocolectomy and ileoanal pouch (n = 2) and an abdominoperineal excision of rectum...
March 2011: Surgical Endoscopy
Konstantinos P Donas, Zoran Rancic, Mario Lachat, Thomas Pfammatter, Thomas Frauenfelder, Frank J Veith, Dieter Mayer
BACKGROUND: We report our clinical experience with the use of a sutureless telescoping anastomosis, initially described as the VORTEC (Viabahn Open Rebranching TEChnique) revascularization technique, for debranching of supra-aortic vessels. METHODS: Between May 2005 and December 2008, 20 patients (15 men) with an aortic arch lesion underwent trans-sternal debranching with sutureless telescoping anastomosis performed with a Viabahn (diameter, 5-8 mm; length, 5-15 cm) or Hemobahn (diameter, 9-13 mm; length, 10-15 cm), followed by endovascular aneurysm repair...
April 2010: Journal of Vascular Surgery
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