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Pelvic drainage colorectal

Mostafa Shalaby, Waleed Thabet, Francesco Rulli, Francesco Palmieri, Federica Saraceno, Ilaria Capuano, Oreste Buonomo, Gabriella Giarratano, Giuseppe Petrella, Mosaad Morshed, Mohamed Farid, Pierpaolo Sileri
PURPOSE: Anastomotic leakage is considered the commonest major complication after surgery for rectal cancer. MATERIALS AND METHODS: Patients who underwent laparoscopic LAR or ULAR for rectal cancer were recruited. The primary outcome was the incidence of the AL during 30 days postoperative. RESULTS: Fifty-nine consecutive patients were included in the study. Fifty-three patients underwent LAR with stapled colorectal anastomoses, while the remaining 6 patients underwent ULAR with hand-sewn coloanal anastomoses...
2019: Annali Italiani di Chirurgia
Mostafa Shalaby, Waleed Thabet, Oreste Buonomo, Nicola Di Lorenzo, Mosaad Morshed, Giuseppe Petrella, Mohamed Farid, Pierpaolo Sileri
Purpose: We evaluate the role of transanal tube drainage (TD) as a conservative treatment for patients with anastomotic leakage (AL). Methods: Patients treated for AL who had undergone a low or an ultralow anterior resection with colorectal or coloanal anastomosis for the treatment of rectal cancer between January 2013 and January 2017 were enrolled in this study. The data were collected prospectively and analyzed retrospectively. The primary outcomes were the diagnosis and the management of AL...
December 20, 2018: Annals of Coloproctology
Rajendra B Nerli, Shridhar C Ghagane, Prasanna Ram, S S Shimikore, Kumar Vinchurkar, Murigendra B Hiremath
Involvement of the bladder by colorectal cancer is sufficiently rare to be encountered by an individual surgeon on an infrequent basis. Extirpative procedures for advanced colorectal cancers can involve partial/total bladder resections. In patients without evidence of distant metastatic disease, a reasonable therapeutic effect can be expected when negative surgical margins are obtained. The decision to perform a bladder-sparing procedure or a total pelvic exenteration (TPE) will be based on the extent of the primary lesion as well as patient characteristics...
December 2018: Indian Journal of Surgical Oncology
Alvaro García-Granero, Jorge Sancho-Muriel, Luis Sánchez-Guillén, Eduardo Alvarez Sarrado, Delfina Fletcher-Sanfeliu, Matteo Frasson, Alfonso A Valverde-Navarro, Francisco Martinez Soriano
BACKGROUND: Most perianal abscesses have a cryptoglandular origin, following the pathogenesis described by Parks in 1961. Supralevator abscesses have the most uncommon location. Nevertheless, such pathology results in a high morbidity because of their difficult diagnosis and treatment. OBJECTIVE: This study aimed to deepen the knowledge of the pathogenesis and management of supralevator abscesses, as well as the complications derived from incorrect treatment, by using simulation in cadavers...
September 2018: Diseases of the Colon and Rectum
Natalija Vukovic, Ljubomir Dinic
The purpose of the review: The analysis of the components of enhanced recovery after surgery (ERAS) protocols in urologic surgery. Recent findings: ERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%...
2018: Frontiers in Medicine
Qianqian Shao, Guole Lin
For colorectal surgeons, how to reduce anastomotic leakage after laparoscopic rectal cancer surgery remains to be challenging. We provide a brief discussion regarding the surgical skills required to prevent anastomotic leakage after rectal cancer surgery, such as the following: 1) Low ligation of inferior mesenteric vessel during laparoscopic total mesorectal excision can improve anastomotic tension and blood supply, thus reducing the risk of anastomotic leakage. While high ligation of inferior mesenteric artery results in poor blood supply and high tension in atastomotic site, thus increasing the risk of anastomotic leakage...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Pan Chi, Shenghui Huang
Many studies have focused on the identification of risk factors and prevention of anastomotic leakage following rectal cancer surgery. However, there is little knowledge regarding classification and management of anastomotic leakage in clinic. Herein, we reviewed and summarized the classification and management of anastomotic leakage after rectal cancer surgery. The relevant treatments of anastomotic leakage should be chosen based on patient's manifestation, including general and local reactions, anatomical location, and nature of the leakage (contained or free, controlled or uncontrolled leakage)...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
J Loriau, E Petit, A Mephon, B Angliviel, E Sauvanet
Management of deep pelvic and digestive endometriosis can lead to colorectal resection and anastomosis. Colorectal anastomosis carries risks for dreaded infectious and functional morbidity. The aim of the study was to establish, regarding the published data, the role of the three most common used surgical techniques to prevent such complications: pelvic drainage, diverting stoma, epiplooplasty. Even if many studies and articles have focused on colorectal anastomotic leakage prevention in rectal cancer surgery data regarding this topic in the setting of endometriosis where lacking...
March 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Sameh Hany Emile, Tito M Abd El-Hamed
Background: The use of prophylactic drainage after colorectal anastomoses has been long debated. This report aimed to review the current literature discussing routine drainage of colorectal anastomoses highlighting two opposite perspectives (prodrainage and antidrainage) to demonstrate the clinical utility of prophylactic drainage and its proper indications. Methods: An organized literature search was conducted querying electronic databases and Google Scholar. Articles evaluating the role of routine prophylactic drainage after colorectal anastomosis were included and divided into two categories: articles supporting the use of drains (prodrainage) and articles disputing routine drainage (antidrainage)...
2017: Gastroenterology Research and Practice
Yosuke Tajima, Hitoshi Kameyama, Saki Yamada, Ryoma Yagi, Masato Nakano, Masayuki Nagahashi, Yoshifumi Shimada, Jun Sakata, Takashi Kobayashi, Hajime Umezu, Toshifumi Wakai
BACKGROUND: Meigs' syndrome is defined as the co-existence of benign ovarian fibroma or fibroma-like tumor, ascites, and pleural effusion. In contrast, pseudo-Meigs' syndrome is defined as the co-existence of other ovarian or pelvic tumors, ascites, and pleural effusion. In Meigs' and pseudo-Meigs' syndromes, ascites and pleural effusion resolve promptly after the complete resection of the ovarian or pelvic tumor(s). Secondary ovarian tumors from colorectal gastrointestinal metastases rarely cause pseudo-Meigs' syndrome; only 11 cases of pseudo-Meigs' syndrome secondary to colorectal cancers have been reported in the literature...
November 14, 2016: World Journal of Surgical Oncology
Steven Poplawski, Matthew Johnson, Philip Philips, Leopold H J Eberhart, Tilo Koch, Loretta M Itri
Fentanyl iontophoretic transdermal system (ITS) [IONSYS® , The Medicines Company, Parsippany, NJ, USA] is a needle-free, patient-controlled, postoperative opioid pain management treatment. It is indicated for the short-term management of acute postoperative pain in adults requiring opioid analgesia in the hospital. The safety and effectiveness of fentanyl ITS for acute postoperative pain management has been demonstrated in a range of surgery and patient types studied in seven phase 3 trials (three placebo-controlled trials and four active-comparator trials)...
December 2016: Pain and Therapy
Abbas Aras, Sebahattin Celik, Remzi Kiziltan, Özkan Yilmaz, Çetin Kotan
The most feared complication of the surgical treatment of rectal cancer is anastomotic leakage, which is related to high rates of mortality and morbidity. Here, we present a patient who could not be treated with surgical drainage but treated by intraluminal Vacuum Associated Closure (VAC). A 34-year-old male patient was treated for rectal cancer by low anterior resection, colorectal anastomosis, and diverting ileostomy following neoadjuvant CRT. The patient reported with a postoperative anastomotic disruption and a large pelvic abscess...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
Shenghui Huang, Pan Chi, Huiming Lin, Xingrong Lu, Ying Huang, Weizhong Jiang, Zongbin Xu, Yanwu Sun, Daoxiong Ye, Xiaojie Wang
OBJECTIVE: To explore the risk factors and clinical features of delayed anastomotic fistula (DAF) following sphincter-preserving operation for rectal cancer. METHODS: Clinical data of 1 594 patients with rectal cancer undergoing sphincter-preserving operation in our department from January 2008 to May 2015 based on the prospective database of Dpartment of Colorectal Surgery, Fujian Medical University Union Hospital were retrospectively analyzed. Sixty patients(3...
April 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Elena Tatiana Cârțână, Dan Ionuț Gheonea, Adrian Săftoiu
The development of endoscopic ultrasound (EUS) has had a significant impact for patients with digestive diseases, enabling enhanced diagnostic and therapeutic procedures, with most of the available evidence focusing on upper gastrointestinal (GI) and pancreatico-biliary diseases. For the lower GI tract the main application of EUS has been in staging rectal cancer, as a complementary technique to other cross-sectional imaging methods. EUS can provide highly accurate in-depth assessments of tumour infiltration, performing best in the diagnosis of early rectal tumours...
February 7, 2016: World Journal of Gastroenterology: WJG
Hong-Yu Zhang, Chun-Lin Zhao, Jing Xie, Yan-Wei Ye, Jun-Feng Sun, Zhao-Hui Ding, Hua-Nan Xu, Li Ding
BACKGROUND: Currently, many surgeons place a prophylactic drain in the abdominal or pelvic cavity after colorectal anastomosis as a conventional treatment. However, some trials have demonstrated that this procedure may not be beneficial to the patients. OBJECTIVE: To determine whether prophylactic placement of a drain in colorectal anastomosis can reduce postoperative complications. METHODS: We systematically searched all the electronic databases for randomized controlled trials (RCTs) that compared routine use of drainage to non-drainage regimes after colorectal anastomosis, using the terms "colorectal" or "colon/colonic" or "rectum/rectal" and "anastomo*" and "drain or drainage...
May 2016: International Journal of Colorectal Disease
Jennifer Blumetti, Herand Abcarian
Anastomotic leak continues to be a dreaded complication after colorectal surgery, especially in the low colorectal or coloanal anastomosis. However, there has been no consensus on the management of the low colorectal anastomotic leak. Currently operative procedures are reserved for patients with frank purulent or feculent peritonitis and unstable vital signs, and vary from simple fecal diversion with drainage to resection of the anastomosis and closure of the rectal stump with end colostomy (Hartmann's procedure)...
December 27, 2015: World Journal of Gastrointestinal Surgery
Christelle Blot, Charles Sabbagh, Lionel Rebibo, Franck Brazier, Cyril Chivot, Mathurin Fumery, Jean-Marc Regimbeau
INTRODUCTION: Anastomotic leakage (AL) is a major complication of colorectal surgery. The leakage is classified as grade B when the patient's clinical condition requires an active therapeutic intervention but does not require further surgery. The management of grade B AL commonly includes administration of antibiotics and/or the placement of a pelvic drainage performed under radiological guidance or transanal drain. The objective of this study was to evaluate the feasibility and the efficacy of endoscopic transanastomotic drainage using double-pigtail stents (DPSs) in the management of grade B AL in colorectal surgery...
May 2016: Surgical Endoscopy
A Ishibe, M Ota, A Kanazawa, J Watanabe, K Tatsumi, K Watanabe, T Godai, S Yamagishi, S Fujii, Y Ichikawa, C Kunisaki, I Endo
BACKGROUND/AIMS: Anastomotic leakage is major complication of colorectal surgery. Total parenteral nutrition (TPN) and fasting are conservative treatments for leakage in the absence of peritonitis in Japan. Elemental diet (ED) jelly is a completely digested formula and is easily absorbed without secretion of digestive juices. The purpose of this study was to assess the safety of ED jelly in management of anastomotic leakage. METHODOLOGY: Six hundred and two patients who underwent elective surgery for left side colorectal cancer from January 2008 to December 2011 were included in the study...
January 2015: Hepato-gastroenterology
A J Kroesen
After colorectal and anorectal interventions for chronic inflammatory bowel diseases, specific complications can occur.In Crohn's disease these complications mainly occur after proctocolectomy. Pelvic sepsis can be prevented by omentoplasty with fixation inside the pelvis. A persisting sepsis of the sacral cavity can be treated primarily by dissection of the anal sphincter which ensures better drainage. In cases of chronic sacral sepsis, transposition of the gracilis muscle is a further effective option. Early recurrence of a transsphincteric anal fistula should be treated by reinsertion of a silicon seton drainage...
April 2015: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Feng Gao, Ming Xu, Feng Song, Xin Zhang, Yong Zhao
OBJECTIVE: This study aimed to investigate the main points of preventing anastomotic fistula formation after low-position Dixon operation. METHODS: From September 2004 to October 2007, our department continuously conducted 146 cases of low-position Dixon operations. The operation mode involved transabdominal radical resection based on total mesorectal excision for all cases. Except for tumor infiltration, one side of the pelvic vegetative nerve was maintained and ligations were conducted at the superior rectal artery root...
September 2014: Pakistan Journal of Medical Sciences Quarterly
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