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https://read.qxmd.com/read/30758467/implementation-of-enhanced-recovery-after-colorectal-surgery-eras-protocol-initial-results-of-the-first-brazilian-experience
#1
Uirá Fernandes Teixeira, Paulo Roberto Ott Fontes, Cristiane Weckerle Nazareth Conceição, Carlos Alberto Teixeira Farias, Daieni Fernandes, Ingrid Petroni Ewald, Luciano Vitola, Florentino Fernandes Mendes
BACKGROUND: Guidelines for enhanced recovery after surgery have their bases in colonic surgery, through the first protocols published in 2012. Since then, this practice has spread throughout the world, mainly due to improvements in surgical outcomes associated with resource savings. AIM: To analyze the first prospective results after the implementation of the guidelines. METHODS: Were retrospectively analyzed 48 patients operated in the institution prior to the standardization...
February 7, 2019: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://read.qxmd.com/read/30742292/management-of-enteroatmospheric-fistula-thanks-to-new-isolation-technique
#2
Seracettin Eğin, Berk Gökçek, Metin Yeşiltaş, Fazıl Sağlam, Burak Güney
We aimed to present our method called as new isolation technique with stopper (NITS) to manage enteroatmospheric fistula (EAF) in an open abdomen (OA). The patient was a 71-year-old male with Hartmann colostomy and incisional hernia. A dual mesh was used for incisional hernia repair after colorectal anastomosis. The patient was urgently re-admitted to hospital due to EAF on the postoperative 30th day. The NITS application was performed twice at different times. General anesthesia was not required for the applications, but sterile conditions in operation room were provided...
January 2019: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://read.qxmd.com/read/30692380/-a-case-report-of-chylous-ascites-after-laparoscopic-sigmoid-colectomy-treated-with-conservative-therapy
#3
Yoshiyuki Owada, Kentaro Kawasaki, Riki Asakura, Kouta Yamada, Masayoshi Hosono, Taro Okazaki, Tetsuya Ienaga
A man in his sixties with a medical history of diabetes and dyslipidemia was detected with a tumor with massive submucosal invasion on colonoscopy. He was diagnosed with sigmoid cancer and underwent laparoscopic sigmoid colectomy with D3 lymph node dissection. An electric surgical knife and an ultrasonically activated device was used to perform D3 lymph node dissection with preservation of the left colic artery(LCA)and division of the S1A and S2A. On postoperative day 4(POD4), 1 day after oral intake was started, chylous ascites began to develop...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://read.qxmd.com/read/30673981/robotic-assisted-surgery-for-complicated-and-non-complicated-diverticulitis-a-single-surgeon-case-series
#4
Julia Xia, Terrah Jean Paul Olson, Seth A Rosen
Laparoscopic colectomy is the preferred approach for surgical management of non-complicated diverticulitis, with lower complication rates, shorter length of stay, and decreased narcotic use compared with open surgery. Complicated diverticulitis, characterized by abscess, fistula or stricture, is more difficult to manage with minimally invasive surgery, with reports of higher conversion rates, prolonged operative time, longer length of stay, and increased complication rates. The robotic platform may provide an alternative safe and feasible option for managing complicated diverticulitis with minimally invasive surgery...
January 23, 2019: Journal of Robotic Surgery
https://read.qxmd.com/read/30636641/variations-in-right-colic-vascular-anatomy-observed-during-laparoscopic-right-colectomy
#5
Chuying Wu, Kai Ye, Yiyang Wu, Qiwei Chen, Jianhua Xu, Jianan Lin, Wengui Kang
BACKGROUND: This study aimed to analyze right colonic vascular variability. METHODS: The study included 60 consecutive patients who underwent laparoscopic radical right colectomy and D3 lymph node dissection for malignant colonic cancer on the ileocecal valve, ascending colon or hepatic flexure (March 2013 to October 2016). The videos of the 60 surgical procedures were collected. Variations of right colonic vascular anatomy were retrospectively analyzed based on 60 high-resolution surgical videos of laparoscopic surgery...
January 12, 2019: World Journal of Surgical Oncology
https://read.qxmd.com/read/30628859/tactics-to-prevent-intra-abdominal-infections-in-general-surgery
#6
Thomas G Weiser, Joseph D Forrester, Jared A Forrester
BACKGROUND: Abdominal infections following surgery have many severe consequences. Several effective, well-evaluated infection prevention and control processes exist to avoid these infections. METHODS: This manuscript reviews and provides supporting evidence for common management strategies useful to avoid postoperative abdominal infection. RESULTS: Prevention of abdominal infection begins with preparation of the environment using standard infection control practices...
January 10, 2019: Surgical Infections
https://read.qxmd.com/read/30615223/temporary-end-on-colostomy-as-a-treatment-for-anastomotic-dehiscence-after-a-transanal-rectal-pull-through-procedure-in-a-dog
#7
Filippo Cinti, Guido Pisani
OBJECTIVE: To describe a temporary end-on colostomy to treat the dehiscence of a transanal rectal pull-through in a dog. STUDY DESIGN: Case report ANIMAL: A 7-year-old intact female Australian shepherd dog that was treated for a rectal adenocarcinoma with a transanal rectal pull-through. METHODS: Partial dehiscence of the previous end-to-end colorectal anastomosis and formation of a perianal sinus tract were diagnosed 4 days after surgery...
January 7, 2019: Veterinary Surgery: VS
https://read.qxmd.com/read/30578646/disruption-of-sialic-acid-metabolism-drives-tumor-growth-by-augmenting-cd8-t-cell-apoptosis
#8
Lenneke A M Cornelissen, Athanasios Blanas, Joost C van der Horst, Laura Kruijssen, Anouk Zaal, Tom O'Toole, Lieke Wiercx, Yvette van Kooyk, Sandra J van Vliet
Sialylated glycan structures are known for their immunomodulatory capacities and their contribution to tumor immune evasion. However, the role of aberrant sialylation in colorectal cancer and the consequences of complete tumor desialylation on anti-tumor immunity remain unstudied. Here, we report that CIRSPR/Cas9-mediated knock out of the CMAS gene, encoding a key enzyme in the sialylation pathway, in the mouse colorectal cancer MC38 cell line completely abrogated cell surface expression of sialic acids (MC38-Sianull ) and, unexpectedly, significantly increased in vivo tumor growth compared to the control MC38-MOCK cells...
December 22, 2018: International Journal of Cancer. Journal International du Cancer
https://read.qxmd.com/read/30536584/physiological-changes-after-colorectal-surgery-suggest-anastomotic-leakage-is-an-early-event-a-retrospective-cohort-study
#9
Adam T Stearns, Filomena Liccardo, Kok-Neang Tan, Emre Sivrikoz, Omer Aziz, John T Jenkins, Robin H Kennedy
INTRODUCTION: Anastomotic leakage (AL) is often identified 7-10 days after colorectal surgery. However, in retrospect, patients may have abnormalities evident much earlier. This study aims to identify the clinical time-point when AL occurs. METHODS: This is a retrospective case-matched cohort-comparison study, assessing patients undergoing left-sided colorectal resection between 2006 and 2015 at a specialist colorectal unit. Patients who developed anastomotic leakage (LEAK) were case-matched to two CONTROL patients by procedure, sex, laparoscopic-modality and diverting stoma...
December 11, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://read.qxmd.com/read/30505581/morbidity-and-mortality-of-synchronous-hepatectomy-with-cytoreductive-surgery-hyperthermic-intraperitoneal-chemotherapy-crs-hipec
#10
Tyler J Mouw, Jennifer Lu, Meghan Woody-Fowler, John Ashcraft, Joseph Valentino, Peter DiPasco, Joshua Mammen, Mazin Al-Kasspooles
Background: Liver resection in conjunction with partial colectomy for colon cancer is considered acceptable treatment for isolated metastasis to the liver. This method is unstudied in patients undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for carcinomatosis due to colon cancer and high grade appendiceal cancer. Methods: A retrospective chart review included patients from 2005 to 2016 undergoing CRS/HIPEC. Cancers other than colorectal adenocarcinoma and high grade appendiceal carcinoma were excluded...
October 2018: Journal of Gastrointestinal Oncology
https://read.qxmd.com/read/30382512/limax-nd-yag-laser-assisted-thoracoscopic-resection-of-pulmonary-metastases-a-single-centre-s-initial-experience
#11
Joseph B Mc Loughlin, Katie E O'Sullivan, Rachel H Brown, Donna A Eaton
INTRODUCTION: Pulmonary metastasectomy and indeed redo-pulmonary metastasectomy are now commonly performed thoracic surgical procedures. The air-sealant, haemostatic, and necrotic properties of the KLS Martin Limax Nd:YAG laser at 1.318 μm make it an ideal tool for limited lung resection such as metastasectomy. We present our initial experience of thoracoscopic laser metastasectomy. METHODS: We reviewed data from the first seven patients in our unit to undergo thoracoscopic laser metastasectomy, in particular, patient age, gender, primary malignancy, primary treatment, complications, length of stay (LOS), and final histopathology...
October 31, 2018: Irish Journal of Medical Science
https://read.qxmd.com/read/30382300/natural-history-of-percutaneous-drainage-of-postoperative-collection-following-colorectal-surgery-in-which-patients-can-follow-up-imaging-be-dispensed-with-before-drain-removal
#12
B Brac, C Sabbagh, B Robert, C Chivot, T Yzet, J M Regimbeau
INTRODUCTION: Colorectal surgery is complicated by postoperative collections in up to 25% of cases depending on local conditions. The aim of this study was to identify predictive factors of success of percutaneous drainage of collections in order to avoid follow-up imaging. PATIENTS AND METHODS: All consecutive patients between January 2009 and December 2016, who had undergone elective or emergency colorectal surgery (colorectal surgery and appendectomy) complicated by a postoperative collection treated by percutaneous drainage with follow-up imaging prior to drain removal, were included in this single-center and retrospective study...
October 31, 2018: Abdominal Radiology
https://read.qxmd.com/read/30324063/the-impact-of-closed-incision-negative-pressure-therapy-on-postoperative-breast-reconstruction-outcomes
#13
Allen Gabriel, Steven Sigalove, Noemi Sigalove, Toni Storm-Dickerson, Jami Rice, Patrick Maxwell, Leah Griffin
Background: Studies report that incision management with closed incision negative pressure therapy (ciNPT) may provide clinical benefits, including protecting surgical incisions, for postsurgical closed incisions (eg, orthopedic, sternotomy, and colorectal). This retrospective analysis compared postoperative outcomes in patients who received ciNPT versus standard of care (SOC) for incision management after breast reconstruction postmastectomy. Methods: Patient demographics, chemotherapy exposure, surgical technique, ciNPT use, number of drains, time to drain removal, and 90-day postoperative complication rates were analyzed from records of 356 patients (ciNPT = 177, SOC = 179) with 665 closed breast incisions (ciNPT = 331, SOC = 334)...
August 2018: Plastic and Reconstructive Surgery. Global Open
https://read.qxmd.com/read/30308424/successful-treatment-for-severe-pancreatitis-with-colonic-perforation-using-video-assisted-retroperitoneal-debridement-a-case-report
#14
Yuto Hozaka, Hiroshi Kurahara, Yuko Mataki, Yota Kawasaki, Satoshi Iino, Masahiko Sakoda, Shinichiro Mori, Kosei Maemura, Hiroyuki Shinchi, Shoji Natsugoe
INTRODUCTION: Colorectal complications including penetration and perforation in acute pancreatitis often become severe and fatal. Effective drainage is pivotal for successful treatment. We present a case of large retroperitoneal abscess with colonic necrotizing perforation due to severe acute pancreatitis treated with video-assisted retroperitoneal debridement (VARD) in a step-up approach. PRESENTATION OF CASE: A 31-year-old man was admitted to a general hospital with a diagnosis of severe acute pancreatitis...
2018: International Journal of Surgery Case Reports
https://read.qxmd.com/read/30304509/guidelines-for-enhanced-recovery-after-lung-surgery-recommendations-of-the-enhanced-recovery-after-surgery-eras%C3%A2-society-and-the-european-society-of-thoracic-surgeons-ests
#15
Timothy J P Batchelor, Neil J Rasburn, Etienne Abdelnour-Berchtold, Alessandro Brunelli, Robert J Cerfolio, Michel Gonzalez, Olle Ljungqvist, René H Petersen, Wanda M Popescu, Peter D Slinger, Babu Naidu
Enhanced recovery after surgery is well established in specialties such as colorectal surgery. It is achieved through the introduction of multiple evidence-based perioperative measures that aim to diminish postoperative organ dysfunction while facilitating recovery. This review aims to present consensus recommendations for the optimal perioperative management of patients undergoing thoracic surgery (principally lung resection). A systematic review of meta-analyses, randomized controlled trials, large non-randomized studies and reviews was conducted for each protocol element...
January 1, 2019: European Journal of Cardio-thoracic Surgery
https://read.qxmd.com/read/30294427/bilirubin-urobilinogen-pancreas-elastase-and-bile-acid-in-drain-fluid-the-gbup-study-analysis-of-biomarkers-for-a-colorectal-anastomotic-leakage
#16
Christoph Paasch, Silke Rink, Marcus Steinbach, Sören Kneif, Dirk Peetz, Andre Klötzler, Ulrich Gauger, Klaus Mohnike, Michael Hünerbein
Purpose: A colorectal anastomotic leakage (CAL) is a major complication after colorectal surgery and leads to high rates of morbidity and prolonged hospital stay. The study aims to evaluate the benefit of using bilirubin, urobilinogen, pancreas elastase and bile acid in the drain fluid (DF) as a predictive marker for the CAL. Methods: From June 2015 to October 2017 100 patients, who underwent left hemicolectomy (LH), sigma resection (SR), high anterior resection (HAR), low anterior resection (LAR) or reversal of Hartmann's Procedure (ROHP) were included in this monocentric non-randomized prospective clinical trial...
November 2018: Annals of Medicine and Surgery
https://read.qxmd.com/read/30217305/inhibition-of-tnf%C3%AE-in-peritoneal-fluids-of-patients-following-colorectal-resection-attenuates-the-postoperative-stress-related-increase-in-colon-cancer-cell-migration-a-prospective-in-vitro-study
#17
Liron Berkovich, Ronen Ghinea, Itzhak Greemland, Salem Majdop, Baruch Shpitz, Moshe Mishaeli, Shmuel Avital
BACKGROUND AND OBJECTIVES: Surgical trauma in patients undergoing colorectal cancer resection generates local and systemic inflammatory responses that can affect oncological outcomes. Post-operative peritoneal fluids of patients undergoing colorectal surgery increase the pro-malignant effect of cancer cells in vitro with correlation to elevated TNFα in these fluids. This study evaluated whether inhibiting TNFα in patients' postoperative fluid biopsies would attenuate this effect. METHODS: Peritoneal fluids from 53 patients undergoing colorectal surgery were sampled before and daily after surgery via intra-abdominal drains...
September 2018: Surgical Oncology
https://read.qxmd.com/read/30171179/urologic-surgery-with-multisystem-comorbidities-a-case-report
#18
Upendra Maddineni, Eric F Worrall, Erik A Baker, Madhavi Earasi, Francis Mathieu, Georgi Guruli
BACKGROUND Originally implemented for colorectal surgery, enhanced perioperative protocols have been incorporated into many surgical fields in an effort to improve outcomes. The cornerstone of many strategies includes patient education, liberalized oral intake on the day of surgery, no routine bowel prep, targeted multimodal analgesia, cautious use of IV hydration, early extubation, avoidance of NG tubes and/or surgical drains, and encouraging early postoperative ambulation. CASE REPORT We report on the successful outcome of a single patient with a rare autosomal dominant disorder (hereditary hemorrhagic telangiectasia) with multisystem involvement including pulmonary, cardiac, hematologic, gastrointestinal, renal, oncologic, and hepatic comorbidities, scheduled for open nephrectomy...
September 1, 2018: American Journal of Case Reports
https://read.qxmd.com/read/30166125/immunological-environment-in-colorectal-cancer-a-computer-aided-morphometric-study-of-whole-slide-digital-images-derived-from-tissue-microarray
#19
Daniel Eyraud, Benjamin Granger, Armelle Bardier, Yann Loncar, GaËlle Gottrand, Gilles Le Naour, Jean-Michel Siksik, Jean-Christophe Vaillant, David Klatzmann, Louis Puybasset, Frederic Charlotte, Jeremy Augustin
Cancer research has moved from investigating tumour cells to including analysis of the tumour microenvironment as well. The aim of this study was to assess the cellular infiltrate of colorectal cancer (CRC) using computer-aided analysis of whole slide digital image derived from tissue microarray (TMA). TMA slides from 31 CRC patients were immunostained for forkhead box protein 3 (FOXP3) and immunomodulatory enzyme indoleamine 2,3-dioxygenase (IDO) at four sites: centre (C) and invasive front (F) of the tumour, proximal non-metastatic draining lymph node (N-), tumour-draining lymph node with metastasis (N+) and healthy mucosa at 10 cm from the cancer (M)...
October 2018: Pathology
https://read.qxmd.com/read/30097970/laparoscopic-lavage-and-drainage-for-hinchey-iii-diverticulitis-review-of-technical-aspects
#20
Matteo Gregori, Diletta Cassini, Norma Depalma, Michelangelo Miccini, Farshad Manoochehri, Gianandrea A Baldazzi
The surgical treatment for patients with generalized peritonitis complicating sigmoid diverticulitis is currently debated; particularly in case of diffuse purulent contamination (Hinchey 3). Laparoscopic lavage and drainage (LLD) has been proposed by some authors as a safe and effective alternative to single- or multi-stage resective surgery. However, among all the different studies on LLD, there is no uniformity in terms of surgical technique adopted and data show significant differences in postoperative outcomes...
August 10, 2018: Updates in Surgery
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