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"anastomotic leak" and colon

Fabian Grass, David Martin, Estelle Moulin, Dieter Hahnloser, Nicolas Demartines, Martin Hübner
BACKGROUND: The present study aimed to analyze risk factors and management strategies for organ space infections (OSI) specifically after colonic resections. METHODS: This was a retrospective analysis of all consecutive colonic resections performed between February 2012 and October 2017 in a single-center quality-improvement project. All OSIs were assessed prospectively by an independent national surveillance program ( ) and classified according to the U...
February 11, 2019: Surgical Infections
Cullen K McCarthy, Paul K McGaha, Noah S Rozich, Nathaniel A Yokell, Jason S Lees, William L Berry
Intestinal anastomoses are commonly performed in both elective and emergent operations. Even so, anastomotic leaks are a highly feared complications of colonic surgeries and can occur in up to 26% of surgical anastomoses, with mortality being up to 39% for patients with such a leak. Currently, there remains a paucity of data detailing the cellular mechanisms of anastomotic healing. Devising preventative strategies and treatment modalities for anastomotic leak could be greatly potentiated by a better understanding of appropriate anastomotic healing...
January 17, 2019: Journal of Visualized Experiments: JoVE
Virgilio Ruiz-Luque, Pablo Parra-Membrives, Carlos Escudero-Severín, José Aguilar-Luque
BACKGROUND: Anastomotic leak after colorectal surgery, which remains a serious clinical problem that causes augmented morbidity and mortality, is usually favored by ischemia. The aim of this study was to determine whether alprostadil may improve anastomotic wound healing under ischemic condition. METHODS: Ninety-three adult Wistar rats were randomized into three groups: control, ischemia (by devascularization along the first 2 cm at each anastomotic end), and ischemia plus alprostadil...
December 20, 2018: Journal of Surgical Research
Roberto Cirocchi, Georgi Popivanov, Gian Andrea Binda, Brandon Michel Henry, Krzysztof Andrzej Tomaszewski, R Justin Davies, Salomone Di Saverio
AIM: In colorectal cancer, ligation of the inferior mesenteric artery (IMA) is a standard surgical approach. In contrast, during treatment of diverticular disease, IMA ligation is not mandatory. The object of this meta-analysis was to assess if IMA preservation reduces the risk of anastomotic leak. METHOD: The search was performed up to August 2018 using the following electronic databases: MEDLINE/PubMed, ISI Web of Knowledge and Scopus. The measures of treatment effect utilized risk ratios for dichotomous variables with the calculation of 95% confidence interval...
January 4, 2019: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
D A Clark, T Cuda, A Riddell, G Radford-Smith, M Solomon
AIM: We studied the levels of amylase in drain fluid to investigate its utility as a biomarker of anastomotic leak in ileal pouch patients who did not have a covering loop ileostomy. The luminal contents of the small intestine are high in amylase. Ileal J pouches are formed for restoration of continuity in patients with ulcerative colitis after removal of the colon and rectum. A drain is placed alongside the ileal pouch in the pelvis. METHOD: This study is a retrospective analysis of prospectively collected daily drain fluid amylase levels in consecutive patients undergoing restorative proctectomy and ileal J pouch anal anastomosis, without a covering loop ileostomy, between November 2016 and April 2018...
December 18, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Anwar Tawfik Amin, Ahmed A S Salem, Abeer Ibrahim
BACKGROUND: Adhesions and infiltration into adjacent tissues are present in about 12% of gastrointestinal (GIT) cancers. These adhesions have high potential risk of malignancy. Free resection margin is a predictor of good survival in such patients. This study aims at evaluating the post-operative outcomes after multi-visceral resection of locally advanced gastrointestinal cancers. PATIENTS AND METHODS: Ninety patients who underwent extended and multi-visceral resection for GIT cancers invading or adhering to adjacent organs have been included...
December 14, 2018: Journal of Gastrointestinal Cancer
Igors Iesalnieks, A Spinelli, M Frasson, F Di Candido, B Scheef, N Horesh, M Iborra, H J Schlitt, A El-Hussuna
BACKGROUND: The aim of the present multicenter study was to analyze the incidence and risk factors associated with postoperative morbidity in patients who had colorectal resection for colonic Crohn's disease. METHODS: Consecutive patients undergoing colorectal resection for colonic Crohn's disease at seven surgical units in 1992-2017 were included. Exclusion criteria were: proctectomy for perianal disease, surgery for cancer, previous colectomies, surgery before 1998...
December 12, 2018: Techniques in Coloproctology
Christopher Mantyh
No abstract text is available yet for this article.
January 2019: Diseases of the Colon and Rectum
Senitila Tutone, Andrew G Hill
No abstract text is available yet for this article.
January 2019: Diseases of the Colon and Rectum
Caterina Santi, Lorenzo Casali, Christian Franzini, Alessio Rollo, Vincenzo Violi
Recently, Indocyanine Green (ICG)-enhanced fluorescence has been introduced in laparoscopic colorectal surgery to provide detailed anatomical informations. The aim of our study is the application of ICG imaging during laparoscopic colorectal resections: to assess anastomotic perfusion to reduce the risk of anastomotic leak, to facilitate vascular dissection when vascular anatomy of tumor site is unclear, and to identify ureter to prevent iatrogenic injury. After the transection, 5 ml of ICG solution is intravenously injected...
December 3, 2018: Updates in Surgery
Andreas Nordholm-Carstensen, Morten Schnack Rasmussen, Peter-Martin Krarup
BACKGROUND: Data on anastomotic leak rates after stapled versus handsewn ileocolic anastomosis are conflicting. In a Cochrane review, the combined estimate favored the stapled technique, but recent cohort studies demonstrated a 2-fold increase in anastomotic leak with the stapled approach. OBJECTIVE: The purpose of this study was to investigate anastomotic leak rates following stapled versus handsewn ileocolic anastomosis. DESIGN: This was a nationwide, retrospective cohort study...
November 26, 2018: Diseases of the Colon and Rectum
Kathleen M Coakley, Sneha Sarasani, Tanu Prasad, Scott R Steele, Ian Paquette, Brant T Heniford, Bradley R Davis
BACKGROUND: For cirrhotic patients awaiting liver transplantation, the Model for End-Stage Liver Disease Sodium (MELD-Na) model is extensively studied. Because of the simplicity of the scoring system, there has been interest in applying MELD-Na to predict patient outcomes in the noncirrhotic surgical patient, and MELD-Na has been shown to predict postoperative morbidity and mortality after elective colectomy. Our aim was to identify the utility of MELD-Na to predict anastomotic leak in elective colorectal cases...
December 2018: Journal of Surgical Research
Christian Galata, Peter Kienle, Christel Weiss, Steffen Seyfried, Christoph Reißfelder, Julia Hardt
PURPOSE: To evaluate risk factors for early postoperative complications in patients with Crohn's disease (CD) after extensive colorectal resection excluding mere ileocecal resection or right hemicolectomy at a university center. METHODS: A retrospective analysis of the prospectively maintained database for surgical patients with CD at our institution was performed. All consecutive patients operated between December 2009 and December 2017 were included. RESULTS: In total, 126 patients were eligible for this study...
November 20, 2018: International Journal of Colorectal Disease
Emanuele Rausa, Michael Eamon Kelly, Emanuele Asti, Alberto Aiolfi, Gianluca Bonitta, Luigi Bonavina
BACKGROUND: There are a variety of surgical approaches for the management of right-sided colonic neoplasms. To date, no method has been shown superior in terms of surgical and perioperative outcomes. This meta-analysis compared open (ORH), laparoscopic-assisted (LRH), total laparoscopic (TLRH), and robotic right hemicolectomy (RRH) to assess surgical outcomes and perioperative morbidity and mortality. STUDY DESIGN: We conducted an electronic systematic search using PubMed, EMBASE, and Web of Science that compared RRH, TLRH, LRH, and ORH...
November 19, 2018: Surgical Endoscopy
Anh T Mai-Phan, Hai Nguyen, Tin T Nguyen, Dung A Nguyen, Truc T Thai
INTRODUCTION: The benefit of mechanical bowel preparation (MBP) before open colon surgery has been debated over the last decade. The aim of this randomized controlled trial was to evaluate the effect of MBP on the outcome of patients who underwent elective laparoscopic colectomy. METHODS: Patients who were scheduled to undergo elective laparoscopic colon resection with primary anastomosis were randomly allocated to a preoperative MBP group (either two bottles of sodium phosphate or 2-L polyethylene glycol) or a no-MBP group...
November 14, 2018: Asian Journal of Endoscopic Surgery
I Mizrahi, F B de Lacy, M Abu-Gazala, L M Fernandez, A Otero, D R Sands, A M Lacy, S D Wexner
BACKGROUND: The aim of this study was to evaluate the impact of fluorescence angiography (FA) on any change in proximal resection margin and/or anastomotic leak (AL) following transanal total mesorectal excision (TaTME) for rectal cancer (RC). METHODS: This retrospective cohort study was conducted at two centers by three senior surgeons. Both institutions' prospectively maintained Institutional Review Board-approved databases were retrospectively queried for all consecutive patients between July 2015 and May 2017 who had laparoscopic hybrid trans-abdominal total mesorectal excision (TME) and TaTME for RC with colorectal or coloanal anastomosis < 10 cm from the anal verge...
October 2018: Techniques in Coloproctology
Michele Grieco, Diletta Cassini, Domenico Spoletini, Enrica Soligo, Emanuela Grattarola, Gianandrea Baldazzi, Silvio Testa, Massimo Carlini
The objective is to investigate the short- and long-term outcomes of laparoscopic resections of splenic flexure colon cancers in three Italian high-volume centers. The laparoscopic resection of splenic flexure colon cancers is a challenging procedure and has not been completely standardized, mainly due to the technical difficulty, the arduous identification of major blood vessels, and the problems associated with anastomosis construction. In this retrospective cohort observational study, a consecutive series of patients treated in three Italian high-volume centers with elective laparoscopic resection of the splenic flexure for cancer is analyzed...
November 8, 2018: Updates in Surgery
B Postaire, E Abet, P Montigny, P A Vent
Anastomotic leak is a serious complication of colonic surgery. The aim of our study is to evaluate the impact of vascular calcifications of the celiac axis and superior mesenteric artery in patients undergoing elective right colectomy, and particularly their relationship to the risk of anastomotic leak. MATERIALS AND METHODS: We performed a retrospective analysis of preoperative abdominal computerized tomography (CT) scans of patients who underwent right colectomy at the Vendean Departmental Hospital (France) between January 2011 and December 2016...
October 31, 2018: Journal of Visceral Surgery
Ciro Andolfi, Konstantin Umanskiy
BACKGROUND: Robotic technology aims to obviate some of the limitations of conventional laparoscopic surgery, yet the role of robotics in colorectal surgery is still largely undefined and varies with respect to its application in abdominal versus pelvic surgery. METHODS: With this review, we aimed to highlight current developments in colorectal robotic surgery. We systematically searched the following databases: PubMed, EMBASE, and Cochrane Library. We critically reviewed the available literature on the use of robotic technology in colon and rectal surgery...
October 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
(no author information available yet)
INTRODUCTION: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. METHODS: A pre-planned analysis of the European Society of Coloproctology 2017 audit...
September 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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