keyword
https://read.qxmd.com/read/38527929/perioperative-outcomes-of-ileorectal-anastomosis-an-analysis-of-823-patients
#1
JOURNAL ARTICLE
Adam Truong, Katherine Hu, David Liska, Michael Valente, Tracy Hull, Scott R Steele, Stefan D Holubar
AIM: Ileorectal anastomosis (IRA) following total abdominal colectomy (TAC) allows for resortation of bowel continuity but prior studies have reported rates of anastomotic leak (AL) to be as high as 23%. We aimed to report rates of AL and complications in a large cohort of patients undergoing IRA. We hypothesized that AL rates were lower than previously reported and that selective use of diverting loop ileostomy (DLI) is associated with decreased AL rates. METHOD: Patients undergoing TAC or end-ileostomy reversal with IRA, with or without DLI, between 1980 and 2021 were identified from a prospectively maintained institutional database and retrospectively analysed...
March 25, 2024: Colorectal Disease
https://read.qxmd.com/read/38520291/modified-graham-patch-repair-of-small-bowel-anastomotic-leak
#2
JOURNAL ARTICLE
Ashley Alden, Robert D Bennett
The modified Graham patch repair is a well-established technique for management of perforating foregut injuries, often learned by surgeons during general surgery training. There is, however, little to no data regarding the utilization of this technique for perforation of the distal midgut or in the re-operative field. We present two cases of midgut anastomotic complications successfully managed with modified graham patch repair at our institution. The first case is a 79-year-old female who underwent an emergent right hemicolectomy at an outside institution for management of an iatrogenic perforation during endoscopic polypectomy...
March 23, 2024: American Surgeon
https://read.qxmd.com/read/38498211/surgical-and-medical-outcomes-in-robotic-compared-to-laparoscopic-colectomy-global-prospective-cohort-from-the-american-college-of-surgeons-national-surgical-quality-improvement-program
#3
JOURNAL ARTICLE
Rodrigo Moisés de Almeida Leite, Sergio Eduardo Alonso Araujo, Alexandre Venancio de Souza, Christy Cauley, Rob Goldstone, Todd Francone, Leandro Cardoso Barchi, Gustavo Yano Callado, Larissa Fagundes, Ulysses Ribeiro, Hannah Bossie, Rocco Ricciardi
BACKGROUND: Evidence regarding the outcomes benefits of robotic approach, when compared to a laparoscopic approach, in colectomy remain limited. OBJECTIVE: This study aimed to analyze the value of robotic approach compared to laparoscopic approach in minimally invasive colectomy. DESIGN: Cohort study of the National Surgical Quality Improvement Program (NSQIP). SETTING: This study included data from the NSQIP from 1/2016 to 12/2021...
March 18, 2024: Surgical Endoscopy
https://read.qxmd.com/read/38485203/influencing-factors-in-surgical-decision-making-a-qualitative-analysis-of-colorectal-surgeons-experiences-of-postoperative-complications
#4
JOURNAL ARTICLE
Carly N Bisset, Susan J Moug, Raymond Oliphant, Nicola Dames, Simon Parson, Jennifer Cleland
AIM: When making anastomotic decisions in rectal cancer surgery, surgeons must consider the risk of anastomotic leakage, which bears implications for the patient's quality of life, cancer recurrence and, potentially, death. The aim of this study was to investigate the views of colorectal surgeons on how their individual attributes (e.g. experience, personality traits) may influence their decision-making and experience of complications. METHOD: This qualitative study used individual interviews for data collection...
March 14, 2024: Colorectal Disease
https://read.qxmd.com/read/38481780/fibrin-glue-and-coats-compromise-the-integrity-of-colonic-anastomosis-an-experimental-trial-on-rats
#5
JOURNAL ARTICLE
Nikolaos Voloudakis, Ioannis Koutelidakis, Emmanouil Christoforidis, Stefanos Atmatzidis, Georgia Kotoreni, Basilios Papaziogas, Dimitrios Schizas, Christos Zavos, Apostolos Papalois, Grigorios Chatzimavroudis
BACKGROUND: Anastomotic leak remains a dreaded complication in colorectal surgery. Identifying optimal techniques that minimize its incidence is an active area of investigation. The aim of this experimental study was to evaluate the effect of commonly used hemostatic products on the integrity of colonic anastomoses. METHODS: Male Wistar rats were randomized into 4 groups. In the control group (A), the anastomosis was performed using the standard hand-sewn technique in the ascending colon...
2024: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://read.qxmd.com/read/38467575/does-complete-pathological-response-increase-perioperative-morbidity-risk-in-rectal-cancer
#6
JOURNAL ARTICLE
Thomas K S Tiang, Adrian S S Yeoh, Bushra Othman, Helen M Mohan, Adele N Burgess, Philip J Smart, David M Proud
AIM: The optimal management of patients with clinical complete response after neoadjuvant treatment for rectal cancer is controversial. The aim of this study is to compare the morbidity between patients with locally advanced rectal cancer who have had a pathological complete response (pCR) or not after neoadjuvant chemoradiotherapy (NCRT) and total mesorectal excision (TME). The study hypothesis was that pCR may impact the surgical complication rate. METHOD: A retrospective cohort study was conducted of a prospectively maintained database in Australia and New Zealand, the Binational Colorectal Cancer Audit, that identified patients with locally advanced rectal cancer (<15 cm from anal verge) from 1 January 2007 to 31 December 2019...
March 11, 2024: Colorectal Disease
https://read.qxmd.com/read/38463372/preoperative-neutrophil-to-lymphocyte-ratio-predicts-symptomatic-anastomotic-leakage-in-elderly-colon-cancer-patients-multicenter-propensity-score-matched-analysis
#7
JOURNAL ARTICLE
Chao-Yang Wang, Xiao-Long Li, Xiao-Long Ma, Xiong-Fei Yang, Yong-Yong Liu, Yong-Jiang Yu
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR), a composite inflammatory biomarker, is associated with the prognosis in patients with colorectal tumors. However, whether the NLR can be used as a predictor of symptomatic postoperative anastomotic leakage (AL) in elderly patients with colon cancer is unclear. AIM: To assess the role of the NLR in predicting the occurrence of symptomatic AL after surgery in elderly patients with colon cancer. METHODS: Data from elderly colon cancer patients who underwent elective radical colectomy with anastomosis at three centers between 2018 and 2022 were retrospectively analyzed...
February 27, 2024: World Journal of Gastrointestinal Surgery
https://read.qxmd.com/read/38462750/preoperative-beta-blockers-and-other-drugs-in-relation-to-anastomotic-leakage-after-anterior-resection-for-rectal-cancer
#8
JOURNAL ARTICLE
Anders Gerdin, Jennifer Park, Jenny Häggström, Josefin Segelman, Peter Matthiessen, Marie-Louise Lydrup, Martin Rutegård
AIM: Previous research has indicated that preoperative beta blocker therapy is associated with a decreased risk of complications after surgery for rectal cancer. This is thought to arise because of the anti-inflammatory activity of the drug. These results need to be reproduced and analyses extended to other drugs with such properties, as this information might be useful in clinical decision-making. The main aim of this work was to replicate previous findings of beta blocker use as a prognostic marker for postoperative leakage...
March 10, 2024: Colorectal Disease
https://read.qxmd.com/read/38441240/state-of-the-art-pouch-surgery-in-the-21st-century
#9
JOURNAL ARTICLE
Marianna Maspero, Tracy L Hull
BACKGROUND: An ileoanal pouch with ileal pouch-anal anastomosis is the preferred method to restore intestinal continuity in patients who require a total proctocolectomy. Pouch surgery has evolved during the past decades thanks to increased experience and research, changes in the medical management of patients who require an ileal pouch, and technological innovations. OBJECTIVE: To review the main changes in pouch surgery during the last two decades, with focus on staging, minimally invasive and transanal approaches, pouch design, and anastomotic configuration...
March 5, 2024: Diseases of the Colon and Rectum
https://read.qxmd.com/read/38441126/radiographic-evaluation-of-ileal-pouch-disorders-a-systematic-review
#10
JOURNAL ARTICLE
Bo Shen, David H Bruining, Hong Ma
BACKGROUND: Radiographic imaging of abdomen and pelvis plays an important role in the diagnosis and management of ileal pouch disorders with modalities including computed tomography, magnetic resonance imaging, contrasted pouchography, and defecography. OBJECTIVES: A systematic review of the literature was performed and applications of cross-sectional imaging, pouchography, defecography, and ultrasonography are described. DATA SOURCES: PubMed, Google Scholar, and Cochrane database...
March 5, 2024: Diseases of the Colon and Rectum
https://read.qxmd.com/read/38424706/influence-of-neoadjuvant-treatment-strategy-on-perioperative-outcomes-in-locally-advanced-rectal-cancer
#11
JOURNAL ARTICLE
Carson McFeetors, Lauren V O'Connell, Megan Choy, Niamh Dundon, Mark Regan, Myles Joyce, Babak Meshkat, Aisling Hogan, Emmeline Nugent
AIM: Neoadjuvant chemoradiotherapy (nCRT) in locally advanced rectal cancer facilitates tumour downstaging and complete pathological response (pCR). The goal of neoadjuvant systemic chemotherapy (total neoadjuvant chemotherapy, TNT) is to further improve local and systemic control. While some patients forgo surgery, total mesorectal excision (TME) remains the standard of care. While TNT appears to be noninferior to nCRT with respect to short-term oncological outcomes few data exist on perioperative outcomes...
February 29, 2024: Colorectal Disease
https://read.qxmd.com/read/38422401/diagnosis-and-treatment-of-pouch-disorders-in-children-a-systematic-review
#12
JOURNAL ARTICLE
Padmini Nallapaneni, Joseph A Picoraro
BACKGROUND: Restorative proctocolectomy and ileal pouch anal anastomosis has become the surgical procedure of choice in pediatric patients with medically-refractory ulcerative colitis or familial adenomatous polyposis. This systematic review aims to assess the diagnosis and treatment of pouch disorders in pediatric patients who undergo ileal pouch anal anastomosis. METHODS: A literature search was performed on MEDLINE, Google Scholar and EMBASE for all publications describing outcomes of pediatric ileal pouch anal anastomosis...
February 28, 2024: Diseases of the Colon and Rectum
https://read.qxmd.com/read/38418633/score-prediction-of-anastomotic-leak-in-colorectal-surgery-a-systematic-review
#13
REVIEW
Alexis Litchinko, Nicolas Buchs, Alexandre Balaphas, Christian Toso, Emilie Liot, Guillaume Meurette, Frédéric Ris, Jeremy Meyer
OBJECTIVE: Predicting the risk of anastomotic leak (AL) is of importance when defining the optimal surgical strategy in colorectal surgery. Our objective was to perform a systematic review of existing scores in the field. METHODS: We followed the PRISMA checklist (S1 Checklist). Medline, Cochrane Central and Embase were searched for observational studies reporting on scores predicting AL after the creation of a colorectal anastomosis. Studies reporting only validation of existing scores and/or scores based on post-operative variables were excluded...
February 28, 2024: Surgical Endoscopy
https://read.qxmd.com/read/38414124/can-the-heald-anal-stent-help-to-reduce-anastomotic-or-rectal-stump-leak-in-elective-and-emergency-colorectal-surgery-a-single-center-experience
#14
JOURNAL ARTICLE
Michael Jones, Brendan Moran, Richard John Heald, John Bunni
Anastomotic and rectal stump leaks are feared complications of colorectal surgery. Diverting stomas are commonly used to protect low rectal anastomoses but can have adverse effects. Studies have reported favorable outcomes for transanal drainage devices instead of diverting stomas. We describe our use of the Heald anal stent and its potential impact in reducing anastomotic or rectal stump leak after elective or emergency colorectal surgery. We performed a single-center retrospective analysis of patients in whom a Heald anal stent had been used to "protect" a colorectal anastomosis or a rectal stump, in an elective or emergency context, for benign and malignant pathology...
February 2024: Annals of Coloproctology
https://read.qxmd.com/read/38408871/clinical-utility-of-laser-speckle-contrast-imaging-and-real-time-quantification-of-bowel-perfusion-in-minimally-invasive-left-sided-colorectal-resections
#15
JOURNAL ARTICLE
Garrett C Skinner, Yao Z Liu, Alan E Harzman, Syed G Husain, Alessandra C Gasior, Lisa A Cunningham, Amber L Traugott, Christopher J McCulloh, Matthew F Kalady, Peter C Kim, Emily S Huang
BACKGROUND: Left-sided colorectal surgery demonstrates high anastomotic leak rates, with tissue ischemia thought to influence outcomes. Indocyanine green is commonly used for perfusion assessment, but evidence remains mixed for whether it reduces colorectal anastomotic leaks. Laser speckle contrast imaging provides dye-free perfusion assessment in real-time through perfusion heatmaps and quantification. OBJECTIVE: This study investigates the efficacy of advanced visualization (indocyanine green versus laser speckle contrast imaging) perfusion assessment and utility of laser speckle perfusion quantification in determining ischemic margins...
February 23, 2024: Diseases of the Colon and Rectum
https://read.qxmd.com/read/38406144/a-miraculous-save-gangrenous-bowel-and-meckle-s-diverticulum-with-acute-superior-mesenteric-artery-thrombosis
#16
Abhilasha Bhargava, Pankaj Gharde, Harshal Tayade, Akash Inamdar
The superior mesenteric artery (SMA) is vital for parts of the small intestine and ascending colon. Thrombosis of this major artery is a severe and potentially fatal condition involving the occlusion of the arterial vascular supply, causing ischemia predisposing to gangrene. Meckel's diverticulum is a congenital outpouching in the lower part of the small intestine. The condition of gangrenous meckels diverticulum is, therefore, even more limited. This study presents a unique case of a 45-year-old male with coexisting features of SMA thrombus with acute small bowel intestinal obstruction...
January 2024: Curēus
https://read.qxmd.com/read/38389761/microvascular-reconstruction-in-salvaging-the-gastric-conduit-post-esophagectomy-after-iatrogenic-right-gastroepiploic-vessel-injury
#17
Rajesh Yellinedi, Rambabu Nuvvula, Madhunarayana Basude, Kalidindi Vijaya Venkata Narsimha Raju, Yogesh Vashisht, Syed Nusrath
The preservation of the right gastroepiploic vessels is essential to ensure proper perfusion of the gastric conduit following esophagectomy. The loss of these vessels can lead to conduit ischemia or necrosis, resulting in significant postoperative complications. Traditional approaches such as colonic or jejunal interposition require extensive surgery and multiple anastomoses. In this report, we present our successful experience of salvaging the gastric tube through microvascular reconstruction following iatrogenic injury to the right gastroepiploic vessels in two cases...
March 2024: Indian Journal of Thoracic and Cardiovascular Surgery
https://read.qxmd.com/read/38385895/bowel-preparation-for-elective-colectomy-in-crohn-s-disease-results-from-a-global-cohort-study-using-the-nsqip-database
#18
JOURNAL ARTICLE
Gustavo Yano Callado, Rodrigo Moisés de Almeida Leite, Sergio Eduardo Alonso Araujo, Leandro Cardoso Barchi, Waleed Seddiq, Isabela Passarin Correa, Ulysses Ribeiro Junior, Rocco Ricciardi
AIM: The role of bowel preparation before colectomy in Crohn's disease patients remains controversial. This retrospective analysis of a prospective cohort study aimed to investigate the clinical outcomes associated with mechanical and antibiotic colon preparation in patients diagnosed with Crohn's disease undergoing elective colectomy. METHOD: Data were collected from the American College of Surgeons National Surgical Quality Improvement Program participant user files from 2016 to 2021...
February 22, 2024: Colorectal Disease
https://read.qxmd.com/read/38381031/reconstructive-techniques-following-low-anterior-resection-for-carcinoma-of-the-rectum
#19
JOURNAL ARTICLE
Anuj Goyal, Anvin Mathew, Princy Joseph, Gourav Kaushal, Nirjhar R Rakesh, Puneet Dhar
INTRODUCTION: Multiple reconstructive techniques have been described for reconstruction after a low anterior resection for carcinoma rectum. Colonic J pouch (CJP), Side to end anastomosis (SEA), transverse coloplasty pouch (TCP) and Straight Colo-rectal/anal anastomosis were the most widely studied. EVIDENCE ACQUISITION: PubMed, Embase and Cochrane data base were searched for randomized, non-randomized studies and systematic reviews from inception of the databases till July 31st , 2023...
February 2024: Minerva surgery
https://read.qxmd.com/read/38357040/tube-stoma-for-the-management-of-ileocolic-anastomotic-leak-in-a-patient-with-metastatic-colon-cancer
#20
Mohammed I Elsayed
This case involves a 53-year-old male who was diagnosed with stenotic ascending colon cancer and peritoneal metastatic deposits. He was initially planned for cytoreductive surgery and heated intraperitoneal chemotherapy (CRS and HIPEC), along with resection of the primary tumor in the form of right hemicolectomy. Intraoperatively, the disease was found to be more extensive than anticipated. Consequently, the plan was modified to include debulking right hemicolectomy with hand-sewn ileocolic anastomosis and extensive peritoneal procedures...
January 2024: Curēus
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