Journal ArticleDOI
Determination of independent predictive factors for anastomotic leak: analysis of 682 intestinal anastomoses
Bryan C. Morse,Joshua P. Simpson,Yonge R. Jones,Brent L. Johnson,Brianna M. Knott,Jennifer A. Kotrady +5 more
TLDR
The recognition of factors associated with anastomotic leakage after intestinal operations can assist surgeons in mitigating these risks in the perioperative period and guide intraoperative decisions.Abstract:Â
Background The objective of this study was to identify risk factors associated with intestinal anastomotic leakage in order to practically assist in surgical decision making. Methods A retrospective review of an academic surgery database was performed over 5 years to identify patients who had intestinal (small bowel and colon) anastomoses to determine independent predictors of anastomotic leakage. Results Over the study period, 682 patients were identified with intestinal anastomoses; the overall leak rate was 5.6% (38/682). In bivariate analysis, 9 factors were associated with anastomotic leaks. Of these, 3 were found to be independent predictors of anastomotic leakage using a logistic regression model: anastomotic tension (odds ratio [OR] = 10.1, 95% Confidence Interval [CI] 1.3 to 76.9), use of drains (OR = 8.9, 95% CI 4.3 to 18.4), and perioperative blood transfusion (OR = 4.2, 95% CI 1.4 to 12.3). Conclusions The recognition of factors associated with anastomotic leakage after intestinal operations can assist surgeons in mitigating these risks in the perioperative period and guide intraoperative decisions.read more
Citations
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Journal ArticleDOI
Risk factors and consequences of anastomotic leak after colectomy: a national analysis.
Emily F. Midura,Dennis J. Hanseman,Bradley R. Davis,Sarah J. Atkinson,Daniel E. Abbott,Shimul A. Shah,Ian M. Paquette +6 more
TL;DR: It is demonstrated that patients who underwent segmental colectomy with anastomosis at American College of Surgeons National Surgical Quality Improvement Program–affiliated hospitals in 2012 have increased morbidity and 30-day mortality rates, experience multiple readmissions to the hospital, and have a higher likelihood of requiring further operative intervention.
Journal ArticleDOI
Equivocal effect of intraoperative fluorescence angiography on colorectal anastomotic leaks.
TL;DR: Intraoperative fluorescence angiography to assess the perfusion of the colon conduit for anastomosis was not associated with colorectal anastOMotic leak, and additional studies are necessary to determine whether this technology is beneficial for coloreCTal surgery.
Journal ArticleDOI
Evidence Review Conducted for the Agency for Healthcare Research and Quality Safety Program for Improving Surgical Care and Recovery: Focus on Anesthesiology for Total Knee Arthroplasty.
Ellen M. Soffin,Melinda Maggard Gibbons,Clifford Y. Ko,Stephen L. Kates,Elizabeth C. Wick,Maxime Cannesson,Michael J. Scott,Christopher L. Wu +7 more
TL;DR: Enhanced recovery after surgery (ERAS) protocols represent patient-centered, evidence-based, multidisciplinary care of the surgical patient as mentioned in this paper. Although these patterns have been validated in numerous surgical specialities, ERAS has not been widely described for patients undergoing hip fracture (HFx) repair.
Journal ArticleDOI
Near-Infrared Fluorescence Imaging for Real-Time Intraoperative Guidance in Anastomotic Colorectal Surgery: A Systematic Review of Literature
Jacqueline van den Bos,Mahdi Al-Taher,Rutger M. Schols,Sander M. J. van Kuijk,Nicole D. Bouvy,Laurents P. S. Stassen +5 more
TL;DR: Although the feasibility of near-infrared fluorescence angiography in anastomotic colorectal surgery seems to be agreed on by all current research, large clinical trials are mandatory to further evaluate the added value of the technique.
Journal ArticleDOI
Prevention of Perioperative Anastomotic Healing Complications: Anastomotic Stricture and Anastomotic Leak.
TL;DR: A more holistic approach to understanding the mechanisms of anastomotic complications is needed in order to develop tailored interventions to reduce their frequency, and this may require a more complete definition of the role of the microbiota in anastsomotic healing.
References
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Journal ArticleDOI
Leakage from stapled low anastomosis after total mesorectal excision for carcinoma of the rectum
TL;DR: Key technical factors incude: a clean dry pelvie cavity, pulsatile colonic blood supply, suction drainage started during closure and mobilization of ample tissue to fill the pelvic space.
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Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review of 1,014 patients
Andrea Vignali,Victor W. Fazio,Ian C. Lavery,Jeffrey W. Milsom,James M. Church,Tracy L. Hull,Scott A. Strong,John R. Oakley +7 more
TL;DR: It is concluded that anastomoses to the rectum using the circular stapler can be done with low mortality and morbidity.
Journal ArticleDOI
Colonic Anastomotic Leak: Risk Factors, Diagnosis, and Treatment
T. Peter Kingham,H. Leon Pachter +1 more
TL;DR: In this article, the authors examine the currently dentified risk factors contributing to intestinal anastootic breakdown and delineate methods of diagnosis and reatment of this universally dreaded complication.
Journal ArticleDOI
Beneficial effect of autologous blood transfusion on infectious complications after colorectal cancer surgery
Markus M. Heiss,K. W. Jauch,Christian Delanoff,G. Mayer,F-W. Schildberg,Wolfgang Mempel,M. Mempel,H-J. Eissner +7 more
TL;DR: The clinical potential of blood-transfusion-mediated immunomodulation, which may be important also in tumour immunology, is shown in patients with apparently curable colorectal cancer.
Journal ArticleDOI
Pelvic drainage and other risk factors for leakage after elective anterior resection in rectal cancer patients: a prospective study of 978 patients.
Chien Yuh Yeh,Chung Rong Changchien,Jeng-Yi Wang,Jinn-Shiun Chen,Hong-Hwa Chen,Jy-Ming Chiang,Reiping Tang +6 more
TL;DR: Investigation of prophylactic pelvic drainage and other factors that might be associated with anastomotic leakage after elective anterior resection of primary rectal cancer found routine use of pelvic drainage is not justified and should be discouraged.