Introduction: Anastomotic leakage is one of the most serious surgical complications that can increase the potential postoperative morbidity, mortality, and overall costs of patient care. Aim of study: To assess the economic burden of anastomotic leakage and to estimate its major clinical effects on patient evaluation.Materials and methods: We retrospectively reviewed single-surgeon data about patients who underwent surgical intervention for colorectal cancer at the 2nd Surgery Department of the Mureș County Emergency Clinical Hospital between January 2019 and July 2020. We assessed general characteristics, surgical data, postoperative information, oncologic results, and financial aspects for each patient. Depending on the presence of anastomotic leakage, patients were divided into two groups: a study group (SG) – patients with postoperative anastomotic failure, and a control Group (CG) – patients without postoperative anastomotic failure.Results: Patients with anastomotic leakage presented increased use of antibiotics, greater number of surgical reinterventions, longer period of intensive care treatment, prolonged hospitalization, increased overall costs, and significantly greater financial loss for the hospital.Conclusion: Anastomotic leakage leads to important negative effects, including longer hospitalization, prolonged intensive care unit stay, greater incidence of surgical reintervention, increased hospitalization costs, and significant financial loss.

Introduction. Colorectal cancer is a common type of malignant disease of the digestive tract. Anastomotic leakage (AL) still represents a serious complication in gastrointestinal surgery, associated with high morbidity and mortality. Methods. We conducted a retrospective case-control study and analyzed a single surgeon's data about 359 patients treated for colorectal cancer. Patients were divided as follows: Study Group (patients with AL - 37 patients) and Control Group (patients without AL - 322 patients). Surgical and anastomotic technique-related information was processed. Results. Surgical procedures for right sided colon tumors resulted in a significantly lower rate of anastomotic leakage (P = 0.0231). For left sided colectomies end to end handsewn double layer anastomosis presented decreased odds (OR = 0.176). For sigmoid segmental resection end to end anastomotic techniques developed low rate of fistula formation (handsewn - OR = 0.593, stapled – OR = 0.685). Performing Dixon type surgical interventions, anastomotic techniques seemed without influence on anastomotic leak appearance (handsewn and stapled), although distal anastomoses were identified as significant risk factors for fistula formation (P = 0.0017). In order to perform subtotal colectomy, side to side sutures (handsewn and stapled) seemed safe choices for anastomotic procedure (P = 0.0073). Patient with anastomotic leakage suffered a significantly longer hospital stay (P = 0.0079), presented higher rate of surgical reintervention (P=0.0001), increased mortality (P=0.0001) and elevated hospitalization costs (P=0.0079). Conclusion. Postoperative complications like anastomosis leakage significantly increase hospitalization period, necessity of surgical reintervention, mortality and financial costs. In order to avoid these unpleasant events, bowel anastomoses require standardization during surgery.

AbstractIntroduction: Minimally invasive surgical procedures have become routine interventions nowadays and represent an effective therapeutic option even for small umbilical hernias, providing favorable postoperative and aesthetic results.Aim of study: To determine the most appropriate minimally invasive treatment option for small and medium size umbilical hernias.Materials and methods: We conducted a prospective study on 50 patients with small or medium umbilical hernia (<4 cm). All patients benefited of minimal invasive surgery with mesh implantation. Depending on the surgical procedure, two major groups were defined: group A – patients with open surgical approach (n = 24) and group B – patients undergoing laparoscopic surgery (n = 26). Clinical, surgical, postoperative, and follow-up data were analyzed.Results: Mesh replacement via open approach through the umbilicus was associated with significantly reduced surgical time (p = 0.0359), administration of painkillers (p = 0.0461), and use of anticoagulants (p = 0.0404). Hospital stays (p = 0.0001) and costs (p = 0.0005) were also significantly lower in this group. After 6 months of follow-up, no recurrence was observed, and no significant differences were detected regarding postoperative pain and the patients’ professional reintegration. Patient satisfaction regarding postoperative scar was superior in the open group.Conclusion: The present study indicates that the ventral patch technique is a safe and effective method for the treatment of small and medium size umbilical hernias.

No abstract

No abstract