Risk factors for future repeat abdominal surgery

Strik, Chema; Stommel, Martijn W J; Schipper, Laura J. de; Goor, Harry van; Broek, Richard P. G. ten

doi:10.1007/s00423-016-1414-3

Cited by 47 publications

(33 citation statements)

References 24 publications

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“…Possible complications of an abdominal incision, especially if it is large and in conditions of contamination of surgical field, are very well known (46,47). In our experience there is a low rate of complications which are related to the dehiscence of appendix stump in the AL group and a postoperative bleeding because of dehiscence of mesenteriolum ligature in CA group.…”

Section: Grade 2 Gangrenousmentioning

confidence: 54%

Acute appendicitis: should the laparoscopic approach be proposed as the gold standard? Six-year experience in an Emergency Surgery Unit

Guercio¹

2016

GCHIR

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clinical practice gold standard in the activity of a general emergency unit with a variety of senior surgeons with different skills on the basic laparoscopy. Study designThe present institutional retrospective cohort study included patients who have been preoperatively evaluated in case of emergency and scheduled for appendectomy within 24 hours after recovery.The main goal is to evaluate if the laparoscopic appendectomy on the whole is an advantageous procedure in a team consisting in senior surgeon who are mostly dedicated at a different kind of surgery, having different skills in laparoscopic surgery, and if those different skills affect the results. We performed a review of available data of patients who underwent appendectomy during the period in which the data of the surgical procedures were registered in the institutional electronic database (Intranet). MethodsThe present retrospective study was carried out from January 2010 to June 2016 in the Unit of General and Emergency Surgery of the "Policlinico P. Giaccone" -University of Palermo (Italy) and concerned the appendectomies performed by 6 senior surgeons working at the Unit during the whole period of observation. The activity of the surgeons that turned up successively in the team, and those who came out was excluded from this study. We included the appendectomies carried out with the conventional three-port laparoscopic approach or the Mac Burney incision for the conventional open approach. The midline xiphoid-pubis incision and the umbilicuspubis laparotomy were excluded if carried out as firstchoice approach. On the contrary, these were taken into consideration if a standard (laparotomic/laparoscopic) technique was converted to an open technique through a wide abdominal access (s).The surgeons were classified with a generic descriptor-based grading (Table 1), related exclusively to general laparoscopic skills and accepted by mutual consent of all operators (11). It should be underlined that the three "skilled" surgeons attended, during their career, a formal course of laparoscopy, on the other hand (contrary) the surgeons classified as "level 3" did not. The severity of acute appendicitis was classified according to the Disease Severity Score described by Garst et al. (12), reported on the Table 2. The surgical procedures were the conventional laparotomic appendectomy performed through a Mac-Burney incision or the three-port laparoscopic approach. The conventional, laparotomic approach was performed with a 2-5 cm long Incision along a Langer line at the junction of lateral one-third and medial twothird of right anterior superior iliac spine and umbilicus. Then, the superficial abdominal fascia is incised. Once the lateral margin of the rectum abdomen muscle is visualized it is medially retracted and the deep fascia incised, or rectum muscle is incised along the direction of its fibers. Then, the external oblique muscle is also incised and transversalis fascia visualized. After this fascia and the peritoneum were incised, the appendix is localized an...

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Section: Grade 2 Gangrenousmentioning

confidence: 54%

Acute appendicitis: should the laparoscopic approach be proposed as the gold standard? Six-year experience in an Emergency Surgery Unit

Guercio¹

2016

GCHIR

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“…It is estimated that 10 to 37% of patients with elective abdominal surgery will require repeated abdominal surgery. 14 The risk of such complications in the patients with previous multiple abdominal surgeries is high, even with open surgery. 14,15 Use of preoperative evaluation tools like Hostile Abdomen Index risk stratification may help to select the right patients for laparoscopic procedures.…”

Section: Discussionmentioning

confidence: 99%

“…14 The risk of such complications in the patients with previous multiple abdominal surgeries is high, even with open surgery. 14,15 Use of preoperative evaluation tools like Hostile Abdomen Index risk stratification may help to select the right patients for laparoscopic procedures. 16 One of the significant limitations of our operative technique was the failure to assess the patency of the graft during operation.…”

Section: Discussionmentioning

confidence: 99%

<p>A Short Series of Laparoscopic Mesenteric Bypasses for Chronic Mesenteric Ischemia</p>

Kazmi¹,

Berge²,

Sahba³

et al. 2020

VHRM

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Background: Laparoscopic aortomesenteric bypass may be performed to treat the chronic mesenteric ischemia patients who are not suitable for endovascular treatment. This study presents an initial experience with a limited series of laparoscopic mesenteric artery revascularization for the treatment of mesenteric ischemia. Methods: Chronic mesenteric ischemia (CMI) patients with previous unsuccessful endovascular treatment or with arterial occlusion and extensive calcification precluding safe endovascular treatment were offered laparoscopic mesenteric revascularization. From October 2015 until November 2018, nine patients with CMI underwent laparoscopic revascularization. In addition to demographic data and perioperative results of the treatment, graft patency was assessed with Duplex ultrasound at 1, 3, 6 and 12 months, and annually thereafter. A descriptive analysis of the data was performed. Results: All bypasses were constructed with an 8 mm ring enforced expanded polytetrafluoroethylene graft in a retrograde fashion (from infrarenal aorta or iliac artery) to either superior mesenteric artery or splenic artery (2 cases). Median operation time was 356 mins (range 247-492 mins). Five patients had a history of unsuccessful endovascular treatment. Laparoscopic technical success was 78%, and the primary open conversion rate was 22%. All laparoscopic revascularization procedures remained patent after discharge during a median follow-up time of 26 months (range 18-49 months). The primary graft patency at 30 days was 78%. Primary assisted, and secondary graft patency was 78% and 100%, respectively. Median weight gain was 2 kg (range 2-18 kg), and all patients achieved relief from postprandial pain and nausea. No mortality was observed during the follow-up period. Conclusion: Laparoscopic aortomesenteric revascularization procedures for chronic mesenteric ischemia are feasible but require careful patient selection. These procedures should only be performed at referral centers by vascular surgeons with prior experience in laparoscopic vascular surgery.

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“…[22] Long-term benefits from this surgical approach are also unconvincing, with many patients reexperiencing abdominal pain only one year after surgery, often due to worsening or de novo formation of additional adhesions. [23][24][25] In the present case, we reported the use of an innovative soft tissue therapy to treat a female with a one-year history of abdominal pain caused by two small-bowel narrowed areas secondary to surgically-induced adhesions.…”

Section: Discussionmentioning

confidence: 99%

Manual physical therapy clears adhesive bowel obstruction and strictures in a patient with Crohn’s disease

Weinstock¹,

Pratt²,

Wurn³

et al. 2018

IJCR

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A woman with Crohn's disease with prior resection presented with a one-year history of persistent abdominal pain. The small bowel follow-through radiograph demonstrated the presence of two strictures in the small intestine due to adhesive scarring.Opting for conservative management, the patient underwent a specialized manual physical therapy regimen. Following treatment, the patient experienced significant decrease of abdominal pain and improved biomechanical function. Radiologic imaging revealed complete resolution of both strictures. Manual physical therapy may be a viable non-operative option to manage small bowel strictures or obstruction.

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Risk factors for future repeat abdominal surgery

Cited by 47 publications

References 24 publications

Acute appendicitis: should the laparoscopic approach be proposed as the gold standard? Six-year experience in an Emergency Surgery Unit

Acute appendicitis: should the laparoscopic approach be proposed as the gold standard? Six-year experience in an Emergency Surgery Unit

<p>A Short Series of Laparoscopic Mesenteric Bypasses for Chronic Mesenteric Ischemia</p>

Manual physical therapy clears adhesive bowel obstruction and strictures in a patient with Crohn’s disease

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