Systematic Review of the Technique of Colorectal Anastomosis

Slieker, Juliette; Daams, Freek; Mulder, Irene M.; Jeekel, J.; Lange, Johan F.

doi:10.1001/2013.jamasurg.33

Cited by 164 publications

(119 citation statements)

References 105 publications

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“…The fact that this knowledge has not found its way into clinical practice might have to do with the fact that most surgeons are convinced that AL is caused by poor surgical technique either leaving gaps, traumatizing intestinal tissue, causing poor blood supply or tension on the suture line [27]. Even though, the evidence for these mechanical factors is neither really that convincing nor particularly conclusive [24], the idea that AL always has a mechanical cause triggered many investigations searching for the perfect anastomotic technique [27,30]. Two arguments support the mechanical hypothesis, namely that experienced surgeons have a lower rate of AL since they are technically better and that those anastomoses which leak within the first 48 hours after surgery unsually do so for technical reasons [27].…”

Section: Introductionmentioning

confidence: 99%

Are gut bacteria associated with the development of anastomotic leaks?

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Are gut bacteria associated with the development of anastomotic leaks?

et al. 2017

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“…It has been shown that male gender, smoking, obesity, and diabetes might represent risk factors for AL, due to the vulnerability of these patients [11]; none of these were associated with higher incidence of AL in our study. Furthermore, the location of the tumor and anastomosis along with the type of intervention and surgical technique might also influence the development of AL [12]; in the current study no certain location or type of intervention proved to influence the AL's appearance.…”

Section: Discussionmentioning

confidence: 52%

The Incidence and Mortality of Anastomotic Leakage after Colorectal Cancer Surgery

Popescu¹,

Sala²,

Gliga³

et al. 2017

Surgery

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Journal of Surgery IntroductionColorectal cancer is one of the most commonly diagnosed cancers worldwide. Its incidence increases with age and higher mortality rate is encountered in men [1]. Therapeutic approach refers to a complex surgical, chemo-and radiotherapy treatment.In spite of numerous surgical techniques developed in the last decades-including new mechanical stapler based methods-anastomotic leakage (AL) remains one of the most feared complications in colorectal surgery. Its incidence ranges from 1.5% to 16% for "per primam" anastomoses with frequent need for redo interventions, longer hospitalization and high mortality rates [2]. AL prediction and identification are still difficult due to its different clinical manifestations, varying from vague abdominal symptoms and prolonged postoperative ileus to fulminant abdominal pain in case of peritonitis and sepsis [3]. It is still a challenging task to distinguish early after surgery the developing septic process from the physiological inflammatory response; however, early diagnosis, before the appearance of clinical symptoms, remains essential for a long term survival [4]. The literature recognizes several risk factors for AL development such as diabetes, smoking, obesity, chronic kidney disease, cardiovascular diseases but facts are still contradictory [5][6][7]. According to several authors [8,9] characteristics of AL depend on many aspects: -The direction of the leakage has a major impact on the patient's symptoms; internal leakages are drained to organs such as the vagina, gallbladder or bladder and external leakages are drained through the teguments. AbstractIntroduction: Anastomotic leakage (AL) remains one of the most feared complications after colorectal surgery with high mortality rates, prolonged hospitalization, highly risk of readmission, finally generating important costs for any healthcare system. AL prediction and early detection are a considerable challenge for each surgeon as no wellestablished and reliable predictors and diagnosis protocols are currently available. Aims:To determine the incidence and mortality of AL after colorectal surgery, with identification of possible predictors and improvement points in the management of this complication. Material and methods:We included 431 patients with colorectal cancer who underwent surgical resection and restoration of the digestive tube's continuity, at the 2 nd Department of Surgery, Emergency County Clinical Hospital of Târgu-Mureș, from January 2010-December 2015. The patients have been divided in two groups: AL group including 21 patients and no leak group with 410 patients. Demographic characteristics and comorbidities were recorded with clinical and laboratory follow-up in the postoperative period.Results: There were no significant differences between the two groups in terms of demographic characteristics and comorbidities. The average age of patients with AL was 65.9 ± 11.6 vs. 65.0 ± 10.3 without AL. Male gender was predominant in both groups. No significant differences were recorde...

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“…The design has been chosen to maximise the frequency separation of resonant modes, with the sensor operating on the first anti-symmetric spatial mode to minimise coupling to the B 1 field during excitation. 1 H phantom imaging at 1.5 T shows moderately effective passive decoupling and the expected local signal enhancement. Although this represents an encouraging proof of concept, significant further work is required to demonstrate utility of the sensor in localised imaging or spectroscopy of annular wounds.…”

Section: Discussionmentioning

confidence: 90%

“…A variety of techniques are used, including suturing, stapling, tissue fusion and compression rings [1]. Despite continuing advances, leakage remains a potentially devastating complication, with a high (6-22%) mortality following surgery [2].…”

Section: Introductionmentioning

confidence: 99%

“…One possibility is magnetic resonance spectroscopy (MRS). 1 H and 31 P MRS have been used to monitor the development of colonic ischemia in animal experiments, based on a transient increase in lactate [10] or a reduction in the a, b and g adenosine triphosphate peaks relative to phosphocreatine [11]. Unfortunately, due to the susceptibility of even the best external coils to body noise [12,13], MRS has a low signal-to-noise ratio (SNR), which leads to poor results in the abdomen.…”

Section: Introductionmentioning

confidence: 99%

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Surgical wound monitoring by MRI with a metamaterial-based implanted local coil

et al. 2018

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Abstract. An implantable sensor for monitoring surgical wounds after bowel reconstruction is proposed. The sensor consists of a coupled pair of 8-element magneto-inductive ring resonators, designed for mounting on a biofragmentable anastomosis ring to give a local increase in signal-to-noise ratio near an annular wound during 1 H magnetic resonance imaging. Operation on an anti-symmetric spatial mode is used to avoid coupling to the B 1 field during excitation, and a single wired connection is used for MRI signal output. The electrical response and field-of-view are estimated theoretically. Prototypes are constructed from flexible elements designed for operation at 1.5 T, electrical responses are characterized and local SNR enhancement is confirmed using agar gel phantoms.

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Systematic Review of the Technique of Colorectal Anastomosis

Cited by 164 publications

References 105 publications

Are gut bacteria associated with the development of anastomotic leaks?

Are gut bacteria associated with the development of anastomotic leaks?

The Incidence and Mortality of Anastomotic Leakage after Colorectal Cancer Surgery

Surgical wound monitoring by MRI with a metamaterial-based implanted local coil

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