Search results for "Rectal surgery"

Impact of surgeon organization and specialization in rectal cancer outcome.

2001

Purpose The present study was designed to assess the differences in the outcome of patients with rectal cancer treated by a group of surgeons before and after being organized as a Coloproctology Unit at the same University Department of Surgery. Methods Comparison of two periods of rectal cancer surgery: I (1986–91) and II (1992–95). Period I: 94 patients were operated on by 14 general surgeons. Period II: 108 patients were operated on by only 4 surgeons of the same group organized as a Colorectal Surgery Unit after visiting referral centres abroad, adopting techniques such as total mesorectal excision (TME) for middle and low rectal cancer and washout of rectal stump. Mean follow-up during…

Risk factors for postoperative delirium after colorectal surgery for carcinoma

2009

Passagere Kolostomieanlagen nach Eingriffen am Colon Sigmoideum und Rektum—Sind Sie Noch Gerechtfertigt?

1997

Abstract Primary anastomosis is increasingly favored even in emergency colorectal surgery. Two-stage procedures are frequently considered obsolete. The aim of this study is to define conditions when a two-staged operative strategy with a temporary colostomy is still appropriate. We analyzed a series of 126 patients who were treated by a colostomy following resection and subsequent closure of the colostomy. In 44 cases the primary operation was a Hartmann resection, in 39 cases a resection with colostomy and mucous fistula and in 43 cases a resection with primary anastomosis and proximal loop colostomy. Complications of diverticular or neoplastic disease were generally managed by resection w…

Supplemental Perioperative Oxygen and the Risk of Surgical Wound Infection<SUBTITLE>A Randomized Controlled Trial</SUBTITLE>

2005

ContextSupplemental perioperative oxygen has been variously reported to halve or double the risk of surgical wound infection.ObjectiveTo test the hypothesis that supplemental oxygen reduces infection risk in patients following colorectal surgery.Design, Setting, and PatientsA double-blind, randomized controlled trial of 300 patients aged 18 to 80 years who underwent elective colorectal surgery in 14 Spanish hospitals from March 1, 2003, to October 31, 2004. Wound infections were diagnosed by blinded investigators using Centers for Disease Control and Prevention criteria. Baseline patient characteristics, anesthetic treatment, and potential confounding factors were recorded.InterventionsPati…

Fit-for-Discharge Criteria after Esophagectomy: An International Expert Delphi Consensus

2021

Summary There are no internationally recognized criteria available to determine preparedness for hospital discharge after esophagectomy. This study aims to achieve international consensus using Delphi methodology. The expert panel consisted of 40 esophageal surgeons spanning 16 countries and 4 continents. During a 3-round, web-based Delphi process, experts voted for discharge criteria using 5-point Likert scales. Data were analyzed using descriptive statistics. Consensus was reached if agreement was ≥75% in round 3. Consensus was achieved for the following basic criteria: nutritional requirements are met by oral intake of at least liquids with optional supplementary nutrition via jejunal fe…

Population‐based study of the treatment and prognosis of carcinoma of the rectum

1997

Background Few population-based studies address the issue of treatment of carcinoma of the rectum (15 cm or less from the anal vcrge) both from surgical and epidemiological aspects. Methods Some 827 patients were analysed in the cancer registry of the Cote-d'Or (Burgundy, France) from 1976 to 1990 (493 931 inhabitants). Results Resection for cure increased from 57.2 per cent before 1981 to 77.0 per cent after 1985 (P <11.001), and the proportion of Dukes A and B cascs from 35.8 to 52.5 per cent (P< 0.001). Among patients resected for cure, continence-preserving resections were performed more frequently during the 1986-1990 period (48.0 per cent) than during the two previous 5-year periods (…

Indocyanine Green-Enhanced Colorectal Surgery—between Being Superfluous and Being a Game-Changer

2020

Nowadays, surgical innovations incorporate new technological conquests and must be validated by evidence-based medicine. The use of augmented reality-assisted indocyanine green (ICG) fluorescence has generated a myriad of intraoperative applications such as demonstration of key anatomical landmarks, sentinel lymph nodes, and real-time assessment of local blood flow. This paper presents a systematic review of the clinical evidence regarding the applications of ICG near-infrared (NIR) fluorescence in colorectal surgery. After we removed duplicate publications and screened for eligibility, a total of 36 articles were evaluated: 23 on perfusion assessment, 10 on lymph node mapping, and 3 on int…

Effects of a low-power He-Ne laser on the healing of experimental colon anastomoses: our experience

1992

Despite technical advances, the incidence of anastomotic leaks in elective colorectal surgery remains around 14%. Recent studies suggest that the use of low-energy lasers may enhance wound healing in different tissues in a selective, nondestructive manner. Based on these findings we have attempted to provide experimental background on the effects of a He-Ne laser during the early stages of healing in 155 colonic anastomoses performed on rats. The irradiation (external or endoscopical) ofthe anastomoses by repeated doses below 4 J/cm 2 suggest (1) the laser-induced enhancement of anastomotic healing can be obtained in both healthy colons or in situations in which anastomotic breakdown is mor…

Safety of hospital discharge before return of bowel function after elective colorectal surgery

2020

Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function.A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multiva…