Search results for "anastomotic leaks"
showing 7 items of 7 documents
Robotic transanal total mesorectal excision: Is the future now?
2021
Total mesorectal excision (TME) is the standard surgical treatment for the curative radical resection of rectal cancers. Minimally invasive TME has been gaining ground favored by the continuous technological advancements. New procedures, such as transanal TME (TaTME), have been introduced to overcome some technical limitations, especially in low rectal tumors, obese patients, and/or narrow pelvis. The earliest TaTME reports showed promising results when compared with the conventional laparoscopic TME. However, recent publications raised concerns regarding the high rates of anastomotic leaks or local recurrences observed in national series. Robotic TaTME (R-TaTME) has been proposed as a nove…
The economic burden of endoscopic treatment for anastomotic leaks following oncological Ivor Lewis esophagectomy
2019
BackgroundComplications after surgery for esophageal cancer are associated with significant resource utilization. The aim of this study was to analyze the economic burden of two frequently used endoscopic treatments for anastomotic leak management after esophageal surgery: Treatment with a Self-expanding Metal Stent (SEMS) and Endoscopic Vacuum Therapy (EVT).Materials and methodsBetween January 2012 and December 2016, we identified 60 German-Diagnosis Related Group (G-DRG) cases of patients who received a SEMS and / or EVT for esophageal anastomotic leaks. Direct costs per case were analyzed according to the Institute for Remuneration System in Hospitals (InEK) cost-accounting approach by c…
Transnasal endoscopy for direct visual control of esophageal stent placement without fluoroscopy
2012
Placement of self-expanding metal stents (SEMSs) is a well-established treatment for esophageal stenosis and postoperative anastomotic leaks. Conventional endoscopic procedures for SEMS placement require fluoroscopic guidance, but transnasal endoscopy (TNE) with ultraslim endoscopes may allow precise stent release under direct visual control without the need for fluoroscopy. This prospectively collected data investigated the feasibility and safety of TNE-guided SEMS placement without fluoroscopy. Between March 2009 and February 2011, 20 consecutive patients underwent TNE-guided SEMS placement without fluoroscopy. The technical success rate was 100 % and no fluoroscopy was required during th…
Anastomotic leaks after anterior resection for mid and low rectal cancer: survey of the Italian Society of Colorectal Surgery.
2008
BACKGROUND: The aim of the survey was to assess the incidence of anastomotic leaks (AL) and to identify risk factors predicting incidence and gravity of AL after low anterior resection (LAR) for rectal cancer performed by colorectal surgeons of the Italian Society of Colorectal Surgery (SICCR). METHODS: Information about patients with rectal cancers less than 12 cm from the anal verge who underwent LAR during 2005 was collected retrospectively. AL was classified as grade I to IV according to gravity. Fifteen clinical variables were examined by univariate and multivariate analyses. Further analysis was conducted on patients with AL to identify factors correlated with gravity. RESULTS: There …
Histological effects of He-Ne laser on the healing of experimental colon anastomoses in the rat
1990
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 histological effects of He-Ne laser during the early stages of healing in 70 colonic anastornoses performed on rats, The irradiation of the anastomoses by two doses of 3.6 J/cm produces an increase in the populations of round cells and fibroblasts of the scar tissue, an increase in new vessel formation and a significant improvement in epithelialization. Th…
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…