scholarly journals Intra-abdominal drains for the prophylaxis of anastomotic leak in elective colorectal surgery

2004 ◽  
Author(s):  
Rachel Rolph ◽  
James MN Duffy ◽  
Swethan Alagaratnam ◽  
Paul Ng ◽  
Richard Novell
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Elective Colorectal Surgery

MELD-Na Score as a Predictor of Anastomotic Leak in Elective Colorectal Surgery

2018 ◽  
Vol 232 ◽  
pp. 43-48 ◽  
Author(s):  
Kathleen M. Coakley ◽  
Sneha Sarasani ◽  
Tanu Prasad ◽  
Scott R. Steele ◽  
Ian Paquette ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Elective Colorectal Surgery

Ketorolac Use and Anastomotic Leak in Elective Colorectal Surgery

2018 ◽  
pp. 1
Author(s):  
Alexander T. Hawkins ◽  
Matthew D. McEvoy ◽  
Jonathan P. Wanderer ◽  
Molly M. Ford ◽  
M. Benjamin Hopkins ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Elective Colorectal Surgery

scholarly journals Current Evidence of Combination of Oral Antibiotics and Mechanical Bowel Preparation in Elective Colorectal Surgery and Their Impact on Anastomotic Leak

2019 ◽  
Vol 27 (1) ◽  
pp. 101-102 ◽  
Author(s):  
Argyrios Ioannidis ◽  
Athanasios Zoikas ◽  
Steven D. Wexner
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Significant Role ◽  
Bowel Preparation ◽  
Mechanical Bowel Preparation ◽  
Current Evidence ◽  
Oral Antibiotics ◽  
Optimal Method ◽  
Elective Colorectal Surgery ◽  
Colorectal Resections

Anastomotic leak represents a potentially catastrophic complication following colorectal surgery. Preoperatively, bowel preparation has a significant role in anastomotic leak prevention, but the optimal method remains unclear. Recently, numerous studies have supported combined mechanical bowel preparation and oral antibiotics prior to elective colorectal operations. Based on the plethora of recent data, we hope that surgeons will routinely use a combination of oral antibiotics and mechanical bowel preparation prior to elective colorectal resections.

scholarly journals Oral neomycin and bacitracin are effective in preventing surgical site infections in elective colorectal surgery: a multicentre, randomized, parallel, single-blinded trial (COLORAL-1)

2021 ◽  
Author(s):  
Alberto Arezzo ◽  
Massimiliano Mistrangelo ◽  
Marco Augusto Bonino ◽  
Paola Salusso ◽  
Edoardo Forcignanò ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Multivariable Analysis ◽  
Mechanical Bowel Preparation ◽  
Surgical Site Infections ◽  
Oral Antibiotic ◽  
Beta Lactam ◽  
Elective Colorectal Surgery ◽  
Intravenous Antibiotics

AbstractSeveral regimens of oral and intravenous antibiotics (OIVA) have been proposed with contradicting results, and the role of mechanical bowel preparation (MBP) is still controversial. This study aims to assess the effectiveness of oral antibiotic prophylaxis in preventing Surgical Site Infections (SSI) in elective colorectal surgery. In a multicentre trial, we randomized patients undergoing elective colorectal resection surgery, comparing the effectiveness of OIVA versus intravenous antibiotics (IVA) regimens to prevent SSI as the primary outcome (NCT04438655). In addition to intravenous Amoxicillin/Clavulanic, patients in the OIVA group received Oral Neomycin and Bacitracin 24 h before surgery. MBP was administered according to local habits which were not changed for the study. The trial was terminated during the COVID-19 pandemic, as many centers failed to participate as well as the pandemic changed the rules for engaging patients. Two-hundred and four patients were enrolled (100 in the OIVA and 104 in the IVA group); 3 SSIs (3.4%) were registered in the OIVA and 14 (14.4%) in the IVA group (p = 0.010). No difference was observed in terms of anastomotic leak. Multivariable analysis indicated that OIVA reduced the rate of SSI (OR 0.21 / 95% CI 0.06–0.78 / p = 0.019), while BMI is a risk factor of SSI (OR 1.15 / 95% CI 1.01–1.30 p = 0.039). Subgroup analysis indicated that 0/22 patients who underwent OIVA/MBP + vs 13/77 IVA/MBP- experienced an SSI (p = 0.037). The early termination of the study prevents any conclusion regarding the interpretation of the data. Nonetheless, Oral Neomycin/Bacitracin and intravenous beta-lactam/beta-lactamases inhibitors seem to reduce SSI after colorectal resections, although not affecting the anastomotic leak in this trial. The role of MBP requires more investigation.

THE FEASIBILITY OF FAST TRACK PROTOCOL FOR ELDERELY PATIENTS WITH COLORECTAL CANCER

2016 ◽  
pp. 26-29
Author(s):  
D. . Zitta ◽  
V. . Subbotin ◽  
Y. . Busirev
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Surgery ◽  
Blood Loss ◽  
Elderly Patients ◽  
Fast Track ◽  
Randomized Study ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Elective Colorectal Surgery ◽  
Complications Rate

Fast track protocol is widely used in major colorectal surgery. It decreases operative stress, shortens hospital stay and reduces complications rate. However feasibility and safety of this approach is still controversial in patients older than 70 years. The AIM of the study was to estimate the safety and effectiveness of fast track protocol in elderly patients with colorectal cancer. MATERIALS AND METHODS. Prospective randomized study included 138 elective colorectal resectionfor cancer during period from 1.01.10 till 1.06.15. The main criteria for the patients selection were age over 70 years and diagnosis of colorectal cancer. 82 of these patients received perioperative treatment according to fast track protocol, other 56 had conventional perioperative care. Patients underwent following procedures: right hemicolectomy (n=7), left hemicolectomy (n=12), transverse colectomy (n=1), sigmoidectomy (n=23), abdomeno-perineal excision (n=19) and low anterior resection of rectum (n=76). Following data were analized: duration of operation, intraoperative blood loss, time offirst flatus and defecation, complications rates. RESULTS. Mean age was 77,4 ± 8 years. There were no differences in gender, co morbidities, body mass index, types of operations between groups. Duration of operations didn't differ significantly between 2 groups. Intraoperative blood loss was higher in conventional group. The time of first flatus and defecation were better in FT-group. There was no mortality in FT-group vs 1,8 %o mortality in conventional group. Complications rate was lower in FT-group: wound infections 3,6% vs 9 %, anastomotic leakage 4,8 %o vs 9 %o, ileus 1,2 vs 5,4 %o, peritonitis 2,4 %o vs 3,6%o, bowel obstruction caused by the adhesions 6 % vs 5,3 %. Reoperation rate was similar 4,8 % vs 3,6 %. CONCLUSION. Fast track protocol in major elective colorectal surgery can be safely applied in elderly patients. The application of fast track protocol in elderly patients improves the restoration of bowel function and reduces the risk of postoperative complication.

scholarly journals P7: ACUTE KIDNEY INJURY AFTER ELECTIVE COLORECTAL SURGERY: RESULTS OF A NATIONAL CLOSED-LOOP AUDIT

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
Keyword(s):  
Acute Kidney Injury ◽  
Quality Improvement ◽  
Colorectal Surgery ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Elective Colorectal Surgery ◽  
National Quality ◽  
Significant Difference ◽  
The Uk

Abstract Introduction The aim of this study was to re-audit the rates of acute kidney injury (AKI) after elective colorectal surgery, following local presentations of results. Method Outcomes After Kidney injury in Surgery (OAKS) and Ileus Management International (IMAGINE), were prospective multicentre audits on consecutive elective colorectal resections, in the UK and Ireland. These were performed over 3-month periods in 2015 and 2018 respectively. During the interim period, results were presented at participating centres to stimulate local quality improvement initiatives. Risk-adjusted 7-day postoperative AKI rates were calculated through multilevel logistic regression based on the OAKS prognostic score. Result Of the 4,917 patients included, 3,133 (63.7%) originated from OAKS and 1,784 (36.3%) from IMAGINE. On univariate analysis, there was no significant difference (p=0.737) in the 7-day AKI rate between OAKS (n=346, 11.8%) and IMAGINE (n=205, 11.5%). However, the risk-adjusted AKI rate in IMAGINE was significantly lower compared to OAKS (-1.8%, 95% CI: -2.3% to -1.3%, p<0.001). Of 47 centres (40.1%) with a recorded local presentation, there was no significant difference in the subsequent AKI rate in IMAGINE (-0.7%, -2.0% to 0.6%, p=0.278). Conclusion Rates of AKI after elective colorectal surgery significantly reduced on re-audit. However, this may be related to increased awareness from participation or national quality improvement initiatives, rather than local presentation of results. Abbrev. AKI - Acute Kidney Injury, OAKS - Outcomes After Kidney injury in Surgery, IMAGINE - Ileus Management International Take-home message Risk-adjusted AKI rates significantly reduced on re-audit, however, this was most likely due to factors separate from the local presentation of initial results.

scholarly journals Defining standards in colorectal optimisation: a Delphi study protocol to achieve international consensus on key standards for colorectal surgery prehabilitation

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e047235
Author(s):  
Iona Pearson ◽  
Sue Blackwell ◽  
Rebecca Fish ◽  
Sarah Daniels ◽  
Malcolm West ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Outcome Measures ◽  
Delphi Study ◽  
Public Involvement ◽  
Healthcare Professionals ◽  
Patient And Public Involvement ◽  
International Consensus ◽  
Elective Colorectal Surgery ◽  
Patient Related Outcome

IntroductionPrehabilitation in colorectal surgery is evolving and may minimise postoperative morbidity and mortality. With many different healthcare professionals contributing to the prehabilitation literature, there is significant variation in reported primary endpoints that restricts comparison. In addition, there has been limited work on patient-related outcome measures suggesting that patients with colorectal cancer needs and issues are being overlooked. The Defining Standards in Colorectal Optimisation Study aims to achieve international consensus from all stakeholders on key standards to provide a framework for reporting future prehabilitation research.Methods and analysisA systematic review will identify key standards reported in trials of prehabilitation in colorectal surgery. Standards that are important to patients will be identified by a patient and public involvement (PPI) event. The longlist of standards generated from the systematic review and PPI event will be used to develop a three-round online Delphi process. This will engage all stakeholders (healthcare professionals and patients) both nationally and internationally. The results of the Delphi will be followed by a face-to-face interactive consensus meeting that will define the final standards for prehabilitation for elective colorectal surgery.Ethics and disseminationThe University of Glasgow College of Medical, Veterinary and Life Sciences Ethics Committee has approved this protocol, which is registered as a study (200190120) with the Core Outcome Measures in Effectiveness Trials Initiative. Publication of the standards developed by all stakeholders will increase the potential for comparative research that advances understanding of the clinical application of prehabilitation.PROSPERO registration numberCRD42019120381.

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