Gastrointestinal Anastomosis

2016 ◽  
pp. 55-58
Author(s):  
Yoshinori Hamada
Keyword(s):  
Gastrointestinal Anastomosis

A PROSPECTIVE ANALYSIS OF RISK FACTORS, PRESENTATION AND OUTCOME OF LEAKAGE AFTER GASTROINTESTINAL ANASTOMOSES

2021 ◽  
pp. 15-19
Author(s):  
Vikash Katiar ◽  
R.K. Jauhari ◽  
Abhinav Sengar ◽  
Vibhu Jain
Keyword(s):  
Risk Factors ◽  
Anastomotic Leak ◽  
Infectious Complications ◽  
Gastrointestinal Anastomosis ◽  
Albumin Concentration ◽  
Causative Factors ◽  
Preoperative Bowel Preparation ◽  
Surgical Duration ◽  
Mean Time ◽  
Ethical Clearance

Background: Despite advancements in modern surgery and postoperative care, disruption of gastrointestinal anastomosis remains the most dreaded complication, even in experienced surgical hands. The cause of leakage is multifactorial consisting of a complete spectrum of pre, intra and postoperative factors. Search for an ideal gastrointestinal anastomosis still remains an unquenched thirst. Study Design: Prospective, hospital based, time bound observational study. Methods: After ethical clearance, 288 consenting adult patients who underwent gastrointestinal anastomosis were observed for risk factors, presentation and outcome of leakage and evaluated using appropriate statistical tools. Results: An overall gastrointestinal anastomotic leak rate of 15.28% with peak incidence at 41-50 years (19.51%) was seen. Peritonitis (p=0.0009, OR=2.9611), COPD (p=0.0181, OR=2.7306), low serum albumin concentration (p=0.0028, OR=3.1442), ASA status of ≥III (p=0.0001, OR=4.0281) and a perioperative blood transfusion requirement of ≥2 units (p=0.0028, OR=3.1442) were the most signicant risk factors associated with leakage. Obstruction (p=0.0160, OR=2.2310), malignancy (p=0.0149, OR=2.6961), steroid therapy (p=0.0176, OR=2.2741), chemoradiation (p=0.0400, OR=2.4889), diabetes (p=0.0427, OR=2.2689), undernutrition (p= 0.0308, OR= 2.1099), anaemia (p=0.0325, OR=2.0183) and sepsis (p=0.0187, OR=2.2702) also showed clear risk augmentation. Risk of leakage was increased with a surgical duration of >4 hours (p=0.0078, OR=2.5610), when anastomosis was done as an emergency procedure (p=0.0427, OR=2.6571) or by a surgeon with expertise of ≤5 years (p=0.0338, OR=2.7733). Neither the level, type, technique of anastomosis; nor the usage of surgical staplers had an impact on leakage. Preoperative bowel preparation and creation of a proximal stoma also had minimal effect on leakage rates; though, the infectious complications that follow were greatly reduced. The most common presentation of anastomotic leak was a suspicious drain output with a mean time of 7.59± 2(2.48) postoperative days; resulting in a prolongation of hospitalization by more than ten days (p<0.0001), along with an increased mortality rate (p<0.0001). Conclusions: Accurately predicting anastomotic leakage still requires more evidence-based information. Even with good risk stratication, many causative factors may not be amenable to immediate correction in the pre-operative period. In such cases, the patient must be considered as a candidate for an enterostomy to help tide the crisis over.

T1847 Optical Fiber Spectroscopy: A Novel Application to Measure Tissue Oxygenation and Blood Content in the At Risk Gastrointestinal Anastomosis

2009 ◽  
Vol 136 (5) ◽  
pp. A-922 ◽  
Author(s):  
C. Kristian Enestvedt ◽  
Kyle A. Perry ◽  
Luke Hosack ◽  
Brian S. Diggs ◽  
Frederic Truffer ◽  
...  
Keyword(s):  
At Risk ◽  
Optical Fiber ◽  
Tissue Oxygenation ◽  
Gastrointestinal Anastomosis ◽  
Blood Content

Endoscopy in the Early Postoperative Setting after Primary Gastrointestinal Anastomosis

2014 ◽  
Vol 18 (11) ◽  
pp. 1911-1916 ◽  
Author(s):  
Mahmoud A. Amr ◽  
Mohammad J. Alzghari ◽  
Stephanie F. Polites ◽  
Mohammad A. Khasawneh ◽  
David S. Morris ◽  
...  
Keyword(s):  
Gastrointestinal Anastomosis ◽  
Postoperative Setting

Application Potential of Mg–Zn–Nd Alloy as a Gastrointestinal Anastomosis Nail Material

2021 ◽  
Author(s):  
Lihui Song ◽  
Ming Gao ◽  
Lili Tan ◽  
Zheng Ma ◽  
Peng Ni ◽  
...  
Keyword(s):  
Gastrointestinal Anastomosis ◽  
Application Potential

Continuous single-layer gastrointestinal anastomosis: A prospective audit

1989 ◽  
Vol 76 (5) ◽  
pp. 493-495 ◽  
Author(s):  
S. Sarin ◽  
R. G. Lightwood
Keyword(s):  
Single Layer ◽  
Gastrointestinal Anastomosis ◽  
Prospective Audit

Caution when interpreting anti-inflammatory drug effects in rat models of gastrointestinal anastomosis

2016 ◽  
Vol 211 (1) ◽  
pp. 303-304
Author(s):  
Chia Kong ◽  
James Glasbey ◽  
Midhun Mohan ◽  
Lisa McNamee ◽  
J. Edward F. Fitzgerald
Keyword(s):  
Drug Effects ◽  
Gastrointestinal Anastomosis ◽  
Rat Models ◽  
Inflammatory Drug ◽  
Anti Inflammatory

SURGICAL AUDIT OF GASTROINTESTINAL ANASTOMOSIS

2001 ◽  
Vol 5 (3) ◽  
pp. A27-A27
Author(s):  
S.F. Lo ◽  
A.W.C. Yip ◽  
T.W. Chow
Keyword(s):  
Gastrointestinal Anastomosis ◽  
Surgical Audit
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