ERAS program adherence-institutionalization, major morbidity and anastomotic leakage after elective colorectal surgery: the iCral2 multicenter prospective study

2021 ◽  
Author(s):  
Marco Catarci ◽  
Giacomo Ruffo ◽  
Massimo Giuseppe Viola ◽  
Felice Pirozzi ◽  
Paolo Delrio ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Prospective Study ◽  
Anastomotic Leakage ◽  
Elective Colorectal Surgery ◽  
Major Morbidity ◽  
Program Adherence ◽  
Multicenter Prospective Study

Monitoring of procalcitonin but not interleukin-6 is useful for the early prediction of anastomotic leakage after colorectal surgery

2017 ◽  
Vol 55 (7) ◽  
Author(s):  
Urszula Zielińska-Borkowska ◽  
Naser Dib ◽  
Wiesław Tarnowski ◽  
Tomasz Skirecki
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Interleukin 6 ◽  
Early Recognition ◽  
Surgical Trauma ◽  
Serum Samples ◽  
Elective Colorectal Surgery ◽  
Surgical Infections ◽  
Bowel Diseases ◽  
The Difference

AbstractBackground:Early recognition of patients who have developed anastomotic leakage (AL) after colorectal surgery is crucial for the successful treatment of this complication. The aim of this study was to assess the usefulness of the assessment of procalcitonin (PCT) and interleukin-6 (IL-6) levels in the prognosis of AL.Methods:This observational study included 157 patients who underwent major elective colorectal surgery. The most common indications for surgery were cancer and inflammatory bowel diseases. Serum samples were obtained directly before surgery (D0) and 1 day (D1) after surgery, and the relationships between the serum concentrations of PCT and IL-6 and development of AL were assessed.Results:In total, 10.2% of patients developed post-surgical infections due to AL. PCT levels on D1 were significantly higher in patients who developed AL [2.73 (1.40–4.62)] than in those who recovered without complications [0.2 (0.09–0.44)]. The area under the ROC curve for PCT on D1 was 0.94, 95% CI (0.89–0.98). The sensitivity and specificity of the prediction of an infection were 87% and 87%, respectively, for PCT on D1, which was higher than 1.09 ng/mL. The increase in PCT concentration between D0 and D1 was significantly higher in patients with AL (p<0.001). Patients who developed AL had higher concentrations of IL-6 on D1, but the difference was not significant (p=0.28).Conclusions:This study confirms that surgical trauma increases serum PCT concentrations and that the concentration of PCT on D1 can predict AL after colorectal surgery. However, IL-6 is not a good early marker for developing AL.

scholarly journals Hospital based randomized prospective study outcomes in colorectal surgery after bowel preparation

2020 ◽  
Vol 7 (4) ◽  
pp. 1191
Author(s):  
Altaf Hussain Bhat ◽  
Gh Hussain Mir ◽  
Sajad Ahmad Bhat ◽  
Muzaffar Ali
Keyword(s):  
Colorectal Cancer ◽  
Colorectal Surgery ◽  
Prospective Study ◽  
Bowel Preparation ◽  
Genetic Disorders ◽  
Mechanical Bowel Preparation ◽  
Minimal Invasive ◽  
Elective Colorectal Surgery ◽  
Group 2 ◽  
Group 1

Background: Research of so many years from the procurable world data has shown that the reasons for most colorectal cancers occur due to change in life style the type of diet, smoking as well as the influence of the surrounding environment in which man lives and increasing age with only a minority of cases associated with genetic disorders. Colorectal cancer is the third most commonly diagnosed cancer. In the first half of the 20th century, mortality from colorectal surgery often exceeded 20%, mainly attributed to sepsis.Methods: The randomized prospective study was conducted on 202 colorectal cancer patients in the department of Colorectal division of General and Minimal Invasive surgery” Sher-i-Kashmir Institute of Medical Sciences, Srinagar.Results: Mean age of patients in Group 1 (with no mechanical bowel preparation (NMBP)) was 51±18.15 years while as same was 50±17.76 years for Group 2 (with mechanical bowel preparation (MBP)). Age range for Group 1 was 16-87 years and16-85 years for Group 2. Regarding outcomes, wound infections were 6.1% and 3.8% in Group 1 and Group 2 respectively. While disruption of anastomosis were 2.0% and 3.8% in group A and B respectively.Conclusions: Statistically no gross difference in terms of morbidity and mortality was found between the use of mechanical bowel preparation versus no use of mechanical bowel preparation in elective colorectal surgery. Elective Colorectal Surgery can safely be performed without enduring MBP in it as it does not possess any sorts of benefits.

Peritoneal Release of TNFα and IL-6 After Elective Colorectal Surgery and Anastomotic Leakage

2003 ◽  
Vol 16 (2) ◽  
pp. 65-69 ◽  
Author(s):  
P. Bertram ◽  
K. Junge ◽  
A. Schachtrupp ◽  
C. Götze ◽  
D. Kunz ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Elective Colorectal Surgery

scholarly journals Early prediction of anastomotic leakage after colorectal surgery by measuring peritoneal cytokines: Prospective study

2008 ◽  
Vol 6 (1) ◽  
pp. 28-35 ◽  
Author(s):  
Burak Uğraş ◽  
Murat Giriş ◽  
Yeşim Erbil ◽  
Murat Gökpınar ◽  
Gamze Çıtlak ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Prospective Study ◽  
Anastomotic Leakage ◽  
Early Prediction

scholarly journals Validation of a score for the early diagnosis of anastomotic leakage following elective colorectal surgery

2015 ◽  
Vol 152 (1) ◽  
pp. 5-10 ◽  
Author(s):  
G. Martin ◽  
A. Dupré ◽  
A. Mulliez ◽  
F. Prunel ◽  
K. Slim ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Early Diagnosis ◽  
Anastomotic Leakage ◽  
Elective Colorectal Surgery

Management and 1-year outcomes of anastomotic leakage after elective colorectal surgery

2020 ◽  
Author(s):  
Felice Borghi ◽  
◽  
Marco Migliore ◽  
Desirée Cianflocca ◽  
Giacomo Ruffo ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Elective Colorectal Surgery

Peritoneal Release of TNFα and IL-6 After Elective Colorectal Surgery and Anastomotic Leakage

2003 ◽  
Vol 16 (2) ◽  
pp. 65-69 ◽  
Author(s):  
P. Bertram ◽  
K. Junge ◽  
A. Schachtrupp ◽  
C. Götze ◽  
D. Kunz ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Elective Colorectal Surgery

scholarly journals Mechanical plus oral bowel preparation with paromomycine and metronidazole reduces infectious complications in elective colorectal surgery: a matched case-control study

2021 ◽  
Author(s):  
Matthias Mehdorn ◽  
Christoph Lübbert ◽  
Iris F. Chaberny ◽  
Ines Gockel ◽  
Boris Jansen-Winkeln
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Intervention Group ◽  
Surgical Site Infections ◽  
Infectious Complications ◽  
Matched Pair ◽  
Antibiotic Administration ◽  
Oral Antibiotic ◽  
Elective Colorectal Surgery ◽  
Matched Case

Abstract Purpose Infectious complications are as high as 30% in elective colorectal surgery. In recent years, several studies have discussed the topic of preoperative bowel decontamination prior to colorectal surgery in order to reduce postoperative infectious complications and have found significant effects of oral antibiotic administration with a large variety of drugs used. No study has evaluated the combination of oral paromomycin and metronidazole in this context. Methods We performed a prospective single-center study with a matched-pair retrospective cohort to evaluate postoperative infectious complications (superficial site infections, organ space abscess, anastomotic leakage) in elective colorectal surgery. Patients A total of 120 patients were available for study inclusion; 101 gave informed consent and were included. A total of 92 patients were matched and subsequently analyzed. We could show a reduction in overall infectious complications in the intervention group (15.2% vs 30.8%, p = 0.018; odds ratio 0.333, 95% CI 0.142–0.784) as well as a reduction in superficial surgical site infections (8.7 vs 19.6%, p = 0.041, OR 0.333, 95% CI 0.121–0.917). The frequency of the other infectious complications such as intraabdominal abscesses and anastomotic leakage showed a tendency towards decreased frequencies in the intervention group (OR 0.714, 95% CI 0.235–2.169 and OR 0.571; 95% CI 0.167–1.952, respectively). Finally, the oral antibiotic administration led to an almost significantly reduced length of stay (12.24 days vs 15.25 days; p = 0.057). Conclusions Oral paromomycine and metronidazole with intravenous ertapenem effectively reduce infectious complications in elective colorectal surgery. Trial registration The study was registered at Clinicaltrials.gov (NCT03759886) December 17, 2018

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