MODIFIED TECHNIQUE THROUGH OVERTUBE FOR ENDOSCOPIC VACUUM-ASSISTED CLOSURE IN PATIENTS WITH ESOPHAGEAL ANASTOMOTIC LEAK

Abstract Aim To study treatments and interventions for anastomotic leak following esophagectomy at a high volume center. Background and Methods Anastomotic leak is a severe and common complication of esophagectomies. Anastomotic leak patients treated between Jan 1 2016 and Dec 31 2018 were retrospectively identified from an institutional database of patients undergoing esophagectomies and were further analyzed. The primary out- comes for the assessed interventions were success- rate of intervention and length-of-stay. The following anastomotic leak treatments were assessed by this study: Conservative treatment, esophageal stents, endoscopic vacuum assisted closure therapy (E-VAC) and surgically placed drains. Results The study population consisted of 223 patients, 28 (12.6%) of who suffered anastomotic leaks. The distribution of the interventions and conservative treatment is illustrated in Figure 1. The success-rate of E-VAC was 75.0% (n=8), compared to a rate of 25.0% for stents (n=4) and 59.1% for conservative treatment (n=13). Surgically placed drains had a success-rate of 100.0%, but were only performed on 3 patients in total. Conclusion E-VAC was the most effective non- surgical leak intervention in terms of success-rate. Due to the design of this study, the effectiveness of conservative treatment was likely under- estimated.

Download Full-text

Tu2018 EFFICACY OF ENDOSCOPIC VACUUM ASSISTED CLOSURE TREATMENT FOR POSTOPERATIVE ANASTOMOTIC LEAK OF GASTRIC CANCER

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2019.03.1162 ◽

2019 ◽

Vol 89 (6) ◽

pp. AB660

Author(s):

Jun Chul Park ◽

Soo In Choi ◽

Eun Hye Kim ◽

Sung Kwan Shin ◽

Sang Kil Lee ◽

...

Keyword(s):

Gastric Cancer ◽

Anastomotic Leak ◽

Vacuum Assisted Closure ◽

Postoperative Anastomotic Leak

Download Full-text

Improvement of Esophageal Anastomotic Leak by Vacuum-assisted Closure in Three Cases with Gastric Cancer

Journal of College of Physicians And Surgeons Pakistan ◽

10.29271/jcpsp.2019.12.s98 ◽

2019 ◽

pp. S98-S100

Author(s):

Seracettin Egin ◽

Semih Hot

Keyword(s):

Gastric Cancer ◽

Anastomotic Leak ◽

Vacuum Assisted Closure

Download Full-text

Modified Gut Anastomotic Technique in Type III and Type IV Jejunoileal Atresias

Journal of Neonatal Surgery ◽

10.21699/jns.v5i4.403 ◽

2016 ◽

Vol 5 (4) ◽

pp. 48 ◽

Cited By ~ 3

Author(s):

Kamal Nain Rattan ◽

Deepak Kumar Garg

Keyword(s):

Anastomotic Leak ◽

Medical Record ◽

Modified Technique ◽

Short Gut Syndrome ◽

Mortality And Morbidity ◽

Anastomotic Technique ◽

Type Iii ◽

Type Iv ◽

Significant Length

Background: Type III and IV jejunoileal atresias are associated with loss of significant length of the gut and can lead to short gut syndrome if further resection of proximal dilated gut is done. We modified the anastomotic technique so that proximal dilated segment of the gut is not resected as to prevent short gut syndrome.Material and Methods: Medical Record of patients of Type III and IV jejuno-ileal atresias managed with modified anastomotic technique in our center during 5-years was reviewed.Results: Fifteen patients were managed with our modified technique. There were no anastomotic leak observed and there was 6% mortality seen in our modified technique.Conclusion: We found less mortality and morbidity in our technique compared to recommended techniques described in literature.

Download Full-text

Microanatomy of the Periplasm of Bacillus Licheniformis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100065365 ◽

1971 ◽

Vol 29 ◽

pp. 262-263

Author(s):

B.K. Ghosh

Keyword(s):

Cell Wall ◽

Plasma Membrane ◽

Bacillus Licheniformis ◽

External Environment ◽

Permeability Barrier ◽

Periplasmic Space ◽

Modified Technique ◽

Gram Positive ◽

Gram Negative ◽

Gram Positive Bacteria

Periplasm of bacteria is the space outside the permeability barrier of plasma membrane but enclosed by the cell wall. The contents of this special milieu exterior could be regulated by the plasma membrane from the internal, and by the cell wall from the external environment of the cell. Unlike the gram-negative organism, the presence of this space in gram-positive bacteria is still controversial because it cannot be clearly demonstrated. We have shown the importance of some periplasmic bodies in the secretion of penicillinase from Bacillus licheniformis.In negatively stained specimens prepared by a modified technique (Figs. 1 and 2), periplasmic space (PS) contained two kinds of structures: (i) fibrils (F, 100 Å) running perpendicular to the cell wall from the protoplast and (ii) an array of vesicles of various sizes (V), which seem to have evaginated from the protoplast.

Download Full-text