Clinical outcomes with a powered circular stapler for colorectal anastomoses: An initial experience with 25 consecutive cases

Abstract Background Anastomotic leakage is one of the most frequent and severe morbidities after esophagectomy. For preventing anastomotic leakage, it is important to design a gastric tube with sufficient blood supply and to perform precise anastomosis at a well-conditioned site. We herein show our method of gastric tube reconstruction and evaluate the outcome. Methods Seven hundred and forty-six esophageal carcinoma patients who received subtotal esophagectomy with gastric tube reconstruction via the retrosternal route between 1994 and 2017 were enrolled in the present study. Although we previously used a greater curvature gastric tube with a 4 cm in diameter (narrow group), since 2000, a ‘flexible gastric tube,’ which was designed on an individual basis with the aim of preserving the vascular plexus in the center of the anterior and posterior stomach wall to the maximum possible extent in order to supply a sufficient amount of blood to the tip of the gastric tube was used (flexible group). Cervical esophagogastric end-to-side anastomosis using the circular stapler was performed during the whole period. The clinical outcomes were compared between the two groups. Results Anastomotic leakage was observed in 36 (4.8%) patients. While 24 of 155 (15.5%) patients showed anastomotic leakage in the narrow group, 12 of 591 (2.0%) patients showed anastomotic leakage in the flexible group and the clinical outcomes were significantly improved. Conclusion Our method of gastric tube reconstruction helped to improve the rate of anastomotic leakage after esophagectomy. At present, we are investigating the status of the blood flow using an ICG fluorescence method and by measuring the degree of oxygen saturation and hemoglobin using a new non-invasive monitoring tool during the operation. Postoperative assessments of the anastomotic site are performed using endoscopic examinations. We herein report the results of these assessments. Disclosure All authors have declared no conflicts of interest.

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INITIAL EXPERIENCE WITH SAME SESSION ENDOSCOPIC FUNDOPLICATION AFTER PER-ORAL ENDOSCOPIC MYOTOMY (POEM+F) - SHORT TERM CLINICAL OUTCOMES FROM A SINGLE CENTER

10.1055/s-0040-1704108 ◽

2020 ◽

Author(s):

P Dashatwar ◽

A Bapaye ◽

S Dharamsi ◽

R Pujari ◽

H Gadhikar

Keyword(s):

Clinical Outcomes ◽

Initial Experience ◽

Single Center ◽

Short Term ◽

Per Oral Endoscopic Myotomy ◽

Endoscopic Myotomy ◽

Endoscopic Fundoplication ◽

Per Oral

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Drotrecogin Alfa (Activated) in Sepsis: Initial Experience With Patient Selection, Cost, and Clinical Outcomes

Journal of Intensive Care Medicine ◽

10.1177/0885066605280795 ◽

2005 ◽

Vol 20 (6) ◽

pp. 291-297 ◽

Cited By ~ 9

Author(s):

Thomas L. Higgins ◽

Jay S. Steingrub ◽

Gary J. Tereso ◽

Mark A. Tidswell ◽

William T. Mcgee

Keyword(s):

Clinical Outcomes ◽

Patient Selection ◽

Drotrecogin Alfa ◽

Initial Experience ◽

Drotrecogin Alfa Activated

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Use of the circular stapler in 1000 consecutive colorectal anastomoses: Experience of one surgical team

Surgery ◽

10.1016/s0039-6060(05)80077-7 ◽

1995 ◽

Vol 117 (2) ◽

pp. 140-145 ◽

Cited By ~ 50

Author(s):

Roger J. Detry ◽

Alex Kartheuser ◽

Luc Delriviere ◽

Joseph Saba ◽

Paul J. Kestens

Keyword(s):

Circular Stapler ◽

Surgical Team ◽

Colorectal Anastomoses

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Our initial experience of three versus two rows circular stapler devices for stapled hemorrhoidopexy: a single institution review of 224 cases

International Surgery Journal ◽

10.18203/2349-2902.isj20200505 ◽

2020 ◽

Vol 7 (3) ◽

pp. 685

Author(s):

Paritosh Gupta ◽

Dhruv N. Kundra ◽

Amanpriya Khanna ◽

Akanksha Aggarwal ◽

Kanu Kapoor

Keyword(s):

Statistical Difference ◽

Circular Stapler ◽

Initial Experience ◽

Stapled Haemorrhoidopexy ◽

Single Institution ◽

Significant Statistical Difference ◽

Significant Difference ◽

Stapler Devices ◽

Operative Notes ◽

Closed Haemorrhoidectomy

Background: Stapled haemorrhoidopexy is a non-excisional approach for haemorrhoids as opposed to conventional open Milligan-Morgan and Ferguson closed haemorrhoidectomy techniques. It repositions the prolapsed haemorrhoid tissue and also causes vascular interruption to the haemorrhoids. This causes faster recovery and lesser post-operative pain.Methods: In authors institute, stapled haemorrhoidopexy was being carried out using two rows proximate PPH circular haemorrhoidal stapler. In February 2018, MIRUS three rows circular stapler was introduced. This is a retrospective observational study carried out at Artemis Hospital, Gurgaon, India. Authors studied records and operative notes of all patients who underwent stapled haemorrhoidopexy between February 2018 and September 2019 and compared key parameters.Results: A total of 224 patients underwent stapled haemorrhoidopexy between February 2018 and September 2019. 116 using MIRUS three rows circular stapler and 108 using two rows proximate PPH circular haemorrhoidal stapler. Most of the studied parameters were comparable with only significant statistical difference seen in higher use of haemostatic sutures in two rows stapler group compared to three rows stapler group. Haemostatic sutures were needed in three row stapler group for 27 patients and in two rows stapler group for 39 patients.Conclusions: Author’s initial experience shows slightly better haemostasis with three rows stapled haemorrhoidopexy with no significant difference in other parameters.

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Mechanical Circular Stapler Device Loaded With Nonabsorbable Titanium Staples for Ileo-prostate Capsuloplasty Following Prostate Capsule Sparing Cystectomy: Initial Experience in Cadavers

Surgical Innovation ◽

10.1177/1553350608328075 ◽

2008 ◽

Vol 15 (4) ◽

pp. 312-316

Author(s):

Sidney C. Abreu ◽

André Luís C. Abreu ◽

Mardhen B. Araújo ◽

Marcelo F. Neves ◽

Gilvan N. Fonseca

Keyword(s):

Circular Stapler ◽

Initial Experience ◽

Stapler Device ◽

Prostate Capsule

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Initial experience with the CatchView thrombectomy device for acute ischemic stroke

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2020-016784 ◽

2020 ◽

pp. neurintsurg-2020-016784

Author(s):

Murat Velioglu ◽

Yilmaz Onal ◽

Abdulbaki Agackiran ◽

Pelin Dogan Ak ◽

Hakki Muammer Karakas

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Clinical Outcomes ◽

National Institutes Of Health ◽

Initial Experience ◽

Nihss Score ◽

Intravenous Tissue Plasminogen Activator ◽

Thrombectomy Device ◽

The Mean ◽

Baseline Characteristics

BackgroundWe report our initial experience with the CatchView (CV) thrombectomy device in patients with acute ischemic stroke (AIS).MethodsA retrospective analysis of 53 of 284 AIS patients (mean age 66.6±14.8 years, range 37–94) treated with a CV device between January 2019 and February 2020 was performed. The baseline characteristics (gender, age, comorbidities, National Institutes of Health Stroke Scale (NIHSS) score, intravenous tissue plasminogen activator (IV-tPA) administration, and occlusion localization) of these subjects were recorded. Modified Thrombolysis in Cerebral Ischemia (mTICI) scores of 2b and 3 were considered to indicate successful recanalization, and subjects with a modified Rankin Scale score of ≤2 on day 90 was considered a good clinical outcomes.ResultsThe mean NIHSS score was 12.3±3. Successful recanalization was achieved in 45 subjects (84.90%), and the rate of good clinical outcomes on day 90 was 43.39%. The secondary distal embolus rate was 5.66%. Symptomatic hemorrhage was observed in 3.77% of the subjects, and the mortality rate was 13.2%.ConclusionsMechanical thrombectomy devices include a wide array of endovascular tools for removing clots in AIS patients. In terms of successful recanalization and good clinical outcomes on day 90, our initial experience with the CV devices was encouraging.

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