An umbrella systematic review of drain fluid analysis in colorectal surgery for the detection of anastomotic leak: not yet ready to translate research studies into clinical practice

2021 ◽  
Author(s):  
David A Clark ◽  
Daniel Steffens ◽  
Michael Solomon
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Fluid Analysis ◽  
Drain Fluid ◽  
Research Studies

Hyponatremia could identify patients with intrabdominal sepsis and anastomotic leak after colorectal surgery: a systematic review of the literature

2019 ◽  
Vol 71 (1) ◽  
pp. 17-20 ◽  
Author(s):  
Ahmad Alsaleh ◽  
Gianluca Pellino ◽  
Natasha Christodoulides ◽  
George Malietzis ◽  
Christos Kontovounisios
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Review Of The Literature

Systematic review and meta-analysis of use of serum C-reactive protein levels to predict anastomotic leak after colorectal surgery

2013 ◽  
Vol 101 (4) ◽  
pp. 339-346 ◽  
Author(s):  
P. P. Singh ◽  
I. S. L. Zeng ◽  
S. Srinivasa ◽  
D. P. Lemanu ◽  
A. B. Connolly ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Meta Analysis ◽  
C Reactive Protein ◽  
Protein Levels ◽  
Reactive Protein

scholarly journals Role of biomarkers in predicting anastomotic leakage following colorectal surgeries

2020 ◽  
Vol 8 (7) ◽  
pp. 2562
Author(s):  
Mumtaz Din Wani ◽  
Ferkhand Mohi Ud Din ◽  
Aabid Rasool Bhat ◽  
Irshad Ahmad Kumar ◽  
Ashiq Hussain Raina ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Anastomotic Leak ◽  
Sensitivity And Specificity ◽  
Peritoneal Fluid ◽  
Clinical Symptoms ◽  
Colorectal Disease ◽  
Total Leukocyte Count ◽  
Drain Fluid ◽  
The Mean

Background: Recovery after surgery for patients with colorectal disease has improved with the advent of minimal access surgery and standardized recovery protocols. Despite these advances, anastomotic leakage remains one of the most dreaded complications following colorectal surgery, with rates of 3-27 per cent depending on specific risk factors. The aim of the study was to assess sensitivity and specificity of systemic and peritoneal drain-fluid bio-markers in early prediction of anastomotic leak; and to co-relate rise in levels of biomarkers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Methods: The present study was a prospective observational study conducted on 60 patients in the Postgraduate Department of Surgery, Government Medical College, Srinagar after obtaining due ethical clearance over a period of two years.Results: The mean age was 54.87±11.901 years with 44 patients (73.3%) were males. Among systemic makers: the mean CRP level was 2.7800±0.500 mg/L, the mean total leukocyte count was 10.783±0.940 thousands and the mean serum procalcitonin level was 0.365±0.1385 ng/ml. Among peritoneal fluid drain bio-makers, the mean IL-6 level was 3551.066±1311.965 pg/ml, the mean IL-10 level was 628.533±460.358 pg/ml and the mean TNF-a level was 16.391±6.736 pg/ml. The anastomotic leak after colo-rectal surgery was noted in 16 patients (26.7%). In our study significant co-relation was noted between the rise in levels of peritoneal drain fluid biomarkers and severity of clinical symptoms but no significant co-relation was noted between the rise in levels of systemic markers and severity of clinical symptoms in patients who have undergone colo-rectal surgeries.Conclusions: Systemic biomarkers are poor predictors of anastomotic leak after colorectal surgery. But sensitivity and specificity of peritoneal fluid drain biomarkers in predicting anastomotic leak was significantly high.

scholarly journals NSAID administration post colorectal surgery increases anastomotic leak rate: systematic review/meta-analysis

2018 ◽  
Vol 33 (3) ◽  
pp. 879-885 ◽  
Author(s):  
Aryan Modasi ◽  
David Pace ◽  
Marshall Godwin ◽  
Chris Smith ◽  
Bryan Curtis
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Anastomotic Leak ◽  
Meta Analysis ◽  
Leak Rate ◽  
Anastomotic Leak Rate

scholarly journals Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of pilonidal disease

2021 ◽  
Author(s):  
M. Milone ◽  
L. Basso ◽  
M. Manigrasso ◽  
R. Pietroletti ◽  
A. Bondurri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Colorectal Surgery ◽  
Consensus Statement ◽  
Pilonidal Disease ◽  
Scientific Evidence ◽  
Italian Society ◽  
Natal Cleft ◽  
Modified Delphi ◽  
Strongly Agree

AbstractPilonidal disease (PD) is a relatively common, benign but challenging condition of the natal cleft. This consensus statement was drawn up by a panel of surgeons, identified by the Italian Society of Colorectal Surgery (SICCR) as having a “special interest” in PD, with the aim of recommending the best therapeutic options according to currently available scientific evidence. A three-step modified-Delphi process was adopted, implying: (1) choice of the panelists; (2) development of a discussion outline and of target issues; and (3) a detailed systematic review of the current literature. The agreement/disagreement level was scored on a five-point Likert scale as follows: “A + : strongly agree; A–: agree; N: unsure/no opinion; D–: disagree; D + : strongly disagree. Each panelist contributed to the production of this manuscript, and the final recommendations were reviewed by the Clinical Practice Guidelines Committee.

scholarly journals Matrix metalloproteinase-9 in relation to patients with complications after colorectal surgery: a systematic review

2020 ◽  
Vol 36 (1) ◽  
pp. 1-10
Author(s):  
Pim Edomskis ◽  
Max R. Goudberg ◽  
Cloë L. Sparreboom ◽  
Anand G. Menon ◽  
Albert M. Wolthuis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Matrix Metalloproteinase ◽  
Anastomotic Leakage ◽  
Animal Studies ◽  
Matrix Metalloproteinase 9 ◽  
Human Studies ◽  
Drain Fluid ◽  
Clinical Biomarker ◽  
Metalloproteinase 9

Abstract Purpose Anastomotic leakage (AL) is the most severe complication following colorectal resection and is associated with increased mortality. The main group of enzymes responsible for collagen and protein degradation in the extracellular matrix is matrix metalloproteinases. The literature is conflicting regarding anastomotic leakage and the degradation of extracellular collagen by matrix metalloproteinase-9 (MMP-9). In this systematic review, the possible correlation between anastomotic leakage after colorectal surgery and MMP-9 activity is investigated. Methods Embase, MEDLINE, Cochrane, and Web of Science databases were searched up to 3 February 2020. All published articles that reported on the relationship between MMP-9 and anastomotic leakage were selected. Both human and animal studies were found eligible. The correlation between MMP-9 expression and anastomotic leakage after colorectal surgery. Results Seven human studies and five animal studies were included for analysis. The human studies were subdivided into those assessing MMP-9 in peritoneal drain fluid, intestinal biopsies, and blood samples. Five out of seven human studies reported elevated levels of MMP-9 in patients with anastomotic leakage on different postoperative moments. The animal studies demonstrated that MMP-9 activity was highest in the direct vicinity of an anastomosis. Moreover, MMP-9 activity was significantly reduced in areas further proximally and distally from the anastomosis and was nearly or completely absent in uninjured tissue. Conclusion Current literature shows some relation between MMP-9 activity and colorectal AL, but the evidence is inconsistent. Innovative techniques should further investigate the value of MMP-9 as a clinical biomarker for early detection, prevention, or treatment of AL.

WikiRecs primary care: developing rapid recommendations for primary care through effective collaboration between systematic review and guideline teams

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697085
Author(s):  
Trudy Bekkering ◽  
Bert Aertgeerts ◽  
Ton Kuijpers ◽  
Mieke Vermandere ◽  
Jako Burgers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Clinical Practice ◽  
Primary Care Physicians ◽  
Urinary Stones ◽  
Care Practice ◽  
Supporting Evidence ◽  
Supervised Exercise ◽  
Review Team ◽  
New Evidence

BackgroundThe WikiRecs evidence summaries and recommendations for clinical practice are developed using trustworthy methods. The process is triggered by studies that may potentially change practice, aiming at implementing new evidence into practice fast.AimTo share our first experiences developing WikiRecs for primary care and to reflect on the possibilities and pitfalls of this method.MethodIn March 2017, we started developing WikiRecs for primary health care to speed up the process of making potentially practice-changing evidence in clinical practice. Based on a well-structured question a systematic review team summarises the evidence using the GRADE approach. Subsequently, an international panel of primary care physicians, methodological experts and patients formulates recommendations for clinical practice. The patient representatives are involved as full guideline panel members. The final recommendations and supporting evidence are disseminated using various platforms, including MAGICapp and scientific journals.ResultsWe are developing WikiRecs on two topics: alpha-blockers for urinary stones and supervised exercise therapy for intermittent claudication. We did not face major problems but will reflect on issues we had to solve so far. We anticipate having the first WikiRecs for primary care available at the end of 2017.ConclusionThe WikiRecs process is a promising method — that is still evolving — to rapidly synthesise and bring new evidence into primary care practice, while adhering to high quality standards.

Sign in / Sign up

Export Citation Format

Share Document