scholarly journals Technical Feasibility of TachoSil Application on Esophageal Anastomoses

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Leonie Haverkamp ◽  
Jelle P. Ruurda ◽  
Richard van Hillegersberg
Keyword(s):  
Mechanical Strength ◽  
Anastomotic Leakage ◽  
Total Gastrectomy ◽  
Gastrointestinal Surgery ◽  
Laparoscopic Total Gastrectomy ◽  
Human Fibrinogen ◽  
Technical Feasibility ◽  
Future Studies ◽  
Patch Application ◽  
Upper Gastrointestinal

Purpose. Sealing esophageal anastomoses with a sealant patch (TachoSil) containing human fibrinogen and thrombin may improve mechanical strength. The aim was to evaluate the technical feasibility of the application of a sealant patch in upper gastrointestinal surgery.Methods. In total 15 patients, 18–80 years old, undergoing thoracolaparoscopic esophagectomy with esophagogastrostomy or laparoscopic total gastrectomy with esophagojejunostomy was included. Different techniques of anastomotic TachoSil patch application were tested and recorded on video.Results. TachoSil was successfully applied to the esophagogastrostomy (n=11) and to the esophagojejunostomy (n=4). A median of 2 (1–6) attempts was necessary to reach successful application. The median duration was 7 (3–26) minutes before successful application was accomplished. The best technique in esophagectomy was the application of TachoSil with the use of 2 cellophane sheets. For total gastrectomy, the patch was folded into a harmonica shape and wrapped around the esophagojejunostomy. Although not significant, the number of attempts and time to success showed a decreasing trend along with the increased experience.Conclusion. Application of TachoSil as a sealant of esophageal anastomoses was technically feasible. Future studies may investigate the value of TachoSil application on the prevention of anastomotic leakage.

scholarly journals EARLY ORAL FEEDING POST-UPPER GASTROINTESTINAL TRACT RESECTION AND PRIMARY ANASTOMOSIS IN ONCOLOGY

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Lilian Pinheiro LOPES ◽  
Taysa Machado MENEZES ◽  
Diogo Oliveira TOLEDO ◽  
Antônio Talvane Torres DE-OLIVEIRA ◽  
Adhemar LONGATTO-FILHO ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Total Gastrectomy ◽  
Primary Anastomosis ◽  
Gastrointestinal Surgery ◽  
Oral Intake ◽  
Wound Dehiscence ◽  
Oral Feeding ◽  
Oral Nutrition ◽  
Early Oral Feeding ◽  
Upper Gastrointestinal

ABSTRACT Background: The practice of starving patients in the immediate period after upper gastrointestinal surgery is widespread. Early oral intake has been shown to be feasible and may result in faster recovery and decrease length of hospital. Aim: To evaluate the feasibility and safety of oral nutrition on postoperative early feeding after upper gastrointestinal surgeries. Methods: Observational cohort design study with convenience retrospective data in both genders, over 18 years, undergoing to total gastrectomy and/or elective esophagectomy. They have received oral or enteral nutrition in less than 48 h after surgery, and among those who started with enteral nutrition, the oral feeding up to seven days. Results: The study was performed in 161 patients, 24 (14.9%) submitted to esophagectomy, 132 (82%) to total gastrectomy and five (3.1%) to esophagogastrectomy. Was observed good dietary acceptance and low percentage (29%) of gastrointestinal intolerances, more pronounced among those with enteral diet. Most of the patients did not present postoperative complications, 11 (6.8%) were reopened, five (3.1%) had fistulas, three (1.9%) wound dehiscence, three (1.9%) fistula more wound dehiscence and six (3.7%) other non-infectious complications. Conclusion: Early oral diet is safe and viable for patients undergoing upper gastrointestinal surgery.

scholarly journals Technical Feasibility and Short-Term Outcome of Intracorporeal Hand-Sewn Esophagojejunostomy After Laparoscopic Total Gastrectomy: Our Experience

2016 ◽  
Vol 79 (6) ◽  
pp. 497-503 ◽  
Author(s):  
Shailesh Puntambekar ◽  
Reda Badran ◽  
Hirav Parikh ◽  
Arpit Bansal ◽  
Vikrant Sharma ◽  
...  
Keyword(s):  
Total Gastrectomy ◽  
Laparoscopic Total Gastrectomy ◽  
Short Term ◽  
Term Outcome ◽  
Technical Feasibility ◽  
Short Term Outcome

scholarly journals Selective Decontamination of the Digestive Tract to Prevent Postoperative Pneumonia and Anastomotic Leakage after Esophagectomy: A Retrospective Cohort Study

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 43
Author(s):  
Robin Janssen ◽  
Frans Van Workum ◽  
Nikolaj Baranov ◽  
Harmen Blok ◽  
Jaap ten Oever ◽  
...  
Keyword(s):  
Cohort Study ◽  
Anastomotic Leakage ◽  
Digestive Tract ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Protective Factor ◽  
Gastrointestinal Surgery ◽  
Surgical Site Infections ◽  
Selective Decontamination ◽  
Postoperative Pneumonia

Infectious complications occur frequently after esophagectomy. Selective decontamination of the digestive tract (SDD) has been shown to reduce postoperative infections and anastomotic leakage in gastrointestinal surgery, but robust evidence for esophageal surgery is lacking. The aim was to evaluate the association between SDD and pneumonia, surgical-site infections (SSIs), anastomotic leakage, and 1-year mortality after esophagectomy. A retrospective cohort study was conducted in patients undergoing Ivor Lewis esophagectomy in four Dutch hospitals between 2012 and 2018. Two hospitals used SDD perioperatively and two did not. SDD consisted of an oral paste and suspension (containing amphotericin B, colistin, and tobramycin). The primary outcomes were 30-day postoperative pneumonia and SSIs. Secondary outcomes were anastomotic leakage and 1-year mortality. Logistic regression analyses were performed to determine the association between SDD and the relevant outcomes (odds ratio (OR)). A total of 496 patients were included, of whom 179 received SDD perioperatively and the other 317 patients did not receive SDD. Patients who received SDD were less likely to develop postoperative pneumonia (20.1% vs. 36.9%, p < 0.001) and anastomotic leakage (10.6% vs. 19.9%, p = 0.008). Multivariate analysis showed that SDD is an independent protective factor for postoperative pneumonia (OR 0.40, 95% CI 0.23–0.67, p < 0.001) and anastomotic leakage (OR 0.46, 95% CI 0.26–0.84, p = 0.011). Use of perioperative SDD seems to be associated with a lower risk of pneumonia and anastomotic leakage after esophagectomy.

scholarly journals Gastric liposarcoma resected by laparoscopic total gastrectomy to achieve a wide surgical margin

2017 ◽  
pp. bcr-2017-221703 ◽  
Author(s):  
Katsuhiro Tomofuji ◽  
Jota Watanabe ◽  
Naoki Ishida ◽  
Shinsuke Kajiwara
Keyword(s):  
Total Gastrectomy ◽  
Surgical Margin ◽  
Laparoscopic Total Gastrectomy
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