Endovascular Treatment of Ileocolic Pseudoaneurysm After a Laparoscopic-Assisted Bowel Resection for Crohn Disease

2008 ◽  
Vol 42 (2) ◽  
pp. 173-175 ◽  
Author(s):  
Yair Edden ◽  
Noam Shussman ◽  
Matan J. Cohen ◽  
Anthony Verstandig ◽  
Alon J. Pikarsky
Keyword(s):  
Endovascular Treatment ◽  
Crohn Disease ◽  
Bowel Resection ◽  
Laparoscopic Assisted

scholarly journals Ileocolonic Healing After Extended Small Bowel Resection in Mice: NOD2 Deficiency Impairs Anastomotic Healing and Postoperative Outcome

2021 ◽  
Author(s):  
Maria Witte ◽  
Johannes Reiner ◽  
Karen Bannert ◽  
Robert Jaster ◽  
Christian Maschmeier ◽  
...  
Keyword(s):  
Gene Expression ◽  
Crohn Disease ◽  
Transforming Growth Factor ◽  
Bowel Resection ◽  
Anastomotic Healing ◽  
Matrix Metalloproteinase 2 ◽  
Ileocecal Resection ◽  
Bursting Pressure ◽  
Septic Complications ◽  
Gelatinase Activity

Abstract Background Nucleotide-binding oligomerization domain-containing protein 2 (NOD2) mutations are a genetic risk factor for Crohn disease. Ileocecal resection is the most often performed surgery in Crohn disease. We investigated the effect of Nod2 knockout (KO) status on anastomotic healing after extended ileocecal resection (ICR) in mice. Methods Male C57BL6/J wild-type and Nod2 KO mice underwent an 11 cm resection of the terminal ileum including the cecum. An end-to-end jejuno-colostomy was performed. Animals were killed after 5 days investigating bursting pressure, hydroxyproline content, and expression of matrix metabolism genes, key cytokines, and histology of the anastomosis. Results Mortality was higher in the Nod2 KO group but not because of local or septic complications. Bursting pressure was significantly reduced in the Nod2 KO mice (32.5 vs 78.0 mmHg, P < 0.0024), whereas hydroxyprolin content was equal. The amount of granulation tissue at the anastomosis was similar but more unstructured in the Nod2 KO mice. Gene expression measured by real-time polymerase chain reaction showed significantly increased expression for Collagen 1alpha and for collagen degradation as measured by matrix metalloproteinase-2, -9, and -13 in the Nod2 KO mice. Gelatinase activity from anastomotic tissue was enhanced by Nod2 status. Gene expression of arginase I, tumor necrosis factor-α, and transforming growth factor-ß but not inducible nitric oxide synthase were also increased at the anastomosis in the Nod2 KO mice compared with the control mice. Conclusions We found that Nod2 deficiency results in significantly reduced bursting pressure after ileocecal resection. This effect is mediated via an increased matrix turnover. Patients with genetic NOD2 variations may be prone to anastomotic failure after bowel resection.

Laparoscopic-assisted bowel resection with construction of a colonic reservoir for cavernous hemangioma of the rectum: report of two cases

2011 ◽  
Vol 15 (2) ◽  
pp. 205-207 ◽  
Author(s):  
R. F. Leal ◽  
M. de Lourdes Setsuko Ayrizono ◽  
P. V. Villalobos Tapia Silva ◽  
P. de Sene Portel Oliveira ◽  
J. J. Fagundes ◽  
...  
Keyword(s):  
Cavernous Hemangioma ◽  
Bowel Resection ◽  
Colonic Reservoir ◽  
Laparoscopic Assisted

scholarly journals Preoperative Intra-abdominal Sepsis, Not Penetrating Behavior Itself, Is Associated With Worse Postoperative Outcome After Bowel Resection for Crohn Disease

Medicine ◽  
2015 ◽  
Vol 94 (45) ◽  
pp. e1987 ◽  
Author(s):  
Tenghui Zhang ◽  
Jianbo Yang ◽  
Chao Ding ◽  
Yi Li ◽  
Lili Gu ◽  
...  
Keyword(s):  
Crohn Disease ◽  
Bowel Resection ◽  
Postoperative Outcome ◽  
Abdominal Sepsis

Laparoscopic-assisted bowel resection offers advantages over open surgery for treatment of segmental Crohn’s disease in children

2003 ◽  
Vol 38 (6) ◽  
pp. 963-965 ◽  
Author(s):  
Daniel von Allmen ◽  
Jonathan E Markowitz ◽  
Amy York ◽  
Petar Mamula ◽  
Melissa Shepanski ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Open Surgery ◽  
Bowel Resection ◽  
Laparoscopic Assisted

scholarly journals Endovascular Treatment for Acute Thromboembolic Occlusion of the Superior Mesenteric Artery and the Outcome Comparison between Endovascular and Open Surgical Treatments: A Retrospective Study

2017 ◽  
Vol 2017 ◽  
pp. 1-10 ◽  
Author(s):  
Zhao Zhang ◽  
Dan Wang ◽  
Guoxun Li ◽  
Ximo Wang ◽  
Yuxiang Wang ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Superior Mesenteric Artery ◽  
Endovascular Therapy ◽  
Mesenteric Artery ◽  
Bowel Resection ◽  
Average Length ◽  
Medical Center ◽  
Technical Success ◽  
Outcome Comparison ◽  
Surgical Treatments

We reported our experience with endovascular treatment for patients with acute thromboembolic occlusion of the superior mesenteric artery (ATOS) as well as comparing the efficacy between endovascular and traditional open surgical treatments. Eighteen consecutive patients with ATOS who received endovascular treatment and 12 patients who received open surgical treatment between February 2007 and October 2012 at Tianjin Union Medical Center (Tianjin, China) were retrospectively reviewed. Primary clinical outcomes included the technical success, requirement of laparotomy, length of bowel resection, perioperative mortality within 30 days, and surgical complications. The patients were followed up for 0.1 to 98 months. For patients who underwent endovascular treatment, complete technical success was achieved in 8 (44.4%) patients and partial success was achieved in the remaining 10 (55.6%) patients. Laparotomy was required in 6 (33.3%) patients. The 30-day mortality was 16.7%. In comparison to open surgical therapy, endovascular therapy achieved lower requirement of laparotomy (in 33.3% versus in 58.3% of cases,p=0.18), significantly shorter average length of bowel resection (88 ± 44 versus 253 ± 103 cm,p=0.01), and lower mortality rate (16.7% versus 33.3%,p=0.68). The endovascular therapy is a promising treatment alternative for ATOS.

Systematic review and meta-analysis of endovascular treatment for acute mesenteric ischaemia

Vascular ◽  
2017 ◽  
Vol 25 (4) ◽  
pp. 430-438 ◽  
Author(s):  
Marawan El Farargy ◽  
Ahmed Abdel Hadi ◽  
Mohamed Abou Eisha ◽  
Khalid Bashaeb ◽  
George A Antoniou
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Endovascular Treatment ◽  
Odds Ratio ◽  
Observational Studies ◽  
Bowel Resection ◽  
Meta Analysis ◽  
Mesenteric Ischaemia ◽  
Conventional Surgery ◽  
Acute Mesenteric Ischaemia

Introduction Acute mesenteric ischaemia is associated with a significant morbidity and mortality. Endovascular techniques have emerged as a viable alternative treatment option to conventional surgery. Our objective was to conduct a systematic review of the literature and perform a meta-analysis of reported outcomes. Methods Our review conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement standards and the protocol was registered in PROSPERO (CRD42016035667). We searched electronic information sources (MEDLINE, EMBASE, CINAHL, CENTRAL) and bibliographic lists of relevant articles to identify studies reporting outcomes of endovascular treatment for acute mesenteric ischaemia of embolic or thrombotic aetiology. We defined 30-day or in-hospital mortality and bowel resection as the primary outcome measures. We used the Newcastle–Ottawa scale to assess the methodological quality of observational studies. We calculated combined overall effect sizes using random effects models; results are reported as the odds ratio and 95% confidence interval. Results We identified 19 observational studies reporting on a total of 3362 patients undergoing endovascular treatment for acute mesenteric ischaemia. The pooled estimate of peri-interventional mortality was 0.245 (95% confidence interval 0.197–0.299), that of the requirement for bowel resection 0.326 (95% confidence interval 0.229–0.439), and the pooled estimate for acute kidney injury was 0.132 (95% confidence interval 0.082–0.204). Eight studies reported comparative outcomes of endovascular versus surgical treatment for acute mesenteric ischaemia (endovascular group, 3187 patients; surgical group, 4998 patients). Endovascular therapy was associated with a significantly lower risk of 30-day mortality (odds ratio 0.45, 95% confidence interval 0.30–0.67, P = 0.0001), bowel resection (odds ratio 0.45, 95% confidence interval 0.34–0.59, P < 0.00001) and acute renal failure (odds ratio 0.58, 95% confidence interval 0.49–0.68, P < 0.00001). No differences were identified in septic complications or the development of short bowel syndrome. Conclusion Endovascular treatment for acute mesenteric ischaemia is associated with a considerable mortality and requirement of bowel resection. However, endovascular therapy confers improved outcomes compared to conventional surgery, as indicated be reduced mortality, risk of bowel resection and acute renal failure. An endovascular-first approach should be considered in patients presenting with acute mesenteric ischaemia.

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