Self-Expandable Metal Stents for Left Sided Colon Obstruction from Diverticulitis. A Single Center Retrospective Series

Background and Objectives: The incidence of diverticulitis is increasing in western countries. Complicated diverticulitis is defined as diverticulitis associated with localized or generalized perforation, localized or distant abscess, fistula, stricture or obstruction. Colonic symptomatic strictures are often treated with segmental colectomy. The aim of our study is to report our experience with Self Expandable Metal Stents (SEMS) placement to relieve sigmoid obstruction secondary to diverticulitis, either as a permanent solution or as a bridge to elective colectomy. Material and Methods: From January 2016 to December 2018, 21 patients underwent SEMS placement for sigmoid obstruction secondary to diverticulitis at our institution. In four patients with poor general conditions, SEMS was considered the definitive form of treatment. In 17 patients, the stent was placed as bridge to elective colectomy. Data were prospectively collected and retrospectively analyzed. Primary outcomes were postoperative mortality and morbidity after SEMS and subsequent elective colectomy. Results: There was no mortality or major morbidity after SEMS placement or subsequent elective colectomy. No stoma was performed. Conclusions: Placement of Colorectal Self Expandable Stent represents a useful tool to relieve obstruction in patients with left-sided colonic diverticulitis. SEMS placement makes it possible to transform an emergency clinical condition into an elective condition, giving time to resolve the inflammation and the infection inevitably associated with complicated diverticulitis.

Download Full-text

Faculty Opinions recommendation of Preoperative hepatic dysfunction could predict postoperative mortality and morbidity in patients undergoing cardiac surgery: Utilization of the MELD scoring system.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726074374.793513539 ◽

2016 ◽

Author(s):

John Augoustides

Keyword(s):

Cardiac Surgery ◽

Scoring System ◽

Hepatic Dysfunction ◽

Postoperative Mortality ◽

Mortality And Morbidity

Download Full-text

Preoperative statin treatment is associated with reduced postoperative mortality and morbidity in patients undergoing cardiac surgery: An 8-year retrospective cohort study

Journal of Thoracic and Cardiovascular Surgery ◽

10.1016/j.jtcvs.2005.11.006 ◽

2006 ◽

Vol 131 (3) ◽

pp. 679-685 ◽

Cited By ~ 72

Author(s):

Leslie L. Clark ◽

John S. Ikonomidis ◽

Fred A. Crawford ◽

Arthur Crumbley ◽

John M. Kratz ◽

...

Keyword(s):

Cardiac Surgery ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Postoperative Mortality ◽

Statin Treatment ◽

Mortality And Morbidity

Download Full-text

Self-Expanding Metal Stent (SEMS) Placement to Treat Bleeding from Late Radiation Esophagitis

Case Reports in Gastrointestinal Medicine ◽

10.1155/2021/6678139 ◽

2021 ◽

Vol 2021 ◽

pp. 1-4

Author(s):

Inayat Gill ◽

Bana Antonios ◽

Zaid Imam ◽

Gehad Ghaith

Keyword(s):

Symptomatic Relief ◽

Erosive Esophagitis ◽

Current Treatment ◽

Metal Stents ◽

Use Of Self ◽

Metal Stent ◽

Sems Placement ◽

Chronic Radiation ◽

Esophageal Ulceration ◽

Radiation Esophagitis

Radiation esophagitis is a serious complication occurring in patients receiving radiotherapy for head and neck cancers. Current treatment with proton pump inhibitors and mucosal protectants provides symptomatic relief with few studies showing improvement in erosive esophagitis or ulceration. Use of self-expandable metal stents (SEMS) in cases of erosive radiation esophagitis refractory to medical therapy has not been studied. We report a case of a patient presenting with recurrent hematemesis from late (chronic) radiation esophagitis with bleeding esophageal ulceration successfully treated with SEMS placement after failure of conservative medical management, proposing a possible utility for SEMS in this setting.

Download Full-text

Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised

BMJ ◽

10.1136/bmj.321.7275.1493 ◽

2000 ◽

Vol 321 (7275) ◽

pp. 1493-1493 ◽

Cited By ~ 1322

Author(s):

A. Rodgers

Keyword(s):

Spinal Anaesthesia ◽

Postoperative Mortality ◽

Mortality And Morbidity

Download Full-text

Association between preoperative prealbumin level and postoperative mortality and morbidity after hepatic resection for hepatocellular carcinoma: A multicenter study from a HBV-endemic area

The American Journal of Surgery ◽

10.1016/j.amjsurg.2020.08.036 ◽

2020 ◽

Author(s):

Ju-Dong Li ◽

Yong-Kang Diao ◽

Jie Li ◽

Han Wu ◽

Li-Yang Sun ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatic Resection ◽

Multicenter Study ◽

Endemic Area ◽

Postoperative Mortality ◽

Mortality And Morbidity

Download Full-text

Fibrin Glue Administration to Support Bronchial Stump Line

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849230801600604 ◽

2008 ◽

Vol 16 (6) ◽

pp. 450-453 ◽

Cited By ~ 9

Author(s):

Soner Gursoy ◽

Murat U Yapucu ◽

Ahmet Ucvet ◽

Serkan Yazgan ◽

Oktay Basok ◽

...

Keyword(s):

High Risk ◽

Fibrin Glue ◽

Pulmonary Resection ◽

Bronchopleural Fistula ◽

Surgical Margin ◽

Postoperative Mortality ◽

Lung Abscess ◽

Bronchial Stump ◽

Neoadjuvant Radiotherapy ◽

Mortality And Morbidity

Bronchopleural fistula is an important cause of mortality and morbidity after pulmonary resection. The use of fibrin glue to reduce the tension and number of sutures in the bronchial stump was assessed in this prospective study of 20 patients between June 2002 and May 2003. They all had a high risk of bronchopleural fistula development because of bronchiectasis, tuberculosis, lung abscess, diabetes mellitus, preoperative neoadjuvant radiotherapy, or residual tumor at the surgical margin. After pulmonary resection, the bronchial stump was closed with separate nonabsorbable sutures supported with fibrin glue. Bronchopleural fistula was observed in only 1 (5%) patient during 6.45 ± 3.09 months of follow-up. There was no postoperative mortality. Closing the bronchial stump with an appropriate technique and supporting it with fibrin glue were considered effective in preventing bronchopleural fistula development after pulmonary resection in high-risk patients.

Download Full-text

Effect of Arterial Hypertension on Postoperative Mortality and Morbidity after Off-pump CABG Surgery

Cardiovascular Journal ◽

10.3329/cardio.v10i1.34356 ◽

2017 ◽

Vol 10 (1) ◽

pp. 13-16

Author(s):

Asraful Hoque ◽

Shahriar Moinuddin

Keyword(s):

Coronary Artery ◽

Arterial Hypertension ◽

Postoperative Mortality ◽

P Value ◽

Hypertensive Patients ◽

Mortality And Morbidity ◽

Off Pump ◽

Group A ◽

Pump Cabg ◽

Group B

Background: Arterial hypertension is one of the leading modifiable risk factor in coronary artery disease patients who underwent coronary artery bypass grafting (CABG) with the major impact on clinical outcome in these patients. This study was done to evaluate the effect of arterial hypertension on postoperative mortality and morbidity after off-pump CABG.Methods: 200 patients with mean age of 52 ± 6 years, (182 male/18 female) undergoing off pump CABG were divided equally into two groups, 100 patients with hypertension (Group A) and 100 patients without hypertension (Group B). Postoperative mortality and morbidities (Wound infection, AMI, TIA, Stroke) up to 6 months were recorded in the 2 groups.Results: In comparison with the normotensive patients, hypertensive patients had a higher mortality rate (Group A 10% and Group B 2%, p value-<0.05) and increased frequency of myocardial infarction (Group A 12 % and Group B 3%, p value - <0.05). There was also increased rate of infection in hypertensive patients (Group A 13 % and Group B 4%, p value - <0.05). We found that hypertensive patients developed post-operative cerebrovascular complications like TIA (Group A 8 % and Group B 1%, p value - <0.05) and stroke (Group A 11 % and Group B 2%, p value - <0.05) more frequently than normotensive patients. Post-operative ventilator support and duration of hospital stay were almost similar in both groups.Conclusions: Among CABG patients, those with a history of hypertension have an increased frequency of post-operative complications and increased mortality.Cardiovasc. j. 2017; 10(1): 13-16

Download Full-text

Comparison of accuracy of prediction of postoperative mortality and morbidity between a new, parsimonious risk calculator (SURPAS) and the ACS Surgical Risk Calculator

The American Journal of Surgery ◽

10.1016/j.amjsurg.2019.07.036 ◽

2020 ◽

Vol 219 (6) ◽

pp. 1065-1072 ◽

Cited By ~ 6

Author(s):

Sina Khaneki ◽

Michael R. Bronsert ◽

William G. Henderson ◽

Maryam Yazdanfar ◽

Anne Lambert-Kerzner ◽

...

Keyword(s):

Postoperative Mortality ◽

Risk Calculator ◽

Surgical Risk ◽

Mortality And Morbidity ◽

Accuracy Of Prediction

Download Full-text

Acute Coronary Syndrome after 17 Years of Bare Metal Stent Implantation: “Very” Very Late Stent Thrombosis

Case Reports in Cardiology ◽

10.1155/2020/9628719 ◽

2020 ◽

Vol 2020 ◽

pp. 1-5

Author(s):

Raghavendra Rao K ◽

S. Reddy ◽

J. R. Kashyap ◽

K. Vikas ◽

Hithesh Reddy ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Stent Thrombosis ◽

Plaque Rupture ◽

Bare Metal Stents ◽

Metal Stents ◽

Bare Metal ◽

Late Stent Thrombosis ◽

Very Late Stent Thrombosis ◽

Mortality And Morbidity ◽

Coronary Syndrome

Very late stent thrombosis (VLST) is a catastrophic and life-threatening complication after percutaneous coronary intervention which presents as an acute coronary syndrome with significantly high mortality and morbidity. VLST is a rare entity with drug-eluting stents and even rarer with bare metal stents. The exact pathophysiologic mechanism of VLST after BMS implantation is not known although various mechanisms have been proposed. Recently, in-stent neoatherosclerosis with intimal plaque rupture has been proposed as a potential mechanism of VLST after BMS. We report a rare case of VLST occurring 17 years after BMS implantation with angiographic and intravascular imaging evidence which provides insight into the mechanisms of VLST.

Download Full-text