Anastomotic healing after resection of left-colon stenosis

1990 ◽  
Vol 33 (3) ◽  
pp. 217-221 ◽  
Author(s):  
Anders Törnqvist ◽  
Peter Blomquist ◽  
Hasse Jiborn ◽  
Bengt Zederfeldt
Keyword(s):  
Left Colon ◽  
Anastomotic Healing ◽  
Colon Stenosis

Effect of Ischemia/Reperfusion as a Systemic Phenomenon on Anastomotic Healing in the Left Colon

2000 ◽  
Vol 24 (8) ◽  
pp. 990-994 ◽  
Author(s):  
Mehmet Ayhan Kuzu ◽  
Adil Tanık ◽  
İIlhami Taner Kale ◽  
Ahmet Keşşaf Aşlar ◽  
Cüneyt Köksoy ◽  
...  
Keyword(s):  
Ischemia Reperfusion ◽  
Left Colon ◽  
Anastomotic Healing

Left colon stenosis caused by tuberculosis

2004 ◽  
Vol 39 (10) ◽  
pp. e5-e7 ◽  
Author(s):  
Lisieux Eyer de Jesus ◽  
Anna Machado Marques ◽  
Myrna Santos Rocha ◽  
Bruno Rafael Cornélio Brom ◽  
Renata Restay Siqueira
Keyword(s):  
Left Colon ◽  
Colon Stenosis

Peroperative contamination and anastomotic leakage after resection for left colon stenosis

1990 ◽  
Vol 5 (3) ◽  
pp. 164-166 ◽  
Author(s):  
A. T�rnqvist ◽  
H. Jiborn ◽  
B. Zederfeldt ◽  
A. Forsgren
Keyword(s):  
Anastomotic Leakage ◽  
Left Colon ◽  
Colon Stenosis

The effect of diverting colostomy on anastomotic healing after resection of left colon obstruction

1990 ◽  
Vol 5 (3) ◽  
pp. 167-169 ◽  
Author(s):  
A. T�rnqvist ◽  
P. Blomquist ◽  
H. Jiborn ◽  
B. Zederfeldt
Keyword(s):  
Left Colon ◽  
Anastomotic Healing ◽  
Colon Obstruction ◽  
Diverting Colostomy

Use of indocianine green fluorescence in acute mesenteric ischemia

2020 ◽  
Vol 3 (2) ◽  
Author(s):  
Jaime Bonnín-Pascual
Keyword(s):  
Indocyanine Green ◽  
Terminal Ileum ◽  
Mesenteric Ischemia ◽  
Intestinal Anastomosis ◽  
Acute Mesenteric Ischemia ◽  
Left Colon ◽  
Infrared Light ◽  
High Morbidity ◽  
Green Fluorescence ◽  
Clinical Cases

Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Introduction: Acute mesenteric ischemia has a high morbidity and mortality and constitutes an intraoperative challenge in the management of ischemic areas. In this context, we analyze the use of indocyanine green fluorescence to assess intestinal vascularization through 3 clinical cases. Case presentation: we present 3 clinical cases operated for acute mesenteric ischemia. Evaluation of intestinal viability is performed under infrared light after intravenous infusion of 25 mg of indocyanine green. Case 1 is a 42-year-old male with multiple antecedents of severe vascular disease, presenting with a massive acute mesenteric ischemia involving multiple intestinal segments. Fluorescence allows two adjusted bowel resections with double intestinal anastomosis. Case 2 is a 74-year-old woman with a history of non-anticoagulated atrial fibrillation who is decided to perform an urgent surgery when an esophageal, gastric and portal system pneumatosis is observed, as indirect signs of ischemia, in urgent CT. During the surgical act there is an ischemia of the terminal ileum and right colon without clear signs of involvement at the esophageal-gastric level. The assessment after administration of ICG discriminates the clear ischemic involvement from terminal ileum to ascending colon and patched in the transverse and left colon, without esophageal or gastric involvement. Case 3 is a 49-year-old woman with aortoiliac and visceral Takayasu disease and revascularization surgery of the celiac trunk. Given the increase in abdominal pain, a new CT scan demonstrates colonic pneumatosis. Urgent laparotomy shows necrosis at the level of the left colon and hypoperfusion of the cecum. The administration of ICG finds a lack of uptake of the entire colon. A subtotal colectomy with ileostomy and mucous fistula is performed. Conclusions: The fluorescence with ICG provides a better visualization of the intestinal vascularization in the AMI, and allows to determine the limits of the affected tissue to perform adjusted resections.

scholarly journals Congestive ischemic colitis occurring after resection of left colon cancer: 4 case series

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takatsugu Fujii ◽  
Shigeo Toda ◽  
Yuki Nishihara ◽  
Yusuke Maeda ◽  
Kosuke Hiramatsu ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Ischemic Colitis ◽  
Case Series ◽  
Left Colon ◽  
Left Colon Cancer

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.

Factors Influencing the Outcome of Intestinal Anastomosis

2011 ◽  
Vol 77 (9) ◽  
pp. 1169-1175 ◽  
Author(s):  
Juan J. LujÁN ◽  
ZoltÁN H. NÉMeth ◽  
Patricia A. Barratt-Stopper ◽  
Rami Bustami ◽  
Vadim P. Koshenkov ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Blood Loss ◽  
Surgical Site Infection ◽  
Bowel Disease ◽  
Intestinal Anastomosis ◽  
Significant Risk ◽  
Left Colon ◽  
Site Infection ◽  
Intraoperative Blood Loss ◽  
Inflammatory Bowel

Anastomotic leak (AL) is one of the most serious complications after gastrointestinal surgery. All patients aged 16 years or older who underwent a surgery with single intestinal anastomosis at Morristown Medical Center from January 2006 to June 2008 were entered into a prospective database. To compare the rate of AL, patients were divided into the following surgery-related groups: 1) stapled versus hand-sewn, 2) small bowel versus large bowel, 3) right versus left colon, 4) emergent versus elective, 5) laparoscopic versus converted (laparoscopic to open) versus open, 6) inflammatory bowel disease versus non inflammatory bowel disease, and 7) diverticulitis versus nondiverticulitis. We also looked for surgical site infection, estimated intraoperative blood loss, blood transfusion, comorbidities, preoperative chemotherapy, radiation, and anticoagulation treatment. The overall rate of AL was 3.8 per cent. Mortality rate was higher among patients with ALs (13.3%) versus patients with no AL (1.7%). Open surgery had greater risk of AL than laparoscopic operations. Surgical site infection and intraoperative blood transfusions were also associated with significantly higher rates of AL. Operations involving the left colon had greater risk of AL when compared with those of the right colon, sigmoid, and rectum. Prior chemotherapy, anticoagulation, and intraoperative blood loss all increased the AL rates. In conclusion, we identified several significant risk factors for ALs. This knowledge should help us better understand and prevent this serious complication, which has significant morbidity and mortality rates.

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