Intraoperative antegrade lavage and anastomotic healing in acute colonic obstruction

1986 ◽  
Vol 29 (4) ◽  
pp. 255-259 ◽  
Author(s):  
M. E. Foster ◽  
C. D. Johnson ◽  
P. J. Billings ◽  
P. W. Davies ◽  
D. J. Leaper
Keyword(s):  
Colonic Obstruction ◽  
Anastomotic Healing

Enhanced intra-anastomotic healing by operative lavage with nutrient solutions in experimental left-sided colonic obstruction

1995 ◽  
Vol 82 (9) ◽  
pp. 1280-1280
Author(s):  
D. S. O'Riordain ◽  
J. E. Aguilar-Nascimento ◽  
R. T. Mathie ◽  
W. K. Man ◽  
R. C. N. Williamson
Keyword(s):  
Colonic Obstruction ◽  
Anastomotic Healing ◽  
Nutrient Solutions

Enhanced intra-anastomotic healing by operative lavage with nutrient solutions in experimental left-sided colonic obstruction

1995 ◽  
Vol 82 (4) ◽  
pp. 461-464 ◽  
Author(s):  
J. E. Aguilar-Nascimento ◽  
R. T. Mathie ◽  
W. K. Man ◽  
R. C. N. Williamson
Keyword(s):  
Colonic Obstruction ◽  
Anastomotic Healing ◽  
Nutrient Solutions

scholarly journals Propensity score‐matched comparison of stenting as a bridge to surgery and emergency surgery for acute malignant left‐sided colonic obstruction

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuepeng Cao ◽  
Qing Chen ◽  
Zhizhan Ni ◽  
Feng Wu ◽  
Chenshen Huang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Propensity Score ◽  
Emergency Surgery ◽  
Perineural Invasion ◽  
Cox Regression ◽  
Colonic Obstruction ◽  
Metal Stents ◽  
Bridge To Surgery ◽  
Cox Regression Analysis ◽  
Self Expanding Metal Stents

Abstract Background Bridge to elective surgery (BTS) using self-expanding metal stents (SEMSs) is a common alternative to emergency surgery (ES) for acute malignant left-sided colonic obstruction (AMLCO). However, studies regarding the long-term impact of BTS are limited and have reported unclear results. Methods A multicenter observational study was performed at three hospitals from April 2012 to December 2019. Propensity score matching (PSM) was introduced to minimize selection bias. The primary endpoint was overall survival. The secondary endpoints included surgical approaches, primary resection types, total stent-related adverse effects (AEs), surgical AEs, length of hospital stay, 30-day mortality and tumor recurrence. Results Forty-nine patients in both the BTS and ES groups were matched. Patients in the BTS group more often underwent laparoscopic resection [31 (63.3%) vs. 8 (16.3%), p < 0.001], were less likely to have a primary stoma [13 (26.5%) vs. 26 (53.1%), p = 0.007] and more often had perineural invasion [25 (51.0 %) vs. 13 (26.5 %), p = 0.013]. The median overall survival was significantly lower in patients with stent insertion (41 vs. 65 months, p = 0.041). The 3-year overall survival (53.0 vs. 77.2%, p = 0.039) and 5-year overall survival (30.6 vs. 55.0%, p = 0.025) were significantly less favorable in the BTS group. In multivariate Cox regression analysis, stenting (hazard ratio(HR) = 2.309(1.052–5.066), p = 0.037), surgical AEs (HR = 1.394 (1.053–1.845), p = 0.020) and pTNM stage (HR = 1.706 (1.116–2.607), p = 0.014) were positively correlated with overall survival in matched patients. Conclusions Self-expanding metal stents as “a bridge to surgery” are associated with more perineural invasion, a higher recurrence rate and worse overall survival in patients with acute malignant left-sided colonic obstruction compared with emergency surgery.

Ogilvie's syndrome presented with delirium in an older lady with corticobasal syndrome

2021 ◽  
pp. 1-3
Author(s):  
Feyza Mutlay ◽  
Derya Kaya ◽  
Ahmet Turan Isik
Keyword(s):  
Palliative Care ◽  
Health Care Professionals ◽  
Colonic Obstruction ◽  
Holistic Approach ◽  
Abdominal Distension ◽  
Corticobasal Syndrome ◽  
Ogilvie's Syndrome ◽  
Geriatric Population ◽  
Ogilvie’S Syndrome ◽  
Neurological Illnesses

Abstract Objective Corticobasal syndrome (CBS) is one of an atypical parkinsonian syndromes characterized by extrapyramidal features as well as cortical involvement signs. A variety of factors may lead to delirium in older adults with chronic progressive life-limiting neurological illnesses like CBS. Ogilvie's syndrome (OS) is an acute colonic pseudo-obstruction in which abdominal distension, nausea, vomiting, and constipation can be seen. We report a case of OS identified as the underlying possible cause of delirium in an 80-year-old woman with CBS. We also discuss the importance of holistic approach which is essential to manage the underlying cause and to preserve the quality of life in particular for the frail geriatric population who potentially needs palliative care or already benefits from palliative care. Method An older patient with CBS presented with symptoms similar to that of acute colonic obstruction and subsequently developed delirium. The patient was found to have colonic pseudo-obstruction (OS). Result Neostigmin infusion was therefore given to treat it and delirium was resolved. Significance of results To the best of our knowledge, clinical manifestation of delirium as OS in a patient with CBS has not been previously reported. OS may be superimposed to CBS in older patients, and OS in such patients may play a role as a precipitating factor for the development of delirium. Given the fact that CBS is progressive and rare neurodegenerative disease and almost all of these patients need palliative care, eventually, health-care professionals, especially in palliative care, should be aware of distinctive challenges of life-limiting chronic neurological illnesses, such as conditions that may lead to the development of acute colonic pseudo-obstruction because the rapid treatment of them prevents the use of potentially harmful drugs, surgical procedures, or inappropriate interventions.

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 &lt; 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.

scholarly journals Splenic flexure volvulus, a rare etiology of colonic obstruction: Case report

2021 ◽  
pp. 106128
Author(s):  
Amirsina Sharifi ◽  
Seyed Mohsen Ahmadi Tafti ◽  
Mohammadreza Keramati ◽  
Alireza Kazemeini ◽  
Behnam Behboudi
Keyword(s):  
Case Report ◽  
Splenic Flexure ◽  
Colonic Obstruction
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