Physiological changes after colorectal surgery suggest anastomotic leakage is an early event: a retrospective cohort study

2018 ◽  
Author(s):  
Adam T. Stearns ◽  
Filomena Liccardo ◽  
Kok‐Neang Tan ◽  
Emre Sivrikoz ◽  
Omer Aziz ◽  
...  
Keyword(s):  
Cohort Study ◽  
Colorectal Surgery ◽  
Anastomotic Leakage ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Early Event ◽  
Physiological Changes

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 Feasibility of early postoperative mobilisation after colorectal surgery: A retrospective cohort study

2018 ◽  
Vol 56 ◽  
pp. 161-166 ◽  
Author(s):  
Fabian Grass ◽  
Basile Pache ◽  
David Martin ◽  
Valérie Addor ◽  
Dieter Hahnloser ◽  
...  
Keyword(s):  
Cohort Study ◽  
Colorectal Surgery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort

scholarly journals E.R.A.S. pathway in colorectal surgery in elderly: Our experience: A retrospective cohort study

2017 ◽  
Vol 43 ◽  
pp. 101-106 ◽  
Author(s):  
Basilio Pirrera ◽  
Andrea Lucchi ◽  
Carlo Gabbianelli ◽  
Vincenzo Alagna ◽  
Giacomo Martorelli ◽  
...  
Keyword(s):  
Cohort Study ◽  
Colorectal Surgery ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Surgery In Elderly

scholarly journals Comparison of Hand-sewn and Modified Mechanical Anastomosis in Esophageal Cancer Patients Undergoing Transhiatal Esophagectomy: An Iranian Retrospective Cohort Study

2020 ◽  
Author(s):  
Seyed Ziaeddin Rasihashemi ◽  
Ali Ramouz ◽  
Samad Beheshtirouy ◽  
Hassan Amini
Keyword(s):  
Esophageal Cancer ◽  
Cohort Study ◽  
Anastomotic Leakage ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Anastomotic Stricture ◽  
Operation Time ◽  
Anastomosis Group ◽  
Transhiatal Esophagectomy ◽  
Mechanical Anastomosis

Abstract Background: There are controversies over the efficacy of mechanical stapler when compared with the hand-sewn (HS) technique in patients who underwent esophagogastric anastomosis in terms of efficacy and post-operative advantages. The purpose of the present study is to compare the clinical outcomes of manual and a modified mechanical stapled (MMS) anastomosis (double stapled technique) during esophagectomy for esophageal cancer.Methods: A retrospective cohort study was conducted on 409 patient’s medical records who underwent transhiatal esophagectomy for esophageal cancer between March 2010 and March 2016. All patients were operated using HS technique or MMS technique. All cases were visited in two weeks, four, eight and twelve months after surgery and were evaluated in terms of postoperative complications including anastomotic leakage, regurgitation, anastomotic stricture, dysphagia and need for anastomotic dilatation.Results: 259 (63.3%) patients were operated using HS technique and 150 patients (36.7%) were operated by MMS technique. The mean operative time was 211.45± 82.25 min for the MMS anastomosis group, whereas for the manual group it was 251.42±52.81 min, respectively (P = 0.023). Postoperatively, 38 (14.67%) anastomotic leakage were detected in the HS group compared to 8 (5.33%) the MMS group (P= 0.002). The results showed lesser anastomotic stricture in patients who underwent MMS anastomosis (P= 0.004). However, during the one-year follow-up period, patients with HS anastomosis required more anastomotic dilatation (P= 0.021).Conclusions: Using a MMS anastomosis may reduce operation time and lead to lower rates of anastomotic leak, decrease anastomotic stricture and anastomotic dilatation.

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