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Search Results: 1 - 10 of 433 matches for " Anastomosis "
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A Modified Technique to Facilitate Anastomosis in Choledochal Cyst  [PDF]
Sezen ?zk?sac?k, Mesut Yaz?c?, Harun Gürsoy
International Journal of Clinical Medicine (IJCM) , 2010, DOI: 10.4236/ijcm.2010.12013
Abstract: The method of choice for the treatment of choledochal cysts in children is excision of the cyst and Roux-en-Y (RY) choledochoenterostomy. When the ratio of the diameter of the main hepatic ductus to that of the proximal RY jejunum is 1:2.5 or lower during choledochoenterostomy, end-to-end anastomosis is recommended. However, this method may cause a difference in diameters between the ends. Here we will present the technical difficulty we experienced due to the difference in diameters in end-to-end RY choledochoenterostomy and our modified anastomosis technique of anas¬tomosis. This slight modification eliminated problems with anastomosis caused by a difference in the diameter of the jejunum and shortened operation time.
Extended Use of Vettath’s Anastomotic Obturator (VAO)  [PDF]
Vettath Prabhakaran Murali, Ismail E. Thazhkuni, Kannan A. Vellachamy
Surgical Science (SS) , 2011, DOI: 10.4236/ss.2011.29098
Abstract: Stroke rate in redo coronary artery bypass surgery has remained a stumbling block, where the aorta is used as origin for the top end of the vein graft. Avoiding the side-clamp on these redo aortas by using the Vettath’s Anastomotic Obturator (VAO) technique of anatomosing the vein graft could bring this down. We have also been able to use this technique in combined aortic valve replacement and CABG. These two situations where the VAO is used are elucidated here.
Early Feeding vs 5-Day Fasting after Distal Elective Bowel Anastomoses in Children. A Randomized Controlled Trial  [PDF]
Roberto Davila-Perez, Eduardo Bracho-Blanchet, Francisco Galindo-Rocha, Jose Tovilla-Mercado, Gustavo Varela-Fascinetto, Emilio Fernandez-Portilla, Pablo Lezama-del-Valle, Jaime Nieto-Zerme?o
Surgical Science (SS) , 2013, DOI: 10.4236/ss.2013.41008
Abstract:

Purpose: Determine the safety and efficacy of early enteral feeding after distal elective bowel anastomoses (DEBA) in children. Methods: Controlled randomized trial including pediatric patients with DEBA, excluding non-elective and high risk patients. Variables: Demographics, operative time, anastomosis placement, beginning peristalsis and bowel movement, time to full diet intake, post-operative stay, persisting vomiting and abdominal distention, wound infection or dehiscence, anastomotic leak, reoperation, death. Randomization into: 1) Experimental group (EG): early feeding group, after a minimum 24 hours fasting period, oral fluids and diet was started; 2) Control group (CG): obligatory 5-day fasting. Descriptive Statistics: Students t test for quantitative and Chi square for qualitative variables, a p-value < 0.05 was considered significant. Results: 60 patients were included since June 2003 to May 2004, 30 ineach group. Mean age 2 years, weight16 kg, malnutrition 33%. Stomal Ethiology: Anorectal-malformation 46%, Hirschsprung 13%, inflammatory 35%, tumoral 5%. Mostly in colon 71%. Mean surgical time 142 min. None developed vomiting or required nasogastric-tube. Mild abdominal distension 13%, mild fever 16.5% and wound complications 18%. Anastomosis leakage 6.5%, none required reoperations. Demographic variables showed no statistical differences. Full oral intake was in the 2nd postoperative day in the EG vs CG (p = 0.001). Postoperative hospital stay was 6.0 ± 3 in the EG vs 9.8 ± 4 days in the CG with clinical but not statistical significance. Peristalsis beginning, first flatus passage and bowel movements showed no statistical differences. The complication incidence was low and equally distributed. Conclusions: Early feeding after DEBA is safe and well tolerated in children.

The Best Choice to Achieve Zero Complications after Pancreatoduodenectomy  [PDF]
Shinji Osada, Hisashi Imai, Yoshiyuki Sasaki, Itaru Yasufuku, Ryuichi Asai, Yoshihisa Tokumaru, Takuji Sakuratani, Kazuhiro Yoshida
Surgical Science (SS) , 2011, DOI: 10.4236/ss.2011.22010
Abstract: Pancreatoduodenectomy (PD) has been performed commonly, but the occurrence of pancreatic fistula (PF) is a critical trigger of complications, which are potentially life threatening, and is also associated with markedly prolonged hospitalization. Many techniques have been proposed for connecting the pancreatic stump with the gastrointestinal tract, stomach vs. jejunum, etc. Among the risk factors for PF, such as general patient factors or disease-related factors, the most important is the texture of the remnant pancreas. Surgical technique might be one improvable aspect that can reduce the pancreatic leakage rate, therefore; various methods of managing the pancreatic remnant have been studied. Methods of reconstruction between the remnant pancreas and the intestine include end-to-side with/without duct-to-mucosa anastomosis or end-to-end invagination styles, has been argued. Here, we review several trials for safety and methods of treating the pancreatic stump after PD, and demonstrate our experiences.
Novel Suture-Less Vascular Anastomotic Device (BYFix) in Femoro-Popliteal Surgery, Early Clinical Experience  [PDF]
M. Schneider, V. Shapira, V. Chernyavskiy, B. Yoffe
Surgical Science (SS) , 2011, DOI: 10.4236/ss.2011.29096
Abstract: Objectives: To evaluate the early experience of using the BYFix-innovative anastomotic device for creating suture-less vascular anastomosis in major and peripheral arteries surgery. Design: Uncontrolled prospective study. Materials: The BYFix anastomotic device for suture-less vascular anastomosis with surgical tools and standard vascular grafts. Methods: 7 patients, age 63.6 ± 9.2 years, with peripheral vascular occlusion above the knee scheduled for surgical repair were operared. They underwent the surgical procedure using the BYFix anastomotic device for creating proximal anastomosis and the conventional manual suturing for creating the distal anastomosis of the implantable vascular graft. Results: The anastomoses by using BYFix anastomotic device were successfully created in all patients. The duration of anastomosis creation was significantly shorter by using BYFix device, compared to conventional manual suturing, 5:10 ± 1:50 minutes compared to 33 ± 17:40 minutes respectively. No adverse events related to BYFix anastomotic device were observed, during the surgical procedure or recovery period. One year follow up revealed no complications related to BYFix anastomotic device. Conclusions: The BYFix anastomotic device enables the creation of efficient vascular anastomosis in peripheral vascular occlusions. It shortens the time needed for creating vascular anastomosis and thus reducing the operation time and might reduce distal complications related to the vascular procedure. Further clinical trials are needed to establish the results.
The pathogenesis of primary pouchitis following ileal pouch-anal anastomosis: a review of current hypotheses  [PDF]
Sally Bath, Christian P. Selinger, Rupert W.L. Leong
Open Journal of Gastroenterology (OJGas) , 2011, DOI: 10.4236/ojgas.2011.12002
Abstract: Primary pouchitis is a common complication of ileal pouch-anal anastomosis following proctocolectomy in patients treated for ulcerative colitis (UC), but is un-usual for those treated for familial adenomatous polyposis (FAP). While a number of theories as to the pathogenesis of this inflammatory condition have been proposed, no single one has been wholly satis-factory. Much research has been devoted to investi-gating a link between the pathogenic factors involved in UC, but not FAP, and those underlying pouchitis. The contribution of sulfate-producing bacteria has also been explored. The role of other intraluminal factors, such as short chain fatty acids and unconju-gated bile salts, has also been investigated. A unifying theory of a multi-step process might explain the pathogenesis of pouchitis, but further research is re-quired to proof causation. It is likely that pouchitis develops as a result of a combination of genetic, im-munological, microbial and metabolic factors. Future insight into the causes of pouchitis may eventually allow for the development of more effective treat-ments.
Pancreatic Anastomosis Healing  [PDF]
Stanislaw Hac, Rafal Peksa, Marek Dobosz, Tomasz Wysocki, Pawel Lampe, Katarzyna Kusnierz, Pawel Mroczkowski, Zbigniew Sledzinski
Open Journal of Pathology (OJPathology) , 2012, DOI: 10.4236/ojpathology.2012.23018
Abstract: Background: Pancreatoduodenectomy (PD) is a complex procedure with a relatively high risk of complications. There is an increasing trend showing that the success of pancreato-enteral anastomosis depends on surgical skill and the material used. Methods: We present four cases of pancreato-enteral anastomosis resected 37 - 114 days after primary surgery and the analysis of the healing process, i.e., morphology of the pancreatic parenchyma, pancreatic duct, and digestive tract mucosa, as well as the pancreatic reaction to the sewing material by microscopic morphometry. Results: Evidence of regeneration in the columnar-lined mucosa of main pancreatic ducts in all cases of pancreato-enterostomy was observed. The inflammatory foreign-body reaction around monofilament stitch was present without an evident infection. There were no microscopic signs of pancreatic duct damage. Total foreign body reaction varied between 138.1 μm and 207.3 μm. Conclusions: This observation supports the beneficial use of thin monofilament threads for pancreato-enteral anastomosis. There was no evidence of harmful action from gastric or intestinal juices on pancreatic remnant or the Wirsung duct.
A Novel Rodent Model Modifying Perioperative Temperature and Humidity during Bowel Surgery and Mimicking Laparoscopic Conditions  [PDF]
Torben Glatz, Gabriel Seifert, Philipp A. Holzner, S. Chikhladze, Birte Kulemann, Olivia Sick, Jens H?ppner, Ulrich Theodor Hopt, Goran Marjanovic
Surgical Science (SS) , 2012, DOI: 10.4236/ss.2012.37069
Abstract: Laparoscopic surgery seems to have a general physiological benefit compared to conventional procedures in several clincal studies especially regarding intestinal anastomotic healing. Reliable experimental data concerning the particular mode of beneficial action are lacking. Clinical studies will not be able to identify the variables responsible for this effect. To establish a feasible, standardized experimental model to investigate variables such as humidity and perioperative room temperature, we employed an incubator designed for neonatal care. This allows individual manipulation and observation of above mentioned variables. Our initial results show that creating intestinal anastomoses in the incubator is safe and easy to perform, creating a valuable possibility to influence perioperative conditions for experimental and clinical research.
Long-axis rotational volvulus in an ileal J-pouch anal anastomosis: A preventable rare complication  [PDF]
Virgilio V. George, Alyssa Fajardo
Case Reports in Clinical Medicine (CRCM) , 2014, DOI: 10.4236/crcm.2014.31007
Abstract:

Puropose: This study was designed to report a very rare long-term complication of ileal-Jpouch anal anastomosis: An 180 degree longaxial rotational volvulus causing J pouch obstruction. Methods: An Ovid and Medline search using the following keywords was performed: J pouch ileoanal anastomosis, J-pouch ileoanal anastomosis complications, J-pouch volvulus, J-pouch complications, restorative proctocolectomy complications, and restorative proctocolectomy volvulus. One J-pouch ileoanal anastomosis 180° volvulus report was found [1]. Result: We describe a long-axis 180° rotational volvulus complication of a J-pouch ileoanal anastomosis. The J pouch was performed three years prior after the laparoscopic total proctocolectomy for chronic ulcerative colitis. Pouch excision and new ileoanal J-pouch surgery were then performed along with pexy using alloderm mesh placement with excellent outcomes. Conclusion: Long-axis 180° rotational volvulus is a rare complication of a J-pouch ileoanal anastomosis. Pouch dysfunction after a long-axis rotational volvulus is an uncommon cause of acute abdomen. Lack of adhesions and pouch size are risk factors for the pouch torsion. Prompt diagnosis and treatment are essential for the pouch salvage. Simple abdominal x-ray, barium enema and CT scan represent important tools for diagnosis. Salvage surgery should be performed even if detorsion and decompression of the affected bowel are achieved. Surgery has excellent outcomes if performed after the prompt diagnosis. Pouch pexy should be done to prevent recurrent volvulus.

Efficacy and Safety of Transanal Tube Drainage for Prevention of Anastomotic Leakage Following Laparoscopic Low Anterior Resection for Rectal Cancers  [PDF]
Yasutake Uchima, Naoki Aomatsu, Hironari Miyamoto, Takuma Okada, Shigeaki Kurihara, Toshiki Hirakawa, Takehiko Iwauchi, Junya Morimoto, Shigehito Yamagata, Kazunori Nakazawa, Kazuhiro Takeuchi
Journal of Cancer Therapy (JCT) , 2018, DOI: 10.4236/jct.2018.97045
Abstract: Introduction: Laparoscopic surgery is widely used for the treatment of colorectal cancer. But anastomotic leakage is one of the most serious complications following laparoscopic low anterior resection (LAR) for rectal cancer. The purpose of this study was to investigate whether transanal drainage tube placement can reduce anastomotic leakage and avoid re-operation after laparoscopic LAR. Methods: Retrospective assessment was performed on 143 patients with rectal cancers who underwent laparoscopic LAR between April 2009 and March 2016. A diverting stoma was not created in all 143 patients. A transanal drainage tube was placed after anastomosis using a double stapling technique, in 90 patients (group TT). In group TT, a 24 Fr. Silicon catheter was inserted into the anus and was placed approximately 20 - 25 cm in the descending colon. Another 53 patients were operated on without a transanal drainage tube (group NTT). Clinicopathological and operative variables, the frequencies of anastomotic leakage and re-operation after leakage were investigated. Results: Between the two groups (Group TT and NTT), age, gender, body mass index, tumor size, Dukes’ stage, the number of Liniar stapler firings for rectal transaction, and the rate of left colic artery preservation were comparable. Intra-operative blood loss and operation time decreased group TT from group NTT (p < 0.05). The frequency of leakage was 2.8% (2/69) in group TT and was 13.2% (7/53) in group NTT. The rate of leakage was significantly lower in group TT (p = 0.03). Furthermore, the re-operation rate for symptomatic anastomotic leakage was 0% (0/2) in group TT, while in contrast it was 28.5% (2/7) in group NTT. The rate of re-operation was lower in group TT than group NTT (p
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