Abstract:
BACKGROUND/AIMS:Strictureplasty (SP) or miniresective 'bowel-sparing' techniques (MR) can prevent the risk of intestinal stomia and short bowel syndrome in patients affected by Crohn's disease (CD). The aim of this study was to analyze the perioperative morbidity and mortality in 104 of 138 consecutive patients treated for CD complications using bowel-sparing techniques. We also considered the factors that may be related to the risk of perioperative complications and the long-term outcome. METHODS:One hundred and four patients were treated with SP and/or MR and then included in a prospectively maintained database. The factors claimed to influence perioperative complications were analyzed using Fisher's exact test for categorical observations and the Mann-Whitney U test for continuous variables. A multivariate analysis, using logistic regression, and a long-term time-to-event analysis using the Kaplan-Meier function, were also performed. RESULTS:Perioperative mortality was nil. In relation to the 6 postoperative complications (5.8%), 4 patients underwent minimal bowel resection (MR), 1 a MR with SP, and 1 SP alone. Three of these patients (2.9%) needed reoperation for septic complications, and 3 (2.9%) were treated as outpatients for enterocutaneous fistulas. A correlation (p < 0.05) was found between low serum hemoglobin levels and postoperative complications at univariate and multivariate analyses. The 5-year surgical recurrence-free rate was 75% overall, 73% for patients treated with SP, 78% with MR, and 77% with MR + SP. CONCLUSIONS:Postoperative complications are not related to conservative or miniresective surgery even when active disease is present at the resection margins or the site of SP. The higher risk reported for patients with low serum hemoglobin and hematocrit levels suggests that surgeons should consider using preoperative iron and vitamin support, parenteral nutrition and erythropoietin therapy, when necessary, in those cases. Our postoperative morbidity, mortality and long-term surgical recurrence rate results support the efficacy and safety of SP and MR surgery in the treatment of complicated CD.
journal_name
Dig Surgjournal_title
Digestive surgeryauthors
Sampietro GM,Cristaldi M,Porretta T,Montecamozzo G,Danelli P,Taschieri AMdoi
10.1159/000018845subject
Has Abstractpub_date
2000-01-01 00:00:00pages
261-7issue
3eissn
0253-4886issn
1421-9883pii
18845journal_volume
17pub_type
杂志文章abstract:BACKGROUND:The prognosis of patients with pancreatic cancer is poor. This is mainly caused by the late diagnosis, the aggressive biology and the lack of effective treatment modalities. Adenoviral gene therapy has the potential to selectively treat both primary tumor and (micro)metastatic tissue. METHODS:This review pr...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000145981
更新日期:2008-01-01 00:00:00
abstract::One of the possible long-term complications following an ileoanal pouch procedure is the development of malignancy in the mucosa of the rectal stump. Only 10 such cases have been reported so far. We report the case of a 23-year-old male who had ulcerative colitis with high-grade dysplasia and underwent an ileoanal pou...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000068855
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Surgery for patients with malignant obstructive jaundice carries high morbidity and mortality rates. Preoperative biliary drainage (PBD) has been used in an attempt to improve the outcome in these patients. AIM:To review the evidence in the literature on whether PBD improves postoperative morbidity and mort...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000050105
更新日期:2001-01-01 00:00:00
abstract:BACKGROUNDS:Endoscopic submucosal dissection (ESD) has been widely performed in the treatment of early esophageal squamous cell carcinoma (ESCC). Few studies have compared the long-term outcomes of esophageal ESD based on absolute indications and relative indications. The aim of the current study was to investigate the...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000507437
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND/AIM:In the present study, we investigated the acute and late phases of splenic circulation after spleen-preserving distal pancreatectomy (SPDP) involving the division of splenic vessels. METHODS:An acute phase of splenic circulation was evaluated by laser flow meter and the late phase was estimated by (99m)...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000051952
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Laparoscopic distal pancreatectomy (LDP) for large pancreatic tumors may require prolonged dissection, and this could be associated with increased operative time and intraoperative complications. METHODS:From a total cohort of 190 consecutive patients undergoing LDP, 18 patients were found to have pancreati...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000445008
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:In order to diagnose an unsuspected gallbladder carcinoma and to examine whether a differential diagnosis could be made between cancer and noncancerous lesions during surgery, we evaluated the findings of fine structures of various types of gallbladder mucosa. METHODS:We used stereomicroscopy with a dye-con...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050156
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Diverticulitis can lead to localized or generalized peritonitis and consequently induce abdominal adhesion formation. If adhesions would lead to abdominal complaints, it might be expected that these would be more prominent after operation for perforated diverticulitis with peritonitis than after elective sig...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000486868
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND AND AIM:Most patients with hepatic metastases from colorectal carcinoma are unsuitable for resection. Radiofrequency ablation (RFA) has been applied to such lesions at laparotomy. This study aimed to evaluate the less invasive approach of percutaneous RFA. METHOD:Patients with unresectable liver metastases ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000080886
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:Biliary leakage after liver resection continues to be reported. Management of bile leakage has changed in recent years, with nowadays non-surgical procedures as the preferred treatment. METHODS:Biliary leakage and management were assessed in 381 patients who underwent liver resection between January 2005 an...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000335734
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND/AIMS:Primary distal bile duct adenocarcinomas (DBDAs) are unusual neoplasms, necessitating pancreaticoduodenectomy for cure. The aims of this study were to evaluate the prognostic importance of lymphatic and perineural invasion, long-term outcome of patients after resection, and differences in outcome with h...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018798
更新日期:2000-01-01 00:00:00
abstract::The intestinal barrier function is considered to play an important role in protecting the penetration of luminal antigens, associated with the development of secondary infection and sepsis and the initiation of the multiple organ dysfunction syndrome. The intestinal mucosal barrier against luminal macromolecules and m...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018651
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Cholecystolithiasis is a common disease. Cholecystectomy is the main treatment method but is associated with various complications in some patients. This study explores a novel, minimally invasive surgery for the removal of calculi and the preservation of the gallbladder using a laparoscope combined with the...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000357823
更新日期:2013-01-01 00:00:00
abstract::Tumour recurrence that obstructs the afferent limb, blocking outflow of bile and pancreatic juice, constitutes a major clinical problem after a Whipple procedure. The endoscopic route is often not a possible alternative. Surgery may be difficult and perhaps dangerous to the often very sick patient and decompression wi...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000071760
更新日期:2003-01-01 00:00:00
abstract::Minimally invasive surgery has been shown to offer many advantages to general surgical patients but has not been widely adopted for colorectal disease. Initial fears surrounding the oncological safety of laparoscopic colectomies have largely subsided but the technical challenges still remain. Surgical robots or telema...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000081350
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND/AIMS:To evaluate the short-term surgical outcomes of laparoscopic intersphincteric resection (ISR) for lower rectal cancer, and to compare them with a case-control series of open ISR. METHODS:Between July 2002 and March 2011, 29 patients with lower rectal cancer underwent laparoscopic ISR, and 22 of 29 pati...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000332007
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND/AIMS:Although the diagnostic value of fluorine-18 2-fluoro-2-deoxy-D-glucose (F-18-FDG) positron emission tomography/computed tomography (F-18-FDG-PET/CT) in patients with colorectal cancer (CRC) has been reported, the association between the F-18-FDG uptake in metastatic lymph nodes (FDGLN) and clinicopatho...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000448222
更新日期:2017-01-01 00:00:00
abstract:BACKGROUND:A choice of retrosternal or orthotopic route for reconstruction exists after three-phase esophagectomy with cervical anastomosis. Whether the route of reconstruction affects postoperative morbidity, mortality and recurrence patterns remains controversial. STUDY DESIGN:Patients with cancer of the thoracic es...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000070387
更新日期:2003-01-01 00:00:00
abstract:AIMS:To describe the extremely rare case of an adenomyoma of the papilla of Vater. CASE REPORT:A 42-year-old woman was hospitalized for epigastralgia and high fever. The clinical presentation and endoscopic, biochemical, and radiologic findings led to the diagnostic impression of a dysfunction of the papilla of Vater....
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050115
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:Laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic benign gallbladder disease. The identification of factors that reliably predict the need to convert LC to open cholecystectomy (OC) would help with patient education and counseling. METHODS:Between January 2000 and December ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000347164
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:The optimal management approach to pancreatic serous cystic neoplasms (SCNs) is still evolving. METHODS:Consecutive patients with SCN managed at the Liverpool Pancreas Cancer Centre between 2000 and 2013 were retrospectively reviewed. RESULTS:There were 64 patients consisting of 39 women (60.9%) and 25 men...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000442094
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Vagus nerve injury (VNI) is a feared complication of antireflux surgery (ARS). The impact of VNI on the functional outcomes of ARS has not yet been evaluated systematically. The aim of this review was to evaluate the impact of VNI on functional and clinical outcome of ARS. METHODS:A systematic search was pe...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000444147
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND/AIMS:It has recently been reported that rebamipide (OPC-12759) inhibits inflammatory cytokines and activation of neutrophils. The aim of the present study was to investigate the effects of preoperative administration of rebamipide on parameters of systemic inflammatory response syndrome (SIRS) and serum leve...
journal_title:Digestive surgery
pub_type: 临床试验,杂志文章
doi:10.1159/000073645
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Therapeutic strategies to prevent port site recurrences in laparoscopy surgery of malignancies have not been investigated until now. METHODS:The effects of taurolidine, heparin, and povidone iodine on the growth of rat and human colon adenocarcinoma as well as gallbladder carcinoma were investigated in vitr...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018754
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND/AIMS:Patients with postoperative pulmonary complications after esophagectomy often have increased mortality. The purpose of the study was to examine the efficacy of preventing postoperative pulmonary complications by an intensive preoperative respiratory rehabilitation (PR) program for esophageal cancer pati...
journal_title:Digestive surgery
pub_type: 杂志文章,随机对照试验
doi:10.1159/000434758
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Proinflammatory cytokines like TNF-alpha and IL-8 have been thought to play a pivotal role in the propagation of severe acute pancreatitis (AP) and the development of its systemic complications, particularly acute lung injury. OBJECTIVE:To investigate the effects of pretreatment with hydrocortisone on the p...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018730
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND/AIM:Delay of laparoscopic cholecystectomy after the diagnosis of biliary colic may increase the probability of recurrent emergency admission while awaiting elective cholecystectomy. The aim of this study was to compare the possible advantages and safety of urgent laparoscopic cholecystectomy (ULC) with elect...
journal_title:Digestive surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1159/000085300
更新日期:2005-01-01 00:00:00
abstract::This study was designed to evaluate the efficacy of preoperative chemotherapy and to investigate the relationship between the histopathologic response and prognosis in patients with colorectal carcinoma. Thirty-six previously untreated patients with advanced colorectal carcinoma were consecutively enrolled in this stu...
journal_title:Digestive surgery
pub_type: 临床试验,杂志文章
doi:10.1159/000018649
更新日期:1998-01-01 00:00:00
abstract:INTRODUCTION:Management of pancreatic leak and haemorrhage is complex with high mortality rates. In this study, the results of completion pancreatectomy which was performed as a last resort option were analysed. PATIENTS AND METHODS:25 patients who had completion pancreatectomy from among 677 patients who had pancreat...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000095395
更新日期:2006-01-01 00:00:00
abstract:AIMS:To evaluate the role of the Physiological and Operative Severity Score for the enUmeration of Mortality and Morbidity (POSSUM), the Portsmouth variant (p-POSSUM) and the Glasgow Prognostic Score (GPS) in predicting outcome after pancreatic surgery with reference to the International Study Group of Pancreatic Surge...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000313693
更新日期:2010-01-01 00:00:00