Abstract:
:Anastomotic leakage after colorectal surgery is correlated with considerable morbidity and mortality. Although many studies focus on risk factors and detection, studies on the treatment strategy for colorectal anastomotic leakage are scarce. A national questionnaire amongst 350 members of the Dutch Society for Gastrointestinal Surgery was undertaken on the current treatment of colorectal anastomotic leakage. The response was 40% after two anonymous rounds. 27% of the respondents state that a leaking anastomosis above the level of the promontory should be salvaged in ASA 1-2 patients <80 years of age, for ASA 3 and/or >80 years of age this percentage is 7.3%. For an anastomosis under the promontory, 50% of the respondents choose preserving the anastomosis for ASA 1-2 compared to 17% for ASA 3 and/or >80 years of age. In ASA 1-2 patients with a local abscess after a rectum resection without protective ileostomy, 31% of the respondents will create an protective ileostomy, 40% break down the anastomosis to create a definite colostomy, in ASA 3 and/or >80 years of age 14% of the respondents create a protective ileostomy and 63% a definitive colostomy. In ASA 1-2 patients with peritonitis after a rectum resection with deviating ileostomy, 31% prefer a laparotomy for lavage and repair of the anastomosis, 25% for lavage without repair and 36% of the respondents prefer to break down the anastomosis. When the patient is ASA 3 and/or >80 years of age, 13% prefer repair, 9% a lavage and 74% breaking down the anastomosis. This questionnaire shows that in contrast to older people, more surgeons make an effort to preserve the anastomosis in younger people.
journal_name
Dig Surgjournal_title
Digestive surgeryauthors
Daams F,Slieker JC,Tedja A,Karsten TM,Lange JFdoi
10.1159/000346348subject
Has Abstractpub_date
2012-01-01 00:00:00pages
516-21issue
6eissn
0253-4886issn
1421-9883pii
000346348journal_volume
29pub_type
杂志文章abstract:BACKGROUND/AIMS:Crohn's disease is a chronic relapsing inflammatory bowel disease requiring surgery in a large number of patients. This review describes new developments in surgical techniques for treating Crohn's disease. RESULTS:Single-incision laparoscopic surgery decreases abdominal wall trauma by reducing the num...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000341567
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The reduction in plasma cholesterol with increase in large and lower dense LDL (pattern A) obtained by statins is usually associated with a prompt reduction in cardiovascular risk, but after bariatric surgery for morbid obesity a delay of some years is observed. No data regarding LDL pattern are available in...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000068861
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND:Both ectopic pancreatic tissue and malignant insulinoma are rare. We encountered the combination of these rare entities in a patient demonstrating hypoglycemic symptoms. METHOD:A patient with episodic hypoglycemia, non-suppressed serum insulin levels, positive fasting test and a positive localization on bot...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000090998
更新日期:2005-01-01 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:Since carcinoma of the esophagus is usually diagnosed at an advanced stage, many cases of esophageal cancer are beyond possible radical resection and only palliative treatment can be performed in such cases. Therefore, a great deal of discussion has taken place concerning indications for treatment modality, ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018619
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND/AIM:Laparoscopy-assisted surgery has proved useful in the treatment of early gastric cancer, but its use in advanced cancer has rarely been studied. To investigate the efficacy and advantages of laparoscopy-assisted distal gastrectomy (LADG) with D2 dissection of lymph nodes versus conventional open D2 dista...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000281818
更新日期:2010-01-01 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 repair of bile duct strictures (BDS) requires identification of healthy bile duct proximal to the stenosis. Identification may be difficult in complex bile duct injuries after cholecystectomy or partial liver resection. AIM:We describe a technique to identify the prestenotic bile duct using the sentinel...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000227276
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Living-donor liver transplantation using a right-lobe graft has increased the frequency of hilar anatomical variations despite its advantage of a larger graft volume. METHODS:Sixty-seven living-donor liver transplantations using right-lobe grafts are reviewed, regarding the surgical anatomy of hilar vascula...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000121907
更新日期:2008-01-01 00:00:00
abstract::Behçet's disease (BD) is a multisystem disorder characterized by vasculitis. The aim of this report is to present a patient with BD and diverticular disease of the colon and discuss the possible association between BD and diverticulosis. To our knowledge, diverticular disease of the colon has not been previously repor...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000050185
更新日期:2001-01-01 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:It is unclear whether total gastrectomy (TG) is always necessary for gastric cancer of the cardia. We therefore investigated whether cardiac cancers treated by TG would have been cured by proximal gastrectomy (PG). METHODS:Photocopies of the resected stomachs of 55 patients who had received TG for cardiac c...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000052000
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND/AIMS:Oesophageal intubation remains one of the principal methods of palliation for an obstructing oesophageal carcinoma. We present a case which illustrates a rare but fatal complication of this procedure. METHODS:A 60-year-old female with oesophageal cancer presented with total dysphagia 9 months following...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000018886
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND/AIMS:Because the TNM system disregards the number of lymph nodes dissected and inter-individual differences exist in the number of regional lymph nodes, the lymph node ratio (LNR), which is estimated by dividing the number of metastatic lymph nodes by the number of dissected lymph nodes, has been proposed as...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000355444
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Tata Memorial Centre (TMC) is a high-volume centre for pancreatic tumour resections. We found a continually increasing referral of pancreatic tumours for re-evaluation for surgery, after an initial unsuccessful attempt at resection. AIM:To evaluate reasons of initial in-operability, the feasibility of re-op...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000489275
更新日期:2019-01-01 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::Partial liver resections are the treatment of choice for patients with a malignant liver or bile duct tumor. The most frequent indications for partial liver resections are colorectal metastasis, hepatocellular carcinoma (HCC) and cholangiocarcinoma. Liver resection is the only therapy with a chance for cure in these p...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000103656
更新日期:2007-01-01 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::This report presents a case of a patient with a huge hepatocellular carcinoma in the right lobe of the liver with an extensive portal venous tumor thrombus extending into the main portal trunk and left portal branch. The patient underwent extended right hemihepatectomy with tumor thrombectomy with direct extraction fr...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000324596
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND/AIMS:Approximately 20% of patients undergoing surgery for ulcerative colitis will retain their rectum. A single-stage proctocolectomy could be an appropriate procedure in patients who are definitely not candidates for a later restorative procedure, but it is generally not advised in acutely ill patients. The...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000381033
更新日期:2015-01-01 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:OBJECTIVE:Systemic and/or local interleukin-6 (IL-6) reportedly plays an active role in the progression and prognosis of thoracic esophageal squamous cell carcinoma (TESCC). We assessed the associations between IL-6 and IL-6 receptor (IL-6R) genetic polymorphisms, tumoral IL-6 expression and survival rates following su...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000336952
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Pancreatic tuberculosis is usually unsuspected as it can present in various forms. Though an uncommon disease, once diagnosed it is potentially curable. PATIENTS AND METHODS:Retrospective review of the records of 9 patients with histologically proven tuberculosis of the pancreas. RESULTS:In none of the 9 p...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000065832
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND/AIMS:Intra-abdominal adhesions typically occur after surgically damaged tissues are situated in apposition, leading to fibrotic connections. The goal of this study was to demonstrate the in vivo efficacy of a cross-linked and insoluble hyaluronic acid (HA) film to reduce postsurgical adhesion in a rat model....
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000253872
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVE:To propose guidelines for treatment based on the study of early and late outcome after various surgical procedures for sclerosing encapsulating peritonitis (SEP). PRIMARY BACKGROUND DATA: SEP is rare. The main complication is intestinal obstruction. Ideal treatment is resection of the membrane, whenever possi...
journal_title:Digestive surgery
pub_type: 杂志文章,多中心研究,评审
doi:10.1159/000018681
更新日期:1998-01-01 00:00:00
abstract::The surgical management of gastroesophageal reflux disease has been simplified by the availability of minimally invasive techniques to treat this condition. The indications and selection of patients remain the same as for open surgery and initial results with laparoscopic antireflux surgery show long-term results equa...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000018686
更新日期:1999-01-01 00:00:00
abstract::The introduction and widespread application of minimally invasive surgery has been one of the most important innovations that radically changed the practice of surgery during the last few decades. The application to pancreatic surgery of minimally invasive approach has only recently emerged: both laparoscopic distal p...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000445012
更新日期:2016-01-01 00:00:00
abstract::Ileal J-pouch-anal anastomosis is a commonly accepted surgical treatment for patients with ulcerative colitis. However, making a J-pouch anal anastomosis can be difficult due to anatomical variations of patients. We experienced an informative case of ulcerative colitis in which the ileal pouch was damaged when it was ...
journal_title:Digestive surgery
pub_type: 杂志文章
doi:10.1159/000105526
更新日期:2007-01-01 00:00:00
abstract::As well as the pronounced effect on body mass index (BMI), bariatric surgery is increasingly recognized as being associated with improvements in morbidity and mortality in a range of conditions, from airways disease to cancer. In metabolic disease, the impact of bariatric surgery is particularly obvious with marked im...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000351440
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Mechanical stapling devices are widely used in all fields of surgery as they can cut and sew tissue in a quick and easy manner. However, complications like bleeding or leakage at the staple line are frequently encountered and can have devastating consequences. Recent developments have led to the introduction...
journal_title:Digestive surgery
pub_type: 杂志文章,评审
doi:10.1159/000096648
更新日期:2006-01-01 00:00:00