Abstract：
PURPOSE:The use of computed tomography (CT) to detect anastomotic leakage (AL) is becoming the standard of care. Accurate detection of AL is crucial. The aim of this study was to define CT criteria that are most predictive for AL. METHODS:From January 2006 to December 2012, all consecutive patients who had undergone CT imaging because of clinical suspicion of anastomotic leakage after colorectal surgery were analysed. All CT scans were re-evaluated by two independent abdominal radiologists blinded for clinical outcome. The images were scored with a set of criteria and a conclusion whether or not AL was present was drawn. Each separate criterion was analysed for its value in predicting AL by uni- and multivariable logistic regression RESULTS:Of 668 patients with colorectal surgery, 108 had undergone CT imaging within 16 days postoperatively. According to our standard of reference, 34 (31%) of the patients had AL. Univariable analysis showed that "fluid near anastomosis" (radiologist 1 (rad 1), p < 0.001; radiologist 2 (rad 2), p < 0.001) and "air near anastomosis" (rad 1, p < 0.001; rad 2, p < 0.001), "air intra-abdominally" (rad 1, p = 0.019; rad 2, p = 0.004) and "contrast leakage" (rad 1, p < 0.001; rad 2, p < 0.001) were associated with AL. Contrast leakage was the only independent predictor for AL in multivariable analysis for both radiologists (rad 1, OR 5.43 (95% CI 1.18-25.02); rad 2, OR 8.51 (95% CI 2.21-32.83)). CONCLUSION:The only independent variable predicting AL is leakage of contrast medium. To improve the accuracy of CT imaging, optimal contrast administration near the anastomosis appears to be crucial.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Huiberts AA,Dijksman LM,Boer SA,Krul EJ,Peringa J,Donkervoort SCdoi
10.1007/s00384-015-2215-9subject
Has Abstractpub_date
2015-06-01 00:00:00pages
843-8issue
6eissn
0179-1958issn
1432-1262journal_volume
30pub_type
杂志文章abstract：PURPOSE:Acute mesenteric ischemia (AMI) is still associated with very high morbidity and mortality while the rareness and heterogeneity hamper the establishment of evidence-based guidelines. We sought to help standardize contemporary treatment by a cohort study at our tertiary center in the rising endovascular age. ME...
journal_title：International journal of colorectal disease
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journal_title：International journal of colorectal disease
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journal_title：International journal of colorectal disease
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journal_title：International journal of colorectal disease
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abstract：BACKGROUND AND AIMS:Evacuation disorders associated with a rectocele can be improved by rectocele repair. This study investigated whether anorectal function tests results change after rectocele repair. PATIENTS AND METHODS:Fourteen patients with 2nd or 3rd degree rectocele and evacuation disorder were treated by poste...
journal_title：International journal of colorectal disease
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abstract：BACKGROUND:In acute or chronic inflammatory bowel disease (IBD) interferon gamma (IFNgamma) is still considered to be an important pro-inflammatory mediator. In the present study we investigated the impact of IFNgamma on interleukin-8 (IL-8) production as a read-out for cell activation in intestinal epithelial cell (IE...
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journal_title：International journal of colorectal disease
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journal_title：International journal of colorectal disease
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