Abstract:
PURPOSE:The reported rate of clinically apparent anastomotic leakage (AL) in a low anterior resection of the rectum (LAR) (≤7 cm from the anal verge) using a circular double-stapled anastomosis (CDSA) without defunctioning stoma is up to 37.5 %. Since AL may result in life-threatening peritonitis, sepsis, and multiple organ failure, LAR and CDSA are regularly combined with defunctioning stoma. Accordingly, we now evaluated whether LAR and CDSA without defunctioning stoma but with extraluminal anastomotic application of an experimental fibrin sealant reduce the AL rate. This might prevent humans from defunctioning stoma increasing quality of life and decreasing surgical costs. METHODS:Forty 8-week-old pigs underwent LAR and CDSA in an end-to-end technique (descendo-rectostomy). Animals were randomized into a therapy and control group (gr.). The therapy gr. (n = 20) received an additional extraluminal circular application of an experimental fibrin sealant to the anastomosis. The objective was to assess the incidence of clinically apparent and non-clinically apparent leakage through the ninth postoperative day. Double-contrast barium CT radiographs of the colorectal region were performed on the ninth postoperative day or earlier, in case there were clinical signs of AL. All remaining animals were sacrificed on the ninth postoperative day and the anastomotic region was histopathologically analyzed. In case of earlier diagnosed AL, animals were sacrificed immediately. Blood samples were taken for complete blood count, chemistry, and coagulation profile prior to surgery and on the first, third, fifth, seventh, and ninth postoperative day. RESULTS:A circular extraluminal anastomotic application of an experimental fibrin protection decreased the rate of clinically and non-clinically apparent AL from 20 % (n = 4) in the control group to 5 % (n = 1) in the treatment group. Ulcerations were also observed in both gr. (control gr.-5 animals, therapy gr. -3 animals). All animals with AL showed necrosis surrounding the hole at the anastomoses. Three additional animals had a full wall defect at the anastomotic region that was blocked by the experimental fibrin sealant. The fibrin sealant was present at necropsy in all treated animals. CONCLUSION:Circular anastomotic protection with the experimental fibrin sealant blocked anastomotic full wall defects, preventing peritonitis and significantly reducing the AL rate from 25 to 5 %.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Wenger FA,Szucsik E,Hoinoiu BF,Cimpean AM,Ionac M,Raica Mdoi
10.1007/s00384-015-2260-4subject
Has Abstractpub_date
2015-08-01 00:00:00pages
1029-39issue
8eissn
0179-1958issn
1432-1262journal_volume
30pub_type
杂志文章abstract:OBJECTIVE:Our study is the first meta-analysis to compare total mesorectal excision (TME) plus lateral lymph node dissection (LLND) with TME on rectal cancer patients regarding outcomes including overall survival, disease-free survival, local recurrence, complications, urinary dysfunction, and sexual dysfunction. METH...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-020-03610-1
更新日期:2020-06-01 00:00:00
abstract:PURPOSE:Published multigene classifiers suggesting outcome prediction for patients with stage UICC II colon cancer have not been translated into a clinical application so far. Therefore, we aimed at validating own and published gene expression signatures employing methods which enable their reconstruction in routine di...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1176-x
更新日期:2011-07-01 00:00:00
abstract::In a prospective study we examined the value of endorectal ultrasound (ERUS) in the preoperative staging of potentially locally excisable tumours. During the study period from 1.1.1991 to 1.3.1996 a total of 160 rectal tumours in 152 patients were staged endosonographically (uT/uN) and compared postoperatively with th...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840050092
更新日期:1997-01-01 00:00:00
abstract:PURPOSE:Aberrant activation of the Wnt/β-catenin pathway plays a major role in the development of colorectal carcinoma (CRC). Axin 2 is a key protein of this pathway and is upregulated in CRC. Here, we investigated RNA- and protein expression of axin 2 in CRC tissues at the single cell level. Moreover, the association ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1709-6
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND AND AIMS:Inpatients developing upper gastrointestinal (GI) haemorrhage are at increased risk of death. This study was performed to elucidate differences in inpatients and outpatients. PATIENTS/METHODS:Three hundred and sixty-two patients who needed esophagogastroduodenoscopy for upper GI bleeding were ident...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-004-0642-0
更新日期:2005-07-01 00:00:00
abstract:PURPOSE:The present study was performed to get a better insight in the incidence of anastomotic leakage leading to reintervention when using the C-seal: a biodegradable sheath that protects the stapled colorectal anastomosis from leakage. METHODS:The C-seal is a thin walled tube-like sheath that forms a protective she...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1724-7
更新日期:2013-10-01 00:00:00
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 C...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-015-2215-9
更新日期:2015-06-01 00:00:00
abstract:BACKGROUND:Colorectal high-grade intraepithelial neoplasia is defined as a high-grade neoplastic lesion with no invasion of submucosa. Because pathological evaluation has inevitable sampling errors, invasive cancer may be underdiagnosed as high-grade intraepithelial neoplasia by regarding submucosa invasion as an indis...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-014-2001-0
更新日期:2014-12-01 00:00:00
abstract:INTRODUCTION:Visceral pain is a symptom reported by over 70% of inflammatory bowel disease (IBD) sufferers. So far, a single, specific cause of this debilitating state has not been established. Chronic pain is one of the most important factors decreasing the quality of life in IBD course. Concurrently, management of pa...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-018-3218-0
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:The objectives of the study were to estimate the incidence and clarify the clinicopathologic feature of sporadic microsatellite instability (MSI)-high (MSI-H) colon cancer. Furthermore, the role of MSI in colon cancer prognosis was also investigated. METHODS:Microsatellite status was identified by genotyping. ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1341-2
更新日期:2012-03-01 00:00:00
abstract::Intestinal lymphangiectasia is a rare disorder, usually presenting with protein-losing enteropathy leading to oedema and ascites. We describe a case that presented as an acute surgical emergency with pain and a mass in the right iliac fossa, which was successfully treated by resection of the involved segment of ileum....
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s003840050044
更新日期:1996-01-01 00:00:00
abstract:PURPOSE:Although small rectal carcinoid tumors can be treated using local excision, complete resection can be difficult because tumors are located in the submucosal layer. We evaluate the factors associated with pathologically complete local resection of rectal carcinoid tumors. METHODS:Data were analyzed of 161 patie...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-012-1538-z
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Some patients with uncomplicated diverticulitis have extraluminal air. Our objective was to determine if patients with Hinchey 1a diverticulitis and isolated extraluminal air present more severe episode than patients without extraluminal air. METHODS:The present study is a monocentric observational retrospe...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-019-03424-w
更新日期:2019-12-01 00:00:00
abstract:PURPOSE:Surgical site infections (SSI) cause excess morbidity and mortality in modern surgery. Several different approaches to reduce the incidence of SSI have been investigated with variable results. METHOD:This is to our knowledge the first systematic randomized evaluation in patients undergoing laparotomy in viscer...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00384-010-0884-y
更新日期:2010-05-01 00:00:00
abstract:INTRODUCTION:Debate persists regarding the relationship between mucin expression and outcome in colon cancer. This arises due to discrepancy in the definition of mucinous adenocarcinoma and the combination of both colon and rectal cancers in analyses. This study examines the relationship between increased mucin product...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-013-1826-2
更新日期:2014-05-01 00:00:00
abstract:PURPOSE:Whether the introduction of extralevator abdominoperineal excision (ELAPE) improves survival and safety remains controversial. We conducted a systematic review and meta-analysis of all comparative studies to define the efficacy and safety of ELAPE and standard abdominoperineal excision (APE). MATERIALS AND MET...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00384-013-1793-7
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND AND AIMS:Hereditary nonpolyposis colorectal cancer (HNPCC) and a subset of sporadic colorectal cancers are characterized by microsatellite instability (MSI) and inactivating frameshift mutations of target genes. Inactivation of BAX, caspase-5 ( cas-5), and other genes coding for pro-apoptotic proteins might ...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-004-0597-1
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:The impact of postoperative complications (POCs) on the long-term prognosis of patients with colorectal carcinoma was analysed with respect to their severity according to the Clavien-Dindo classification (CDC). METHODS:The prospectively collected data of 2158 patients who underwent curative resection of a c...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03557-3
更新日期:2020-06-01 00:00:00
abstract::An audit was performed of 77 patients with a single colorectal cancer visualised and sited before surgery by colonoscopic examination. The site of the cancer described at colonoscopy was compared with the actual site found at laparotomy. Six significant errors in preoperative localisation were encountered, when a chan...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/BF00298535
更新日期:1995-01-01 00:00:00
abstract:PURPOSE:Anastomotic leakage (AL) after total mesorectal excision (TME) for rectal cancer is suspected to alter function. However, very few reports have been devoted to this problem. The aim of this study was to assess the influence of AL on function and quality of life (QoL) after laparoscopic TME for cancer. METHODS:...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-014-1833-y
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Collagenous colitis is a chronic inflammatory bowel disease of unknown origin. In some cases of collagenous colitis, histomorphological features are comparable to other inflammatory bowel diseases. AIM:To assess functional NOD2/CARD15 polymorphisms for the susceptibility to collagenous colitis in a case-con...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-006-0158-x
更新日期:2007-04-01 00:00:00
abstract:PURPOSE:Ileal pouch-anal anastomosis (IPAA) has been established as the procedure of choice for patients who require excision of the colon and rectum for familial adenomatous polyposis and ulcerative colitis. The requirement for proximal stomal diversion in IPAA is controversial. OBJECTIVES:To compare post-operative o...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,评审
doi:10.1007/s00384-020-03814-5
更新日期:2021-01-04 00:00:00
abstract:PURPOSE:The RET protooncogene plays a crucial role in neural crest development; accordingly, mutations of RET cause MEN2A and familial medullary thyroid carcinoma, while the expression deregulation of RET is involved in the pathophysiology of glioblastoma multiforme (GBM) and pancreatic cancer (PDAC). The aim of this s...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-011-1150-7
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Colorectal cancer (CRC) is the third most frequent cancer diagnosed in men and the second in women. Laparoscopic surgery has been a technical revolution in colorectal surgery, facilitating a better recovery of patients with lower morbidity and better esthetic results, compared to traditional surgery via lapa...
journal_title:International journal of colorectal disease
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00384-018-3157-9
更新日期:2018-11-01 00:00:00
abstract:PURPOSE:The Bethesda guidelines suggest to perform microsatellite instability (MSI) test in early onset rectal cancer and not in patients>50 years with proximal colon cancer. The aim of the study was to evaluate whether the risk of high MSI (MSI-H) is greater in proximal colon cancer of patients 51-60 years old than in...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-008-0484-2
更新日期:2008-08-01 00:00:00
abstract:INTRODUCTION:It is generally believed that resumption of feeding after colorectal resection is indicated only after recovery of bowel function. This study was designed to verify safety, feasibility, and tolerance of early oral postoperative feeding (EOF) outside an enhanced recovery after surgery (ERAS) program. MATER...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
doi:10.1007/s00384-011-1138-3
更新日期:2011-06-01 00:00:00
abstract:PURPOSE:To verify if in large haemorrhoidal prolapse (independently from the degree) in patients with no symptoms of obstructed defaecation syndrome, the use of a stapled hemorrhoidopexy variant, comprising a double stapler haemorrhoidopexy (DSH), makes it possible to reduce the percentage of failures or relapses and t...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-009-0750-y
更新日期:2009-12-01 00:00:00
abstract:PURPOSE:Postoperative ileus (POI) is one of the complications that can occur after every surgical procedure including arthroplasty. It can have detrimental consequences for the patient and portrays an economic burden on health care systems. The risk factors for POI after arthroplasty described in the literature are sca...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-018-3184-6
更新日期:2019-02-01 00:00:00
abstract:PURPOSE:This study investigates whether contrast enema (CE) and flexible endoscopy (FE) should be performed routinely after low anterior resection (LAR) before ileostomy reversal. Additionally, the impact of previous anastomotic leakage (AL) on diagnostic test accuracy (DTA) was assessed. METHODS:This is a retrospecti...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-020-03766-w
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:The prognostic significance of anti-53 autoantibody in colorectal cancer (CRC) patients is unclear due to measurement of overall rather than disease-specific survival and generally short follow-up periods in many studies. We aim to investigate prognostic significance of anti-p53 auto-antibodies in a study wi...
journal_title:International journal of colorectal disease
pub_type: 杂志文章
doi:10.1007/s00384-008-0458-4
更新日期:2008-06-01 00:00:00