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    Tytuł:
    The use of state-of-the-art haemostatic materials in gastrointestinal surgery
    Autorzy:
    Przywózka-Suwał, Alicja
    Ziółkowski, Bartosz
    Szczepkowski, Marek
    Powiązania:
    https://bibliotekanauki.pl/articles/1391519.pdf
    Data publikacji:
    2021
    Wydawca:
    Index Copernicus International
    Tematy:
    anastomotic leak
    haemostatic agents
    hemostasis
    Opis:
    Haemostatic materials such as: gelatine sponges, oxygenated cellulose meshes, tissue sealants, collagen matrices with human thrombin and fibrinogen are gaining on popularity in gastrointestinal surgery, especially in colorectal surgery. We searched for available scientific publications in the Pubmed and Cochrane database on the use of individual hemostatic materials in the field of gastrointestinal surgery. The analysis focused on the assessment of the safety of the use of individual materials in terms of the rate of bleeding complications and the rate of anastomotic leakage cases. The use of haemostatic materials has for years been a recognized method of reducing the rate of intra- and postoperative complications, both in gastrointestinal surgery and in other surgical specialties. Based on the available studies, it can be concluded that the use of hemostatic materials such as matrices, sponges and adhesives in gastrointestinal surgery, even in patients at high risk of anastomotic leakage and bleeding complications, reduces the incidence of complications. The growing popularity of haemostatics and sealants in surgery means that they are currently used in a wide range of indications, and surgeons are more and more willing to use them even in case of standard surgical procedures, which is reflected in the available studies. Choosing a haemostat should be a conscious decision, taking into account the site and type of bleeding, mechanism of action, ease of use, efficacy, safety, and price, among others.
    Źródło:
    Polish Journal of Surgery; 2021, 93, 1; 49-54
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Risk factors and inflammatory predictors for Anastomotic Leakage following Total Mesorectal Excision with defunctioning stoma
    Autorzy:
    Chernyshov, Stanislav
    Alexeev, Mikhail
    Rybakov, Evgeny
    Tarasov, Mikhail
    Shelygin, Yuri
    Zarodniuk, Irina
    Sukhina, Marina
    Powiązania:
    https://bibliotekanauki.pl/articles/1392655.pdf
    Data publikacji:
    2018
    Wydawca:
    Index Copernicus International
    Tematy:
    Anastomotic Leak
    Low Anterior Resection
    C-Reactive Protein
    Procalcitonin
    Biomarkers
    Opis:
    Background: This study aims to examine the factors involved in anastomotic leak (AL) following low anterior resection and total mesorectal excision (LAR-TME) and to determine the usefulness of early measurement of the inflammatory biomarkers C-Reactive Protein (CRP) and Procalcitonin (PCT). Methods: One hundred patients undergoing LAR-TME with proximal diverting stoma were analysed between 2013 and 2016. Postoperative CRP and PCT levels were measured on the 3rd and 6th postoperative days. Results: There were 11 clinical leaks with a negative impact in univariate analysis on AL of male gender, larger and stenotic tumours, intraoperative blood loss > 200 mL, need for perioperative blood transfusion, postoperative anaemia and operating time exceeding 180 minutes. Upon multivariate analysis, only perioperative blood transfusion was an independent AL risk factor. Recorded CRP was higher in AL patients when compared with non-AL cases on both the 3rd postoperative day (152.4 mg/L vs 93 mg/L, respectively; P < 0.0001) and the 6th postoperative day (130.5 mg/L vs 68.2 mg/L; P < 0.0001). PCT levels also significantly differed between AL and non-AL cases on the 3rd postoperative day (0.5 ng/mL vs 0.2 ng/mL, respectively; P < 0.0001) and the 6th postoperative day (1.16 ng/mL vs 0.1 ng/mL, respectively; P < 0.0001). Both CRP and PCT showed high negative predictive values (NPV) for the diagnosis of AL on both postoperative days. Conclusion: Following low restorative proctectomy, high NPV of CRP and PCT measurements for the diagnosis of anastomotic leaks may assist decision-making for early hospital discharge.
    Źródło:
    Polish Journal of Surgery; 2018, 90, 3; 31-36
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Evaluation of risk factors for postoperative complications in rectal cancer patients
    Autorzy:
    Zeman, Marcin
    Czarnecki, Marek
    Grajek, Maciej
    Idasiak, Adam
    Tukiendorf, Andrzej
    Czarniecka, Agnieszka
    Powiązania:
    https://bibliotekanauki.pl/articles/1391899.pdf
    Data publikacji:
    2020
    Wydawca:
    Index Copernicus International
    Tematy:
    anastomotic leak
    anterior resection
    postoperative complications
    rectal cancer
    Opis:
    Introduction: The complications of surgical treatment for rectal cancer, particularly anastomotic leaks after anterior resection, are a significant clinical problem. We retrospectively analysed preoperative factors that may affect the occurrence of complications. Meterial and Methods: A total of 392 rectal cancer patients were included in a retrospective analysis. A total of 257 anterior resections (AR) and 135 abdominoperineal resections (APR) were performed. The risk factors for early postoperative complications were analysed by logistic regression and receiver operating characteristic curves. Results: The significant risk factors for severe complications (grade 3B and higher on the Clavien-Dindo scale) in the multivariate analysis were neutrophil to lymphocyte ratio > 5 (P = 0.047) in the AR group, age of the patients (P = 0.031) in the APR group, and coronary artery disease in both groups (P = 0.03, P = 0.011, respectively). There were no risk factors for anastomotic leaks in the AR group before the analysis was divided into early and late leaks. In the univariate analysis, the statistically significant risk factors for early leaks were preoperative neutrophil to lymphocyte ratio > 5 and peripheral blood platelet count, while late leaks were associated with coronary artery disease; however, in the multivariate analysis, these factors were not statistically significant. Conclusions: The risk factors for severe postoperative complications were neutrophil to lymphocyte ratio > 5, advanced age of the patients and coronary artery disease. The different risk factors for early and late anastomotic leaks after anterior resection may indicate their different aetiologies.
    Źródło:
    Polish Journal of Surgery; 2020, 92, 5; 24-30
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Buttressing hepaticojejunostomys with hepatic round ligament flap may be beneficial
    Autorzy:
    Banerjee, Jayant Kumar
    Bharathi, Ramanathan Saranga
    Rao, Pankaj Purushotam
    Powiązania:
    https://bibliotekanauki.pl/articles/1393023.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    hepatic round ligament/ ligamentum teres hepatis
    Bilioenteric anastomosis
    Hepaticojejunostomy
    Bile leak
    Anastomotic stricture
    Autologous hepatic round ligament flap
    Opis:
    Background: Bile leaks and anastomotic strictures are important complications of hepaticojejunostomy (HJ). Evidence suggests that the use of hepatic round ligament (HRL) to buttress HJ may be beneficial. This study evaluates the feasibility of this approach. Methods: HJs performed over 2 years (Jun 2014- May 2016), with HRL reinforcement, were analyzed. Operative outcomes measured included technical difficulty, blood loss, time necessary for flap harvest, and reinforcement of HJ. The postoperative outcomes measured were the presence of bile leak and anastomotic stricture. Results: Forty-one patients (27 M: 14 F), aged 2-79 years, median age of61 years, underwent HJ with HRL buttress; 27 for periampullary/ head of the pancreas carcinoma; 4 for choledochal cysts; 4 for chronic pancreatitis; 3 for gallbladder carcinoma; 3 for benign biliary stricture. The time for harvesting HRL flaps and buttressing HJ was <10 minutes. No blood was lost during harvesting the flaps. One patient (2.5 %) had grade A leak following radical cholecystectomy, and structures were not observed during a median follow-up of 18 months (6 months to 2years). Conclusion: HRL-based buttressing of HJ can reduce the bile leak and/or stricture rate.
    Źródło:
    Polish Journal of Surgery; 2017, 89, 4; 5-10
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
    Tytuł:
    Anastomotic leaks in gastrointestinal surgery and their prevention
    Autorzy:
    Banasiewicz, Tomasz
    Dziki, Adam
    Lampe, Paweł
    Lorenc, Zbigniew
    Szczepkowski, Marek
    Zieliński, Jacek
    Wallner, Grzegorz
    Powiązania:
    https://bibliotekanauki.pl/articles/1393190.pdf
    Data publikacji:
    2017
    Wydawca:
    Index Copernicus International
    Tematy:
    GI tract anastomosis
    anastomotic leak
    protective stoma
    fibrin glue
    perioperative nutrition
    collagen matrix coated with the fibrynogen and thrombin
    Opis:
    Anastomotic leak in the gastrointestinal tract is one of the most important complications of resection. They are the main cause of reoperation, their occurrence worsens the prognosis of the patient, increasing the proportion of direct mortality, as well as being a significant risk factor for recurrence of cancer. The risk of leaks within the gastrointestinal tract is greatly varied, depending on the location and extent of the resection, but also on patient, disease or a surgical procedure, including surgeon. To determine the potential risk of leakage can be significant for introduction some prophylactic actions. Some of them have the character of general recommendations, as proper nutrition of the patient in the perioperative period, while another part is directly connected to the surgical procedure. The second group includes protective stoma, the use of tissue glues, insertion transrectal drain for rectal anastomosis decompression, the use of stents or the use of collagen matrix coated with fibrinogen and thrombin. Important to reduce the proportion of leaks can be more precise and targeted prophylactic recommendations, based on the individualized determination of risk factors leaks. Further research for this purpose are necessary for this purpose, the big hope can be associated with data obtained through mobile applications.
    Źródło:
    Polish Journal of Surgery; 2017, 89, 2; 49-56
    0032-373X
    2299-2847
    Pojawia się w:
    Polish Journal of Surgery
    Dostawca treści:
    Biblioteka Nauki
    Artykuł
      Wyświetlanie 1-5 z 5

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