“Intestinal stomas are the surgical exteriorization of either small or large bowel through the anterior abdominal wall. While the principles behind stoma creation are typically the same, there are many different stoma configurations that are created for myriad indications.”Continue reading
Category Archives: Colorectal Surgery
Risk of Anastomotic Leak After Repeat Intestinal Resection in Patients With Crohn’s Disease?
“Repeat intestinal resection in patients with Crohn’s disease is associated with an increased rate of anastomotic leakage when compared with initial resection despite similar patient, medication, and procedural factors.”Continue reading
Histological Margin Positivity in the Prediction of Recurrence After Crohn’s Resection
“The presence of involved histological margins at the time of index resection in Crohn’s disease is associated with recurrence, and plexitis shows promise as a marker of more aggressive disease. Further studies with homogeneity of histopathological and recurrence reporting are required.“”The presence of involved histological margins at the time of index resection in Crohn’s disease is associated with recurrence, and plexitis shows promise as a marker of more aggressive disease. Further studies with homogeneity of histopathological and recurrence reporting are required.“Continue reading
Life-threatening pelvis sepsis
“Although extremely uncommon, severe sepsis does occur post-treatment for haemorrhoids and all surgeons who treat such patients should be aware of the potential complications and alert to their presenting features. Early presentation without evidence of tissue necrosis may be managed conservatively, although most cases are managed by means of surgery.”
“Treatments for haemorrhoids can be divided in to conservative measures such as anal hygiene and topical ointments or suppositories, and interventions.
These are either office-based such as:
-rubber band ligation (RBL)
Haemorrhoidectomy has long been the mainstay of surgical therapy, but recently new techniques have been described, principally the stapled haemorrhoidopexy or procedure for prolapsing haemorrhoids (PPH).”Continue reading
Mesenteric Venous Thrombosis
“Mesenteric venous thrombosis is caused by impairment of venous return of the bowel due to local blood coagulation. Primary mesenteric venous thrombosis is considered spontaneous and idiopathic, whereas secondary mesenteric venous thrombosis is due to an underlying condition. Mesenteric venous thrombosis can lead to venous engorgement and mesenteric ischemia and accounts for 5 to 15 percent of mesenteric ischemic events.”Continue reading
Handsewn vs. stapled anastomoses in colon and rectal surgery
“Trials comparing handsewn with stapled anastomoses in colon and rectal surgery have not found statistical differences. Despite this, authors have differed in their conclusions as to which technique is superior. To help determine whether differences in patient outcomes are present, a meta-analysis of all trials was performed.”Continue reading
ketorolac use and the risk of anastomotic leak after colorectal surgery.
“This meta-analysis included seven studies with 400,822 patients. Our results demonstrated that ketorolac administration after surgery increases the risk of anastomotic leak [OR = 1.41, 95% CI: 0.81–2.49, Z = 1.21, P = 0.23].”
“Anastomotic leak is a serious complication that occurs after colorectal surgery, which can lead to increased morbidity and mortality. Non-selective NSAIDs (such as ketorolac) may affect the healing of the intestine by inhibiting the action of cyclooxygenase. NSAIDs have been shown to weaken granulocyte function, which is an essential part of the acute phase of wound healing. NSAIDs may also inhibit epithelial cell migration and mucosal recovery, which are important in the pathophysiology of intestinal ulcer healing. These findings suggest a potential biological mechanism that may explain the association identified in this study.”
Chen W, et al Administration After Colorectal Surgery Increases Anastomotic Leak Rate: A Meta-Analysis and Systematic Review. Front Surg. 2022 Feb 9;9:652806. Free Full Text