Intraoperative endoscopic assessment of circular-stapled anastomosis can detect early anastomotic bleeding and leakage. Although the postoperative rate of bleeding and leakage was not significantly reduced in our study, we still recommend endoscopic assessment of the circular-stapled anastomosis as a routine procedure in colorectal surgery, as the benefits outweigh the risks.
The mean HSA was determined in these normal subjects to be 5.84 cm(2). It was directly proportional to chest circumference and independent of height, weight, BMI, and gender.
Background: The first laparoscopic cholecystectomy (LC) in Austria was performed on March 22nd, 1990 at the General Hospital Linz. As the experience increased during time the scope of contraindications has been narrowed and the rate of conversion has been decreased. However, acute cholecystitis still leads to a higher conversion rate.Methods: We retrospectively analysed all cholecystectomies from 1990 till 2010. All acute cholecystectomies have been carried out with regard to conversion, risk factors for conversion, morbidity and mortality.Results: We performed 7541 cholecystectomies. 701 (9.3%) patients had primary open cholecystectomy (OC) and 452 (6%) had concomitant CHE without further evaluation for this study. From the remaining 6139 patients with LC 1775 (male 885 [36%], female 890 [21%]) have been operated due to acute cholecystitis. 141 (7.9%, 78 male, 63 female, median age 66 years, range 20-94) of them led to conversion. The acute inflammation itself including difficulties in Calot's triangle was the most common cause for conversion (56%) followed by adhesions (19.1%). Two patients have been converted due to common bile duct lesion (1.4%) In case of acute operation and conversion the mortality was 5%, morbidity was 20%. Out of the 4364 patients with elective LC 200 had to be converted (4.6%). The overall conversion rate was 5.5%. The Reoperation rate after conversion was 6.3% (n ¼ 9).Conclusions: Acute cholecystitis leads significantly more often to conversion as in elective LC. Male patients present at the clinic more frequent than female with acute cholecystitis, but in the acute situation the conversion rate is equal.
Laparoscopic sigmoid resections for diverticulitis can be performed with great safety and low conversion rate. Several adjustments in operation technique and perioperative management had to be done to achieve a complication rate and conversion rate at an acceptable low level.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.