Endoscopy in the Early Postoperative Setting after Primary Gastrointestinal Anastomosis

Amr, Mahmoud A.; Alzghari, Mohammad; Polites, Stephanie F.; Khasawneh, Mohammad A.; Morris, David S.; Baron, Todd H.; Zielinski, Martin D.

doi:10.1007/s11605-014-2625-y

Cited by 23 publications

(17 citation statements)

References 30 publications

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“…Gastrointestinal anastomosis is the most common gastrointestinal reconstruction surgery [ 1 , 2 ]. A frequent complication after gastrointestinal anastomosis is gastrointestinal fistula formation, the incidence of which is 0–17.4% [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of Early Postoperative Feeding in Gastrointestinal Anastomotic Fistula Formation and Healing Time in Rabbits

Tang

Cai

Cui

2018

BioMed Research International

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Objectives To determine whether early postoperative feeding attenuates the inhibitory effects of intestinal anastomosis in rabbits. Methods After undergoing gastrointestinal anastomosis, 48 rabbits were randomly divided into experimental and control groups. The rabbits in the experimental group were fed a liquid diet beginning 24 h postoperatively, while the control rabbits received only total parenteral nutrition after the operation. Exploratory laparotomies were performed on four rabbits in each group 3, 5, 7, 10, and 15 days postoperatively, and the healing rate of the anastomosis, anastomotic bursting pressure, anastomotic breaking strength, and hydroxyproline content at the anastomosis were determined. Results The anastomoses healed in 91.6% (22/24) of the control group and 95.8% (23/24) of the experimental group. The anastomotic bursting pressure decreased remarkably in both groups 3 days postoperatively, reaching the lowest value. The anastomotic breaking strength did not differ between the two groups 3 days postoperatively, when both reached their lowest points, and both groups increased markedly and peaked 10 days postoperatively. The hydroxyproline content of the anastomosis was slightly lower in the experimental group 3 days postoperatively, although both groups peaked 7 days postoperatively. Conclusions Early postoperative feeding does not increase the anastomosis healing time or rate of gastrointestinal anastomosis leakage.

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Section: Introductionmentioning

confidence: 99%

Influence of Early Postoperative Feeding in Gastrointestinal Anastomotic Fistula Formation and Healing Time in Rabbits

Tang

Cai

Cui

2018

BioMed Research International

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“…However, there are two limitations of this intervention. Firstly, colonoscopy may seem aggressive and possibly even dangerous to perform in the early postoperative period because of air insufflation, local colonoscope trauma and torque [ 9 ]. Thus colonoscopic hemostasis needs to be performed by skilled and experienced doctors.…”

Section: Resultsmentioning

confidence: 99%

Colonoscopy is the first choice for early postoperative rectal anastomotic bleeding

Lou

Zhang

et al. 2014

World J Surg Onc

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BackgroundAnastomotic bleeding is rare but is one of the dangerous complications, with associated morbidity and mortality, at the early stage of rectal cancer surgery. The aim of this study was to report our experiences in the treatment of this emergency condition.MethodsWe retrospectively analyzed the general characteristics, treatment and outcome of patients with severe anastomotic bleeding after undergoing rectal cancer resection with stapled anastomosis at the Department of Colorectal Surgery of Changhai Hospital (China) between January 2011 and December 2013.ResultsAnastomotic bleeding occurred in six out of 2,181 patients (0.3%) who underwent anterior resection with stapled anastomosis due to rectal cancer. All patients’ bleeding was stopped with colonoscopic techniques. There were no anastomotic leakages or strictures in these six patients.ConclusionsAnastomotic bleeding was a very rare complication after rectal cancer resection with stapled anastomosis. Colonoscopic treatment, including electrocoagulation and clipping, were both safely and effectively used in the early postoperative period to cease persistent anastomotic bleeding.

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“…1 Emerging technology has allowed many of the most feared complications of anastomotic surgery, including bleeding and leakage, to be detected early and often to be treated without surgery. 2,3 For example, anastomotic bleeding frequently can be treated with endoscopic clipping or cauterization when the anastomotic site is within the reach of the endoscope. 2 Yet anastomotic complications can be severe and can lead to disability and occasionally death 4 .…”

Section: Anastomotic Complications: a Spectrum Of Clinical Presentationsmentioning

confidence: 99%

“…2,3 For example, anastomotic bleeding frequently can be treated with endoscopic clipping or cauterization when the anastomotic site is within the reach of the endoscope. 2 Yet anastomotic complications can be severe and can lead to disability and occasionally death 4 . In order to understand how to prevent anastomotic complications, an evidence-based approach grounded both on an understanding of the pathophysiology and on clinical trials that demonstrate efficacy is needed.…”

Section: Anastomotic Complications: a Spectrum Of Clinical Presentationsmentioning

confidence: 99%

Prevention of Perioperative Anastomotic Healing Complications

Guyton

Hyman

Alverdy

2016

Advances in Surgery

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Synopsis The anastomotic healing complications of postoperative leak and stricture continue to plague surgeons despite many broadly targeted interventions. Evaluation of preventive measure efficacy is difficult due to inconsistent definitions and reporting of these complications. Few interventions have been shown to impact rates of leakage or stricture. However, new evidence is emerging that the intestinal microbiota can play an important role in the development of anastomotic complications. A more holistic approach to understanding the mechanisms of anastomotic complications is needed in order to develop tailored interventions to reduce their frequency. Such an approach may require a more complete definition of the role of the microbiota in anastomotic healing.

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Endoscopy in the Early Postoperative Setting after Primary Gastrointestinal Anastomosis

Abstract: Despite theoretical risks of adverse events of flexible endoscopy in the early postoperative period, no endoscopic perforations or disruptions occurred in recently created surgical anastomoses.

Cited by 23 publications

References 30 publications

Influence of Early Postoperative Feeding in Gastrointestinal Anastomotic Fistula Formation and Healing Time in Rabbits

Influence of Early Postoperative Feeding in Gastrointestinal Anastomotic Fistula Formation and Healing Time in Rabbits

Colonoscopy is the first choice for early postoperative rectal anastomotic bleeding

Prevention of Perioperative Anastomotic Healing Complications

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