Placement of a covered polyester stent prevents complications from a colorectal anastomotic leak and supports healing: Randomized controlled trial in a large animal model

Tsereteli, Zurab; Sporn, Emanuel; Geiger, Timothy M.; Cleveland, D. S.; Frazier, Shellaine R.; Rawlings, Arthur; Bachman, Sharon L.; Miedema, Brent W.; Thaler, Klaus

doi:10.1016/j.surg.2008.05.018

Cited by 31 publications

(24 citation statements)

References 26 publications

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“…Data evaluating the appropriateness of endoscopic management of colon perforations are scarce, despite the large amount of information about techniques especially coming from animal models [94,117,118].…”

Section: Managementmentioning

confidence: 99%

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Endoscopic “rescue” treatment for gastrointestinal perforations, anastomotic dehiscence and fistula

Dabizzi

Ceglie²,

Baig

et al. 2016

Clinics and Research in Hepatology and Gastroenterology

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Section: Managementmentioning

confidence: 99%

“…A randomized controlled trial in animal models has shown that the temporary placement of a SEPS (Polyflex-Boston Scientific Inc.) across a colorectal anastomosis can prevent leak-related complications [117].…”

Section: Stentmentioning

confidence: 99%

Endoscopic “rescue” treatment for gastrointestinal perforations, anastomotic dehiscence and fistula

Dabizzi

Ceglie²,

Baig

et al. 2016

Clinics and Research in Hepatology and Gastroenterology

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“…In the pigs treated without an endoluminal stent, five of eight pigs developed either an intra-abdominal abscess or a fistula. 47 A similar animal study was performed using a soluble intraluminal stent. In this study, the internal stents dissolved quickly, but led to a better histological appearance on microscopic review.…”

Section: Other Adjunctive Measuresmentioning

confidence: 99%

Staple Line/Anastomotic Reinforcement and Other Adjuncts: Do They Make a Difference?

Betzold

Laryea

2014

Clinics in Colon and Rectal Surgery

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). CME Objectives: At the completion of this article the reader should be able to summarize the complications of stapled anastomoses and the various staple line reinforcement agents.The first gastrointestinal anastomosis was performed over 200 years ago.1 Since then, there has been a push to improve anastomotic techniques with the goals of reducing complications, standardizing methods, and reducing operative time. These goals led to the development of the surgical stapler and the subsequent technological improvements by Ravitch and Steichen.2 Before the use of circular staplers, many patients were treated with sphincter extirpation. Staple technology has allowed for these patients to be treated with low colorectal anastomoses. However, anastomotic complications, especially leaks, remain the Achilles heel of these procedures. These complications have the potential to be devastating, and the rate of anastomotic leak in colorectal surgery has remained significant, hence the pursuit of adjuncts and reinforcements for stapled anastomoses. Complications Associated with Stapled AnastomosesComplications related to stapled anastomoses include bleeding, device failure, and anastomotic failure, which include stricture or leak (►Table 1). Some of these complications can be directly related to the device itself, with at least 112 deaths resulting from 20,000 malfunctions in a recent review. AbstractSince the development of the stapled intestinal anastomosis, efforts have been aimed at reducing complications and standardizing methods. The main complications associated with stapled anastomoses include bleeding, device failure, and anastomotic failure (leaks and strictures). These complications are associated with increased cost of care, increase in cancer recurrence, decreased overall survival, poor quality of life, and in some cases the need for further procedures including a diverting ostomy. Reducing these complications therefore has important implications. To this end, techniques to reduce the incidence of anastomotic complications have been the focus of many investigators. In this review, we summarize the current staple line reinforcement technology as well as other adjunctive measures, and specifically discuss the role of biologic materials in this realm.

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“…Unlike uncovered stents, fully covered SEMS has several advantages in the management of benign strictures. These fully covered SEMS have limited local tissue reaction; thus, they are used in benign conditions such as colonic strictures, fistulas, perforation, and leaks in the digestive tract 8,9…”

Section: Endoscopic Management Of Benign Colorectal Stricturesmentioning

confidence: 99%

Endoscopic Management of Refractory Benign Colorectal Strictures

2013

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In colonoscopic study, benign colorectal strictures with or without symptomatic pain are not rarely encountered. Benign colorectal stricture can be caused by a number of problems, such as anastomotic stricture after surgery, inflammatory bowel disease, postendoscopic submucosal dissection, diverticular disease, ischemic colitis, and so on. There are various modalities for the management of benign colorectal stricture. Endoscopic balloon dilatation is generally considered as the primary treatment for benign colorectal stricture. In refractory benign colorectal strictures, several treatment sessions of balloon dilatation are needed for successful dilatation. The self-expandable metal stent and many combined techniques are performed at present. However, there is no specific algorithmic modality for refractory benign colorectal strictures.

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Placement of a covered polyester stent prevents complications from a colorectal anastomotic leak and supports healing: Randomized controlled trial in a large animal model

Cited by 31 publications

References 26 publications

Endoscopic “rescue” treatment for gastrointestinal perforations, anastomotic dehiscence and fistula

Endoscopic “rescue” treatment for gastrointestinal perforations, anastomotic dehiscence and fistula

Staple Line/Anastomotic Reinforcement and Other Adjuncts: Do They Make a Difference?

Endoscopic Management of Refractory Benign Colorectal Strictures

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