Clinics in Colon and Rectal Surgery 
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This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.Paulo Gustavo Kotze, MD, MSc, PhD
Clin Colon Rectal Surg 2022; 35: 001-002 DOI: 10.1055/s-0041-1740033 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - January 17, 2022 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to the Guest Editor Source Type: research
Influence of the Microbiome on Anastomotic Leak
Clin Colon Rectal Surg 2021; 34: 439-446 DOI: 10.1055/s-0041-1735276Despite advances in surgical technique and the expanded use of antibiotics, anastomotic leak remains a dreaded complication leading to increased hospital length of stay, morbidity, mortality, and cost. Data continues to grow addressing the importance of a functional and diverse colonic microbiome to ensure adequate healing. Individual pathogens, such as Enterococcus faecalis and Pseudomonas aeruginosa, have been implicated in the pathogenesis of anastomotic leak. Yet how these pathogens proliferate remains unclear. It is possible that decreased microbial d...
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Williamson, Ashley J. Alverdy, John C. Tags: Review Article Source Type: research
Treatment Modalities for Anastomotic Leakage in Rectal Cancer Surgery
Clin Colon Rectal Surg 2021; 34: 431-438 DOI: 10.1055/s-0041-1736465Despite advances in rectal cancer surgery, anastomotic leakage (AL) remains a common complication with a significant impact on patient recovery, health care costs, and oncologic outcomes. The spectrum of clinical severity associated with AL is broad, and treatment options are diverse with highly variable practices across the colorectal community. To be effective, the treatment must match not only the patient's current status but also the type of leak, the surgeon's skill, and the resources available. In this chapter, we will review the current and emergent...
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Keller, Deborah S. Talboom, K. van Helsdingen, C.P.M Hompes, Roel Tags: Review Article Source Type: research
Special Considerations of Anastomotic Leak in Patients with Rectal Cancer
This study will discuss special considerations for anastomotic leak prevention and clinical implications of this complication in patients with rectal cancer. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Abstract | Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Cauley, Christy E. Kalady, Matthew F. Tags: Review Article Source Type: research
Anastomotic Leak after Ileal Pouch –Anal Anastomosis
Clin Colon Rectal Surg 2021; 34: 417-425 DOI: 10.1055/s-0041-1735274There are special considerations when treating anastomotic leak after restorative proctocolectomy and ileal pouch–anal anastomosis. The epidemiology, risk factors, anatomic considerations, diagnosis and management, as well as the short- and long-term consequences to the patient are unique to this patent population. Additionally, there are specific concerns such as “tip of the J” leaks, transanal management of anastomotic leak/presacral sinus, functional outcomes after leak, and considerations of redo pouch procedures. [...] Thieme Medical Publishers,...
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Guyton, Kristina Kearney, David Holubar, Stefan D. Tags: Review Article Source Type: research
Diagnosis and Management of Chronic Anastomotic Leak
Clin Colon Rectal Surg 2021; 34: 406-411 DOI: 10.1055/s-0041-1732322Chronic anastomotic leaks present a daunting challenge to colorectal surgeons. Unfortunately, anastomotic leaks are common, and a significant number of leaks are diagnosed in a delayed fashion. The clinical presentation of these chronic leaks can be silent or have low grade, indolent symptoms. Operative options can be quite formidable and highly complex. Leaks are typically diagnosed by radiographic and endoscopic imaging during the preoperative assessment prior to defunctioning stoma reversal. The operative strategy depends on the location of the anastomo...
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Bhama, Anuradha R. Maykel, Justin A. Tags: Review Article Source Type: research
Diagnosis of Anastomotic Leak
Clin Colon Rectal Surg 2021; 34: 391-399 DOI: 10.1055/s-0041-1735270Anastomotic leaks after colorectal surgery is associated with increased morbidity and mortality. Understanding the impact of anastomotic leaks and their risk factors can help the surgeon avoid any modifiable pitfalls. The diagnosis of an anastomotic leak can be elusive but can be discerned by the patient's global clinical assessment, adjunctive laboratory data and radiological assessment. The use of inflammatory markers such as C-Reactive Protein and Procalcitonin have recently gained traction as harbingers for a leak. A CT scan and/or a water soluble cont...
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Hernandez, Paul T. Paspulati, Raj M. Shanmugan, Skandan Tags: Review Article Source Type: research
Anastomotic Troubleshooting
Clin Colon Rectal Surg 2021; 34: 385-390 DOI: 10.1055/s-0041-1735269Anastomotic leak remains a critical and feared complication in colorectal surgery. The development of a leak can be catastrophic for a patient, resulting in overall increased morbidity and mortality. To help mitigate this risk, there are several ways to assess and potentially validate the integrity of a new anastomosis to give the patient the best chance of avoiding this postoperative complication. A majority of anastomoses will appear intact with no obvious sign of anastomotic dehiscence on gross examination. However, each anastomosis should be interrogat...
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Sell, Naomi M. Francone, Todd D. Tags: Review Article Source Type: research
New Technologies to Prevent Anastomotic Leak
Clin Colon Rectal Surg 2021; 34: 379-384 DOI: 10.1055/s-0041-1735268Leaks from anastomoses can be a serious complication of any gastrointestinal resection. Leaks lead to increased morbidity, delayed postoperative recovery, and potential delays in adjuvant treatment in cancer cases. Prevention of anastomotic leak has been an area of ongoing research for decades. Methods of assessing bowel perfusion have been developed that may provide forewarning of anastomotic compromise. Physical reinforcement of the anastomosis with buttressing material is an available method employed with the goal of preventing leaks. Liquid-based seala...
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Uppal, Abhineet Pigazzi, Alessio Tags: Review Article Source Type: research
Anastomotic Technique —How to Optimize Success and Minimize Leak Rates
Clin Colon Rectal Surg 2021; 34: 371-378 DOI: 10.1055/s-0041-1735267Determining when to perform a bowel anastomosis and whether to divert can be difficult, as an anastomosis made in a high-risk patient or setting has potential for disastrous consequences. While the surgeon has limited control over patient-specific characteristics, the surgeon can control the technique used for creating anastomoses. Protecting and ensuring a vigorous blood supply is fundamental, as is mobilizing bowel completely, and employing adjunctive techniques to attain reach without tension. There are numerous ways to create anastomoses, with variatio...
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Man, Jeannette Hrabe, Jennifer Tags: Review Article Source Type: research
Risk Factors for Anastomotic Leak, Consideration for Proximal Diversion, and Appropriate Use of Drains
Clin Colon Rectal Surg 2021; 34: 366-370 DOI: 10.1055/s-0041-1735266Anastomotic leaks are a major source of morbidity after colorectal surgery. There is a myriad of risk factors that may contribute to anastomotic leaks. These risk factors can be categorized as modifiable, nonmodifiable, and intraoperative factors. Identification of these risk factors allows for preoperative optimization that may minimize the risk of anastomotic leak. Knowledge of such high-risk features may also affect intraoperative decision-making regarding the creation of an anastomosis, consideration for proximal diversion, or placement of a drain. A t...
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Favuzza, Joanne Tags: Review Article Source Type: research
Management of Anastomotic Leak
Clin Colon Rectal Surg 2021; 34: 357-358 DOI: 10.1055/s-0041-1736546 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Bhama, Anuradha R. Tags: Preface Source Type: research
Anastomotic Leaks in Colorectal Surgery
Clin Colon Rectal Surg 2021; 34: 355-356 DOI: 10.1055/s-0041-1735264 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents | Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - November 23, 2021 Category: Surgery Authors: Delaney, Conor P. Tags: Preface Source Type: research
Special Considerations of Anastomotic Leaks in Crohn's Disease
Clin Colon Rectal Surg DOI: 10.1055/s-0041-1735273Rates of anastomotic leak following intestinal resections in the setting of inflammatory bowel disease are significantly influenced by clinical characteristics. While the literature can be contradictory due to significant heterogeneity in the published data, several common themes appear to consistently arise. With respect to Crohn's disease, low serum albumin, preoperative abscess, reoperative abdominal surgery, and steroid use are associated with an increased risk of postoperative intra-abdominal septic complications. On the contrary, biologic therapy, immunomodulator use,...
Source: Clinics in Colon and Rectal Surgery - October 1, 2021 Category: Surgery Authors: Jeganathan, N. Nimalan A. Koltun, Walter A. Tags: Review Article Source Type: research
Management of Acute Anastomotic Leaks
Clin Colon Rectal Surg DOI: 10.1055/s-0041-1735271Management of the acute anastomotic leak is complex and patient-specific. Clinically stable patients often benefit from a nonoperative approach utilizing antibiotics with or without percutaneous drainage. Clinically unstable patients or nonresponders to conservative management require operative intervention. Surgical management is dictated by the degree of contamination and inflammation but includes drainage with proximal diversion, anastomotic resection with end-stoma creation, or reanastomosis with proximal diversion. Newer therapies, including colorectal stenting, vacuum...
Source: Clinics in Colon and Rectal Surgery - October 1, 2021 Category: Surgery Authors: Hedrick, Traci L. Kane, William Tags: Review Article Source Type: research
