1,721,056 research outputs found
Management of intraoperative complications during laparoscopic left colectomy
No full textINTRODUCTION: Minimally invasive surgery has gained a major role in the current management of colorectal disease since the introduction of laparoscopy in the early 1990s for colorectal procedures. The laparoscopic approach, in fact, is not exempt from the risk of intraoperative complications, some of which can occur outside the field of view. The aim of this chapter was to review the different types of complications that can happen during left colectomy, analyzing the causes, how to prevent them and what to do in case they occur.
EVIDENCE ACQUISITION: A literature search was carried out using the MEDLINE and PubMed databases for studies published between January 1980 and October 2020. The following terms were used for the search: “complications,” “risk factors,” “colorectal surgery,” “colorectal resection,” “laparoscopy,” “left colectomy,” “intraoperative complications,” “splenic injury,” and “intraoperative bleeding.”
EVIDENCE SYNTHESIS: From our literature search we identified twenty-four studies, including two systematic reviews and metanalyses, that were the most pertinent to the subject.
CONCLUSIONS: Many different complications can occur during laparoscopic left colectomy. Maintaining control of the
situation is important to provide a prompt solution to the occurred injury. Increasing the reporting rate of complications
may help, in the future, to analyze the causes and improve management strategies, keeping in mind that the only surgeon who does not have complications is the one who does not operate
Intraluminal anastomotic assessment using indocyanine green near-infrared imaging for left-sided colonic and rectal resections: a systematic review
No full textBackground Indocyanine green fuorescence angiography (ICG-FA) has been used in colorectal surgery to assess anastomotic
perfusion and reduce the risks of anastomotic leaks. The main objective of this paper is to review the data on the transanal
application of ICG-FA for the intraluminal assessment of colorectal anastomosis.
Methods A literature search was conducted for articles published between 2011 and 2021 using PubMed and Cochrane
databases, related to the application of ICG for the intraluminal assessment of colorectal anastomosis. Original scientifc
manuscripts, review articles, meta-analyses, and case reports were considered eligible.
Results A total of 305 studies have been identifed. After abstract screening for duplicates, 285 articles remained. Of those,
271 were not related to the topic of interest, 4 were written in a language other than English, and 4 had incomplete data. Six
articles remained for the fnal analysis. The intraluminal assessment of colorectal anastomosis with ICG-FA is feasible, safe,
and may reduce the incidence of leaks.
Conclusion The intraluminal assessment of anastomotic perfusion via ICG-FA may be a promising novel application of ICG
technology. More data is needed to support this application further to reduce leak rates after colorectal surgery, and future
randomized clinical trials are awaited
Role of surgical approach on LARS: LAR vs. TEM, TAMIS, transanal excision, TaTME
No full textDespite advances in surgical techniques, low anterior resection syndrome (LARS) is common in patients after surgery for rectal adenocarcinoma. Fecal incontinence, urgency, and incomplete evacuation are frequent complaints. Anorectal function can be assessed by dynamic magnetic resonance imaging (MRI), anorectal manometry, and by several assessment tools including the LARS score. Despite their different approach to the pelvic
dissection, both transabdominal low anterior resection (LAR) and transanal total mesorectal excision (TaTME)
share a similar prevalence of LARS after surgery. Data regarding functional outcomes after transanal techniques are lacking, but the functional results seem to be favorable when compared to proctectomy. Pre-operative evaluation of anorectal function is recommended to provide a better estimate of functional outcomes post-operatively and to provide tailored recommendations for restorative versus non-restorative surger
Laparoscopic intracorporeal double purse-string ileorectal anastomosis with transanal natural orifice specimen extraction
No full textTransanal natural orifice specimen extraction (t-NOSE) has the potential benefit to minimize risks of surgical site infection and incisional hernia at the extraction site. We describe how t-NOSE can be used to deliver an intact specimen after laparoscopic total colectomy with oncologic criteria and, at the same time,
to ease a double pursestring, single-stapled intracorporeal ileorectal anastomosis
With adequate precautions colorectal cancer surgery can be safely continued during COVID-19 pandemic
Full text linkTransanal transection and single-stapled anastomosis for ileo-anal pouch surgery – a video vignette
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