1.Mortality rate and high-risk factors in post-operative generalized peritonitis after colon surgery
Journal of Medical Research 2008;56(4):71-74
Background: Post operative generalized peritonitis is a serious complication of abdominal surgery with a high mortality rate. Objectives: 1) To figure out the mortality rate of patients with generalized peritonitis after colon surgery. 2) To discover the risk factors for intensive care. Subjects and method: The retrospective research was conducted on the records of all patients with post-operative generalized peritonitis in Binh Dan Hospital. The patients with generalized peritonitis that were not related to colon surgery were exempted. The data was processed by SPSS. 11.5 software. Results: During 6 years from Jan 1998 to Jan 2004, there were 38 patients (26 men, 12 women) that met the research criteria were included. Ages of patients ranged from 23 to 91, with most of them being 41 years of age or more. The mortality rate was 31.6% (12 cases). There was no difference in mortality rate between male and female. High risk factors included age over 60; underlying malignant disease and late re-operation. Conclusion: The mortality rate of patients with post-operative peritonitis after colon surgery remained high. Intervention as soon as the peritonitis signs were presented (within 24hrs) was an important factor that impacted on prognosis.
Mortality
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Peritonitis
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Colon surgery
3.Protection of the proximal colon segment during laparoscopic proctosigmoidectomy.
Hao QU ; Zhi-xia LI ; Yan-fu DU ; Min-zhe LI ; Yu-dong ZHANG
Chinese Journal of Gastrointestinal Surgery 2012;15(1):17-18
To evaluate the protection of proximal colon segment by analyzing blood supply disorder of proximal colon segment during laparoscopic proctosigmoidectomy(11 cases) in the Chaoyang Hospital of Capital Medical University. It is concluded that the disorder of blood supply of proximal colon segment during laparoscopic proctosigmoid surgery has two reasons. One is the anatomic factor of mesenteric vessels; the other is the inappropriate operative procedure. It is recommended that left colonic artery should be retained, and inferior mesenteric artery should be handled at a low level, thus, the risk of proximal intestine blood supply disorder caused by vascular anatomy variation can be reduced.
Colon, Sigmoid
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surgery
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Humans
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Laparoscopy
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methods
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Rectum
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surgery
6.Preoperative Tattooing Using Indocyanine Green in Laparoscopic Colorectal Surgery.
Sang Jae LEE ; Dae Kyung SOHN ; Kyung Su HAN ; Byung Chang KIM ; Chang Won HONG ; Sung Chan PARK ; Min Jung KIM ; Byung Kwan PARK ; Jae Hwan OH
Annals of Coloproctology 2018;34(4):206-211
PURPOSE: The aim of the present study was to evaluate the usefulness of indocyanine green (ICG) as a preoperative marking dye for laparoscopic colorectal surgery. METHODS: Between March 2013 and March 2015, 174 patients underwent preoperative colonoscopic tattooing using 1.0 to 1.5 mL of ICG and saline solution before laparoscopic colorectal surgery. Patients’ medical records and operation videos were retrospectively assessed to evaluate the visibility, duration, and adverse effects of tattooing. RESULTS: The mean age of the patients was 65 years (range, 34–82 years), and 63.2% of the patients were male. The median interval between tattooing and operation was 1.0 day (range, 0–14 days). Tattoos placed within 2 days of surgery were visualized intraoperatively more frequently than those placed at an earlier date (95% vs. 40%, respectively, P < 0.001). For tattoos placed within 2 days before surgery, the visualization rates by tattoo site were 98.6% (134 of 136) from the ascending colon to the sigmoid colon. The visualization rates at the rectosigmoid colon and rectum were 84% (21 of 25) and 81.3% (13 of 16), respectively (P < 0.001). No complications related to preoperative ICG tattooing occurred. CONCLUSION: Endoscopic ICG tattooing is more useful for the preoperative localization of colonic lesions than it is for rectal lesions and should be performed within 2 days before laparoscopic surgery.
Colon
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Colon, Ascending
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Colon, Sigmoid
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Colorectal Surgery*
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Humans
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Indocyanine Green*
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Laparoscopy
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Male
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Medical Records
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Rectum
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Retrospective Studies
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Sodium Chloride
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Tattooing*
7.Three Surgical Approaches of Laparoscopic Splenic Flexure Mobilization
Journal of Minimally Invasive Surgery 2019;22(2):85-86
Splenic flexure mobilization during laparoscopic colorectal surgery, which is used for elongation of the remaining colon after resecting the left colon or rectum, is sometimes essential for making a secure anastomosis without tension. However, laparoscopic splenic flexure mobilization is often time consuming and technically demanding, particularly in obese patients with severe adhesion. Therefore, three surgical approaches are introduced to make the procedure easier according to the method of entering the lesser sac: anterior approach, inferio-medial approach, and lateral approach.
Colon
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Colon, Transverse
;
Colorectal Surgery
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Humans
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Laparoscopy
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Methods
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Peritoneal Cavity
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Rectum
8.Research progression on preoperative mechanical bowel preparation for elective colorectal surgery.
Zhenhong ZOU ; Liying ZHAO ; Jiaming WU ; Hao CHEN ; Guoxin LI
Chinese Journal of Gastrointestinal Surgery 2015;18(6):628-630
Preoperative mechanical bowel preparation (MBP) has been established as a standard procedure for elective colorectal surgery in most surgical centers since 1950s. However, the routine use of MBP for elective colorectal surgery is still in debate, as the researches on the evaluation of MBP have been carried out in recent 20 years. By searching and analyzing the existing evidence, we conclude that MBP should be routinely abandoned for elective open colorectal surgery, but should be routinely used for elective laparoscopic rectal surgery, and it still awaits large-scale RCTs for further evaluation of MBP for elective laparoscopic colonic surgery.
Colon
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Colorectal Surgery
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Elective Surgical Procedures
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Humans
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Laparoscopy
;
Preoperative Care
9.Changes of the colonic physiologic functions after colonic anastomosis with a degradable stent in a porcine model.
Xu FENG ; Xiao LIANG ; Yifan WANG ; Shilin HE ; Xiujun CAI
Chinese Medical Journal 2014;127(18):3249-3253
BACKGROUNDA new procedure of colonic anastomosis with a degradable stent has already been proven to be simple, feasible, and safe in our porcine model. In this study, we evaluated its impact on the colonic physiologic functions.
METHODSA total of 20 pigs were assigned randomly to either a stent anastomosis group (SA, n = 10) or a conventional anastomosis group (CA, n = 10). Colonic anastomosis with a degradable stent was performed in the SA group, and conventional hand-sewn anastomosis was performed in the CA group. Body weight, fecal weight, total colonic transit time, immunohistochemistry staining of interstitial cells of Cajal (ICC), plasma diamine oxidases (DAO) levels, and Western blotting analysis of occludin were evaluated before and after anastomosis.
RESULTSNo obvious diarrhea or constipation was observed in all pigs. No significant difference in body weight between the groups was detected at any time. Yet, the fecal weight was less in the CA group compared with the SA group on postoperative day (POD) 7. No observable colonic paralysis or retention occurred. For total colonic transit time, there was no significant difference between the two groups at any time or among different time points in the same group. The integrated optical density of ICC showed no significant difference on either POD 14 or 30. The plasma DAO levels were remarkably elevated after surgery, and began to decrease since POD 3. However, there was no significant difference between both two groups in plasma DAO levels at any time either. For both groups, the expression of occludin was not significantly different from their pre-surgery level on either POD 14 or 30.
CONCLUSIONSAccording to these results, this procedure with a degradable stent was supposed to be the same as the conventional hand-sewn procedure in their impact on the colonic physiologic functions.
Anastomosis, Surgical ; methods ; Animals ; Colon ; surgery ; Stents ; Swine