1.Outcomes of redo for failed colorectal or coloanal anastomoses: a systematic review and meta-analysis
Ricardo Purchio GALLETTI ; Gabriel Andrade AGARENO ; Lucas de Abreu SESCONETTO ; Rafael Benjamim Rosa da SILVA ; Rafael Vaz PANDINI ; Lucas Soares GERBASI ; Victor Edmond SEID ; Sérgio Eduardo Alonso ARAUJO ; Francisco TUSTUMI
Annals of Coloproctology 2023;39(5):375-384
Purpose:
This study aimed to review the outcomes of redo procedures for failed colorectal or coloanal anastomoses.
Methods:
A systematic review was performed using the PubMed, Embase, Cochrane, and LILACS databases. The inclusion criteria were adult patients undergoing colectomy with primary colorectal or coloanal anastomosis and studies that assessed the postoperative results. The protocol is registered in PROSPERO (No. CRD42021267715).
Results:
Eleven articles met the eligibility criteria and were selected. The studied population size ranged from 7 to 78 patients. The overall mortality rate was 0% (95% confidence interval [CI], 0%–0.01%). The postoperative complication rate was 40% (95% CI, 40%–50%). The length of hospital stay was 13.68 days (95% CI, 11.3–16.06 days). After redo surgery, 82% of the patients were free of stoma (95% CI, 75%–90%), and 24% of patients (95% CI, 0%–39%) had fecal incontinence. Neoadjuvant chemoradiotherapy (P=0.002) was associated with a lower probability of being free of stoma in meta-regression.
Conclusion
Redo colorectal and coloanal anastomoses are strategies to restore colonic continuity. The decision to perform a redo operation should be based on a proper evaluation of the morbidity and mortality risks, the probability of remaining free of stoma, the quality of life, and a functional assessment.
2.Omega 3 Fatty Acids and COVID-19:A Comprehensive Review
Donald HATHAWAY III ; Krunal PANDAV ; Madhusudan PATEL ; Adrian RIVA-MOSCOSO ; Bishnu Mohan SINGH ; Aayushi PATEL ; Zar CHI MIN ; Sarabjot SINGH-MAKKAR ; Muhammad KHAWAR SANA ; Rafael SANCHEZ-DOPAZO ; Rockeven DESIR ; Michael Maher MOURAD FAHEM ; Susan MANELLA ; Ivan RODRIGUEZ ; Alina ALVAREZ ; Rafael ABREU
Infection and Chemotherapy 2020;52(4):478-495
The rapid international spread of severe acute respiratory syndrome coronavirus 2 responsible for coronavirus disease 2019 (COVID-19) has posed a global health emergency in 2020. It has affected over 52 million people and led to over 1.29 million deaths worldwide, as of November 13th, 2020. Patients diagnosed with COVID-19 present with symptoms ranging from none to severe and include fever, shortness of breath, dry cough, anosmia, and gastrointestinal abnormalities. Severe complications are largely due to overdrive of the host immune system leading to “cytokine storm”. This results in disseminated intravascular coagulation, acute respiratory distress syndrome, multiple organ dysfunction syndrome, and death. Due to its highly infectious nature and concerning mortality rate, every effort has been focused on prevention and creating new medications or repurposing old treatment options to ameliorate the suffering of COVID-19 patients including the immune dysregulation. Omega-3 fatty acids are known to be incorporated throughout the body into the bi-phospholipid layer of the cell membrane leading to the production of less pro-inflammatory mediators compared to other fatty acids that are more prevalent in the Western diet. In this article, the benefits of omega-3 fatty acids, especially eicosapentaenoic acid and docosahexaenoic acid, including their anti-inflammatory, immunomodulating, and possible antiviral effects have been discussed.
3.Omega 3 Fatty Acids and COVID-19:A Comprehensive Review
Donald HATHAWAY III ; Krunal PANDAV ; Madhusudan PATEL ; Adrian RIVA-MOSCOSO ; Bishnu Mohan SINGH ; Aayushi PATEL ; Zar CHI MIN ; Sarabjot SINGH-MAKKAR ; Muhammad KHAWAR SANA ; Rafael SANCHEZ-DOPAZO ; Rockeven DESIR ; Michael Maher MOURAD FAHEM ; Susan MANELLA ; Ivan RODRIGUEZ ; Alina ALVAREZ ; Rafael ABREU
Infection and Chemotherapy 2020;52(4):478-495
The rapid international spread of severe acute respiratory syndrome coronavirus 2 responsible for coronavirus disease 2019 (COVID-19) has posed a global health emergency in 2020. It has affected over 52 million people and led to over 1.29 million deaths worldwide, as of November 13th, 2020. Patients diagnosed with COVID-19 present with symptoms ranging from none to severe and include fever, shortness of breath, dry cough, anosmia, and gastrointestinal abnormalities. Severe complications are largely due to overdrive of the host immune system leading to “cytokine storm”. This results in disseminated intravascular coagulation, acute respiratory distress syndrome, multiple organ dysfunction syndrome, and death. Due to its highly infectious nature and concerning mortality rate, every effort has been focused on prevention and creating new medications or repurposing old treatment options to ameliorate the suffering of COVID-19 patients including the immune dysregulation. Omega-3 fatty acids are known to be incorporated throughout the body into the bi-phospholipid layer of the cell membrane leading to the production of less pro-inflammatory mediators compared to other fatty acids that are more prevalent in the Western diet. In this article, the benefits of omega-3 fatty acids, especially eicosapentaenoic acid and docosahexaenoic acid, including their anti-inflammatory, immunomodulating, and possible antiviral effects have been discussed.