-
Je něco špatně v tomto záznamu ?
Randomized experimental study of two novel techniques for transanal repair of dehiscent low rectal anastomosis
J. Kalvach, O. Ryska, J. Martinek, T. Hucl, J. Pazin, J. Hadac, O. Foltan, H. Kristianova, J. Ptacnik, J. Juhasova, M. Ryska, S. Juhas
Jazyk angličtina Země Německo
Typ dokumentu časopisecké články
Grantová podpora
NV16-31806A
Agentura Pro Zdravotnický Výzkum České Republiky
NLK
ProQuest Central
od 2000-01-01 do Před 1 rokem
Nursing & Allied Health Database (ProQuest)
od 2000-01-01 do Před 1 rokem
Health & Medicine (ProQuest)
od 2000-01-01 do Před 1 rokem
- MeSH
- anastomóza chirurgická metody MeSH
- lidé MeSH
- nádory rekta * chirurgie MeSH
- netěsnost anastomózy etiologie chirurgie MeSH
- prasata MeSH
- rektum chirurgie MeSH
- sepse * MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Anastomotic leak after low anterior rectal resection is a dreadful complication. Early diagnosis, prompt management of sepsis followed by closure of anastomotic defect may increase chances of anastomotic salvage. In this randomized experimental study, we evaluated two different methods of trans-anal anastomotic repair. METHODS: A model of anastomotic leak was created in 42 male pigs. Laparoscopic low anterior resection was performed with anastomosis created using a circular stapler with half of the staples removed. Two days later, animals were randomized into a TAMIS (trans-anal minimally invasive surgery) repair, endoscopic suture (ENDO) or control group with no treatment (CONTROL). Signs of intraabdominal infection (IAI), macroscopic anastomotic healing and burst tests were evaluated to assess closure quality after animals were sacrificed on the ninth postoperative day. RESULTS: Closure was technically feasible in all 28 animals. Two animals had to be euthanized due to progressive sepsis at four and five days after endoscopic closure. Healed anastomosis with no visible defect was observed in 10/14 and 11/14 animals in TAMIS and ENDO groups, respectively, versus 2/14 in CONTROL (p < 0.05). Overall IAI rate was significantly lower in TAMIS (4/14; p = 0.006) and ENDO (5/14; p = 0.018) compared to CONTROL (12/14). Burst tests confirmed sealed closure in healed anastomosis with a median failure pressure of 190 (110-300) mmHg in TAMIS and 200 (100-300) mmHg in ENDO group (p = 0.644). CONCLUSION: In this randomized experimental study, we found that both evaluated techniques are effective in early repair of dehiscent colorectal anastomosis with a high healing rate.
1st Department of Surgery The General University Hospital Prague Prague Czech Republic
Institute of Animal Physiology and Genetics Czech Academy of Science Libechov Czech Republic
Royal Lancaster Infirmary University Hospitals of Morecambe Bay NHS Foundation Trust Lancaster UK
Citace poskytuje Crossref.org
- 000
- 00000naa a2200000 a 4500
- 001
- bmc22018270
- 003
- CZ-PrNML
- 005
- 20240807102502.0
- 007
- ta
- 008
- 220720s2022 gw f 000 0|eng||
- 009
- AR
- 024 7_
- $a 10.1007/s00464-021-08726-1 $2 doi
- 035 __
- $a (PubMed)34495386
- 040 __
- $a ABA008 $b cze $d ABA008 $e AACR2
- 041 0_
- $a eng
- 044 __
- $a gw
- 100 1_
- $a Kalvach, J $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic. Jaroslav.Kalvach@uvn.cz $u Surgery Department 2nd Faculty of Medicine, Charles University and Central Military Hospital, Severovýchodní II 580/22, Záběhlice, Prague, 14100, Czech Republic. Jaroslav.Kalvach@uvn.cz $1 https://orcid.org/0000000335419939
- 245 10
- $a Randomized experimental study of two novel techniques for transanal repair of dehiscent low rectal anastomosis / $c J. Kalvach, O. Ryska, J. Martinek, T. Hucl, J. Pazin, J. Hadac, O. Foltan, H. Kristianova, J. Ptacnik, J. Juhasova, M. Ryska, S. Juhas
- 520 9_
- $a BACKGROUND: Anastomotic leak after low anterior rectal resection is a dreadful complication. Early diagnosis, prompt management of sepsis followed by closure of anastomotic defect may increase chances of anastomotic salvage. In this randomized experimental study, we evaluated two different methods of trans-anal anastomotic repair. METHODS: A model of anastomotic leak was created in 42 male pigs. Laparoscopic low anterior resection was performed with anastomosis created using a circular stapler with half of the staples removed. Two days later, animals were randomized into a TAMIS (trans-anal minimally invasive surgery) repair, endoscopic suture (ENDO) or control group with no treatment (CONTROL). Signs of intraabdominal infection (IAI), macroscopic anastomotic healing and burst tests were evaluated to assess closure quality after animals were sacrificed on the ninth postoperative day. RESULTS: Closure was technically feasible in all 28 animals. Two animals had to be euthanized due to progressive sepsis at four and five days after endoscopic closure. Healed anastomosis with no visible defect was observed in 10/14 and 11/14 animals in TAMIS and ENDO groups, respectively, versus 2/14 in CONTROL (p < 0.05). Overall IAI rate was significantly lower in TAMIS (4/14; p = 0.006) and ENDO (5/14; p = 0.018) compared to CONTROL (12/14). Burst tests confirmed sealed closure in healed anastomosis with a median failure pressure of 190 (110-300) mmHg in TAMIS and 200 (100-300) mmHg in ENDO group (p = 0.644). CONCLUSION: In this randomized experimental study, we found that both evaluated techniques are effective in early repair of dehiscent colorectal anastomosis with a high healing rate.
- 650 _2
- $a anastomóza chirurgická $x metody $7 D000714
- 650 _2
- $a netěsnost anastomózy $x etiologie $x chirurgie $7 D057868
- 650 _2
- $a zvířata $7 D000818
- 650 _2
- $a ženské pohlaví $7 D005260
- 650 _2
- $a lidé $7 D006801
- 650 _2
- $a mužské pohlaví $7 D008297
- 650 12
- $a nádory rekta $x chirurgie $7 D012004
- 650 _2
- $a rektum $x chirurgie $7 D012007
- 650 12
- $a sepse $7 D018805
- 650 _2
- $a prasata $7 D013552
- 655 _2
- $a časopisecké články $7 D016428
- 700 1_
- $a Ryska, O $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic $u Royal Lancaster Infirmary, University Hospitals of Morecambe Bay, NHS Foundation Trust, Lancaster, UK
- 700 1_
- $a Martinek, J $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic $u Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- 700 1_
- $a Hucl, T $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic $u Department of Hepatogastroenterology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
- 700 1_
- $a Pazin, J $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic $u Surgery Department 2nd Faculty of Medicine, Charles University and Central Military Hospital, Severovýchodní II 580/22, Záběhlice, Prague, 14100, Czech Republic
- 700 1_
- $a Hadac, J $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic $u Surgery Department 2nd Faculty of Medicine, Charles University and Central Military Hospital, Severovýchodní II 580/22, Záběhlice, Prague, 14100, Czech Republic
- 700 1_
- $a Foltán, Ondřej $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic $u 1st Department of Surgery, The General University Hospital in Prague, Prague, Czech Republic $7 xx0321133
- 700 1_
- $a Kristianova, H $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic $u 1st Department of Surgery, The General University Hospital in Prague, Prague, Czech Republic
- 700 1_
- $a Ptacnik, J $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic $u 1st Department of Surgery, The General University Hospital in Prague, Prague, Czech Republic
- 700 1_
- $a Juhasova, J $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic
- 700 1_
- $a Ryska, M $u Surgery Department 2nd Faculty of Medicine, Charles University and Central Military Hospital, Severovýchodní II 580/22, Záběhlice, Prague, 14100, Czech Republic
- 700 1_
- $a Juhas, S $u Institute of Animal Physiology and Genetics, Czech Academy of Science, Libechov, Czech Republic
- 773 0_
- $w MED00004464 $t Surgical endoscopy $x 1432-2218 $g Roč. 36, č. 6 (2022), s. 4050-4056
- 856 41
- $u https://pubmed.ncbi.nlm.nih.gov/34495386 $y Pubmed
- 910 __
- $a ABA008 $b sig $c sign $y p $z 0
- 990 __
- $a 20220720 $b ABA008
- 991 __
- $a 20240807102457 $b ABA008
- 999 __
- $a ok $b bmc $g 1822053 $s 1169513
- BAS __
- $a 3
- BAS __
- $a PreBMC
- BMC __
- $a 2022 $b 36 $c 6 $d 4050-4056 $e 20210908 $i 1432-2218 $m Surgical endoscopy $n Surg Endosc $x MED00004464
- GRA __
- $a NV16-31806A $p Agentura Pro Zdravotnický Výzkum České Republiky
- LZP __
- $a Pubmed-20220720
