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Can intraluminal devices prevent or reduce colorectal anastomotic leakage:A review

World Journal of Gastroenterology 2011年第40期17卷 4461-4469页

作者： annelien n morks Klaas Havenga Rutger J Ploeg Division of Abdominal Surgery Department of Surgery University Medical Center Groningen 9700 RB Groningen The Netherlands

Colorectal anastomotic leakage is a serious complication of colorectal surgery, leading to high morbidity and mortality rates. In recent decades, many strategies aimed at lowering the incidence of anastomotic leakage have been examined. The focus of this review will be on mechanical aids protecting the colonic anastomosis against leakage. A literature search was performed using MEDLInE, EMBASE, and The Cochrane Collaborative library for all papers related to prevention of anastomotic leakage by placement of a device in the colon. Devices were categorised as decompression devices, intracolonic devices, and biodegradable devices. A decompression device functions by keeping the anal sphincter open, thereby lowering the intraluminal pressure and lowering the pressure on the anastomosis. Intracolonic devices do not prevent the formation of dehiscence. However, they prevent the faecal load from contacting the anastomotic site, thereby preventing leakage of faeces into the peritoneal cavity. Many attempts have been made to find a device that decreases the incidence of AL;however, to date, none of the devices have been widely accepted.

关键词： Anastomotic leakage Colorectal surgery Complication Rectum Device

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Current surgical treatment of diverticular disease in the netherlands

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World Journal of Gastroenterology 2010年第14期16卷 1742-1746页

作者： annelien n morks Bastiaan R Klarenbeek Elvira R Flikweert Donald L van der Peet Thomas M Karsten Eric H Eddes Miguel A Cuesta Peter W de Graaf Department of Surgery Reinier de Graaf Gasthuis PO Box 5011 2600 GA Delft The Netherlands Department of Surgery VU University Medical Center PO Box 7057 1007 MB Amsterdam The Netherlands Department of Surgery Deventer Ziekenhuis PO Box 5001 7400 GC Deventer The Netherlands

AIM: To evaluate the development of diagnostic tools, indications for surgery and treatment modalities concerning diverticular disease (DD) in the netherlands. METHODS: Data were collected from 100 patients who underwent surgery for DD in three Dutch hospitals. All hospitals used the same standardized data base. The collected data included patient demographics, patient history, type of surgery and complications. Patients were divided into two groups, one undergoing elective surgery (elective group) and the other undergoing acute surgery (acute group). RESULTS: Two hundred and ninety-nine patients were admitted between 2000 and 2007. One hundred and seventy-eight patients underwent acute surgery and 121 patients received elective operations. The median age of the 121 patients was 69 years (range: 28-94 years), significantly higher in acute patients (P = 0.010). Laparoscopic resection was performed in 31% of elective patients. In the acute setting, 61% underwent a Hartmann procedure. The overall morbidity and mortality were 51% and 10%, and 60% and 16% in the acute group, which were significantly higher than in the elective group (36% and 1%). Only 35% of the temporary ostomies were restored. COnCLUSIOn: This study gives a picture of current surgical practice for DD in the netherlands. new developments are implemented in daily practice, resulting in acceptable morbidity and mortality rates.

关键词： Diverticulitis Surgery Diverticular disease

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