Hadi Ahmadi Amoli; mohamadreza karoobi; Hossein Zabihi Mahmoudabadi; Saeid Ghorbani; Reza Hajebi; Ehsan Rahimpour; Farzad Vaghef Davari
Volume 24, Issue 2 , 2022
Abstract
Background: Anastomotic leak (AL) is one of the common complications of colorectal surgeries. In COVID-19 pandemic, shortening the hospitalization period seems valuable in reducing postoperative complications
Objectives:. C-reactive protein is valuable in early diagnosis and also exclusion of AL.
Method: ...
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Background: Anastomotic leak (AL) is one of the common complications of colorectal surgeries. In COVID-19 pandemic, shortening the hospitalization period seems valuable in reducing postoperative complications
Objectives:. C-reactive protein is valuable in early diagnosis and also exclusion of AL.
Method: This study was a survey of laboratory tests. The patients were enrolled with the elective of colorectal surgery between 2017 and 2019. We measured the symptoms of Anastomotic leak such as high-level C-reactive protein, leukocytosis, body temperature, and ileus by passing five days from the surgery. Moreover, we evaluated the value of C-reactive protein to exclude Anastomosis leakage within 5 postoperative days.
Results: three hundred and fifteen patients were enrolled in this study. The mean age of the patients was 56.2 years old. Anastomotic leak was detected in 26 patients. C-reactive protein levels in the second day, third day, fourth day, and fifth day were significant for the Anastomotic leak (P-value <0.05). In postoperative days 2 and 4, CPR levels below 44 mg/L and 27.2 mg/L were found to be significant for the exclusion of anastomosis leakage.
Conclusion: Postoperative serum CRP, especially on postoperative days 2 and 4 with cut off value of 44 mg/L and 27.2 mg/L in the absence of ileus, fever, leukocytosis, and normal abdominal examination, could be considered as a highly sensitive adjutant to exclude AL and shorten the hospitalization period.
Farzad Vaghef Davari; Mohammad Shirkhoda; Amirmohsen Jalaeefar; Rezvan Hashemi
Volume 23, Issue 4 , 2021
Abstract
Background: Laparoscopic enteral-feeding access is the best option for patients with advanced upper gastrointestinal, oropharyngeal, and laryngeal cancers needing to maintain their caloric intake before surgery or during chemoradiotherapy.
Methods: During a laparoscopic procedure by a cystostomy catheter ...
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Background: Laparoscopic enteral-feeding access is the best option for patients with advanced upper gastrointestinal, oropharyngeal, and laryngeal cancers needing to maintain their caloric intake before surgery or during chemoradiotherapy.
Methods: During a laparoscopic procedure by a cystostomy catheter system, a jejunostomy tube was placed for 14 patients. All the patients had a 2-month follow-up for complications and performance of the feeding system.
Results: Based on the obtained results, there was no internal leak and peritonitis among the subjects. One patient converted to an open procedure due to perforation during the procedure. In three patients, the extraction of the catheter was encountered during the follow-up period and a replacement was required. One case of wound infection and one case of catheter obstruction occurred among the subjects. Catheter obstruction was easily resolved using warm water and pancreatic enzyme irrigation. There was one patient with partial intestinal obstruction who was managed through nonoperative means. No significant bleeding was encountered during the surgery.
Conclusion: Laparoscopic jejunostomy with this method is simple and cost-effective and can be performed within an acceptable timeframe with minimum complications. It is the procedure of choice for upper GI and laryngeal cancer patients, those at increased risk of aspiration, and subjects not candidates of percutaneous endoscopic gastrostomy.
