TITLE

Radiological evaluation of colorectal anastomoses

AUTHOR(S)
Doeksen, A.; Tanis, P. J.; Wüst, A. F. J.; Vrouenraets, B. C.; van Lanschot, J. J. B.; van Tets, W. F.
PUB. DATE
September 2008
SOURCE
International Journal of Colorectal Disease;Sep2008, Vol. 23 Issue 9, p863
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The purpose of this study was to determine the accuracy, interobserver variability, timing and discordance with relaparotomy of postoperative radiological examination of colorectal anastomoses. From 2000 to 2005, 429 patients underwent an ileocolonic, colo-colonic, or colorectal anastomosis. Radiological examination of the anastomosis was not performed routinely, but only when there were clinically signs of leakage. Radiological imaging was reviewed by an independent radiologist and medical records were retrospectively analyzed. Clinical anastomotic leakage was the standard of reference and defined as leakage confirmed during relaparotomy, drainage of pus per anum or as an anastomotic defect identified at digital examination. Radiological evaluation of the anastomosis was performed in 91 patients (21%): CT in 27 patients, contrast radiography in 40, and both imaging modalities in 24 patients. The interobserver variability of CT and contrast radiography was 10% and 14%, respectively. The sensitivity and negative predictive value of imaging of the anastomosis was 65% and 73%, respectively. Anastomotic leakage was found in 11 of 21 patients (52%) who underwent relaparotomy despite negative imaging. Three of 36 patients (8%) with a diagnosis of anastomotic leakage based on radiological examination had an intact anastomosis at relaparotomy. Radiological imaging of the anastomosis after colorectal surgery should be restrictively applied and interpreted with caution because of the high false-negative rate and the substantial interobserver variability.
ACCESSION #
33336850

 

Related Articles

  • Intramedullary Nailing of Subtrochanteric Fractures. Riehl, John T.; Koval, Kenneth J.; Langford, Joshua R.; Munro, Mark W.; Kupiszewski, Stanley J.; Haidukewych, George J. // Bulletin of the Hospital for Joint Diseases;2014, Vol. 72 Issue 2, p159 

    Introduction: Subtrochanteric femur fractures remain challenging injuries to treat. Historically, varus malreduction has been linked to the development of nonunion; however, there is a paucity of literature evaluating the impact of sagittal plane malreduction. The purpose of this study was to...

  • The Postoperative Use of Wound Adhesives.  // Journal of Dermatologic Surgery & Oncology;Nov92, Vol. 18 Issue 11, p990 

    The use of wound adhesives and surgical tapes are common following dermatologic and plastic surgical procedures. Their use reduces wound tension, separation, and ultimately improves the postoperative scar. The most commonly used wound adhesives to enhance the surgical strips are tincture of...

  • SOFT-TISSUE WORKSHOP ON SKIN FLAPS AND GRAFTS.  // Journal of Dermatologic Surgery & Oncology;Aug84, Vol. 10 Issue 8, p649 

    The article presents information on a soft tissue workshop on "Skin Flaps and Grafts." The topics that will be undertaken in the workshop are as follows. Natural Healing of Wounds, Preparation for Grafting, Kinds of Skin Grafts, Cutting Skin Grafts, Graft immobilization and Post-operative Care,...

  • Comparison of safety and efficacy of papaya dressing with hydrogen peroxide solution on wound bed preparation in patients with wound gape. Murthy, Mangala B.; Murthy, Bhasker K.; Bhave, Sanjay // Indian Journal of Pharmacology;Dec2012, Vol. 44 Issue 6, p784 

    Objective: Indian papaya or Carica papaya is known to have de-sloughing and woundhealing properties due to the presence of protease enzymes. The present study was done to compare the efficacy and safety of papaya dressing with hydrogen peroxide solution for preparation of wound bed in patients...

  • Burst Abdomen - A Grave Postoperative Complication. Parmar, Girish; Gohil, Ajit; Hathila, V. P. // Internet Journal of Surgery;2009, Vol. 20 Issue 1, p8 

    Introduction: Burst abdomen represents one of the most frustrating and difficult post-operative complications experienced by surgeons who do a significant volume of surgery. Burst abdomen occurs because of various preoperative, operative and postoperative predisposing factors which can be...

  • Hyaluronate carboxymethylcellulose-based bioresorbable membrane (Seprafilm) reduces adhesion under the incision to make unplanned re-laparotomy safer. Hashimoto, Daisuke; Hirota, Masahiko; Yagi, Yasushi; Baba, Hideo // Surgery Today;Sep2012, Vol. 42 Issue 9, p863 

    Purpose: Hyaluronate carboxymethylcellulose-based bioresorbable membrane (HC membrane; Seprafilm) is used to prevent postoperative adhesion. We conducted this study to assess the effectiveness of the HC membrane in reducing the severity of adhesions in patients undergoing unplanned...

  • Comparison of wound-healing and tissue effects using the Gyrus PlasmaKnife with monopolar, Coblation, and Harmonic Scalpel methodologies. Sibbons, Paul D.; Southgate, Aaron // Comparative Clinical Pathology;Jun2006, Vol. 15 Issue 1, p17 

    The aim of this study was to assess the histological and thermal effects of different dissection technologies on tissue around incision and to consider their comparative wound healing profiles. The technologies used were Gyrus PlasmaKnife, monopolar electrode, Coblation wand, and Harmonic...

  • Vitalitec International, The Sternal Closure Device: A novel closure technique for sternal dehiscence. Tunçay, Aydın; Akçalı, Yiğit; Özmen, Rifat; Gazioğlu, Özer; Serhatlıoğlu, Faruk // Journal of Clinical & Experimental Investigations / Klinik ve De;Dec2014, Vol. 5 Issue 4, p534 

    Objective: Impaired sternal wound healing remains problematic after median sternotomy and can cause to significant morbidity after cardiac surgical procedures. Although some reconstruction systems exist for sternal closure, their use is limited by expense and practicality, and simple wire...

  • Surgical Wound Dehiscence. Hahler, Barbara // MEDSURG Nursing;Oct2006, Vol. 15 Issue 5, p296 

    Dehiscence is postoperative wound separation that involves all layers of the abdominal wall. It is associated with death, prolonged hospital stays, and incisional herniation (Khan, Naqvi, Irshad, & Chaudhary, 2004). Because medical-surgical nurses frequently care for postoperative patients,...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics