| Clinical review: Healing in gastrointestinal anastomoses, part II. | |
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MedLine Citation:
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PMID: 16518802 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Complications arising from gastrointestinal anastomosis failures are a major source of morbidity and mortality. This review examines the effects of local blood flow on anastomotic healing, and discusses strategies for improving perfusion. Disruption of blood supply plays a significant role in the development of anastomotic leakage. Several methods have been suggested to improve perfusion. Omental pedicles have been employed as buttresses to promote angiogenesis, but efficacy in preventing anastomotic dehiscence has not been established. The administration of exogenous pharmacologic agents (such as vascular endothelial growth factor) is another potential strategy, although the oncological safety of this approach has been questioned. Two techniques which show promise in reducing anastomotic leakage rates include the vascular augmentation of grafts at risk for ischemia (supercharging) and ischemic conditioning (utilizing the delay phenomenon). Further studies of these strategies are needed to establish their efficacy and safety for routine use in gastrointestinal anastomoses. |
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Authors:
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C Kristian Enestvedt; Sarah K Thompson; Eugene Y Chang; Blair A Jobe |
Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Microsurgery Volume: 26 ISSN: 0738-1085 ISO Abbreviation: Microsurgery Publication Date: 2006 |
Date Detail:
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Created Date: 2006-03-23 Completed Date: 2006-07-06 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309230 Medline TA: Microsurgery Country: United States |
Other Details:
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Languages: eng Pagination: 137-43 Citation Subset: IM |
Copyright Information:
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2006 Wiley-Liss, Inc. |
Affiliation:
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Department of Surgery, Oregon Health and Science University, Portland, OR, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical Animals Esophagectomy Gastrointestinal Diseases / surgery* Humans Ischemia / physiopathology Ischemic Preconditioning Microcirculation Neovascularization, Physiologic / physiology Omentum / surgery Surgical Flaps Surgical Wound Dehiscence / physiopathology Vascular Endothelial Growth Factor A / physiology Wound Healing* / physiology |
| Chemical | |
Reg. No./Substance:
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0/Vascular Endothelial Growth Factor A |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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