Document Detail


Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery.
MedLine Citation:
PMID:  18283511     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The risk factors and incidence of anastomotic leak following colorectal surgery are well reported in the literature. However, the management of the multiple clinical scenarios that may be encountered has not been standardized. METHODS: The medical literature from 1973 to 2007 was reviewed using PubMed for papers relating to anastomotic leaks and abdominal abscess, with a specific emphasis on predisposing factors, prevention strategies, and treatment approaches. A six-round modified Delphi research method was utilized to find consensus among a group of expert colorectal surgeons and interventional radiologists regarding standardized management algorithms for anastomotic leaks. RESULTS: Management scenarios were divided into those for intraperitoneal anastomoses, extraperitoneal (low pelvic) anastomoses, and anastomoses with proximal diverting stomas. Management options were then based on the clinical presentation and radiographic findings and organized into three interconnected algorithms. CONCLUSIONS: This process was a useful first step toward establishing guidelines for the management of anastomotic leak.
Authors:
R Phitayakorn; C P Delaney; H L Reynolds; B J Champagne; A G Heriot; P Neary; A J Senagore;
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  32     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1147-56     Citation Subset:  IM    
Affiliation:
Division of Colorectal Surgery, Case Medical Center, 11100 Euclid Avenue, Cleveland, Ohio 44106-5047, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdominal Abscess / etiology,  therapy*
Algorithms*
Anastomosis, Surgical / adverse effects*
Colectomy / adverse effects*
Colon / surgery
Humans
Pelvis
Peritonitis / etiology,  therapy*
Rectum / surgery
Surgical Wound Dehiscence / etiology,  therapy*
Investigator
Investigator/Affiliation:
R Phitayakorn / ; C P Delaney / ; H L Reynolds / ; B J Champagne / ; A G Heriot / ; P Neary / ; A J Senagore / ; P Ambrosetti / ; C Bailey / ; C Bailey / ; R P Billingham / ; M Braga / ; W D Buie / ; A W Darzi / ; P R Douglas / ; E J Dozois / ; N S Fearnhead / ; F A Frizelle / ; S L Gearhart / ; Q H Gonzalez / ; S Z Tlalpan / ; J R Haaga / ; G J Harris / ; A F Horgan / ; P G Horgan / ; H Kehlet / ; S H Kim / ; A M Lacy / ; J Leroy / ; F López-Kostner / ; K A Ludwig / ; J Marks / ; A J Megibow / ; J I Merlino / ; J R Monson / ; R W Motson / ; D A Nakamoto / ; G L Newstead / ; P R O'Connell / ; Y Panis / ; F Penninckx / ; A Rajput / ; F Seow Choen / ; M J Stamos / ; A Vignali / ; S D Wexner / ; K S Wong /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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