Article
Surgery
Nina S. Cohen, Jiselle M. Bock, Addison K. May
Summary: Surgical site infections are a significant cause of illness and death. There is strong evidence supporting several preventive measures, but their effective implementation is not optimal. It is crucial to identify high-risk patients and avoid pitfalls in diagnosing surgical site infections, especially in emergency surgery patients with physiological disorders. Maintaining a high level of suspicion after surgery is critical in identifying patients with surgical site infections and preventing failure to rescue.
Review
Biochemistry & Molecular Biology
Simran Grewal, J. Reinder D. Reuvers, Gabor S. A. Abis, Rene H. J. Otten, Geert Kazemier, Hein B. A. C. Stockmann, Marjolein van Egmond, Steven J. Oosterling
Summary: Prophylactic oral antibiotics combined with mechanical bowel preparation can reduce the rates of surgical-site infection and anastomotic leakage in patients undergoing elective colorectal carcinoma surgery, with selective decontamination of the digestive tract showing greater effectiveness in reducing anastomotic leakage compared to broad-spectrum antibiotics.
Article
Oncology
V. T. Hoek, S. Buettner, C. L. Sparreboom, R. Detering, A. G. Menon, G. J. Kleinrensink, M. W. J. M. Wouters, J. F. Lange, J. K. Wiggers
Summary: This study aimed to develop a robust preoperative prediction model for anastomotic leakage after surgical resection for rectal cancer. Significant risk factors were identified and included in the prediction model, which can be used for patient counselling and risk-stratification before undergoing rectal resection for cancer.
Article
Surgery
Kevin Talboom, Nynke G. Greijdanus, Cyriel Y. Ponsioen, Pieter J. Tanis, Wilhelmus A. Bemelman, Roel Hompes
Summary: Early initiation of EVASC for anastomotic leakage after rectal cancer resection yields high rates of healed and functional anastomosis. EVASC shows increasing success with the implementation of highly selective diversion and early diagnosis of the leak.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Medicine, General & Internal
Dongai Jin, Li Chen
Summary: CRP is a reliable predictor of anastomotic leakage after laparoscopic transabdominal rectal resection surgery, with higher levels from postoperative days 4 to 7 indicating the need for a more careful patient evaluation.
Article
Surgery
Oscar Akesson, Isak Heyman, Jan Johansson, Pehr Rissler, Dan Falkenback
Summary: This study used early endoscopic assessment and a novel endoscopy score system to predict anastomotic complications after esophagectomy, with the results showing that the combined endoscopy score was the only predictor and an accurate tool for predicting anastomotic complications.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Surgery
Yi-Chang Chen, Tao-Wei Ke, Yuan-Yao Tsai, Abe Fingerhut, William Tzu-Liang Chen
Summary: This study retrospectively analyzed the charts of 15 consecutive patients and found that laparoscopic redo anastomosis was feasible and safe for the management of intraperitoneal anastomotic leakage after colonic surgery.
Article
Oncology
Liliana Mereu, Francesca Dalpra, Valeria Berlanda, Riccardo Pertile, Daniela Coser, Basilio Pecorino, Maria Gabriella D'Agate, Francesco Ciarleglio, Alberto Brolese, Saverio Tateo
Summary: This study evaluated the incidence, risk factors, and utility of drainage and stoma in patients undergoing intestinal surgery for ovarian cancer. The results showed that rectosigmoid resection for ovarian cancer is a standardized procedure with comparable results for anastomotic leakage (AL), and risk factors for AL are discretely homogeneous. The use of stomas and/or drains, however, was not standardized according to the literature. Therefore, further exploration is needed to verify the preventive role of protective stoma and/or intra-abdominal drains in selected and standardized situations.
Review
Gastroenterology & Hepatology
Andrea Vignali, Paola De Nardi
Summary: Endoluminal vacuum-assisted therapy is a new method for treating colorectal anastomotic leaks, which ensures continuous drainage of the abscess cavity and promotes the formation of granulation tissue. It is more effective in preserving the anastomosis compared to conventional treatments. However, there is still a lack of standardization in the indications, inclusion criteria, and definitions of success, and the long-term and functional results are poorly reported.
WORLD JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Oncology
Zhongyuan He, Hongda Liu, Ling Zhou, Qingya Li, Linjun Wang, Diancai Zhang, Hao Xu, Zekuan Xu
Summary: This study aimed to explore the risk factors and efficacy of conservative treatment for Anastomotic leakage (AL) after gastrectomy in patients with gastric cancer. The results showed that low albumin concentration, diabetes, laparoscopic method, total gastrectomy, and proximal gastrectomy were predicting factors for AL. Conservative treatment was relatively safe and effective for AL management.
FRONTIERS IN ONCOLOGY
(2023)
Article
Engineering, Biomedical
Gyeongjin Joo, Tamanna Sultana, Sohanur Rahaman, Sang Ho Bae, Hae Il Jung, Byong-Taek Lee
Summary: The fibrous membrane sealing patch developed using a combination of PCL and gelatin showed promising results in preventing post-surgical leakage, with higher gelatin content leading to better outcomes in terms of fiber diameter and hydrophilicity. The P1G4 membrane, with a ratio of PCL to gelatin at 1:4, exhibited optimal performance in an in vivo study, demonstrating its potential as a biomaterial for tissue repair to prevent leakage after surgery.
JOURNAL OF BIOMATERIALS SCIENCE-POLYMER EDITION
(2021)
Review
Medicine, General & Internal
Umberto Bracale, Roberto Peltrini, Marcello De Luca, Mariangela Ilardi, Maria Michela Di Nuzzo, Alberto Sartori, Maurizio Sodo, Michele Danzi, Francesco Corcione, Carlo De Werra
Summary: The aim of this systematic review is to identify risk factors for esophago-jejunal anastomotic leakage (EJAL) in patients undergoing total gastrectomy for gastric cancer. Through a comprehensive analysis of the literature, several patient-related, perioperative, and technical risk factors have been identified.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Surgery
Steffen Axt, Kristin Haller, Peter Wilhelm, Claudius Falch, Peter Martus, Jonas Johannink, Jens Rolinger, Christian Beltzer, Lena Axt, Alfred Koenigsrainer, Andreas Kirschniak
Summary: The objective of this study was to demonstrate the diagnostic value of early postoperative flexible endoscopy for rectal anastomosis evaluation. The results showed that early endoscopic evaluation can safely detect anastomotic leakage, allowing for early treatment to avoid severe complications and mortality.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2022)
Article
Medicine, General & Internal
Giuseppe Brisinda, Maria Michela Chiarello, Gilda Pepe, Maria Cariati, Valeria Fico, Paolo Mirco, Valentina Bianchi
Summary: This retrospective cohort study examined the risk factors for anastomotic leakage in rectal cancer surgery and identified several clinical, surgical, and pathological features associated with leakage. Anastomotic leakage adversely affects the morbidity and mortality of rectal cancer patients.
WORLD JOURNAL OF CLINICAL CASES
(2022)
Article
Oncology
Xinjian Zhong, Xiaoyu Xie, Hang Hu, Yi Li, Shunhua Tian, Qun Qian, Congqing Jiang, Xianghai Ren
Summary: This study developed a novel drainage technique involving the placement of drainage tubes during handsewn anastomosis to reduce the occurrence of anastomotic leakage after intersphincteric resection. The results showed that the use of trans-anastomotic drainage tubes significantly reduced the incidence of anastomotic leakage and did not adversely affect anal function.
FRONTIERS IN ONCOLOGY
(2022)
Article
Gastroenterology & Hepatology
Alexandre Balaphas, Jeremy Meyer, Nicolas C. Buchs, Ali Modarressi, Leo H. Buhler, Christian Toso, Carmen Gonelle-Gispert, Frederic Ris
Summary: This study reports the presence of mesenchymal stem cells in the anal canal transition zone in pigs for the first time, and demonstrates the feasibility of their isolation. These findings offer potential for isolating human anal canal transition zone mesenchymal stem cells, which could be used to study sphincters healing and treat anal incontinence.
DIGESTIVE DISEASES AND SCIENCES
(2023)
Article
Surgery
Melisa Dirchwolf, Chiara Becchetti, Susanne Stampf, Christa Haldimann, Franz Immer, Franziska Beyeler, Christian Toso, Philipp Dutkowski, Daniel Candinas, Jean-Francois Dufour, Vanessa Banz
Summary: This study analyzed the impact of perceived liver donor quality on transplant recipient outcomes. It included all deceased liver donors during 2008-2018 in the Swiss Transplant Cohort Study. The results showed that perceived poor-quality liver donors accounted for 19.2% of the total, but this did not significantly affect re-listing or death within the first week and first year post-transplant.
ANZ JOURNAL OF SURGERY
(2023)
Article
Surgery
Pouya Iranmanesh, Shinil K. Shah, Mickael Chevallay, Christian Toso, Stefan P. Monig, Monika E. Hagen, Erik B. Wilson, Minoa K. Jung
Summary: This study retrospectively analyzed patient data from two databases at two high-volume bariatric centers to identify predictors of early postoperative complications after RRYGB. The results showed that male sex and ASA score > 2 were independent predictors of early postoperative complications after RRYGB.
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
(2023)
Review
Surgery
Jeremy Meyer, Elin Roos, Richard Justin Davies, Nicolas Christian Buchs, Frederic Ris, Christian Toso
Summary: An updated systematic review and meta-analysis of 11 randomized controlled trials (RCTs) confirms that prophylactic negative-pressure wound therapy (pNPWT) reduces the incidence of surgical site infection (SSI) after laparotomy.
WORLD JOURNAL OF SURGERY
(2023)
Article
Medicine, General & Internal
Noemie Lang, Antonella Diciola, Intidhar Labidi-Galy, Frederic Ris, Mariagrazia Di Marco, Nicolas Mach, Patrick Petignat, Christian Toso, Manuela Undurraga, Martin Hubner
Summary: Pressurised intraperitoneal aerosol chemotherapy (PIPAC) is a laparoscopic procedure aiming to improve local efficacy and minimize systemic side effects. The Nab-PIPAC trial is evaluating the safety and tolerability of nab-paclitaxel and cisplatin administered intraperitoneally in patients with gastric, pancreatic, or ovarian cancer. The study involves sequential intraperitoneal laparoscopic administration of nab-paclitaxel and cisplatin at escalating doses to determine the maximum tolerated dose.
Article
Dermatology
Jeremy Meyer, Elin Roos, Ziad Abbassi, Christian Toso, Christian Nicolas Buchs, Frederic Ris
Summary: This study suggests that prophylactic negative pressure wound therapy (pNPWT) may be effective in reducing the incidence of surgical site infections (SSIs) after abdominal surgery, but more randomized controlled trials are needed for confirmation.
JOURNAL OF WOUND CARE
(2023)
Article
Surgery
Charles-Henri Wassmer, Rebecca Revol, Isabelle Uhe, Mickael Chevallay, Christian Toso, Pascal Gervaz, Philippe Morel, Pierre-Alexandre Poletti, Alexandra Platon, Frederic Ris, Frank Schwenter, Thomas Perneger, Raphael P. H. Meier
Summary: A practical clinical severity score was developed and validated to guide the management of patients with small bowel obstruction.
INTERNATIONAL JOURNAL OF SURGERY
(2023)
Article
Medicine, General & Internal
Julien Maillard, Nadia Elia, Frederic Ris, Delphine S. Courvoisier, Dina Zekry, Intidhar Labidi Galy, Christian Toso, Stefan Monig, Isabelle Zaccaria, Bernhard Walder
Summary: This study aims to describe the patterns of HRQoL changes at 6 months after high-risk oncological surgery and assess the level of regret among patients and their next-of-kin regarding the decision to undergo surgery. Patients over 18 years old undergoing specific surgeries are included in this prospective observational cohort study. The primary outcome is the proportion of patients with changes in HRQoL at 6 months after surgery, while the secondary outcome is to assess regret levels.
Article
Oncology
Stephanie Lacotte, Florence Slits, Beat Moeckli, Andrea Peloso, Stephane Koenig, Matthieu Tihy, Sofia El Hajji, Quentin Gex, Laura Rubbia-Brandt, Christian Toso
Summary: Nonalcoholic steatohepatitis (NASH) can lead to hepatocellular carcinoma (HCC), but its impact on anticancer immunity is not fully understood. In a mouse model of NASH, an expansion of CD44(+)CXCR6(+)PD-1(+)CD8(+) T cells in the liver was observed. Although NASH mice had a higher percentage of OVA-specific CD8(+) T cells, they failed to prevent HCC growth. However, treatment with an anti-CD122 antibody restored CD8 activity and reduced HCC growth. Human datasets also supported these findings in NASH-affected livers and HCC tissues.
Review
Oncology
Julie Mareschal, Alexandra Hemmer, Jonathan Douissard, Yves Marc Dupertuis, Tinh-Hai Collet, Thibaud Koessler, Christian Toso, Frederic Ris, Laurence Genton
Summary: Gastrointestinal cancer surgery is the primary treatment for gastrointestinal cancers. Prehabilitation before surgery aims to optimize the patient's condition and improve postoperative recovery. This review summarizes the latest evidence of preoperative prehabilitation on postoperative outcomes and discusses potential therapeutic targets. Preoperative interventions combining nutrition and physical activity show improvements in physical performance and quality of life in patients with esophagogastric and colorectal cancers, but no benefits in postoperative complications and mortality. Further studies are needed to confirm these findings and identify patients who will benefit from prehabilitation.
Letter
Gastroenterology & Hepatology
Jeremy Meyer, Emilie Liot, Vaihere Delaune, Alexandre Balaphas, Bruno Roche, Guillaume Meurette, Frederic Ris
COLORECTAL DISEASE
(2023)
Review
Oncology
Charles-Henri Wassmer, Sofia El Hajji, Xenofon Papazarkadas, Philippe Compagnon, Parissa Tabrizian, Stephanie Lacotte, Christian Toso
Summary: ICI therapy has improved the management of HCC patients and made liver transplantation possible for some of them. However, acute rejection after ICI therapy challenges its safety in transplant settings. A three-month washout period is desirable to reduce the risk of acute rejection, and the use of ICIs after liver transplantation should be avoided whenever possible.
