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Bowel Anastomosis
157
or rubber dilators. Dilation is more successful if initiated within the first few
weeks after surgery. In fact, almost all coloanal or ileoanal anastomoses will
stricture to some degree during the early postoperative period, especially if a
diverting stoma is present. All such anastomoses should undergo digital
examination at 4–6 weeks after surgery and just before stoma closure (usually
at 2–3 months). Strictures are usually soft and easily dilated during these
examinations. Higher colorectal, colocolic or ileocolic strictures may be
approached using endoscopic balloon dilation. If these measures fail, or if the
stricture is extremely tight or long, revision surgery may be required. These
are difficult operations, however, because of the pelvic fibrosis that develops
after anastomotic leak and complications are common. In some cases,
permanent fecal diversion is the only option [24-27].
Early obstruction at the anastomotic site can result from edema or
excessive inversion; late obstruction can be caused by recurrent carcinoma.
References
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corticosteroids in anastomotic leakage: a prospective study of 259 left-
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[2] Alves A, Panis Y, Mathieu P, et al. Postoperative mortality and
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prospective multicenter study. Arch Surg. 2005; 140:278-83.
[3] Fazio VW, Tekkis PP, Remzi F, Lavery IC. Assessment of operative risk
[4] Tekkis PP, Poloniecki JD, Thompson MR
[5] Ho YH, Ashour MA. Techniques for colorectal anastomosis. World J
Gastroeneterol 2010; 16:1610-21.
[6] Neutzling CB, Lutosa SA, Proenca IM, et al. Stapled versus handsewn
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[7] Leung E, Ferjani AM, Stellard N, Wong LS. Predicting post-operative
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[18] Karliczek A, Jesus EC, Matos D, et al. Drainage or nondrainage in
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[19] Agnifili A, Schietroma M, Carloni A, et al. The value of omentoplasty in
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[20] Boccola MA, Lin J, Rozen WN, et al. Reducing anastomotic leakage in
oncologic colorectal surgery: an evidence- based review. Anticancer Res
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[22] Buchs NC, Gervaz P, Secic M, et al. Incidence, consequences, and risk
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Bowel Anastomosis
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[24] Davis B, Rivadeneira DE. Complications of colorectal anastomoses:
leaks, strictures, and bleeding. Surg Clin North Am 2013; 93:61-87.
[25] Dietz DW. Postoperative complications. In: The ASCRS textbook of
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Index
#
20th century, 78
A
abdominal wound, ix, 25, 78
access, x, 59, 104, 120
accessibility, 52
acid, 8, 35, 37, 40, 80, 84, 85, 146
AD, ix, 77
adaptation, 69
adenocarcinoma, 53
adhesion(s), 80, 84, 89, 98, 144
adults, 62, 83
advancements, 3
adventitia, 91
age, 25, 44, 50, 112
aggregation, 98
alcohol abuse, 72
alcohol consumption, 52
ALT, 32
ambidexterity, 56
amplitude, 125
anatomy, 2, 19, 22, 48, 58, 62, 63, 89, 90,
91, 122, 125, 126, 127, 128, 129, 130,
149
anemia, 52, 155
aneurysm, 112, 113, 119, 134, 135, 137,
138
angiography, 156
antibiotic, 156
anus, 84, 86, 152
anxiety, xi, 139
aorta, ix, x, 103, 104, 110, 112, 113, 115,
117, 120, 121, 122, 123, 124, 125, 126,
127, 134, 136, 137
apex, 88
arrest, ix, x, 103, 104, 114, 124, 125, 127
arteriosclerosis, 114
artery, 15, 91, 108, 109, 127, 135, 136
ascending colon, 91
ascites, 25
aseptic, 78
aspiration, 25
assessment, 50, 63, 67, 69, 76
assimilation, 87
asymptomatic, 29
atherosclerosis, 131
automate, 122
automation, 67
B
bacteria, 89
base, 53
BD, 74
Index
162
BEA, vii, 1, 2, 3, 4, 6, 7, 8, 24, 25, 26, 27,
28, 29, 30, 31, 32, 33, 36
beef, 82
bending, 116, 117, 118, 119, 126
beneficial effect, 86
benign, vii, 1, 3, 6, 7, 26, 27, 30, 37, 39, 40,
42, 44, 45, 80, 159
bile, vii, 1, 3, 5, 6, 7, 8, 12, 15, 17, 19, 24,
25, 28, 29, 30, 32, 35, 36, 37, 38, 40, 41,
44, 45, 46
bile duct, vii, 1, 5, 6, 7, 12, 15, 17, 19, 24,
25, 28, 29, 32, 35, 36, 37, 38, 40, 41, 44,
45, 46
bile duct stricture, 5, 40, 41, 45
bile peritonitis, 25
biliary atresia, 3, 37
biliary cirrhosis, vii, 1, 3, 28
biliary fistula, viii, 2, 25, 30, 31
biliary obstruction, 3, 27, 32, 39, 42, 45
biliary stricture, vii, 1, 6, 26, 30, 40, 41, 42,
44, 45
biliary tract, vii, 1, 2, 3, 4, 6, 7, 15, 17, 19,
20, 21, 22, 23, 24, 28, 29, 33, 34, 35, 36,
37, 38, 41
bilioenteric anastomoses, vii, 2, 3, 8, 24, 31,
32, 34, 35
bilirubin, 25, 32
biomarkers, 32
bleeding, xi, 7, 19, 27, 36, 64, 140, 155,
156, 159
blood, x, xi, 50, 52, 62, 64, 69, 78, 80, 82,
83, 90, 104, 105, 111, 112, 113, 115,
118, 124, 125, 131, 134, 136, 137, 140,
153, 155, 156
blood flow, 52, 90, 111, 113, 118, 125, 136
blood pressure, 111, 112
blood stream, 112
blood supply, xi, 78, 80, 83, 140, 155, 156
blood vessels, 50, 82, 134
bloodstream, 119
body weight, 92
bone, ix, 78
bowel, vii, xi, 50, 51, 52, 53, 54, 71, 72, 73,
74, 76, 80, 84, 85, 88, 92, 93, 94, 96, 99,
140, 141, 142, 143, 146, 147, 155, 156,
158
bowel obstruction, 141
breakdown, 52, 97
C
cadaver, 50, 63
caecum, 88, 89, 90
calcification, 131
calibration, 83
cancer, 5, 37, 41, 50, 72, 73, 134, 141, 158
capillary, 99
capsule, 20, 23
carcinoma, 5, 7, 27, 86, 155, 157
cardiac surgery, 82
carnivores, 89, 90
catheter, 31, 32
cauterization, 91
CBD, 28
CEC, 124
cecum, 91
cellulose, 89
challenges, 79
chemotherapy, 52, 155
children, 40, 62
cholangiocarcinoma, vii, 1, 4, 7, 29, 40
cholangiography, 26, 31, 32, 33, 40, 41, 42
cholangiojejunostomy, vii, 2, 7
cholangitis, vii, 1, 3, 5, 6, 24, 25, 27, 28, 29,
30, 32, 34, 35, 38
cholecystectomy, 2, 29, 36, 39, 44, 45
choledochal cysts, vii, 1, 40
choledochoduodenostomy, vii, 2, 6, 38, 39,
42, 43, 44
choledochojejunostomy, vii, 2, 16, 36, 39,
43
choledocholithiasis, 43
cholelithiasis, 27, 43
chromium, 82
circulation, 108, 117, 118, 119, 122
City, 1
classification, 34
clinical application, 106, 130
clinical assessment, 26
Index
163
clinical judgment, 49
clinical symptoms, 34
closure, viii, 47, 60, 76, 78, 79, 81, 82, 157
CNS, ix, x, 103, 104, 114
coagulation process, 64
coatings, 82
colectomy, 58, 147, 149, 150, 151
colic, 54, 58, 62
collagen, 50, 51, 59, 96, 97, 98
collateral, 117, 120, 125
colon, 12, 13, 15, 17, 60, 61, 74, 84, 85, 86,
88, 89, 90, 91, 92, 101, 141, 143, 144,
146, 149, 150, 151, 152, 153, 154, 155,
157, 158, 159
colon cancer, 157
color, 155
colorectal, x, xi, 52, 53, 72, 73, 74, 84, 86,
94, 95, 100, 139, 140, 141, 147, 149,
156, 157, 158, 159
colorectal cancer, 94
colostomy, 86, 152, 156
common bile duct, 5, 6, 7, 12, 14, 15, 17,
27, 28, 30, 38, 43
common sense, 154
communication, 66
compensation, 128
complexity, 56, 61
compliance, 122
complications, vii, viii, ix, x, xi, 2, 3, 6, 7,
24, 25, 26, 27, 28, 30, 32, 33, 40, 41, 42,
54, 79, 81, 82, 94, 98, 103, 104, 112,
114, 139, 140, 141, 154, 157, 159
comprehension, 66
compression, ix, 84, 103, 123, 124, 132
computer, 50, 137
conciliation, 49
concordance, 98
configuration, x, 94, 95, 104, 115, 122, 125,
127, 129, 130, 141
conflict, 125, 131
Congress, 101, 136
consensus, 151
conservation, 54, 63
constipation, 156
Constitution, 45
construction, ix, xi, 80, 83, 103, 114, 140
consumption, 67
containers, 63
contamination, 52, 131, 141, 157
controlled trials, 53, 74
controversial, 27, 36, 155
convergence, 113
coordination, 53, 67
coronary arteries, 135
corticosteroids, 157
cost, 58, 65, 71, 82, 83
creep, 95, 97
CT, 25, 29, 32, 154, 156
CT scan, 29, 154, 156
cure, 87, 112
curriculum, 50, 65
cyst, 29, 44
cystic duct, 5, 9, 15
D
Dacron fabric, ix, 103, 114, 115, 124
deaths, 113
deconstruction, 66
deficiencies, 52, 155
deformation, 64, 131
dehiscence, 24, 25, 158
dehydration, 89
delayed gastric emptying, 30
deposition, 97
depth, 56, 91
depth perception, 56
descending colon, 90
diabetes, 52, 70, 155
diet, 89
diffusion, 141
dilation, 24, 26, 29, 30, 32, 33, 35, 42, 157,
159
direct bilirubin, 32
direct observation, 68
directives, 49
disability, 87
diseases, vii, 1, 2, 3, 40, 78, 87
dislocation, 111, 112, 118, 132
disorder, 87
Index
164
displacement, 118, 128
disposition, 125
diversity, 83
diverticulitis, 86
dogs, 62, 78, 79, 80, 85, 90, 98, 101, 138
DOI, 100, 136
drainage, vii, 1, 6, 7, 25, 30, 31, 32, 38, 154
duodenum, 5, 12, 13, 14, 28, 29
dura mater, 84
durability, 81
E
edema, 52, 83, 98, 157
editors, 134
education, vii, 50, 70
EEA, 150
Egypt, ix, 2, 77
elaboration, 105
election, 141
electrocautery, 80
electrolyte, 72
emboli, 156
embolization, 156
emergency, x, 80, 114, 139, 140, 154
emission, 63
endoscopic retrograde
cholangiopancreatography, 6
endoscopy, 28, 29, 45
endotracheal intubation, 90
enemas, 156
engineering, 37
England, 43, 65
environment(s), 49, 66, 76
epinephrine, 156
epithelial cells, 37
epithelium, 29, 44, 88, 98
equipment, 52, 56, 62, 141
ergonomics, 56
erosion, 110, 111, 131
esophagus, 51, 52, 57
ethanol, 41
etiology, 3
evacuation, 95
evidence, viii, 25, 32, 48, 50, 53, 57, 73, 81,
94, 95, 141, 155, 158
evolution, 105, 106, 112, 125
examinations, 157
exercise, 49
experimental design, 62
exposure, 12, 15, 17, 18, 19, 49, 80, 120
external fixation, 131
extraction, 83
extravasation, 85
exudate, 98
F
family life, 49
fat, 98, 155
FDA, 110
fear, 82
feces, 78, 80
fermentation, 89
fever, 34, 154
fibrin, 84
fibrinolytic, 98
fibroblasts, 97, 98, 124
fibrosis, 6, 144, 157
fidelity, 50, 62, 63
financial, 58
fistulas, 24, 25
fixation, ix, 62, 104, 107, 114, 117, 118,
119, 122, 132
flexibility, 59
fluid, 25, 32, 89, 153, 154
fluorescence, 86
food, 6, 28, 29, 88
force, 45, 96
formaldehyde, 63
formation, 8, 24, 29, 30, 51, 89, 94, 96, 98
fragility, 61, 116, 124
freezing, 60
friction, 110, 111
G
gallbladder, 5, 7, 9, 12, 13, 20, 37, 42, 89
Index
165
gallstones, 2
gastrectomy, 58, 91
gastritis, 27
gastrointestinal tract, vii, 1, 3, 5, 8, 51, 74,
80, 83, 88, 90, 105
general surgeon, 49
general surgery, 49, 77
genes, 88
genetic disorders, 124
genetic engineering, 88
gland, 29
glucose, 60
glycol, 72
goblet cells, 29, 88
graft technique, 2
Greece, 2
Greeks, ix, 77
growth, 90
growth rate, 90
guidance, 42
H
haemostasis, 114, 117, 123, 124, 131, 133
healing, viii, 47, 51, 52, 72, 78, 80, 81, 84,
86, 91, 96, 98, 101, 155
health, 36
height, 94
hematoma, 155
hemorrhage, 6, 30, 39
hemostasis, 112, 122, 124, 155
hepaticojejunostomy, vii, 2, 28, 29, 39, 40,
44, 45
hepatojejunostomy, vii, 2, 5, 7, 18, 40
herbivorous, ix, 77
hernia, xi, 99, 140
histology, 29
history, ix, 3, 4, 77
HM, 72
hormones, 88
horses, 89
host, 119, 120
House, 37, 44
housing, 87, 90
human, 37, 50, 54, 56, 58, 59, 60, 62, 63,
64, 65, 75, 78, 79, 82, 84, 85, 87, 89, 90,
128, 129
human body, 65
hybrid, 112, 135
hyperplasia, 29
hypotension, 89, 155
hypothermia, x, 52, 104, 125
hypovolemia, 60
I
iatrogenic, vii, 1, 6, 7, 35, 36, 40, 41
ID, 41
ideal, xi, 8, 27, 53, 65, 67, 81, 106, 113,
124, 125, 127, 132, 140
identification, 15, 58
ileostomy, 152
ileum, 60, 143, 144, 146
immersion, 63
impairments, 124
improvements, 3, 106, 112
in vitro, 97, 134
in vivo, 116
incidence, 28, 29, 84, 85, 91, 94, 95, 114,
153, 155, 158
independence, 48
individuals, 71
infection, 24, 52, 81, 84, 88, 131, 155
inflammation, xi, 81, 91, 98, 140
inflammatory cells, 98
injury(ies), vii, 1, 6, 7, 15, 25, 30, 35, 36,
37, 40, 41, 44, 45, 46, 72
insertion, ix, x, 5, 9, 103, 104, 114, 115,
121, 128
integration, 124
integrity, x, 60, 96, 104, 115, 127
interface, 91
interference, 129
intervention, 87
intestinal anastomosis, vii, viii, 48, 54, 56,
57, 58, 61, 62, 63, 64, 65, 66, 67, 70, 74,
76, 78, 79, 80, 81, 83, 90, 94, 99, 148,
158
intestinal flora, 52
Index
166
intestinal obstruction, 84
intestinal tract, 50
intestine, viii, ix, 47, 51, 54, 59, 60, 61, 72,
77, 78, 79, 80, 82, 89, 90, 144
intima, 105
intra-abdominal abscess, viii, 2, 25, 28
intussusception, 6, 27
invaginate, ix, 78
inversion, 79, 148, 157
iodine, 92
irradiation, 52, 155
irrigation, 17, 19
ischemia, 83, 95, 107, 108, 113, 114, 117,
124, 140, 156
isolation, 127
Italy, 37, 103
J
Japan, 101, 106
jaundice, 2, 3, 5, 27, 32, 34, 37, 45
jejunum, 5, 6, 9, 16, 20, 39, 60, 79, 91
K
knots, 8, 18, 54, 56, 78
L
laboratory tests, 34
laceration, 105, 127
laparoscopic cholecystectomy, 3, 36, 37, 41,
44, 45, 46, 70
laparoscopic surgery, 37, 56, 58, 60, 65, 69,
70, 71, 156
laparoscopy, 56, 57, 58
laparotomy, 99, 120, 152, 154
large intestine, 62, 72, 89, 90, 144, 146
lead, 6, 25, 29, 69, 81, 85, 87
leakage, 25, 28, 30, 31, 32, 41, 44, 52, 53,
72, 73, 83, 84, 85, 91, 94, 95, 96, 98,
100, 140, 154, 155, 157, 158
leaks, 25, 67, 69, 70, 94, 146, 153, 154, 158,
159
learning, viii, ix, 47, 48, 49, 56, 57, 58, 59,
63, 66, 67, 69, 73, 74, 76
learning process, 63, 66, 74
legs, 11
lesions, 41, 56, 80, 134, 137
leukocytosis, 154
life cycle, 88
life expectancy, 6, 7
ligament, 12, 13, 15, 17, 19, 20
light, 132
liver, 2, 3, 8, 19, 23, 32, 34, 35, 41, 42
liver damage, 32
liver function tests, 34, 35
liver transplant, 41, 42
liver transplantation, 41, 42
longitudinal study, 46
low temperatures, 60
lumen, xi, 8, 18, 22, 51, 54, 79, 83, 96, 114,
116, 118, 124, 125, 129, 133, 140, 146,
156
lung transplantation, 108, 136
Luo, 135
lymphocytes, 98
lymphoid tissue, 89
M
magnesium, 105
magnetic resonance, 42
magnitude, 98
majority, 82, 96, 114
malignancy, 27, 31, 156
malignant diseases, vii, 1
malnutrition, 52, 155
man, 87, 88, 90, 91
management, 30, 37, 39, 40, 41, 42, 43, 44,
45, 58, 92
manipulation, 24, 29, 32, 83, 108, 117
manufacturing, 82
Marfan syndrome, 114, 135
Marx, 42
mass, 156
materials, viii, ix, 48, 52, 57, 59, 62, 65, 77,
81, 82, 86, 99, 112, 141
matter, 91, 141