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[PMID]: 29489659 [Au] Autor: Yao Z; Tian W; Xu X; Huang Q; Zhao Y [Ad] Endereço: Department of General Surgery, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu, China. [Ti] Título: An innovative method for placing a double-lumen irrigation-suction tube in the management of abdominal infection: A case report. [So] Source: Medicine (Baltimore);97(9):e0048, 2018 Mar. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Currently, the use of double-lumen irrigation-suction tube for drainage has become increasingly more common. However, the insertion process is complex, and the position of the double cannula placed in this manner is not accurate. We developed a method for placing the drainage tube and use it in the treatment of an abdominal infection. PATIENT CONCERNS: A 51-year-old man with an abdominal infection due to colonic anastomotic fistula was admitted. Routine laboratory tests revealed an elevated white blood cell count (17 × 10/L) and C-reactive protein level (78 mg/L). Computed tomography (CT) revealed that the peritoneal cavity was filled with fluid. DIAGNOSES: The patient was diagnosed with colonic anastomosis fistula by gastrointestinal radiography. Abdominal infection was diagnosed based on CT scan, inflammatory markers, and patient signs and symptoms. INTERVENTIONS: Two punctures were performed. After skin expansion, the source of infection was drained with a suction catheter (diameter = 1.0 cm) under continuous negative pressure of 150 to 200 millibars, along with continuous saline irrigation at 300 mL/h. OUTCOMES: Pus in the abdomen drained completely. The abdominal infection was controlled. There were no adverse events. LESSONS: Abdominal infection in fistulas is a fatal disease. The main therapeutic target is full drainage at an early stage. Precise positioning of the tube, continuous negative pressure irrigation and drainage are key points in the treatment. [Mh] Termos MeSH primário: Abscesso Abdominal/terapia Sucção/métodos [Mh] Termos MeSH secundário: Abscesso Abdominal/etiologia Doenças do Colo/complicações Seres Humanos Fístula Intestinal/complicações Masculino Meia-Idade Sucção/instrumentação Irrigação Terapêutica/instrumentação Resultado do Tratamento [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180301 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000010048

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[PMID]: 28470562 [Au] Autor: Cima RR; Bergquist JR; Hanson KT; Thiels CA; Habermann EB [Ad] Endereço: Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, 200 First St. SW, Rochester, MN, 55905, USA. cima.robert@mayo.edu. [Ti] Título: Outcomes are Local: Patient, Disease, and Procedure-Specific Risk Factors for Colorectal Surgical Site Infections from a Single Institution. [So] Source: J Gastrointest Surg;21(7):1142-1152, 2017 Jul. [Is] ISSN: 1873-4626 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Colorectal surgical site infections (SSIs) contribute to postoperative morbidity, mortality, and resource utilization. Risk factors associated with colorectal SSI are well-documented. However, quality improvement efforts are informed by national data, which may not identify institution-specific risk factors. METHOD: Retrospective cohort study of colorectal surgery patients uses institutional ACS-NSQIP data from 2006 through 2014. ACS-NSQIP data were enhanced with additional variables from medical records. Multivariable logistic regression identified factors associated with SSI development. RESULTS: Of 2376 patients, 213 (9.0%) developed at least one SSI (superficial 4.8%, deep 1.1%, organ space 3.5%). Age < 40, BMI > 30, ASA3+, steroid use, smoking, diabetes, pre-operative sepsis, higher wound class, elevated WBC or serum glutamic-oxalocetic transaminase, low hematocrit or albumin, Crohn's disease, and prolonged incision-to-closure time were associated with increased SSI rate (all P < 0.01). After adjustment, BMI > 30, steroids, diabetes, and wound contamination were associated with SSI. Patients with Crohn's had greater odds of SSI than other indications. CONCLUSION: Institutional modeling of SSI suggests that many previously suggested risk factors established on a national level do not contribute to SSIs at our institution. Identification of institution-specific predictors of SSI, rather than relying upon conclusions derived from external data, is a critical endeavor in facilitating quality improvement and maximizing value of quality investments. [Mh] Termos MeSH primário: Doenças do Colo/cirurgia Doenças Retais/cirurgia Infecção da Ferida Cirúrgica/etiologia [Mh] Termos MeSH secundário: Adulto Idoso Feminino Seres Humanos Modelos Logísticos Masculino Meia-Idade Melhoria de Qualidade Estudos Retrospectivos Fatores de Risco Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180305 [Lr] Data última revisão: 180305 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170505 [St] Status: MEDLINE [do] DOI: 10.1007/s11605-017-3430-1

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[PMID]: 29391097 [Au] Autor: Sujatha-Bhaskar S; Alizadeh RF; Koh C; Inaba C; Jafari MD; Carmichael JC; Stamos MJ; Pigazzi A [Ad] Endereço: Department of Surgery, University of California, Irvine School of Medicine, Irvine, California, USA. [Ti] Título: The Growing Utilization of Laparoscopy in Emergent Colonic Disease. [So] Source: Am Surg;83(10):1068-1073, 2017 Oct 01. [Is] ISSN: 1555-9823 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Emergent colonic disease has traditionally been managed with open procedures. Evaluation of recent trends suggests a shift toward minimally invasive techniques in this disease setting. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) targeted colectomy database from 2012 to 2014 was used to examine clinical data from patients who emergently underwent open colectomy (OC) and laparoscopic colectomy (LC). Multivariate regression was utilized to analyze preoperative characteristics and determine risk-adjusted outcomes with intent-to-treat and as-treated approach. Of 10,018 patients with emergent colonic operation, 90 per cent (9023) underwent OC whereas 10 per cent (995) underwent LC. Laparoscopic utilization increased annually, with LC composing 10.9 per cent of emergent colonic operations in 2014 compared with 9.3 per cent in 2012. Compared with LC, patients treated with OC had higher rates of overall morbidity (odds ratio 2.01, 95% confidence interval 1.74-2.34, P < 0.01) and 30-day mortality (odds ratio 1.79, 95% confidence interval 1.30-2.46, P < 0.01). Subset analysis of emergent patients without preoperative septic shock revealed consistent benefits with laparoscopy in overall morbidity, 30-day mortality, ileus, and surgical site infection. In select patients with hemodynamic stability, emergent LC appears to be a safe and beneficial operation. This study reflects the growing preference and utilization of minimally invasive techniques in emergent colonic operations. [Mh] Termos MeSH primário: Colectomia/métodos Doenças do Colo/cirurgia Laparoscopia/utilização Padrões de Prática Médica/tendências [Mh] Termos MeSH secundário: Adolescente Adulto Idoso Idoso de 80 Anos ou mais Colectomia/mortalidade Doenças do Colo/mortalidade Bases de Dados Factuais Emergências Feminino Seres Humanos Análise de Intenção de Tratamento Laparoscopia/mortalidade Laparoscopia/tendências Masculino Meia-Idade Análise Multivariada Complicações Pós-Operatórias/epidemiologia Complicações Pós-Operatórias/etiologia Estudos Retrospectivos Risco Ajustado Resultado do Tratamento Estados Unidos/epidemiologia Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180214 [Lr] Data última revisão: 180214 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180203 [St] Status: MEDLINE

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[PMID]: 29350896 [Au] Autor: Milickovic M; Savic D; Stankovic N; Vukadin M; Bozic D [Ti] Título: Transverse colon volvulus in neurologicaly imparied patient as an emergency surgical condition: A case report. [So] Source: Vojnosanit Pregl;74(1):78-80, 2017 Jan. [Is] ISSN: 0042-8450 [Cp] País de publicação: Serbia [La] Idioma: eng [Ab] Resumo: Introduction: Transverse colon volvulus is an uncommon cause of bowel obstruction in general. Predisposing factors are mental retardation, dysmotility disorders, chronic constipation and congenital megacolon. Case report: We presented transverse colon volvulus in a 16-year-old boy with cerebral palsy. Chronic constipation in neurologicaly impaired patient was a risk factor predisposing to volvulus. The patient was admitted to the hospital with enormous abdominal distension and acute respiratory insufficiency. A boy was emergently taken to the operating room for exploratory laparotomy. During the surgery, a 360º clockwise volvulus of the transverse colon was found. After reduction of volvulus, an enormous transverse colon was resected and colostomy was formed. In the postoperative period, despite the good functioning of stoma and intraabdominal normotension, numerous and long lasting respiratory problems developed. The patient was discharged from our institution after 8 months. Conclusion: Though very rare in pediatric group, the possibility of a transverse colon volvulus must be considered in the differential diagnosis of acute large bowel obstruction. [Mh] Termos MeSH primário: Paralisia Cerebral/complicações Colectomia Colo Transverso/cirurgia Doenças do Colo/cirurgia Colostomia Volvo Intestinal/cirurgia [Mh] Termos MeSH secundário: Adolescente Paralisia Cerebral/diagnóstico Paralisia Cerebral/fisiopatologia Colo Transverso/diagnóstico por imagem Doenças do Colo/complicações Doenças do Colo/diagnóstico por imagem Emergências Seres Humanos Volvo Intestinal/complicações Volvo Intestinal/diagnóstico por imagem Tempo de Internação Masculino Complicações Pós-Operatórias/etiologia Fatores de Tempo Resultado do Tratamento [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180213 [Lr] Data última revisão: 180213 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180120 [St] Status: MEDLINE [do] DOI: 10.2298/VSP150911015M

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[PMID]: 29364805 [Au] Autor: Devaraj NK [Ad] Endereço: Department of Family Medicine. Faculty of Medicine. Universiti Putra Malaysia. Selangor. Malaysia. [Ti] Título: Letter to the Editor: Colonic Perforation. [So] Source: Acta Med Port;30(12):891, 2017 12 29. [Is] ISSN: 1646-0758 [Cp] País de publicação: Portugal [La] Idioma: eng [Mh] Termos MeSH primário: Colonoscopia Perfuração Intestinal [Mh] Termos MeSH secundário: Doenças do Colo Seres Humanos [Pt] Tipo de publicação: LETTER; COMMENT [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180202 [Lr] Data última revisão: 180202 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180125 [St] Status: MEDLINE [do] DOI: 10.20344/amp.9556

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[PMID]: 29245311 [Au] Autor: Cui B; Zhou L; Khan S; Cui J; Liu W [Ad] Endereço: aDepartment of Digestive DiseasesbDepartment of Imaging, General Hospital, Tianjin Medical University, Tianjin, China. [Ti] Título: Role of enteral nutrition in pancreaticocolonic fistulas secondary to severe acute pancreatitis: A case report. [So] Source: Medicine (Baltimore);96(49):e9054, 2017 Dec. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Pancreaticocolonic fistula (PCF) is an exceedingly rare complication of severe acute pancreatitis (SAP) and has primarily been treated surgically, but a few reported cases are successfully treated with nonsurgical methods. PATIENT CONCERNS: A 32-year-old male presented to our hospital with chief complaints of sharp and persistent left upper quadrant abdominal pain radiating to the back. DIAGNOSES: Computed tomography showed a pancreatic pseudocyst replacing a majority of the pancreatic parenchyma and PCF that formed between the pancreas and the colon. However, the final diagnosis of PCF was confirmed by drainage tube radiograph, which revealed extravasation of contrast from the tail of the pancreas into the colon. INTERVENTIONS: A therapeutic strategy of enteral nutrition (EN) was applied. OUTCOMES: The patient responded well to the treatment. No complication and recurrence were reported during 2-year follow-up. LESSONS: This case highlights the role of EN in the treatment of PCF secondary to SAP. To the best of our knowledge, this is the first case of PCF that treated successfully with EN, rather than surgical or endoscopic intervention. [Mh] Termos MeSH primário: Doenças do Colo/terapia Nutrição Enteral/métodos Fístula Intestinal/terapia Fístula Pancreática/terapia Pancreatite/complicações [Mh] Termos MeSH secundário: Doença Aguda Adulto Doenças do Colo/etiologia Seres Humanos Fístula Intestinal/etiologia Masculino Fístula Pancreática/etiologia Pseudocisto Pancreático/etiologia Resultado do Tratamento [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171226 [Lr] Data última revisão: 171226 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171217 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000009054

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[PMID]: 29215477 [Au] Autor: Coakley KM; Kasten KR; Sims SM; Prasad T; Heniford BT; Davis BR [Ad] Endereço: Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina. [Ti] Título: Prophylactic Ureteral Catheters for Colectomy: A National Surgical Quality Improvement Program-Based Analysis. [So] Source: Dis Colon Rectum;61(1):84-88, 2018 Jan. [Is] ISSN: 1530-0358 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Despite improvement in technique and technology, using prophylactic ureteral catheters to avoid iatrogenic ureteral injury during colectomy remains controversial. OBJECTIVE: The aim of this study was to evaluate outcomes and costs attributable to prophylactic ureteral catheters with colectomy. DESIGN: This was a retrospective study. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: The colectomy-targeted American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2014 was queried. MAIN OUTCOME MEASURES: The primary end point was the rate of 30-day ureteral injury after colectomy. Univariate and multivariate analyses determined factors associated with ureteral injury and urinary tract infection in patients undergoing colectomy. RESULTS: A total of 51,125 patients were identified with a mean age of 60.9 ± 14.9 years and a BMI of 28.4 ± 6.7 k/m; 4.90% (n = 2486) of colectomies were performed with prophylactic catheters, and 333 ureteral injuries (0.65%) were identified. Prophylactic ureteral catheters were most commonly used for diverticular disease (42.2%; n = 1048), with injury occurring most often during colectomy for diverticular disease (36.0%; n = 120). Univariate analysis of outcomes demonstrated higher rates of ileus, wound infection, urinary tract infection, urinary tract infection as reason for readmission, superficial site infection, and 30-day readmission in patients with prophylactic ureteral catheter placement. On multivariate analysis, prophylactic ureteral catheter placement was associated with a lower rate of ureteral injury (OR = 0.45 (95% CI, 0.25-0.81)). LIMITATIONS: This was a retrospective study using a clinical data set. CONCLUSIONS: Here, prophylactic ureteral catheters were used in 4.9% of colectomies and most commonly for diverticulitis. On multivariate analysis, prophylactic catheter placement was associated with a lower rate of ureteral injury. Additional research is needed to delineate patient populations most likely to benefit from prophylactic ureteral stent placement. See Video Abstract at http://links.lww.com/DCR/A482. [Mh] Termos MeSH primário: Colectomia/efeitos adversos Doenças do Colo/cirurgia Ureter/lesões Doenças Ureterais/prevenção & controle Cateteres Urinários [Mh] Termos MeSH secundário: Idoso Seres Humanos Doença Iatrogênica/prevenção & controle Meia-Idade Complicações Pós-Operatórias/prevenção & controle Melhoria de Qualidade Estudos Retrospectivos Doenças Ureterais/etiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171215 [Lr] Data última revisão: 171215 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171208 [St] Status: MEDLINE [do] DOI: 10.1097/DCR.0000000000000976

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[PMID]: 28745710 [Au] Autor: Krylov NN; Lyatifova LV [Ad] Endereço: First Moscow State medical University named after I.M. Sechenov, Moscow, Russia. [Ti] Título: [Autoplasmotherapy in coloproctology]. [Ti] Título: Autoplazmoterapiia v koloproktologii.. [So] Source: Khirurgiia (Mosk);(7):61-64, 2017. [Is] ISSN: 0023-1207 [Cp] País de publicação: Russia (Federation) [La] Idioma: rus [Mh] Termos MeSH primário: Terapia Biológica/métodos Doenças do Colo/terapia Plasma Rico em Plaquetas Doenças Retais/terapia [Mh] Termos MeSH secundário: Seres Humanos Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171130 [Lr] Data última revisão: 171130 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170727 [St] Status: MEDLINE [do] DOI: 10.17116/hirurgia2017761-64

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[PMID]: 28978953 [Au] Autor: Kaz AM; Dominitz JA [Ad] Endereço: Gastroenterology Section, VA Puget Sound Health Care System, Seattle, WA, USA. [Ti] Título: Editorial: The Name Game: Circumventing Quality Metrics by Categorizing Incomplete Colonoscopy as Sigmoidoscopy. [So] Source: Am J Gastroenterol;112(10):1553-1555, 2017 Oct. [Is] ISSN: 1572-0241 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Cecal intubation rate (CIR) is an important metric for colonoscopy quality. Guidelines propose a minimum CIR of 90% for all indications, and 95% in screening procedures. In this issue, a study of three UK teaching hospitals demonstrated one-third of endoscopists inappropriately converted colonoscopies to flexible sigmoidoscopies, and several endoscopists only reached the 90% CIR benchmark because of these inappropriate conversions. Our professional societies and healthcare organizations must continue to work to improve the accurate assessment of colonoscopy quality in order to identify underperforming clinicians who should be provided with additional training for the benefit of their patients. [Mh] Termos MeSH primário: Doenças do Colo/diagnóstico Colonoscopia Intubação Gastrointestinal Sigmoidoscopia [Mh] Termos MeSH secundário: Competência Clínica Colonoscopia/métodos Colonoscopia/estatística & dados numéricos Seres Humanos Intubação Gastrointestinal/métodos Intubação Gastrointestinal/normas Intubação Gastrointestinal/estatística & dados numéricos Melhoria de Qualidade Indicadores de Qualidade em Assistência à Saúde Sigmoidoscopia/métodos Sigmoidoscopia/estatística & dados numéricos Reino Unido [Pt] Tipo de publicação: EDITORIAL [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171019 [Lr] Data última revisão: 171019 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171006 [St] Status: MEDLINE [do] DOI: 10.1038/ajg.2017.258

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[PMID]: 28953636 [Au] Autor: Ren C; Liu Y; Cao R; Zhao T; Chen D; Yao L; Pan Z [Ad] Endereço: aDepartment of Emergency Surgery bDepartment of Pathology cDepartment of Radiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, Anhui, China. [Ti] Título: Colonic obstruction caused by accessory spleen torsion: A rare case report and literature review. [So] Source: Medicine (Baltimore);96(39):e8116, 2017 Sep. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: RATIONALE: Accessory spleen torsion is a rare cause of the acute abdomen. The complications of accessory spleen torsion, such as intestinal obstruction, are rarer. We herein report a case of colonic obstruction caused by accessory spleen torsion because of the unusual condition. PATIENT CONCERNS: A 15-year-old patient presented with acute intestinal obstruction with signs of peritoneal irritation. Abdominal computed tomography (CT) and ultrasonography examinations revealed a soft tissue mass in the left midabdomen. Systemic inflammatory response syndrome (SIRS) was observed in this case. DIAGNOSES: The diagnosis of peritonitis and colonic obstruction secondary to accessory spleen torsion was made. Pathologic examination showed infracted splenic tissue. INTERVENTIONS: We performed emergency laparotomy and found that accessory spleen torsion pressured against splenic flexure and descending colon, and caused colon obstruction. The patient underwent accessory splenectomy and enteral decompression. OUTCOMES: At 6 months follow-up, the patient recovered well with perfect digestion. LESSONS: Accessory spleen torsion and its complications are extremely rare. This entity should be considered in differential diagnosis of acute abdomen. However, in case of acute abdomen with critical clinical situation, emergency surgical intervention is necessary for timely diagnosis and treatment. [Mh] Termos MeSH primário: Doenças do Colo/etiologia Obstrução Intestinal/etiologia Baço/anormalidades Esplenopatias/complicações Anormalidade Torcional/complicações [Mh] Termos MeSH secundário: Adolescente Seres Humanos Masculino Baço/patologia Síndrome de Resposta Inflamatória Sistêmica/etiologia [Pt] Tipo de publicação: CASE REPORTS; JOURNAL ARTICLE; REVIEW [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171013 [Lr] Data última revisão: 171013 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170928 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008116

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