Endoscopy in the Early Postoperative Setting after Primary Gastrointestinal Anastomosis

被引:20
作者
Amr, Mahmoud A. [1 ]
Alzghari, Mohammad J. [1 ]
Polites, Stephanie F. [1 ]
Khasawneh, Mohammad A. [1 ]
Morris, David S. [1 ]
Baron, Todd H. [2 ]
Zielinski, Martin D. [1 ]
机构
[1] St Marys Hosp, Mayo Clin, Dept Surg, Div Trauma Crit Care & Gen Surg, Rochester, MN 55902 USA
[2] Dept Med, Div Gastroentrol & Hepatol, Rochester, MN 55902 USA
关键词
Gastrointestinal anastomosis; Endoscopy; Anastomotic dehiscence; Healing; Collagen; ELECTRONIC SEARCH STRATEGIES; Y GASTRIC BYPASS; INTRAOPERATIVE ENDOSCOPY; RISK-FACTORS; LEAKS; STRICTURES; VALIDATION; MANAGEMENT; DERIVATION; MORBIDITY;
D O I
10.1007/s11605-014-2625-y
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Gastrointestinal anastomoses may require early evaluation and treatment via flexible endoscopic techniques when complications arise. There is reticence, however, to perform endoscopy given the applied mechanical forces. We aimed to identify the incidence of gastrointestinal anastomotic perforation or disruption resulting from endoscopy performed a parts per thousand currency sign6 weeks of anastomoses. Review of patients from 2002 to 2013 who underwent flexible endoscopy within 6 weeks of creation of gastrointestinal anastomosis. Exclusion criteria included intraoperative endoscopy, anastomotic perforation prior to endoscopy, and endoscopy remote from the anastomotic site. Data are presented as median (interquartile range; IQR) or percentages as appropriate. Twenty-four patients met our criteria (age 69 years [IQR 54-77], 54 % men]). Endoscopy was performed at a median postoperative time of 18 days (IQR 8-30). Indications for endoscopy included bleeding (66 %), obstruction (13 %), pain (13 %), concern for pancreatic duct leak (4 %), and concern for ischemia (4 %). Six patients underwent therapeutic endoscopic procedures including coagulation (8 %), balloon dilation (8 %), tube decompression (8 %), and stent placement (4 %). There were no anastomotic perforations or disruptions as a result of endoscopy. Despite theoretical risks of adverse events of flexible endoscopy in the early postoperative period, no endoscopic perforations or disruptions occurred in recently created surgical anastomoses.
引用
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页码:1911 / 1916
页数:6
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