Risk factors associated with anastomotic leak in patients with Crohn disease undergoing bowel resections / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the risk factors and the prevention management of anastomotic leak in patients with Crohn disease undergoing bowel resections.</p><p><b>METHODS</b>Clinical data of 91 patients with Crohn disease undergoing intestinal resection from 1990 to 2010 were analyzed retrospectively. Logistic regression analysis was used to assess the risk factors of anastomotic leak.</p><p><b>RESULTS</b>A total of 120 intestinal anastomosis were performed in 91 patients, and anastomosis leak occurred in 14 patients (11.7%). Univariate analysis showed that operative timing (emergency or elective surgery), anastomosis type (side-to-side or end to end and end-to-side), operative time (≥3 h or <3 h), methods of anastomosis (handsewn or stapled) were the risk factors for anastomotic leak (P<0.05). Multivariate analysis revealed that emergency surgery (OR=3.891, 95%CI:1.332-13.692), end to end and end-to-side anastomosis (OR=3.236, 95%CI:1.165-11.950), handsewn anastomosis (OR=5.715, 95%CI:1.454-17.328) were independent risk factors of anastomotic leak.</p><p><b>CONCLUSION</b>Avoiding emergency operation, use of side to side anastomosis, and application of stapling may lower the incidence of postoperative anastomotic leak in patients with Crohn disease undergoing bowel resections.</p>

Application of Ligasure vessel sealing instrument in laparoscopic hepatectomy for liver cancer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the indication and effect of the application of Ligasure vessel sealing instrument in laparoscopic hepatectomy for liver cancer.</p><p><b>METHODS</b>Eleven patients with liver cancer undergoing laparoscopic hepatectomy were analyzed for the tumor size and location, operation time, volume of intraoperative bleeding, postoperative hospital stay and short-term clinical outcomes.</p><p><b>RESULTS</b>All the operations were performed successfully in the 11 cases. All the tumors were less than 7 cm in diameter, locating at the segments II, III, V, VI and VII. The mean operation time was 91 min (80-126 min), and the intraoperative blood loss averaged 82 ml (20-200 ml). The average postoperative hospital stay of the patients was 8 days (7-9 days). No complications were observed in these cases.</p><p><b>CONCLUSION</b>Ligasure vessel sealing instrument in laparoscopic hepatectomy is applicable in cases of perimeter liver cancer. This instrument can decrease the operation time, reduce the intraoperative blood loss and postoperative hospital stay with good safety and minimal invasiveness.</p>