Ricerc@Sapienza

ERAS protocol and indocyanine green fluorescence angiography (ICG-FA) represent the new surgical revolution minimizing complications and shortening recovery time in colorectal surgery. As of today, no studies have been published in the literature evaluating the impact of the ICG-FA in the ERAS protocol for the patients suitable for colorectal surgery. The aim of our study was to assess whether the systematic evaluation of intestinal perfusion by ICG-FA could improve patients outcomes when managed with ERAS perioperative protocol, thus reducing surgical complication rate.

Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified definition.

Meckel's diverticulum is among the most common congenital defects of the gastrointestinal tract, and is associated with a total lifetime risk of complications around 4%. While debate on prophylactic resection of incidental Meckel's diverticulum continues, there have been reports of its successful use for urinary diversion and reconstruction. In contrast, its use as a means of fecal diversion has been described anecdotally. Herein, we describe our technique of temporary fecal diversion using Meckel's diverticulum as reliable conduit for stoma formation in a toddler.

Obiettivi: La deiscenza anastomotica (AL) rimane la più importante complicanza chirurgica nel cancro colo-rettale (CRC) con
dei tassi variabili riportati in letteratura tra il 3 e il 20% e un aumento della mortalità associata dal 6% al 22%.
Attualmente non vi sono dei test intraoperatori validati predittivi della tenuta anastomotica.
Diversi fattori come la tensione anastomotica, vascolarizzazione e l’esecuzione di un’appropriata tecnica chirurgica, sono
riportati in letteratura essere correlati con il rischio di AL.

Background: Anastomotic leakage still remains the most important surgical complication after colorectal surgery. The reported rate of anastomotic leak ranges from 3 to 20% and morbidity can be substantial, with an increased associated mortality of 6–22%.
Nowadays no intraoperative tests (as the hydropneumatic assessment) predictive of anastomotic continence are validated. Some factors influencing anastomotic leakage are reported in literature like colonic tension, vascularization and the execution of the proper anastomotic technique.

Introduction: The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be determined. This study aimed to determine whether oral antibiotics combined with mechanical bowel preparation (MBP+Abx) was associated with a reduced risk of anastomotic leak when compared to mechanical bowel preparation alone (MBP) or no bowel preparation (NBP). Methods: A pre-planned analysis of the European Society of Coloproctology (ESCP) 2017 Left Sided Colorectal Resection audit was performed.

Introduction: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. Methods: A pre-planned analysis of the European Society of Coloproctology 2017 audit.

There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure.