Our Summary

This research paper discusses a study aimed at evaluating a new technique to prevent a severe complication known as anastomotic leakage after colorectal surgery. Anastomotic leakage can occur due to insufficient blood supply to the area. The new technique uses a special dye, indocyanine green (ICG), which is detected by a fluorescence angiography device during surgery, allowing the surgical team to assess the blood supply to the area before and after the surgery.

The study was conducted on 107 patients undergoing colorectal surgery, most of whom were cancer patients. The team found that in four cases, the blood supply to the area to be joined was insufficient, prompting them to adjust the surgery. None of these patients experienced anastomotic leakage.

Overall, the study concludes that this new technique provides valuable information during surgery which can help prevent complications. However, the researchers note that larger studies are needed to validate the effectiveness of this new technique.

FAQs

  1. What is the new technique discussed in the study for preventing anastomotic leakage after colorectal surgery?
  2. How does the use of indocyanine green (ICG) dye and a fluorescence angiography device help in the prevention of anastomotic leakage?
  3. What were the results of the study and what is the next step in validating the effectiveness of this new technique?

Doctor’s Tip

A doctor might tell a patient undergoing bowel resection surgery to follow a clear liquid diet before the procedure and to avoid eating or drinking anything after midnight the night before surgery. They may also advise the patient to take any prescribed medications as directed and to stop any blood-thinning medications prior to surgery to reduce the risk of bleeding.

After surgery, the doctor may recommend gradually reintroducing solid foods into the diet and staying hydrated to promote healing and prevent constipation. They may also suggest gentle physical activity to aid in recovery and to help prevent complications such as blood clots.

Additionally, the doctor may advise the patient to watch for signs of infection, such as fever, increased pain, or redness and swelling at the incision site, and to contact them immediately if any of these symptoms occur. They may also provide instructions on how to care for the incision site and when to follow up for a post-operative appointment.

Suitable For

Patients who may be recommended for bowel resection include those with colorectal cancer, inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis), diverticulitis, bowel obstructions, perforations, or other conditions that affect the bowel. These patients may experience symptoms such as persistent abdominal pain, bleeding, changes in bowel habits, or other complications that may require surgical intervention. Additionally, patients who have previously undergone bowel surgery and are at risk for complications such as anastomotic leakage may also be recommended for bowel resection with the use of techniques like fluorescence angiography with indocyanine green to assess blood supply and reduce the risk of complications.

Timeline

Before bowel resection:

  1. Patient undergoes diagnostic tests and consultations with healthcare providers to determine the need for surgery.
  2. Patient may need to follow a special diet or take medications to prepare for surgery.
  3. Patient undergoes bowel resection surgery.

After bowel resection:

  1. Patient is monitored closely in the hospital for any complications such as infection or bleeding.
  2. Patient may experience pain and discomfort at the surgical site.
  3. Patient may need to follow a specific diet and take medications to aid in recovery.
  4. Patient undergoes follow-up appointments with healthcare providers to monitor healing and address any concerns.

Overall, the timeline for a patient before and after bowel resection surgery can vary depending on the individual’s specific circumstances and recovery process.

What to Ask Your Doctor

Some questions a patient should ask their doctor about bowel resection include:

  1. What is the reason for recommending bowel resection surgery?
  2. What are the potential risks and complications associated with bowel resection?
  3. How will the surgery be performed and what is the expected recovery time?
  4. Will I need a temporary or permanent colostomy after the surgery?
  5. How often do patients experience anastomotic leakage after bowel resection surgery?
  6. Are there any new techniques or technologies, such as fluorescence angiography with indocyanine green, that can help reduce the risk of complications during surgery?
  7. What are the success rates of using fluorescence angiography with indocyanine green in preventing anastomotic leakage?
  8. Are there any additional steps or precautions that can be taken to minimize the risk of complications during and after bowel resection surgery?
  9. How will my post-operative care and follow-up appointments be managed to ensure a successful recovery?
  10. Are there any lifestyle changes or dietary restrictions I should follow after bowel resection surgery to promote healing and prevent complications?

Reference

Authors: Boni L, David G, Dionigi G, Rausei S, Cassinotti E, Fingerhut A. Journal: Surg Endosc. 2016 Jul;30(7):2736-42. doi: 10.1007/s00464-015-4540-z. Epub 2015 Oct 20. PMID: 26487209