The Experts below are selected from a list of 294 Experts worldwide ranked by ideXlab platform

A. M. Lacy - One of the best experts on this subject based on the ideXlab platform.

  • The impact of Fluorescence Angiography on anastomotic leak rate following transanal total mesorectal excision for rectal cancer: a comparative study
    Surgical Endoscopy, 2020
    Co-Authors: A. M. Otero-piñeiro, F. B. Lacy, JOHANNES J LAARHOVEN, B. Martín-perez, S. Valverde, R. Bravo, A. M. Lacy
    Abstract:

    Background Anastomotic leak (AL) is the most feared complication in colorectal surgery. Indocyanine green (ICG) Fluorescence Angiography allows for real-time intraoperative evaluation of bowel perfusion. This study aimed to assess the impact of ICG on perioperative outcomes in patients treated with transanal total mesorectal excision (TaTME) for rectal cancer. Methods Comparative study based on a retrospective analysis of prospectively collected data, to validate the use of ICG assessment (ICGA) during TaTME (November/2011–June/2018). The primary outcome was the clinical AL rate. The secondary outcomes included modification of proximal colonic transection, anastomotic redo, additional surgical maneuvers and surgical morbidity. Results Two hundred and eighty-four patients were included, 204 (71.8%) in non-ICG group and 80 (28.2%) in ICG group. No significant differences were found in patient and tumor features. Mean anastomotic height was 4.85 cm vs. 5.04 cm ( p  = 0.500), diverting stoma was constructed in 205 patients (72.1% vs. 72.5%; p  = 0.941). Fluorescence Angiography modified the surgical plan in 23 patients (28.7%). AL was diagnosed in 23 patients (11.3%) in the non-ICG group and in two patients (2.5%) in the ICG group ( p  = 0.020). Postoperative intraabdominal collection was diagnosed in 19 patients (7.4% vs. 5.1%; p  = 0.490), and reintervention was needed in 24 patients (10.8% vs. 7.6%; p  = 0.420). Median length of hospital stay was 6.0 (IQR 5.0–9) vs. 4.0 (IQR 3.0–8.5) ( p  = 0.005). ICGA was found as independent protective factor for AL in the multivariate analysis of the whole cohort ( n  = 284) (OR 0.142; 95% CI 0.032–0.633; p  = 0.010). Conclusion ICG Fluorescence Angiography modified the proximal colonic transection in more than one-quarter of patients, leading to a significant decrease of AL rate.

Konstantinos Zarras - One of the best experts on this subject based on the ideXlab platform.

  • Intraoperative real-time Fluorescence Angiography with indocyanine green for evaluation of intestinal viability during surgery for an incarcerated obturator hernia: a case report.
    Patient safety in surgery, 2018
    Co-Authors: Dimitra Daskalopoulou, Joseph Kankam, Jens Plambeck, Peter C. Ambe, Konstantinos Zarras
    Abstract:

    Background Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of ischaemic bowel can be challenging. In this case report we discuss intraoperative Fluorescence Angiography with indocyanine green (ICG) as an objective means of accessing bowel perfusion following hernia reduction.

  • Intraoperative real-time Fluorescence Angiography with indocyanine green for evaluation of intestinal viability during surgery for an incarcerated obturator hernia: a case report
    BMC, 2018
    Co-Authors: Dimitra Daskalopoulou, Joseph Kankam, Jens Plambeck, Peter C. Ambe, Konstantinos Zarras
    Abstract:

    Abstract Background Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of ischaemic bowel can be challenging. In this case report we discuss intraoperative Fluorescence Angiography with indocyanine green (ICG) as an objective means of accessing bowel perfusion following hernia reduction. Case presentation The case of a 92-year-old, caucasian, female patient presenting with symptoms of small bowel obstruction secondary to an incarcerated left sided obturator hernia is presented. An incarcerated segment of the small bowel was reduced during emergency laparoscopy. Intraoperative ICG Fluorescence Angiography revealed ischaemic changes in the normal appearing bowel, so that the involved segment was resected. The postoperative course was uneventful and the patient was discharged home safely on postoperative day seven. Conclusion Intraoperative ICG Fluorescence Angiography provides an objective method of judging bowel perfusion and therefore represents a useful tool for assessing intestinal perfusion in patients with incarcerated hernia

A. M. Otero-piñeiro - One of the best experts on this subject based on the ideXlab platform.

  • The impact of Fluorescence Angiography on anastomotic leak rate following transanal total mesorectal excision for rectal cancer: a comparative study
    Surgical Endoscopy, 2020
    Co-Authors: A. M. Otero-piñeiro, F. B. Lacy, JOHANNES J LAARHOVEN, B. Martín-perez, S. Valverde, R. Bravo, A. M. Lacy
    Abstract:

    Background Anastomotic leak (AL) is the most feared complication in colorectal surgery. Indocyanine green (ICG) Fluorescence Angiography allows for real-time intraoperative evaluation of bowel perfusion. This study aimed to assess the impact of ICG on perioperative outcomes in patients treated with transanal total mesorectal excision (TaTME) for rectal cancer. Methods Comparative study based on a retrospective analysis of prospectively collected data, to validate the use of ICG assessment (ICGA) during TaTME (November/2011–June/2018). The primary outcome was the clinical AL rate. The secondary outcomes included modification of proximal colonic transection, anastomotic redo, additional surgical maneuvers and surgical morbidity. Results Two hundred and eighty-four patients were included, 204 (71.8%) in non-ICG group and 80 (28.2%) in ICG group. No significant differences were found in patient and tumor features. Mean anastomotic height was 4.85 cm vs. 5.04 cm ( p  = 0.500), diverting stoma was constructed in 205 patients (72.1% vs. 72.5%; p  = 0.941). Fluorescence Angiography modified the surgical plan in 23 patients (28.7%). AL was diagnosed in 23 patients (11.3%) in the non-ICG group and in two patients (2.5%) in the ICG group ( p  = 0.020). Postoperative intraabdominal collection was diagnosed in 19 patients (7.4% vs. 5.1%; p  = 0.490), and reintervention was needed in 24 patients (10.8% vs. 7.6%; p  = 0.420). Median length of hospital stay was 6.0 (IQR 5.0–9) vs. 4.0 (IQR 3.0–8.5) ( p  = 0.005). ICGA was found as independent protective factor for AL in the multivariate analysis of the whole cohort ( n  = 284) (OR 0.142; 95% CI 0.032–0.633; p  = 0.010). Conclusion ICG Fluorescence Angiography modified the proximal colonic transection in more than one-quarter of patients, leading to a significant decrease of AL rate.

Dimitra Daskalopoulou - One of the best experts on this subject based on the ideXlab platform.

  • Intraoperative real-time Fluorescence Angiography with indocyanine green for evaluation of intestinal viability during surgery for an incarcerated obturator hernia: a case report.
    Patient safety in surgery, 2018
    Co-Authors: Dimitra Daskalopoulou, Joseph Kankam, Jens Plambeck, Peter C. Ambe, Konstantinos Zarras
    Abstract:

    Background Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of ischaemic bowel can be challenging. In this case report we discuss intraoperative Fluorescence Angiography with indocyanine green (ICG) as an objective means of accessing bowel perfusion following hernia reduction.

  • Intraoperative real-time Fluorescence Angiography with indocyanine green for evaluation of intestinal viability during surgery for an incarcerated obturator hernia: a case report
    BMC, 2018
    Co-Authors: Dimitra Daskalopoulou, Joseph Kankam, Jens Plambeck, Peter C. Ambe, Konstantinos Zarras
    Abstract:

    Abstract Background Bowel incarceration represents a dreaded complication amongst patients with hernias. The intraoperative evaluation of the bowel perfusion following hernia reduction with regard to the need for resection of ischaemic bowel can be challenging. In this case report we discuss intraoperative Fluorescence Angiography with indocyanine green (ICG) as an objective means of accessing bowel perfusion following hernia reduction. Case presentation The case of a 92-year-old, caucasian, female patient presenting with symptoms of small bowel obstruction secondary to an incarcerated left sided obturator hernia is presented. An incarcerated segment of the small bowel was reduced during emergency laparoscopy. Intraoperative ICG Fluorescence Angiography revealed ischaemic changes in the normal appearing bowel, so that the involved segment was resected. The postoperative course was uneventful and the patient was discharged home safely on postoperative day seven. Conclusion Intraoperative ICG Fluorescence Angiography provides an objective method of judging bowel perfusion and therefore represents a useful tool for assessing intestinal perfusion in patients with incarcerated hernia

S. Valverde - One of the best experts on this subject based on the ideXlab platform.

  • The impact of Fluorescence Angiography on anastomotic leak rate following transanal total mesorectal excision for rectal cancer: a comparative study
    Surgical Endoscopy, 2020
    Co-Authors: A. M. Otero-piñeiro, F. B. Lacy, JOHANNES J LAARHOVEN, B. Martín-perez, S. Valverde, R. Bravo, A. M. Lacy
    Abstract:

    Background Anastomotic leak (AL) is the most feared complication in colorectal surgery. Indocyanine green (ICG) Fluorescence Angiography allows for real-time intraoperative evaluation of bowel perfusion. This study aimed to assess the impact of ICG on perioperative outcomes in patients treated with transanal total mesorectal excision (TaTME) for rectal cancer. Methods Comparative study based on a retrospective analysis of prospectively collected data, to validate the use of ICG assessment (ICGA) during TaTME (November/2011–June/2018). The primary outcome was the clinical AL rate. The secondary outcomes included modification of proximal colonic transection, anastomotic redo, additional surgical maneuvers and surgical morbidity. Results Two hundred and eighty-four patients were included, 204 (71.8%) in non-ICG group and 80 (28.2%) in ICG group. No significant differences were found in patient and tumor features. Mean anastomotic height was 4.85 cm vs. 5.04 cm ( p  = 0.500), diverting stoma was constructed in 205 patients (72.1% vs. 72.5%; p  = 0.941). Fluorescence Angiography modified the surgical plan in 23 patients (28.7%). AL was diagnosed in 23 patients (11.3%) in the non-ICG group and in two patients (2.5%) in the ICG group ( p  = 0.020). Postoperative intraabdominal collection was diagnosed in 19 patients (7.4% vs. 5.1%; p  = 0.490), and reintervention was needed in 24 patients (10.8% vs. 7.6%; p  = 0.420). Median length of hospital stay was 6.0 (IQR 5.0–9) vs. 4.0 (IQR 3.0–8.5) ( p  = 0.005). ICGA was found as independent protective factor for AL in the multivariate analysis of the whole cohort ( n  = 284) (OR 0.142; 95% CI 0.032–0.633; p  = 0.010). Conclusion ICG Fluorescence Angiography modified the proximal colonic transection in more than one-quarter of patients, leading to a significant decrease of AL rate.