TY - JOUR
T1 - Endoscopy in the Early Postoperative Setting after Primary Gastrointestinal Anastomosis
AU - Amr, Mahmoud A.
AU - Alzghari, Mohammad J.
AU - Polites, Stephanie F.
AU - Khasawneh, Mohammad A.
AU - Morris, David S.
AU - Baron, Todd H.
AU - Zielinski, Martin D.
N1 - Publisher Copyright:
© 2014, The Society for Surgery of the Alimentary Tract.
PY - 2014/11
Y1 - 2014/11
N2 - Introduction: 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 ≤6 weeks of anastomoses. Methods: 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. Results: 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. Conclusion: 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.
AB - Introduction: 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 ≤6 weeks of anastomoses. Methods: 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. Results: 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. Conclusion: 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.
KW - Anastomotic dehiscence
KW - Collagen
KW - Endoscopy
KW - Gastrointestinal anastomosis
KW - Healing
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U2 - 10.1007/s11605-014-2625-y
DO - 10.1007/s11605-014-2625-y
M3 - Article
C2 - 25118643
AN - SCOPUS:84939880663
SN - 1091-255X
VL - 18
SP - 1911
EP - 1916
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 11
ER -