The incidence of Crohn’s disease(CD)has increased in recent years,with most patients requiring intestinal resection.Complications after intestinal resection for CD can lead to poor prognosis and recurrence,among whic...The incidence of Crohn’s disease(CD)has increased in recent years,with most patients requiring intestinal resection.Complications after intestinal resection for CD can lead to poor prognosis and recurrence,among which infectious complic-ations are the most common.This study aimed to investigate the common risk factors,including medications,preoperative nutritional status,surgery-related factors,microorganisms,lesion location and type,and so forth,causing infectious complications after intestinal resection for CD,and to propose corresponding preventive measures.The findings provided guidance for identifying suscept-ibility factors and the early intervention and prevention of infectious complic-ations after intestinal resection for CD in clinical practice.展开更多
All colorectal surgeons are faced from time to time with anastomotic leakage after colorectal surgery. This complication has been studied extensively without a significant reduction of incidence over the last 30 years...All colorectal surgeons are faced from time to time with anastomotic leakage after colorectal surgery. This complication has been studied extensively without a significant reduction of incidence over the last 30 years. New techniques of prevention, by innovative anastomotic techniques should improve results in the future, but standardization and "teachability" should be guaranteed. Risk scoring enables intra-operative decision-making whether to restore continuity or deviate. Early detection can lead to reduction in delay of diagnosis as long as a standard system is used. For treatment options, no firm evidence is available, but future studies could focus on repair and saving of the anastomosis on the one hand or anastomotical breakdown and definitive colostomy on the other hand.展开更多
Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity.Although many ofthese complications remain uncommon,the range of possible mo...Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity.Although many ofthese complications remain uncommon,the range of possible morbidities is wide and includes multiple organ systems.Perioperative visual loss(POVL)is a well described,but uncommon complication that may occur due to ischemia to the optic nerve,retina,or cerebral cortex.Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery.Peripheral nerve injuries,such as those caused by prolonged traction to the brachial plexus,are more commonly encountered postoperative events.Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning,albeit rarely.Other uncommon positioning complications such as tongue swelling resulting in airway compromise,femoral artery ischemia,and avascular necrosis of the femoral head have also been reported.Many of these are well-understood and largely avoidable through thoughtful attention to detail.Other complications,such as POVL,remain incompletely understood and thus more difficult to predict or prevent.Here,the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity.展开更多
基金Supported by Scientific Research Foundation of Shanghai Municipal Health Commission of Changning District,No.20234Y038.
文摘The incidence of Crohn’s disease(CD)has increased in recent years,with most patients requiring intestinal resection.Complications after intestinal resection for CD can lead to poor prognosis and recurrence,among which infectious complic-ations are the most common.This study aimed to investigate the common risk factors,including medications,preoperative nutritional status,surgery-related factors,microorganisms,lesion location and type,and so forth,causing infectious complications after intestinal resection for CD,and to propose corresponding preventive measures.The findings provided guidance for identifying suscept-ibility factors and the early intervention and prevention of infectious complic-ations after intestinal resection for CD in clinical practice.
文摘All colorectal surgeons are faced from time to time with anastomotic leakage after colorectal surgery. This complication has been studied extensively without a significant reduction of incidence over the last 30 years. New techniques of prevention, by innovative anastomotic techniques should improve results in the future, but standardization and "teachability" should be guaranteed. Risk scoring enables intra-operative decision-making whether to restore continuity or deviate. Early detection can lead to reduction in delay of diagnosis as long as a standard system is used. For treatment options, no firm evidence is available, but future studies could focus on repair and saving of the anastomosis on the one hand or anastomotical breakdown and definitive colostomy on the other hand.
文摘Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity.Although many ofthese complications remain uncommon,the range of possible morbidities is wide and includes multiple organ systems.Perioperative visual loss(POVL)is a well described,but uncommon complication that may occur due to ischemia to the optic nerve,retina,or cerebral cortex.Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery.Peripheral nerve injuries,such as those caused by prolonged traction to the brachial plexus,are more commonly encountered postoperative events.Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning,albeit rarely.Other uncommon positioning complications such as tongue swelling resulting in airway compromise,femoral artery ischemia,and avascular necrosis of the femoral head have also been reported.Many of these are well-understood and largely avoidable through thoughtful attention to detail.Other complications,such as POVL,remain incompletely understood and thus more difficult to predict or prevent.Here,the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity.
