Mohammad Amin Shahrbaf
Abstract
Gastrointestinal (GI) anastomosis is a usual procedure in the context of GI cancer surgeries. Performing an anastomosis may be complicated by infection, bleeding, anastomotic stricture, and anastomotic leakage. Anastomosis leakage is one of the devastating complications after performing an anastomosis ...
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Gastrointestinal (GI) anastomosis is a usual procedure in the context of GI cancer surgeries. Performing an anastomosis may be complicated by infection, bleeding, anastomotic stricture, and anastomotic leakage. Anastomosis leakage is one of the devastating complications after performing an anastomosis which can be associated with several preoperative, intraoperative, and postoperative risk factors. Gender, body mass index, chemoradiotherapy, and underlying disease are preoperative risk factors for anastomosis leakage. In addition, surgical technique, operation time, tumor characteristics, blood loss, and blood transfusion are intraoperative risk factors. Diverting stoma and intestinal microbiota are assumed as post-operative risk factors for anastomosis leakage. In this comprehensive review, we aimed to describe risk factors of anastomosis leakage, especially blood transfusion. Blood transfusion can affect anastomotic healing by interfering with microcirculation, anastomotic healing phases, and the inflammatory phase of anastomosis healing. Compromised microcirculation caused by transfusion is one of the possible mechanisms for the failure of the anastomoses.
Majid Rrazavi; Mona Najaf Najafi; Mahnaz Ahmadi; Iman Kashani
Abstract
Introduction:Bleeding during ENT surgeries may contribute to impaired view. The less blood in surgical filed, the better quality and more surgeon’s satisfaction is expected. Deliberate hypotension is a technique to achieve this goal. Current study aimed to evaluate effects of Labetalol andNitroglycerinein ...
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Introduction:Bleeding during ENT surgeries may contribute to impaired view. The less blood in surgical filed, the better quality and more surgeon’s satisfaction is expected. Deliberate hypotension is a technique to achieve this goal. Current study aimed to evaluate effects of Labetalol andNitroglycerinein deliberate hypotension. Methods: It is a double blind RCT,conducted on 68 septo-rhinoplastypatients in ENT ward, Imam Reza Hospital, Mashhad, during 2017 after obtaining written consent. Patients were assigned to receive Nitroglycerine (n=32) or Labetalol (n=36) randomly. Mean arterial pressure and HR monitored. Total blood loss was estimated and recorded at a Boezaart Surgical Field Grading Scale. Surgeon’s satisfaction with surgical field condition was measured after the procedures using a questionnaire at a 5-point Likert scale. Results: Two studied groups were similar in demographic characteristics. Heart rate was lower in Labetalol group (P <0.001) significantly, but there was no significant difference between two groups regarding mean arterial pressure variations (P = 0.12). Surgeon’s satisfaction with the operation condition was not significantly different (P= 0.28). According to Boezaart scale, no statistically significant difference was found between groups with regard to bleeding volume (P= 0.75). Patients in Labetalol group received less additive drugs to maintain hypotension than another group (P=0.025). Conclusion: Although Labetalol and Nitoglycerine are not much different in reducing blood loss or providing a better view of surgical field but Labetalol is superior in maintaining heart rate and hypotension and noneed toadditive drug.