A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Anales de Edafología y Agrobiología Tomo 41 Número 7-8

Suelos. Empleo de mpleo del coeficiente de correlacion para la seleccion de caracteristicas en taxonomia numerica de suelos, por F. Monturiol Rodríguez y. L. Alcala Del Olmo B.-- Modelos dinamicos en el estudio de la genesis del suelo p o r J. E. Garcia Hernandez.-- A computer-based soil evaluation system for assessing soil productivity p o r D. de la Rosa.-- Relaciones fisico-quimicas y espectrales del suelo p o r Jose L. Labrandero.-- procesos de alteracion; genesis y estabilidad mineral de suelos volcanicos (volcan de piedrabuena, ciudad real) II. caracteres fisicos y fisico-quimicos p o r Martín De Vidales, J. L., Sanz, J., Casas, J., Rodríguez Sanchidrian, J. Y, Guerra Delgado, A.-- Significado de la presencia de horizontes bt en suelos de las facies de madrid. aproximacion para explicar el contenido de arcilla en este tipo de horizontes p o r Jimenez Ballesta, R. Martin De Vidales. J. L. y Garcia Gimenez, R.-- Actividad enzima tica y microbiana en diversos andosoles de tenerife p o r J. M. Lozano, P. T. C. Carvalho Y F. Velasco.-- Estudio de la variabilidad de poblaciones de nema todos fitoparasitos de limonero. l. tylenchulus semipenetrans Cobb por Ortuño Martinez, A.Hernansaez Rabay, A., Gomez Gomez, J. y Abrisqueta Garcia, J. M.-- Estudio climatico de la hoja topografica 1:50.000 905 de linares (Jaen) p o r G. Delgado y J. Aguilar.-- Estudio del sistema SI(oh)4-AI+ -Mg2+ -Na+ -h20 a temperatura y presion ordinarias. l. precipit acion de silicio, aluminio y magnesio por Reyes, M., Huertas, F., Linares, J. y Reyes, E. -- Estudio del sistema SI(oh)4-AI+ -Mg2+ -Na+ -h20 a temperatura y presion ordinarias. II. Composicion quimica y mineralogica de los precipitados, por Reyes, M., Huertas, F., Linares, J. y Reyes, E.-- Fertilidad. estudio comparativo sobre nitrificaciones en un suelo de regadio frente a uno de secano por F. Gallardo-Lara. A. Molina-Diaz Y E. Esteban-Velasco.-- Consideraciones sobre la utilizacion de la tecnica extractiv a de burriel y hernando para la evaluacion del p asimilable en suelos por J. A. Díez.—Nutrición y Fisiología Vegetal. Balance nutriente evolutivo: aplicaciones por O. Carpena Artes y R. O. Carpena Ruiz.-- Estudio de algunos aspectos ecofisiologicos en el analisis de la produccion de grano en los cultivos de cebada (gen. Hordeum l) II. Efecto del nitrogeno y del azufre por via foliar por L. F. Garcia Del Moral, J. M. Ramos y L. Recalde-Manrique y L. Recalde Martinez.- Evolucion de la fraccion organica y mineral de un pastizal de la marisma del guadalquivir. ii. fraccion organica de la vegetación por Hernandez, J. M., Barroso, M., Chaves, M. y Murillo, J. M.-- Evolucion de la fraccion organica y mineral de una pradera halofita de la marisma del guadalquivir. III. relaciones fisiológicas Por Barroso, M., Hernandez, J. M., Murillo, J. M. Y Chaves, M.-- Ordenacion automatica de comunidades de pastizal. un ejemplo de su validez con la eliminacion de las especies menos abundantes por A. Puerto Martin, M. Rico Rodriguez, B. Redondo Prieto y J. M. Gomez Gutierrez.-- Produccion y extraccion de bioelementos en pastizales naturales y especies pratenses cultivadas por B. García Criado. A. Garcia Ciudad, M. I. Montalvo Hernandez y L. Garcia Criado.-- Precocidad en tomate para consumo en fresco por J. Cuartero Y F. Nuez.-- Estudio de la nutricion del cultivo del haba (Vicia faba L.) por Eduardo Esteban Velasco. Francisco Gallardo-Lara y Josefa Robles Fernandez.-- Relaciones proteinas y lipidos con niveles de bioelementos edaficos en semillas de leguminosas por Ortuño Martinez, A. Hernansaez Rabay, A. Y Abrisqueta Garcia. J. M.-- Influencia del pretratamiento de semillas de girasol con boro sobre la germinacion y primeras fases de desarrollo de la planta por Jimenez. F. y Aguilar, A.-- Determinacion de la variedad de patata (solanum tuberosum l.) por analisis electroforetico de las proteinas del tuberculo. por J. Lopez-Gorgé, A. Chueca y M. Vilchez.-- Cambios metabolicos durante el proceso de maduracion de la uva (vitis vinifera, l. var. palomino) en la zona del marco de jerez de la frontera (cadiz) por L. Catalina, C. Mazuelos, R. Romero Y R. Sarmiento.-- Datos nomenclaturales y ecologicos sobre taxones españoles del genero satureja (labiatae) por Salvador Rivas-Martinez.—Trabajos recapitulativos.-- La Rizosfera: Interacciones Microbio-Planta por J. M. Barea y C. Azcon-Aguilar.-- MÉtodos de a tomizacion electrotermica en espectrofotometria de absorcion atomica revisión por M. D. Mingorance y M. Lachica.—Notas.Peer reviewe

The impact of stapling technique and surgeon specialism on anastomotic failure after right?sided colorectal resection: an international multicentre, prospective audit

Aim There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure. Method Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side?to?side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak. Results One thousand three hundred and forty?seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54–1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52–1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46–4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04–2.64, P = 0.04). Conclusion This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high?risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration

Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit

Aim: The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30\ua0days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results: This study included 3208 patients, of whom 78.4% (n\ua0=\ua02515) underwent surgery for malignancy and 11.7% (n\ua0=\ua0375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8% (n\ua0=\ua03041) of patients, which was handsewn in 38.9% (n\ua0=\ua01183) and stapled in 61.1% (n\ua0=\ua01858). Patients undergoing handsewn anastomosis were more likely to be emergency admissions (20.5% handsewn vs 12.9% stapled) and to undergo open surgery (54.7% handsewn vs 36.6% stapled). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (P\ua0=\ua00.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR\ua0=\ua01.43; 95% CI: 1.04\u20131.95; P\ua0=\ua00.03). Conclusion: Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe

The relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit.

BACKGROUND: Anastomosis technique following right sided colonic resection is widely variable and may affect patient outcomes. This study aimed to assess the association between leak and anastomosis technique (stapled versus handsewn) METHODS: This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a two-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, using a pre-specified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random effect variable. RESULTS: This study included 3208 patients, of whom 78.4% (n=2515) underwent surgery for malignancy and 11.7% (n=375) for Crohn's disease. An anastomosis was performed in 94.8% (n=3041) of patients, which was handsewn in 38.9% (n=1183) and stapled in 61.1% (n=1858) cases. Patients undergoing handsewn anastomosis were more likely to be emergency admissions (20.5% handsewn versus 12.9% stapled) and to undergo open surgery (54.7% versus 36.6%). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (p=0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted odds ratio 1.43, 95% confidence interval 1.04-1.95, p=0.03). DISCUSSION: Despite being used in lower risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe. This article is protected by copyright. All rights reserve

Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO

Aim: Patient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. Method: This was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien\u2013Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals. Results: In all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10\u20134.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13\u20133.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20\u20134.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08\u20131.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07\u20131.37). Conclusion: Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients

Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection: an international snapshot audit

Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results This study included 3208 patients, of whom 78.4\% (n = 2515) underwent surgery for malignancy and 11.7\% (n = 375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8\% (n = 3041) of patients, which was handsewn in 38.9\% (n = 1183) and stapled in 61.1\% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5\% handsewn vs 12.9\% stapled) and to undergo open surgery (54.7\% handsewn vs 36.6\% stapled). The overall anastomotic leak rate was 8.1\% (245/3041), which was similar following handsewn (7.4\%) and stapled (8.5\%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95\% CI: 1.04-1.95; P = 0.03). Conclusion Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe