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  1. Article ; Online: Imaging slow brain activity during neocortical and hippocampal epileptiform events with electrical impedance tomography.

    Hannan, Sana / Aristovich, Kirill / Faulkner, Mayo / Avery, James / Walker, Matthew C / Holder, David S

    Physiological measurement

    2021  Volume 42, Issue 1, Page(s) 14001

    Abstract: Objective: Electrical impedance tomography (EIT) is an imaging technique that produces tomographic images of internal impedance changes within an object using surface electrodes. It can be used to image the slow increase in cerebral tissue impedance ... ...

    Abstract Objective: Electrical impedance tomography (EIT) is an imaging technique that produces tomographic images of internal impedance changes within an object using surface electrodes. It can be used to image the slow increase in cerebral tissue impedance that occurs over seconds during epileptic seizures, which is attributed to cell swelling due to disturbances in ion homeostasis following hypersynchronous neuronal firing and its associated metabolic demands. In this study, we characterised and imaged this slow impedance response during neocortical and hippocampal epileptiform events in the rat brain and evaluated its relationship to the underlying neural activity.
    Approach: Neocortical or hippocampal seizures, comprising repeatable series of high-amplitude ictal spikes, were induced by electrically stimulating the sensorimotor cortex or perforant path of rats anaesthetised with fentanyl-isoflurane. Transfer impedances were measured during ≥30 consecutive seizures, by applying a sinusoidal current through independent electrode pairs on an epicortical array, and combined to generate an EIT image of slow activity.
    Main results: The slow impedance responses were consistently time-matched to the end of seizures and EIT images of this activity were reconstructed reproducibly in all animals (p < 0.03125, N = 5). These displayed foci of activity that were spatially confined to the facial somatosensory cortex and dentate gyrus for neocortical and hippocampal seizures, respectively, and encompassed a larger volume as the seizure progressed. Centre-of-mass analysis of reconstructions revealed that this activity corresponded to the true location of the epileptogenic zone, as determined by EEG recordings and fast neural EIT measurements which were obtained simultaneously.
    Significance: These findings suggest that the slow impedance response presents a reliable marker of hypersynchronous neuronal activity during epileptic seizures and can thus be utilised for investigating the mechanisms of epileptogenesis in vivo and for aiding localisation of the epileptogenic zone during presurgical evaluation of patients with refractory epilepsies.
    MeSH term(s) Animals ; Electric Impedance ; Hippocampus/diagnostic imaging ; Humans ; Neocortex/diagnostic imaging ; Rats ; Rats, Sprague-Dawley ; Tomography
    Language English
    Publishing date 2021-02-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 1149545-5
    ISSN 1361-6579 ; 0967-3334
    ISSN (online) 1361-6579
    ISSN 0967-3334
    DOI 10.1088/1361-6579/abd67a
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Noninvasive Assessment of Acute Graft-Versus-Host Disease of the Gastrointestinal Tract After Allogeneic Hemopoietic Stem Cell Transplantation Using

    Cherk, Martin H / Khor, Robert / Barber, Thomas W / Yap, Kenneth S K / Patil, Sushrut / Walker, Patricia / Avery, Sharon / Roberts, Stuart / Kemp, William / Pham, Alan / Bailey, Michael / Kalff, Victor

    Journal of nuclear medicine : official publication, Society of Nuclear Medicine

    2022  Volume 63, Issue 12, Page(s) 1899–1905

    Abstract: Acute graft-versus-host disease of the gastrointestinal tract (acute GIT-GVHD) often complicates allogeneic hemopoietic stem cell transplantation (AHSCT). ...

    Abstract Acute graft-versus-host disease of the gastrointestinal tract (acute GIT-GVHD) often complicates allogeneic hemopoietic stem cell transplantation (AHSCT).
    MeSH term(s) Humans ; Graft vs Host Disease/diagnostic imaging ; Fluorodeoxyglucose F18 ; Positron Emission Tomography Computed Tomography/adverse effects ; Hematopoietic Stem Cell Transplantation/adverse effects ; Gastrointestinal Tract/pathology ; Endoscopy, Gastrointestinal/adverse effects ; Retrospective Studies
    Chemical Substances Fluorodeoxyglucose F18 (0Z5B2CJX4D)
    Language English
    Publishing date 2022-04-21
    Publishing country United States
    Document type Journal Article
    ZDB-ID 80272-4
    ISSN 1535-5667 ; 0097-9058 ; 0161-5505 ; 0022-3123
    ISSN (online) 1535-5667
    ISSN 0097-9058 ; 0161-5505 ; 0022-3123
    DOI 10.2967/jnumed.121.263688
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  3. Article ; Online: Optimised induction of on-demand focal hippocampal and neocortical seizures by electrical stimulation.

    Hannan, Sana / Faulkner, Mayo / Aristovich, Kirill / Avery, James / Walker, Matthew C / Holder, David S

    Journal of neuroscience methods

    2020  Volume 346, Page(s) 108911

    Abstract: Background: Epilepsy is a common neurological disorder affecting over 60 million people globally, approximately a third of whom are refractory to pharmacotherapy. Surgical resection of the epileptogenic zone is frequently unsuitable or ineffective, ... ...

    Abstract Background: Epilepsy is a common neurological disorder affecting over 60 million people globally, approximately a third of whom are refractory to pharmacotherapy. Surgical resection of the epileptogenic zone is frequently unsuitable or ineffective, particularly for individuals with focal neocortical or mesial temporal lobe epilepsy. Therefore, there is a need to develop animal models for elucidating the mechanisms of focal epilepsies and evaluating novel treatment strategies.
    New method: We present two adapted in vivo seizure models, the neocortical and hippocampal epileptic afterdischarge models, that enable stereotyped seizures to be induced on demand by electrical stimulation in anaesthetised, neurologically intact rats. The stimulation parameters and anaesthetic were optimised to generate electrographically reproducible, self-sustaining seizures with a well-defined focal origin.
    Results: Neocortical or hippocampal seizures were consistently generated under fentanyl-isoflurane anaesthesia by stimulating the sensorimotor cortex or perforant path, respectively, with 100 Hz trains of biphasic square-wave pulses. The induced seizures were suppressed by propofol, an established antiseizure anaesthetic, thus validating the clinical responsiveness of the developed models.
    Comparison with existing methods: The high degree of reproducibility in seizure presentation, predictable seizure induction and ability to operate in anaesthetised animals renders these models overall less laborious and more cost-effective than most conventionally used seizure models.
    Conclusions: The proposed models provide an efficient method for the high-throughput screening of novel antiseizure therapies, including closed-loop stimulation paradigms, and are well-suited to in vivo investigations that require tight regulation of seizure timing under anaesthetised conditions, particularly neuroimaging studies aimed at understanding the development of epileptogenic networks.
    MeSH term(s) Animals ; Electric Stimulation ; Hippocampus ; Neocortex ; Rats ; Reproducibility of Results ; Seizures
    Language English
    Publishing date 2020-08-14
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 282721-9
    ISSN 1872-678X ; 0165-0270
    ISSN (online) 1872-678X
    ISSN 0165-0270
    DOI 10.1016/j.jneumeth.2020.108911
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  4. Article ; Online: In vivo imaging of deep neural activity from the cortical surface during hippocampal epileptiform events in the rat brain using electrical impedance tomography.

    Hannan, Sana / Faulkner, Mayo / Aristovich, Kirill / Avery, James / Walker, Matthew C / Holder, David S

    NeuroImage

    2020  Volume 209, Page(s) 116525

    Abstract: Electrical impedance tomography (EIT) is a medical imaging technique which reconstructs images of the internal impedance changes within an object using non-penetrating surface electrodes. To date, EIT has been used to image fast neural impedance changes ... ...

    Abstract Electrical impedance tomography (EIT) is a medical imaging technique which reconstructs images of the internal impedance changes within an object using non-penetrating surface electrodes. To date, EIT has been used to image fast neural impedance changes during somatosensory evoked potentials and epileptiform discharges through the rat cerebral cortex with a resolution of 2 ​ms and <300 ​μm. However, imaging of neural activity in subcortical structures has never been achieved with this technique. Here, we evaluated the feasibility of using EIT to image epileptiform activity in the rat hippocampus using non-penetrating electrodes implanted on the cortical surface. Hippocampal epileptiform events, comprising repetitive 30-50 ​Hz ictal spikes, were induced by electrically stimulating the perforant path of rats anaesthetised with fentanyl-isoflurane. For each of ≥30 seizures, impedance measurements were obtained by applying 100 ​μA current at 1.4 ​kHz through an independent pair of electrodes on a 54-electrode planar epicortical array and recording boundary voltages on all remaining electrodes. EIT images of averaged ictal spikes were reconstructed using impedance recordings from all seizures in each animal. These revealed a focus of neural activity localised to the dentate gyrus which was spatially and temporally aligned to local field potential (LFP) recordings and could be reconstructed reproducibly in all animals with a localisation accuracy of ≤400 ​μm (p ​< ​0.03125, N ​= ​5). These findings represent the first experimental evidence of the ability of EIT to image neural activity in subcortical structures from the surface of the cortex with high spatiotemporal resolution and suggest that this method may be used for improving understanding of functional connectivity between cortico-hippocampal networks in both physiological and pathophysiological states.
    MeSH term(s) Animals ; Cerebral Cortex/diagnostic imaging ; Cerebral Cortex/physiology ; Electric Impedance ; Female ; Hippocampus/diagnostic imaging ; Hippocampus/physiology ; Humans ; Rats ; Rats, Sprague-Dawley ; Tomography/methods
    Language English
    Publishing date 2020-01-08
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
    ZDB-ID 1147767-2
    ISSN 1095-9572 ; 1053-8119
    ISSN (online) 1095-9572
    ISSN 1053-8119
    DOI 10.1016/j.neuroimage.2020.116525
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  5. Article ; Online: Allopurinol and cardiovascular outcomes in patients with ischaemic heart disease: the ALL-HEART RCT and economic evaluation.

    Mackenzie, Isla S / Hawkey, Christopher J / Ford, Ian / Greenlaw, Nicola / Pigazzani, Filippo / Rogers, Amy / Struthers, Allan D / Begg, Alan G / Wei, Li / Avery, Anthony J / Taggar, Jaspal S / Walker, Andrew / Duce, Suzanne L / Barr, Rebecca J / Dumbleton, Jennifer S / Rooke, Evelien D / Townend, Jonathan N / Ritchie, Lewis D / MacDonald, Thomas M

    Health technology assessment (Winchester, England)

    2024  Volume 28, Issue 18, Page(s) 1–55

    Abstract: Background: Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout. Observational and small interventional studies have suggested beneficial cardiovascular effects of ... ...

    Abstract Background: Allopurinol is a xanthine oxidase inhibitor that lowers serum uric acid and is used to prevent acute gout flares in patients with gout. Observational and small interventional studies have suggested beneficial cardiovascular effects of allopurinol.
    Objective: To determine whether allopurinol improves major cardiovascular outcomes in patients with ischaemic heart disease.
    Design: Prospective, randomised, open-label, blinded endpoint multicentre clinical trial.
    Setting: Four hundred and twenty-four UK primary care practices.
    Participants: Aged 60 years and over with ischaemic heart disease but no gout.
    Interventions: Participants were randomised (1 : 1) using a central web-based randomisation system to receive allopurinol up to 600 mg daily that was added to usual care or to continue usual care.
    Main outcome measures: The primary outcome was the composite of non-fatal myocardial infarction, non-fatal stroke or cardiovascular death. Secondary outcomes were non-fatal myocardial infarction, non-fatal stroke, cardiovascular death, all-cause mortality, hospitalisation for heart failure, hospitalisation for acute coronary syndrome, coronary revascularisation, hospitalisation for acute coronary syndrome or coronary revascularisation, all cardiovascular hospitalisations, quality of life and cost-effectiveness. The hazard ratio (allopurinol vs. usual care) in a Cox proportional hazards model was assessed for superiority in a modified intention-to-treat analysis.
    Results: From 7 February 2014 to 2 October 2017, 5937 participants were enrolled and randomised to the allopurinol arm (
    Limitations: The results may not be generalisable to younger populations, other ethnic groups or patients with more acute ischaemic heart disease. One thousand six hundred and thirty-seven participants (57.4%) in the allopurinol arm withdrew from randomised treatment, but an on-treatment analysis gave similar results to the main analysis.
    Conclusions: The ALL-HEART study showed that treatment with allopurinol 600 mg daily did not improve cardiovascular outcomes compared to usual care in patients with ischaemic heart disease. We conclude that allopurinol should not be recommended for the secondary prevention of cardiovascular events in patients with ischaemic heart disease but no gout.
    Future work: The effects of allopurinol on cardiovascular outcomes in patients with ischaemic heart disease and co-existing hyperuricaemia or clinical gout could be explored in future studies.
    Trial registration: This trial is registered as EU Clinical Trials Register (EudraCT 2013-003559-39) and ISRCTN (ISRCTN 32017426).
    Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 11/36/41) and is published in full in
    MeSH term(s) Humans ; Male ; Middle Aged ; Aged ; Female ; Allopurinol/therapeutic use ; Cost-Benefit Analysis ; Acute Coronary Syndrome ; Quality of Life ; Prospective Studies ; Uric Acid ; Myocardial Ischemia/drug therapy ; Gout/drug therapy ; Stroke/drug therapy ; Myocardial Infarction/drug therapy
    Chemical Substances Allopurinol (63CZ7GJN5I) ; Uric Acid (268B43MJ25)
    Language English
    Publishing date 2024-03-29
    Publishing country England
    Document type Randomized Controlled Trial ; Journal Article
    ZDB-ID 2006765-3
    ISSN 2046-4924 ; 1366-5278
    ISSN (online) 2046-4924
    ISSN 1366-5278
    DOI 10.3310/ATTM4092
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  6. Article: A Cost-Effective Microfluidic Device to Teach the Principles of Electrophoresis and Electroosmosis.

    Shaffer, Tyler A / Herrada, Carlos U / Walker, Avery M / Casto-Boggess, Laura D / Holland, Lisa A / Johnson, Timothy R / Jones, Megan E / Elshamy, Yousef S

    Journal of chemical education

    2023  Volume 100, Issue 7, Page(s) 2782–2788

    Abstract: Electrophoresis is integral to analytical and biochemistry experiences in undergraduate education; however, fundamental principles of the method are often taught in upper-level laboratories through hands-on experiences. A laboratory activity is reported ... ...

    Abstract Electrophoresis is integral to analytical and biochemistry experiences in undergraduate education; however, fundamental principles of the method are often taught in upper-level laboratories through hands-on experiences. A laboratory activity is reported that teaches the concepts of electrophoretic mobility and electroosmotic flow. A single reuseable instrument, called a mini-E, costs 37 USD and consists of a DC power supply, a voltmeter, platinum electrodes, and a chip cast in polydimethylsiloxane. This activity uses common reagents costing only 0.02 USD per student. Experiments are devised that allow students to investigate the properties of electrophoretic flow and electroosmotic flow by separating the two commonly used food dyeing agents Brilliant Blue FCF and Allura Red AC in vinegar and in a solution of ammonium hydroxide. A dark-purple mixture of these dyes is separated into red and blue bands that are easily visualized. The migration order of the dyes differs when the separation is performed under conditions of reversed polarity and suppressed electroosmotic flow (vinegar) compared to conditions of normal polarity and active electroosmotic flow (ammonium hydroxide). When delivered to chemistry majors, students had a significant gain in their ability to apply the concepts of electroosmosis and electrophoresis to predict analyte migration. Although this activity targets upper-level chemistry content, it can also be adapted for other laboratory experiences.
    Language English
    Publishing date 2023-06-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 218164-2
    ISSN 1938-1328 ; 0021-9584
    ISSN (online) 1938-1328
    ISSN 0021-9584
    DOI 10.1021/acs.jchemed.2c01028
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  7. Article ; Online: Inactivation of p53 provides a competitive advantage to del(5q) myelodysplastic syndrome hematopoietic stem cells during inflammation.

    Muto, Tomoya / Walker, Callum S / Agarwal, Puneet / Vick, Eric / Sampson, Avery / Choi, Kwangmin / Niederkorn, Madeline / Ishikawa, Chiharu / Hueneman, Kathleen / Varney, Melinda / Starczynowski, Daniel T

    Haematologica

    2023  Volume 108, Issue 10, Page(s) 2715–2729

    Abstract: Inflammation is associated with the pathogenesis of myelodysplastic syndromes (MDS) and emerging evidence suggests that MDS hematopoietic stem and progenitor cells (HSPC) exhibit an altered response to inflammation. Deletion of chromosome 5 (del(5q)) is ... ...

    Abstract Inflammation is associated with the pathogenesis of myelodysplastic syndromes (MDS) and emerging evidence suggests that MDS hematopoietic stem and progenitor cells (HSPC) exhibit an altered response to inflammation. Deletion of chromosome 5 (del(5q)) is the most common chromosomal abnormality in MDS. Although this MDS subtype contains several haploinsufficient genes that impact innate immune signaling, the effects of inflammation on del(5q) MDS HSPC remains undefined. Utilizing a model of del(5q)-like MDS, inhibiting the IRAK1/4-TRAF6 axis improved cytopenias, suggesting that activation of innate immune pathways contributes to certain clinical features underlying the pathogenesis of low-risk MDS. However, low-grade inflammation in the del(5q)-like MDS model did not contribute to more severe disease but instead impaired the del(5q)-like HSPC as indicated by their diminished numbers, premature attrition and increased p53 expression. Del(5q)-like HSPC exposed to inflammation became less quiescent, but without affecting cell viability. Unexpectedly, the reduced cellular quiescence of del(5q) HSPC exposed to inflammation was restored by p53 deletion. These findings uncovered that inflammation confers a competitive advantage of functionally defective del(5q) HSPC upon loss of p53. Since TP53 mutations are enriched in del(5q) AML following an MDS diagnosis, increased p53 activation in del(5q) MDS HSPC due to inflammation may create a selective pressure for genetic inactivation of p53 or expansion of a pre-existing TP53-mutant clone.
    MeSH term(s) Humans ; Tumor Suppressor Protein p53/genetics ; Tumor Suppressor Protein p53/metabolism ; Chromosome Deletion ; Myelodysplastic Syndromes/pathology ; Hematopoietic Stem Cells/metabolism ; Signal Transduction ; Chromosomes, Human, Pair 5/genetics ; Chromosomes, Human, Pair 5/metabolism
    Chemical Substances Tumor Suppressor Protein p53
    Language English
    Publishing date 2023-10-01
    Publishing country Italy
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2333-4
    ISSN 1592-8721 ; 0017-6567 ; 0390-6078
    ISSN (online) 1592-8721
    ISSN 0017-6567 ; 0390-6078
    DOI 10.3324/haematol.2022.282349
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  8. Article ; Online: Imaging fast electrical activity in the brain during ictal epileptiform discharges with electrical impedance tomography.

    Hannan, Sana / Faulkner, Mayo / Aristovich, Kirill / Avery, James / Walker, Matthew / Holder, David

    NeuroImage. Clinical

    2018  Volume 20, Page(s) 674–684

    Abstract: ... in an acute rat model of epilepsy, throughout the cerebral cortex. Seizures lasting 16.5 ± 5.3 s ...

    Abstract Electrical Impedance Tomography (EIT) is an emerging medical imaging technique which can produce tomographic images of internal impedance changes within an object using non-penetrating surface electrodes. It has previously been used to image impedance changes due to neuronal depolarisation during evoked potentials in the rat somatosensory cortex with a resolution of 2 ms and <200 μm, using an epicortical electrode array. The purpose of this work was to use this technique to elucidate the intracortical spatiotemporal trajectory of ictal spike-and-wave discharges (SWDs), induced by electrical stimulation in an acute rat model of epilepsy, throughout the cerebral cortex. Seizures lasting 16.5 ± 5.3 s with repetitive 2-5 Hz SWDs were induced in five rats anaesthetised with fentanyl-isoflurane. Transfer impedance measurements were obtained during each seizure with a 57-electrode epicortical array by applying 50 μA current at 1.7 kHz to two electrodes and recording voltages from all remaining electrodes. Images were reconstructed from averaged SWD-related impedance traces obtained from EIT measurements in successive seizures. We report the occurrence of reproducible impedance changes during the initial spike phase, which had an early onset in the whisker barrel cortex and spread posteriorly, laterally and ventrally over 20 ms (p < 0.03125, N = 5). These findings, which confirm and extend knowledge of SWD initiation and expression, suggest that EIT is a valuable neuroimaging tool for improving understanding of neural circuits implicated in epileptic phenomena.
    MeSH term(s) Animals ; Brain Mapping/methods ; Cerebral Cortex/diagnostic imaging ; Cerebral Cortex/physiopathology ; Disease Models, Animal ; Electric Impedance ; Electric Stimulation ; Electrocorticography/methods ; Epilepsy/diagnostic imaging ; Epilepsy/physiopathology ; Female ; Rats, Sprague-Dawley ; Signal Processing, Computer-Assisted ; Tomography/methods
    Language English
    Publishing date 2018-09-05
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2701571-3
    ISSN 2213-1582 ; 2213-1582
    ISSN (online) 2213-1582
    ISSN 2213-1582
    DOI 10.1016/j.nicl.2018.09.004
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  9. Article ; Online: Impact of a lifestyle modification program on the metabolic syndrome and associated risk factors in long-term survivors of stem cell transplantation.

    Viner Smith, E / Tierney, A C / Klarica, D / Walker, P / Avery, S

    Bone marrow transplantation

    2016  Volume 51, Issue 5, Page(s) 722–724

    Language English
    Publishing date 2016-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 632854-4
    ISSN 1476-5365 ; 0268-3369 ; 0951-3078
    ISSN (online) 1476-5365
    ISSN 0268-3369 ; 0951-3078
    DOI 10.1038/bmt.2015.312
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  10. Article ; Online: Examining Utility of Routine Splenic Flexure Mobilization during Colectomy and Impact on Anastomotic Complications.

    Dilday, Joshua C / Gilligan, Timothy C / Merritt, Clay M / Nelson, Daniel W / Walker, Avery S

    American journal of surgery

    2019  Volume 219, Issue 6, Page(s) 998–1005

    Abstract: Background: Despite a lack of supporting data, routine splenic flexure mobilization (SFM) during colectomy has been thought to reduce anastomotic leak (AL). We evaluated the impact of SFM on outcomes in distal colectomy.: Study design: The 2005-2016 ... ...

    Abstract Background: Despite a lack of supporting data, routine splenic flexure mobilization (SFM) during colectomy has been thought to reduce anastomotic leak (AL). We evaluated the impact of SFM on outcomes in distal colectomy.
    Study design: The 2005-2016 NSQIP database identified 66,068 patients undergoing distal colectomy with anastomosis. Cohorts were stratified by addition of SFM. Postoperative outcomes were compared between groups. Regression analysis identified factors affecting odds of developing AL.
    Results: SFM was performed in 27,475 patients (41.6%). There was no difference in overall complications between cases with SFM and those without (p = 0.55). SFM had longer operative times (220 min vs. 184 min; p < 0.0001). SFM was not associated with any difference in AL rate (3.6% vs. 3.7%; p = 0.86). Factors most associated with AL were lack of oral antibiotic preparation (OR 1.93; p < 0.001), chemotherapy (OR 1.91; p < 0.001), and weight loss (OR 1.68; p = 0.0005). Operative indication and approach did not affect leak.
    Conclusions: SFM in distal colectomy increased operative time without decreasing overall complications or AL. Routine splenic flexure mobilization may add risk without significant benefit.
    MeSH term(s) Aged ; Anastomosis, Surgical ; Anastomotic Leak/epidemiology ; Colectomy/methods ; Female ; Humans ; Intraoperative Care/methods ; Male ; Middle Aged ; Retrospective Studies ; Spleen
    Language English
    Publishing date 2019-07-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2953-1
    ISSN 1879-1883 ; 0002-9610
    ISSN (online) 1879-1883
    ISSN 0002-9610
    DOI 10.1016/j.amjsurg.2019.07.030
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