Carbon dioxide embolism associated with transanal total mesorectal excision surgery: A report from the international registries

Edward A. Dickson; Marta Penna; Chris Cunningham; Fiona M. Ratcliffe; Jonathan Chantler; Nicholas A. Crabtree; Jurriaan B. Tuynman; Matthew R. Albert; John R.T. Monson; Roel Hompes; Walaa Abdelmoaty; Michel Adamina; Felix Aigner; Karim Alavi; Benjamin Albers; Hazar Al Furajii; Andrew Allison; Sergio Eduardo; Alonso Araujo; George Y. Apostolides; Alberto Arezzo; Steven J. Arnold; Kamal Aryal; Shady Ashamalla; Shazad Ashraf; Sana Ashraf; Vikram Attaluri; Ralph Austin; Giuliano Barugo-La; Andrew Beggs; H. J. Belgers; Stephen Bell; Willem Bemelman; Stefano Berti; Matthias Biebl; Joris Blondeel; Balazs Binky; Ioan-Nis Baloyiannis; Dibyendu Bandyopadhyay; Luigi Boni; Liliana Bordeianou; Benjamin Box; Stephen Boyce; Walter Brokelman; Carl J. Brown; Lukas Bruegger; Christian Buchli; Nicolas Christian Buchs; Orhan Bulut; Caroline Burt; Attila Bursics; Ronan A. Cahill; Juan Pablo Campana; Marco Caricato; Aleidis Caro-Tar-Rago; Fida Casans; Elisa Cassinotti; Antonio Caycedo-Marulan-Da; Sami A. Chadi; Pramodh Chandrasinghe; Sanjay Chaudhri; Nicole Chaumont; Praminthra Chitsabesan; Julien Coget; Pablo Collera; Mark Coleman; Edward D. Courtney; Francois Dagbert; Stephen J. Dalton; Geissmann Daniel; David A. Clark; Lieven De-Drye; Javier De La Torre; Giovanni Dapri; Sanjeev P. Dayal; Cecile De Chaisemartin; F. Borja De Lacy; Olga Blasco Delgado; Francesca Di Candido; Gabriel Diaz Del Gobbo; E. J.R. De Graaf; Paolo Delrio; Karl De Pooter; Pieter D'Hooge; Pascal Doornebosch; Sarah Duff; Philippe Du Jardin; Khasan E. Dzhumabaev; Mon Tom Edwards; Ika Egenvall; Eloy Espin; Morandi Eugenio; Mon-Ika Egenvall; Jens Ravn Eriksen; Arne E. Faerden; Seraina Faes; Vicente Simó Fernández; Alessandro Fichera; Johan Fierens; Kjell Fierens; Timothy Forgan; Nader Francis; James Francombe; Elisa Francone; Todd Francone; Bawantha Gamage; Jose Alberto Perez Garcia; I. Ethem Gecim; Bart Van Geluwe; Christian Gin-Gert; Virgilio George; Markus Gloeckler; Ismail Gögenur; André Goulart; Tomáš Grolich; Eric Haas; Usmaan Hameed; Dieter Hahnloser; Athur Harikrishnan; Guy Harris; Ingrid Haunold; Charles Hendrickse; Tom Hendrickx; Michael Heyns; James Horwood; Daniel Huerga; Masaaki Ito; Aldo Jarimba; Henry K.M. Joeng; Oliver Jones; Guido Jutten; Zdeněk Kala; Yoshiaki Kita; Joep Knol; Rajesh Thengugal Kochupapy; Werner Kneist; Amy S.Y. Kok; Miranda Kusters; Antonio M. Lacy; Miklos Laka-Tos; Roshan Lal; Zaher Lakkis; Pedro Leão; Anton Lambrechts; Lawrence Lee; Bernard Lelong; Edmund Leung; Emanuele Lezoche; Alexander Sender Liberman; Paul Lidder; Meyline An-Drade Lima; Arun Loganathan; Luis J. Lombana; Laura Loren-Zon; Laura Lorenzon; Haug Loriz; Marti Lukas; Dean Lutrin; Paul Mackey; Zaman Z. Mamedli; Steve Mansfield; Peter Marcello; Steven Marcoen; Juan M. Romero Marcos; Tobias Marcy; Slawomir Marecik; John Marks; Patrizia Marsanic; Adrian Mattacheo; Dipen Maun; Denzil May; Justin A. Maykel; David Mcarthur; Iain Mccallum; Kathryn Mccarthy; Elisabeth C. Mclemore; Carlos Ramon Sil-Viera Mendes; Evangelos Messaris; Antonios Michalopoulos; Saulius Mikalauskas; Anthony Miles; Monica Millan; Sarah Mills; Danilo Miskovic; Isacco Montroni; Etienne Moore; Tim Moore; Shinichiro Mori; Simona Mori; Mario Morino; Andrea Muratore; Ventzislav Mutafchiyski; Alistair Myers; Yves Van Nieuwenhove; Yuji Nishizawa; Paul Ng; Gregory John Nolan; Vincent Obias; Alex Ochsner; Jae Hwan Oh; Thierry Onghena; Samuel Oommen; Bruce A. Orkin; Khalid Osman; Susana Ourô; Yves Panis; Theodosios Papavramidis; Michael Von Papen; Géza Papp; Ian Paquette; Marius T. Paraoan; Jesús P. Paredes; Carlos Pastor; Paul R.L. Pattyn; Sharaf Karim Perdawood; Cherylin Fu Wan Pei; Jakob Piehslinger; Dimitar Penchev; Rodrigo Oliva Perez; Roberto Persiani; Frank Pfeffer; P. Terry Phang; Vesa Pokela; Andrea Picchetto; Eligijus Poskus; Daniel Prieto; Fayez A. Que-Reshy; Sean Ramcharan; Stephanie Rauch; Daniela Rega; Juan C. Reyes; Frederic Ris; Salvadora Delgado Rivilla; Timothy Alexander Rockall; Paulo Roquete; Gustavo Rossi; Giacomo Ruffo; Yo-Shiharu Sakai; Dana Sands; Guilherme Pagin São Julião; Andrea Scala; Alessandro Scala; Dario Scala; Lope Estévez Schwarz; Victor Edmond Seid; Gerald Seitinger; Irshad A. Shaikh; Abhiram Sharma; Colin Siet-Ses; Baljit Singh; Ole Helmer Sjo; Dae Kyung Sohn; Claudio Sora-Via; M. N. Sosef; Antonino Spinelli; Chris Speakman; Scott Steele; Vorburger Stephan; Andrew R.L. Stevenson; Peter Stotland; Peter Studer; S. Strypstein; Patricia Sylla; Alexander Szyszkowitz; Anjay Talwar; Peter Tanis; Patricia Tejedor; Enrique Pastor Teso; Joaquin Tognelli; Jared Torkington; Peter Tschann; Jean-Jacques Tuech; Andreas Tuerler; George Tzovaras; Giampaolo Ugolini; Francesc Vallribera; Franky Vansteenkiste; Eva Vangenechten; Emiel G.G. Verdaasdonk; Nuno Vilela; Brunner Walter; Oliver J. Warren; T. Visser; Satish Warrier; Mike Warner; Janindra Waru-Savitarne; Mark H. Whiteford; Tom Andreas Wik; Jacques-Alain Witzig; Torsten Wolff; Albert M. Wolthuis; Greg Wynn

doi:10.1097/DCR.0000000000001410

Carbon dioxide embolism associated with transanal total mesorectal excision surgery: A report from the international registries

Edward A. Dickson, Marta Penna, Chris Cunningham, Fiona M. Ratcliffe, Jonathan Chantler, Nicholas A. Crabtree, Jurriaan B. Tuynman, Matthew R. Albert, John R.T. Monson, Roel Hompes, Walaa Abdelmoaty, Michel Adamina, Felix Aigner, Karim Alavi, Benjamin Albers, Hazar Al Furajii, Andrew Allison, Sergio Eduardo, Alonso Araujo, George Y. ApostolidesAlberto Arezzo, Steven J. Arnold, Kamal Aryal, Shady Ashamalla, Shazad Ashraf, Sana Ashraf, Vikram Attaluri, Ralph Austin, Giuliano Barugo-La, Andrew Beggs, H. J. Belgers, Stephen Bell, Willem Bemelman, Stefano Berti, Matthias Biebl, Joris Blondeel, Balazs Binky, Ioan-Nis Baloyiannis, Dibyendu Bandyopadhyay, Luigi Boni, Liliana Bordeianou, Benjamin Box, Stephen Boyce, Walter Brokelman, Carl J. Brown, Lukas Bruegger, Christian Buchli, Nicolas Christian Buchs, Orhan Bulut, Caroline Burt, Attila Bursics, Ronan A. Cahill, Juan Pablo Campana, Marco Caricato, Aleidis Caro-Tar-Rago, Fida Casans, Elisa Cassinotti, Antonio Caycedo-Marulan-Da, Sami A. Chadi, Pramodh Chandrasinghe, Sanjay Chaudhri, Nicole Chaumont, Praminthra Chitsabesan, Julien Coget, Pablo Collera, Mark Coleman, Edward D. Courtney, Francois Dagbert, Stephen J. Dalton, Geissmann Daniel, David A. Clark, Lieven De-Drye, Javier De La Torre, Giovanni Dapri, Sanjeev P. Dayal, Cecile De Chaisemartin, F. Borja De Lacy, Olga Blasco Delgado, Francesca Di Candido, Gabriel Diaz Del Gobbo, E. J.R. De Graaf, Paolo Delrio, Karl De Pooter, Pieter D'Hooge, Pascal Doornebosch, Sarah Duff, Philippe Du Jardin, Khasan E. Dzhumabaev, Mon Tom Edwards, Ika Egenvall, Eloy Espin, Morandi Eugenio, Mon-Ika Egenvall, Jens Ravn Eriksen, Arne E. Faerden, Seraina Faes, Vicente Simó Fernández, Alessandro Fichera, Johan Fierens, Kjell Fierens, Timothy Forgan, Nader Francis, James Francombe, Elisa Francone, Todd Francone, Bawantha Gamage, Jose Alberto Perez Garcia, I. Ethem Gecim, Bart Van Geluwe, Christian Gin-Gert, Virgilio George, Markus Gloeckler, Ismail Gögenur, André Goulart, Tomáš Grolich, Eric Haas, Usmaan Hameed, Dieter Hahnloser, Athur Harikrishnan, Guy Harris, Ingrid Haunold, Charles Hendrickse, Tom Hendrickx, Michael Heyns, James Horwood, Daniel Huerga, Masaaki Ito, Aldo Jarimba, Henry K.M. Joeng, Oliver Jones, Guido Jutten, Zdeněk Kala, Yoshiaki Kita, Joep Knol, Rajesh Thengugal Kochupapy, Werner Kneist, Amy S.Y. Kok, Miranda Kusters, Antonio M. Lacy, Miklos Laka-Tos, Roshan Lal, Zaher Lakkis, Pedro Leão, Anton Lambrechts, Lawrence Lee, Bernard Lelong, Edmund Leung, Emanuele Lezoche, Alexander Sender Liberman, Paul Lidder, Meyline An-Drade Lima, Arun Loganathan, Luis J. Lombana, Laura Loren-Zon, Laura Lorenzon, Haug Loriz, Marti Lukas, Dean Lutrin, Paul Mackey, Zaman Z. Mamedli, Steve Mansfield, Peter Marcello, Steven Marcoen, Juan M. Romero Marcos, Tobias Marcy, Slawomir Marecik, John Marks, Patrizia Marsanic, Adrian Mattacheo, Dipen Maun, Denzil May, Justin A. Maykel, David Mcarthur, Iain Mccallum, Kathryn Mccarthy, Elisabeth C. Mclemore, Carlos Ramon Sil-Viera Mendes, Evangelos Messaris, Antonios Michalopoulos, Saulius Mikalauskas, Anthony Miles, Monica Millan, Sarah Mills, Danilo Miskovic, Isacco Montroni, Etienne Moore, Tim Moore, Shinichiro Mori, Simona Mori, Mario Morino, Andrea Muratore, Ventzislav Mutafchiyski, Alistair Myers, Yves Van Nieuwenhove, Yuji Nishizawa, Paul Ng, Gregory John Nolan, Vincent Obias, Alex Ochsner, Jae Hwan Oh, Thierry Onghena, Samuel Oommen, Bruce A. Orkin, Khalid Osman, Susana Ourô, Yves Panis, Theodosios Papavramidis, Michael Von Papen, Géza Papp, Ian Paquette, Marius T. Paraoan, Jesús P. Paredes, Carlos Pastor, Paul R.L. Pattyn, Sharaf Karim Perdawood, Cherylin Fu Wan Pei, Jakob Piehslinger, Dimitar Penchev, Rodrigo Oliva Perez, Roberto Persiani, Frank Pfeffer, P. Terry Phang, Vesa Pokela, Andrea Picchetto, Eligijus Poskus, Daniel Prieto, Fayez A. Que-Reshy, Sean Ramcharan, Stephanie Rauch, Daniela Rega, Juan C. Reyes, Frederic Ris, Salvadora Delgado Rivilla, Timothy Alexander Rockall, Paulo Roquete, Gustavo Rossi, Giacomo Ruffo, Yo-Shiharu Sakai, Dana Sands, Guilherme Pagin São Julião, Andrea Scala, Alessandro Scala, Dario Scala, Lope Estévez Schwarz, Victor Edmond Seid, Gerald Seitinger, Irshad A. Shaikh, Abhiram Sharma, Colin Siet-Ses, Baljit Singh, Ole Helmer Sjo, Dae Kyung Sohn, Claudio Sora-Via, M. N. Sosef, Antonino Spinelli, Chris Speakman, Scott Steele, Vorburger Stephan, Andrew R.L. Stevenson, Peter Stotland, Peter Studer, S. Strypstein, Patricia Sylla, Alexander Szyszkowitz, Anjay Talwar, Peter Tanis, Patricia Tejedor, Enrique Pastor Teso, Joaquin Tognelli, Jared Torkington, Peter Tschann, Jean-Jacques Tuech, Andreas Tuerler, George Tzovaras, Giampaolo Ugolini, Francesc Vallribera, Franky Vansteenkiste, Eva Vangenechten, Emiel G.G. Verdaasdonk, Nuno Vilela, Brunner Walter, Oliver J. Warren, T. Visser, Satish Warrier, Mike Warner, Janindra Waru-Savitarne, Mark H. Whiteford, Tom Andreas Wik, Jacques-Alain Witzig, Torsten Wolff, Albert M. Wolthuis, Greg Wynn

Risultato della ricerca: Contributo in rivista › Articolo in rivista

24 Citazioni (Scopus)

Abstract

BACKGROUND: Carbon dioxide embolus has been reported as a rare but clinically important risk associated with transanal total mesorectal excision surgery. To date, there exists limited data describing the incidence, risk factors, and management of carbon dioxide embolus in transanal total mesorectal excision. OBJECTIVE: This study aimed to obtain data from the transanal total mesorectal excision registries to identify trends and potential risk factors for carbon dioxide embolus specific to this surgical technique. DESIGN: Contributors to both the LOREC and OSTRiCh transanal total mesorectal excision registries were invited to report their incidence of carbon dioxide embolus. Case report forms were collected detailing the patient-specific and technical factors of each event. SETTINGS: The study was conducted at the collaborating centers from the international transanal total mesorectal excision registries. MAIN OUTCOME MEASURES: Characteristics and outcomes of patients with carbon dioxide embolus associated with transanal mesorectal excision were measured. RESULTS: Twenty-five cases were reported. The incidence of carbon dioxide embolus during transanal total mesorectal excision is estimated to be ≈0.4% (25/6375 cases). A fall in end tidal carbon dioxide was noted as the initial feature in 22 cases, with 13 (52%) developing signs of hemodynamic compromise. All of the events occurred in the transanal component of dissection, with mean (range) insufflation pressures of 15 mm Hg (12-20 mm Hg). Patients were predominantly (68%) in a Trendelenburg position, between 30° and 45°. Venous bleeding was reported in 20 cases at the time of carbon dioxide embolus, with periprostatic veins documented as the most common site (40%). After carbon dioxide embolus, 84% of cases were completed after hemodynamic stabilization. Two patients required cardiopulmonary resuscitation because of cardiovascular collapse. There were no deaths. LIMITATIONS: This is a retrospective study surveying reported outcomes by surgeons and anesthetists. CONCLUSIONS: Surgeons undertaking transanal total mesorectal excision must be aware of the possibility of carbon dioxide embolus and its potential risk factors, including venous bleeding (wrong plane surgery), high insufflation pressures, and patient positioning. Prompt recognition and management can limit the clinical impact of such events. See Video Abstract at http://links. lww.com/DCR/A961.

Lingua originale	English
pagine (da-a)	794-801
Numero di pagine	8
Rivista	DISEASES OF THE COLON & RECTUM
Volume	62
DOI	https://doi.org/10.1097/DCR.0000000000001410
Stato di pubblicazione	Pubblicato - 2019

Keywords

Adult
Aged
Aged, 80 and over
Carbon Dioxide
Carbon dioxide embolus
Embolism, Air
Female
Hemorrhage
Humans
Insufflation
Internationality
Intraoperative Complications
Male
Middle Aged
Patient Positioning
Postoperative Care
Rectal surgery
Rectum
Registries
Registry report
Retrospective Studies
Risk Factors
Transanal
Transanal Endoscopic Surgery
Transanal total mesorectal excision
Veins

Accesso al documento

10.1097/DCR.0000000000001410

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Cita questo

Dickson, E. A., Penna, M., Cunningham, C., Ratcliffe, F. M., Chantler, J., Crabtree, N. A., Tuynman, J. B., Albert, M. R., Monson, J. R. T., Hompes, R., Abdelmoaty, W., Adamina, M., Aigner, F., Alavi, K., Albers, B., Al Furajii, H., Allison, A., Eduardo, S., Araujo, A., ... Wynn, G. (2019). Carbon dioxide embolism associated with transanal total mesorectal excision surgery: A report from the international registries. DISEASES OF THE COLON & RECTUM, 62, 794-801. https://doi.org/10.1097/DCR.0000000000001410

@article{122563a74d624f96b8ce498502133918,

title = "Carbon dioxide embolism associated with transanal total mesorectal excision surgery: A report from the international registries",

abstract = "BACKGROUND: Carbon dioxide embolus has been reported as a rare but clinically important risk associated with transanal total mesorectal excision surgery. To date, there exists limited data describing the incidence, risk factors, and management of carbon dioxide embolus in transanal total mesorectal excision. OBJECTIVE: This study aimed to obtain data from the transanal total mesorectal excision registries to identify trends and potential risk factors for carbon dioxide embolus specific to this surgical technique. DESIGN: Contributors to both the LOREC and OSTRiCh transanal total mesorectal excision registries were invited to report their incidence of carbon dioxide embolus. Case report forms were collected detailing the patient-specific and technical factors of each event. SETTINGS: The study was conducted at the collaborating centers from the international transanal total mesorectal excision registries. MAIN OUTCOME MEASURES: Characteristics and outcomes of patients with carbon dioxide embolus associated with transanal mesorectal excision were measured. RESULTS: Twenty-five cases were reported. The incidence of carbon dioxide embolus during transanal total mesorectal excision is estimated to be ≈0.4% (25/6375 cases). A fall in end tidal carbon dioxide was noted as the initial feature in 22 cases, with 13 (52%) developing signs of hemodynamic compromise. All of the events occurred in the transanal component of dissection, with mean (range) insufflation pressures of 15 mm Hg (12-20 mm Hg). Patients were predominantly (68%) in a Trendelenburg position, between 30° and 45°. Venous bleeding was reported in 20 cases at the time of carbon dioxide embolus, with periprostatic veins documented as the most common site (40%). After carbon dioxide embolus, 84% of cases were completed after hemodynamic stabilization. Two patients required cardiopulmonary resuscitation because of cardiovascular collapse. There were no deaths. LIMITATIONS: This is a retrospective study surveying reported outcomes by surgeons and anesthetists. CONCLUSIONS: Surgeons undertaking transanal total mesorectal excision must be aware of the possibility of carbon dioxide embolus and its potential risk factors, including venous bleeding (wrong plane surgery), high insufflation pressures, and patient positioning. Prompt recognition and management can limit the clinical impact of such events. See Video Abstract at http://links. lww.com/DCR/A961.",

keywords = "Adult, Aged, Aged, 80 and over, Carbon Dioxide, Carbon dioxide embolus, Embolism, Air, Female, Hemorrhage, Humans, Insufflation, Internationality, Intraoperative Complications, Male, Middle Aged, Patient Positioning, Postoperative Care, Rectal surgery, Rectum, Registries, Registry report, Retrospective Studies, Risk Factors, Transanal, Transanal Endoscopic Surgery, Transanal total mesorectal excision, Veins, Adult, Aged, Aged, 80 and over, Carbon Dioxide, Carbon dioxide embolus, Embolism, Air, Female, Hemorrhage, Humans, Insufflation, Internationality, Intraoperative Complications, Male, Middle Aged, Patient Positioning, Postoperative Care, Rectal surgery, Rectum, Registries, Registry report, Retrospective Studies, Risk Factors, Transanal, Transanal Endoscopic Surgery, Transanal total mesorectal excision, Veins",

author = "Dickson, {Edward A.} and Marta Penna and Chris Cunningham and Ratcliffe, {Fiona M.} and Jonathan Chantler and Crabtree, {Nicholas A.} and Tuynman, {Jurriaan B.} and Albert, {Matthew R.} and Monson, {John R.T.} and Roel Hompes and Walaa Abdelmoaty and Michel Adamina and Felix Aigner and Karim Alavi and Benjamin Albers and {Al Furajii}, Hazar and Andrew Allison and Sergio Eduardo and Alonso Araujo and Apostolides, {George Y.} and Alberto Arezzo and Arnold, {Steven J.} and Kamal Aryal and Shady Ashamalla and Shazad Ashraf and Sana Ashraf and Vikram Attaluri and Ralph Austin and Giuliano Barugo-La and Andrew Beggs and Belgers, {H. J.} and Stephen Bell and Willem Bemelman and Stefano Berti and Matthias Biebl and Joris Blondeel and Balazs Binky and Ioan-Nis Baloyiannis and Dibyendu Bandyopadhyay and Luigi Boni and Liliana Bordeianou and Benjamin Box and Stephen Boyce and Walter Brokelman and Brown, {Carl J.} and Lukas Bruegger and Christian Buchli and {Christian Buchs}, Nicolas and Orhan Bulut and Caroline Burt and Attila Bursics and Cahill, {Ronan A.} and {Pablo Campana}, Juan and Marco Caricato and Aleidis Caro-Tar-Rago and Fida Casans and Elisa Cassinotti and Antonio Caycedo-Marulan-Da and Chadi, {Sami A.} and Pramodh Chandrasinghe and Sanjay Chaudhri and Nicole Chaumont and Praminthra Chitsabesan and Julien Coget and Pablo Collera and Mark Coleman and Courtney, {Edward D.} and Francois Dagbert and Dalton, {Stephen J.} and Geissmann Daniel and Clark, {David A.} and Lieven De-Drye and {De La Torre}, Javier and Giovanni Dapri and Dayal, {Sanjeev P.} and {De Chaisemartin}, Cecile and {Borja De Lacy}, F. and {Blasco Delgado}, Olga and {Di Candido}, Francesca and {Diaz Del Gobbo}, Gabriel and {De Graaf}, {E. J.R.} and Paolo Delrio and {De Pooter}, Karl and Pieter D'Hooge and Pascal Doornebosch and Sarah Duff and {Du Jardin}, Philippe and Dzhumabaev, {Khasan E.} and {Tom Edwards}, Mon and Ika Egenvall and Eloy Espin and Morandi Eugenio and Mon-Ika Egenvall and {Ravn Eriksen}, Jens and Faerden, {Arne E.} and Seraina Faes and {Sim{\'o} Fern{\'a}ndez}, Vicente and Alessandro Fichera and Johan Fierens and Kjell Fierens and Timothy Forgan and Nader Francis and James Francombe and Elisa Francone and Todd Francone and Bawantha Gamage and {Perez Garcia}, {Jose Alberto} and {Ethem Gecim}, I. and {Van Geluwe}, Bart and Christian Gin-Gert and Virgilio George and Markus Gloeckler and Ismail G{\"o}genur and Andr{\'e} Goulart and Tom{\'a}{\v s} Grolich and Eric Haas and Usmaan Hameed and Dieter Hahnloser and Athur Harikrishnan and Guy Harris and Ingrid Haunold and Charles Hendrickse and Tom Hendrickx and Michael Heyns and James Horwood and Daniel Huerga and Masaaki Ito and Aldo Jarimba and Joeng, {Henry K.M.} and Oliver Jones and Guido Jutten and Zden{\v e}k Kala and Yoshiaki Kita and Joep Knol and {Thengugal Kochupapy}, Rajesh and Werner Kneist and Kok, {Amy S.Y.} and Miranda Kusters and Lacy, {Antonio M.} and Miklos Laka-Tos and Roshan Lal and Zaher Lakkis and Pedro Le{\~a}o and Anton Lambrechts and Lawrence Lee and Bernard Lelong and Edmund Leung and Emanuele Lezoche and {Sender Liberman}, Alexander and Paul Lidder and {An-Drade Lima}, Meyline and Arun Loganathan and Lombana, {Luis J.} and Laura Loren-Zon and Laura Lorenzon and Haug Loriz and Marti Lukas and Dean Lutrin and Paul Mackey and Mamedli, {Zaman Z.} and Steve Mansfield and Peter Marcello and Steven Marcoen and {Romero Marcos}, {Juan M.} and Tobias Marcy and Slawomir Marecik and John Marks and Patrizia Marsanic and Adrian Mattacheo and Dipen Maun and Denzil May and Maykel, {Justin A.} and David Mcarthur and Iain Mccallum and Kathryn Mccarthy and Mclemore, {Elisabeth C.} and {Ramon Sil-Viera Mendes}, Carlos and Evangelos Messaris and Antonios Michalopoulos and Saulius Mikalauskas and Anthony Miles and Monica Millan and Sarah Mills and Danilo Miskovic and Isacco Montroni and Etienne Moore and Tim Moore and Shinichiro Mori and Simona Mori and Mario Morino and Andrea Muratore and Ventzislav Mutafchiyski and Alistair Myers and {Van Nieuwenhove}, Yves and Yuji Nishizawa and Paul Ng and {John Nolan}, Gregory and Vincent Obias and Alex Ochsner and {Hwan Oh}, Jae and Thierry Onghena and Samuel Oommen and Orkin, {Bruce A.} and Khalid Osman and Susana Our{\^o} and Yves Panis and Theodosios Papavramidis and {Von Papen}, Michael and G{\'e}za Papp and Ian Paquette and Paraoan, {Marius T.} and Paredes, {Jes{\'u}s P.} and Carlos Pastor and Pattyn, {Paul R.L.} and {Karim Perdawood}, Sharaf and {Wan Pei}, {Cherylin Fu} and Jakob Piehslinger and Dimitar Penchev and {Oliva Perez}, Rodrigo and Roberto Persiani and Frank Pfeffer and {Terry Phang}, P. and Vesa Pokela and Andrea Picchetto and Eligijus Poskus and Daniel Prieto and Que-Reshy, {Fayez A.} and Sean Ramcharan and Stephanie Rauch and Daniela Rega and Reyes, {Juan C.} and Frederic Ris and {Delgado Rivilla}, Salvadora and {Alexander Rockall}, Timothy and Paulo Roquete and Gustavo Rossi and Giacomo Ruffo and Yo-Shiharu Sakai and Dana Sands and {S{\~a}o Juli{\~a}o}, {Guilherme Pagin} and Andrea Scala and Alessandro Scala and Dario Scala and {Est{\'e}vez Schwarz}, Lope and {Edmond Seid}, Victor and Gerald Seitinger and Shaikh, {Irshad A.} and Abhiram Sharma and Colin Siet-Ses and Baljit Singh and {Helmer Sjo}, Ole and {Kyung Sohn}, Dae and Claudio Sora-Via and Sosef, {M. N.} and Antonino Spinelli and Chris Speakman and Scott Steele and Vorburger Stephan and Stevenson, {Andrew R.L.} and Peter Stotland and Peter Studer and S. Strypstein and Patricia Sylla and Alexander Szyszkowitz and Anjay Talwar and Peter Tanis and Patricia Tejedor and {Pastor Teso}, Enrique and Joaquin Tognelli and Jared Torkington and Peter Tschann and Jean-Jacques Tuech and Andreas Tuerler and George Tzovaras and Giampaolo Ugolini and Francesc Vallribera and Franky Vansteenkiste and Eva Vangenechten and Verdaasdonk, {Emiel G.G.} and Nuno Vilela and Brunner Walter and Warren, {Oliver J.} and T. Visser and Satish Warrier and Mike Warner and Janindra Waru-Savitarne and Whiteford, {Mark H.} and {Andreas Wik}, Tom and Jacques-Alain Witzig and Torsten Wolff and Wolthuis, {Albert M.} and Greg Wynn",

year = "2019",

doi = "10.1097/DCR.0000000000001410",

language = "English",

volume = "62",

pages = "794--801",

journal = "DISEASES OF THE COLON & RECTUM",

issn = "0012-3706",

publisher = "-New York, Springer Verlag -Philadelphia, PA: Lippincott, Williams & Wilkins",

}

Dickson, EA, Penna, M, Cunningham, C, Ratcliffe, FM, Chantler, J, Crabtree, NA, Tuynman, JB, Albert, MR, Monson, JRT, Hompes, R, Abdelmoaty, W, Adamina, M, Aigner, F, Alavi, K, Albers, B, Al Furajii, H, Allison, A, Eduardo, S, Araujo, A, Apostolides, GY, Arezzo, A, Arnold, SJ, Aryal, K, Ashamalla, S, Ashraf, S, Ashraf, S, Attaluri, V, Austin, R, Barugo-La, G, Beggs, A, Belgers, HJ, Bell, S, Bemelman, W, Berti, S, Biebl, M, Blondeel, J, Binky, B, Baloyiannis, I-N, Bandyopadhyay, D, Boni, L, Bordeianou, L, Box, B, Boyce, S, Brokelman, W, Brown, CJ, Bruegger, L, Buchli, C, Christian Buchs, N, Bulut, O, Burt, C, Bursics, A, Cahill, RA, Pablo Campana, J, Caricato, M, Caro-Tar-Rago, A, Casans, F, Cassinotti, E, Caycedo-Marulan-Da, A, Chadi, SA, Chandrasinghe, P, Chaudhri, S, Chaumont, N, Chitsabesan, P, Coget, J, Collera, P, Coleman, M, Courtney, ED, Dagbert, F, Dalton, SJ, Daniel, G, Clark, DA, De-Drye, L, De La Torre, J, Dapri, G, Dayal, SP, De Chaisemartin, C, Borja De Lacy, F, Blasco Delgado, O, Di Candido, F, Diaz Del Gobbo, G, De Graaf, EJR, Delrio, P, De Pooter, K, D'Hooge, P, Doornebosch, P, Duff, S, Du Jardin, P, Dzhumabaev, KE, Tom Edwards, M, Egenvall, I, Espin, E, Eugenio, M, Egenvall, M-I, Ravn Eriksen, J, Faerden, AE, Faes, S, Simó Fernández, V, Fichera, A, Fierens, J, Fierens, K, Forgan, T, Francis, N, Francombe, J, Francone, E, Francone, T, Gamage, B, Perez Garcia, JA, Ethem Gecim, I, Van Geluwe, B, Gin-Gert, C, George, V, Gloeckler, M, Gögenur, I, Goulart, A, Grolich, T, Haas, E, Hameed, U, Hahnloser, D, Harikrishnan, A, Harris, G, Haunold, I, Hendrickse, C, Hendrickx, T, Heyns, M, Horwood, J, Huerga, D, Ito, M, Jarimba, A, Joeng, HKM, Jones, O, Jutten, G, Kala, Z, Kita, Y, Knol, J, Thengugal Kochupapy, R, Kneist, W, Kok, ASY, Kusters, M, Lacy, AM, Laka-Tos, M, Lal, R, Lakkis, Z, Leão, P, Lambrechts, A, Lee, L, Lelong, B, Leung, E, Lezoche, E, Sender Liberman, A, Lidder, P, An-Drade Lima, M, Loganathan, A, Lombana, LJ, Loren-Zon, L, Lorenzon, L, Loriz, H, Lukas, M, Lutrin, D, Mackey, P, Mamedli, ZZ, Mansfield, S, Marcello, P, Marcoen, S, Romero Marcos, JM, Marcy, T, Marecik, S, Marks, J, Marsanic, P, Mattacheo, A, Maun, D, May, D, Maykel, JA, Mcarthur, D, Mccallum, I, Mccarthy, K, Mclemore, EC, Ramon Sil-Viera Mendes, C, Messaris, E, Michalopoulos, A, Mikalauskas, S, Miles, A, Millan, M, Mills, S, Miskovic, D, Montroni, I, Moore, E, Moore, T, Mori, S, Mori, S, Morino, M, Muratore, A, Mutafchiyski, V, Myers, A, Van Nieuwenhove, Y, Nishizawa, Y, Ng, P, John Nolan, G, Obias, V, Ochsner, A, Hwan Oh, J, Onghena, T, Oommen, S, Orkin, BA, Osman, K, Ourô, S, Panis, Y, Papavramidis, T, Von Papen, M, Papp, G, Paquette, I, Paraoan, MT, Paredes, JP, Pastor, C, Pattyn, PRL, Karim Perdawood, S, Wan Pei, CF, Piehslinger, J, Penchev, D, Oliva Perez, R, Persiani, R, Pfeffer, F, Terry Phang, P, Pokela, V, Picchetto, A, Poskus, E, Prieto, D, Que-Reshy, FA, Ramcharan, S, Rauch, S, Rega, D, Reyes, JC, Ris, F, Delgado Rivilla, S, Alexander Rockall, T, Roquete, P, Rossi, G, Ruffo, G, Sakai, Y-S, Sands, D, São Julião, GP, Scala, A, Scala, A, Scala, D, Estévez Schwarz, L, Edmond Seid, V, Seitinger, G, Shaikh, IA, Sharma, A, Siet-Ses, C, Singh, B, Helmer Sjo, O, Kyung Sohn, D, Sora-Via, C, Sosef, MN, Spinelli, A, Speakman, C, Steele, S, Stephan, V, Stevenson, ARL, Stotland, P, Studer, P, Strypstein, S, Sylla, P, Szyszkowitz, A, Talwar, A, Tanis, P, Tejedor, P, Pastor Teso, E, Tognelli, J, Torkington, J, Tschann, P, Tuech, J-J, Tuerler, A, Tzovaras, G, Ugolini, G, Vallribera, F, Vansteenkiste, F, Vangenechten, E, Verdaasdonk, EGG, Vilela, N, Walter, B, Warren, OJ, Visser, T, Warrier, S, Warner, M, Waru-Savitarne, J, Whiteford, MH, Andreas Wik, T, Witzig, J-A, Wolff, T, Wolthuis, AM & Wynn, G 2019, 'Carbon dioxide embolism associated with transanal total mesorectal excision surgery: A report from the international registries', DISEASES OF THE COLON & RECTUM, vol. 62, pagg. 794-801. https://doi.org/10.1097/DCR.0000000000001410

TY - JOUR

T1 - Carbon dioxide embolism associated with transanal total mesorectal excision surgery: A report from the international registries

AU - Dickson, Edward A.

AU - Penna, Marta

AU - Cunningham, Chris

AU - Ratcliffe, Fiona M.

AU - Chantler, Jonathan

AU - Crabtree, Nicholas A.

AU - Tuynman, Jurriaan B.

AU - Albert, Matthew R.

AU - Monson, John R.T.

AU - Hompes, Roel

AU - Abdelmoaty, Walaa

AU - Adamina, Michel

AU - Aigner, Felix

AU - Alavi, Karim

AU - Albers, Benjamin

AU - Al Furajii, Hazar

AU - Allison, Andrew

AU - Eduardo, Sergio

AU - Araujo, Alonso

AU - Apostolides, George Y.

AU - Arezzo, Alberto

AU - Arnold, Steven J.

AU - Aryal, Kamal

AU - Ashamalla, Shady

AU - Ashraf, Shazad

AU - Ashraf, Sana

AU - Attaluri, Vikram

AU - Austin, Ralph

AU - Barugo-La, Giuliano

AU - Beggs, Andrew

AU - Belgers, H. J.

AU - Bell, Stephen

AU - Bemelman, Willem

AU - Berti, Stefano

AU - Biebl, Matthias

AU - Blondeel, Joris

AU - Binky, Balazs

AU - Baloyiannis, Ioan-Nis

AU - Bandyopadhyay, Dibyendu

AU - Boni, Luigi

AU - Bordeianou, Liliana

AU - Box, Benjamin

AU - Boyce, Stephen

AU - Brokelman, Walter

AU - Brown, Carl J.

AU - Bruegger, Lukas

AU - Buchli, Christian

AU - Christian Buchs, Nicolas

AU - Bulut, Orhan

AU - Burt, Caroline

AU - Bursics, Attila

AU - Cahill, Ronan A.

AU - Pablo Campana, Juan

AU - Caricato, Marco

AU - Caro-Tar-Rago, Aleidis

AU - Casans, Fida

AU - Cassinotti, Elisa

AU - Caycedo-Marulan-Da, Antonio

AU - Chadi, Sami A.

AU - Chandrasinghe, Pramodh

AU - Chaudhri, Sanjay

AU - Chaumont, Nicole

AU - Chitsabesan, Praminthra

AU - Coget, Julien

AU - Collera, Pablo

AU - Coleman, Mark

AU - Courtney, Edward D.

AU - Dagbert, Francois

AU - Dalton, Stephen J.

AU - Daniel, Geissmann

AU - Clark, David A.

AU - De-Drye, Lieven

AU - De La Torre, Javier

AU - Dapri, Giovanni

AU - Dayal, Sanjeev P.

AU - De Chaisemartin, Cecile

AU - Borja De Lacy, F.

AU - Blasco Delgado, Olga

AU - Di Candido, Francesca

AU - Diaz Del Gobbo, Gabriel

AU - De Graaf, E. J.R.

AU - Delrio, Paolo

AU - De Pooter, Karl

AU - D'Hooge, Pieter

AU - Doornebosch, Pascal

AU - Duff, Sarah

AU - Du Jardin, Philippe

AU - Dzhumabaev, Khasan E.

AU - Tom Edwards, Mon

AU - Egenvall, Ika

AU - Espin, Eloy

AU - Eugenio, Morandi

AU - Egenvall, Mon-Ika

AU - Ravn Eriksen, Jens

AU - Faerden, Arne E.

AU - Faes, Seraina

AU - Simó Fernández, Vicente

AU - Fichera, Alessandro

AU - Fierens, Johan

AU - Fierens, Kjell

AU - Forgan, Timothy

AU - Francis, Nader

AU - Francombe, James

AU - Francone, Elisa

AU - Francone, Todd

AU - Gamage, Bawantha

AU - Perez Garcia, Jose Alberto

AU - Ethem Gecim, I.

AU - Van Geluwe, Bart

AU - Gin-Gert, Christian

AU - George, Virgilio

AU - Gloeckler, Markus

AU - Gögenur, Ismail

AU - Goulart, André

AU - Grolich, Tomáš

AU - Haas, Eric

AU - Hameed, Usmaan

AU - Hahnloser, Dieter

AU - Harikrishnan, Athur

AU - Harris, Guy

AU - Haunold, Ingrid

AU - Hendrickse, Charles

AU - Hendrickx, Tom

AU - Heyns, Michael

AU - Horwood, James

AU - Huerga, Daniel

AU - Ito, Masaaki

AU - Jarimba, Aldo

AU - Joeng, Henry K.M.

AU - Jones, Oliver

AU - Jutten, Guido

AU - Kala, Zdeněk

AU - Kita, Yoshiaki

AU - Knol, Joep

AU - Thengugal Kochupapy, Rajesh

AU - Kneist, Werner

AU - Kok, Amy S.Y.

AU - Kusters, Miranda

AU - Lacy, Antonio M.

AU - Laka-Tos, Miklos

AU - Lal, Roshan

AU - Lakkis, Zaher

AU - Leão, Pedro

AU - Lambrechts, Anton

AU - Lee, Lawrence

AU - Lelong, Bernard

AU - Leung, Edmund

AU - Lezoche, Emanuele

AU - Sender Liberman, Alexander

AU - Lidder, Paul

AU - An-Drade Lima, Meyline

AU - Loganathan, Arun

AU - Lombana, Luis J.

AU - Loren-Zon, Laura

AU - Lorenzon, Laura

AU - Loriz, Haug

AU - Lukas, Marti

AU - Lutrin, Dean

AU - Mackey, Paul

AU - Mamedli, Zaman Z.

AU - Mansfield, Steve

AU - Marcello, Peter

AU - Marcoen, Steven

AU - Romero Marcos, Juan M.

AU - Marcy, Tobias

AU - Marecik, Slawomir

AU - Marks, John

AU - Marsanic, Patrizia

AU - Mattacheo, Adrian

AU - Maun, Dipen

AU - May, Denzil

AU - Maykel, Justin A.

AU - Mcarthur, David

AU - Mccallum, Iain

AU - Mccarthy, Kathryn

AU - Mclemore, Elisabeth C.

AU - Ramon Sil-Viera Mendes, Carlos

AU - Messaris, Evangelos

AU - Michalopoulos, Antonios

AU - Mikalauskas, Saulius

AU - Miles, Anthony

AU - Millan, Monica

AU - Mills, Sarah

AU - Miskovic, Danilo

AU - Montroni, Isacco

AU - Moore, Etienne

AU - Moore, Tim

AU - Mori, Shinichiro

AU - Mori, Simona

AU - Morino, Mario

AU - Muratore, Andrea

AU - Mutafchiyski, Ventzislav

AU - Myers, Alistair

AU - Van Nieuwenhove, Yves

AU - Nishizawa, Yuji

AU - Ng, Paul

AU - John Nolan, Gregory

AU - Obias, Vincent

AU - Ochsner, Alex

AU - Hwan Oh, Jae

AU - Onghena, Thierry

AU - Oommen, Samuel

AU - Orkin, Bruce A.

AU - Osman, Khalid

AU - Ourô, Susana

AU - Panis, Yves

AU - Papavramidis, Theodosios

AU - Von Papen, Michael

AU - Papp, Géza

AU - Paquette, Ian

AU - Paraoan, Marius T.

AU - Paredes, Jesús P.

AU - Pastor, Carlos

AU - Pattyn, Paul R.L.

AU - Karim Perdawood, Sharaf

AU - Wan Pei, Cherylin Fu

AU - Piehslinger, Jakob

AU - Penchev, Dimitar

AU - Oliva Perez, Rodrigo

AU - Persiani, Roberto

AU - Pfeffer, Frank

AU - Terry Phang, P.

AU - Pokela, Vesa

AU - Picchetto, Andrea

AU - Poskus, Eligijus

AU - Prieto, Daniel

AU - Que-Reshy, Fayez A.

AU - Ramcharan, Sean

AU - Rauch, Stephanie

AU - Rega, Daniela

AU - Reyes, Juan C.

AU - Ris, Frederic

AU - Delgado Rivilla, Salvadora

AU - Alexander Rockall, Timothy

AU - Roquete, Paulo

AU - Rossi, Gustavo

AU - Ruffo, Giacomo

AU - Sakai, Yo-Shiharu

AU - Sands, Dana

AU - São Julião, Guilherme Pagin

AU - Scala, Andrea

AU - Scala, Alessandro

AU - Scala, Dario

AU - Estévez Schwarz, Lope

AU - Edmond Seid, Victor

AU - Seitinger, Gerald

AU - Shaikh, Irshad A.

AU - Sharma, Abhiram

AU - Siet-Ses, Colin

AU - Singh, Baljit

AU - Helmer Sjo, Ole

AU - Kyung Sohn, Dae

AU - Sora-Via, Claudio

AU - Sosef, M. N.

AU - Spinelli, Antonino

AU - Speakman, Chris

AU - Steele, Scott

AU - Stephan, Vorburger

AU - Stevenson, Andrew R.L.

AU - Stotland, Peter

AU - Studer, Peter

AU - Strypstein, S.

AU - Sylla, Patricia

AU - Szyszkowitz, Alexander

AU - Talwar, Anjay

AU - Tanis, Peter

AU - Tejedor, Patricia

AU - Pastor Teso, Enrique

AU - Tognelli, Joaquin

AU - Torkington, Jared

AU - Tschann, Peter

AU - Tuech, Jean-Jacques

AU - Tuerler, Andreas

AU - Tzovaras, George

AU - Ugolini, Giampaolo

AU - Vallribera, Francesc

AU - Vansteenkiste, Franky

AU - Vangenechten, Eva

AU - Verdaasdonk, Emiel G.G.

AU - Vilela, Nuno

AU - Walter, Brunner

AU - Warren, Oliver J.

AU - Visser, T.

AU - Warrier, Satish

AU - Warner, Mike

AU - Waru-Savitarne, Janindra

AU - Whiteford, Mark H.

AU - Andreas Wik, Tom

AU - Witzig, Jacques-Alain

AU - Wolff, Torsten

AU - Wolthuis, Albert M.

AU - Wynn, Greg

PY - 2019

Y1 - 2019

N2 - BACKGROUND: Carbon dioxide embolus has been reported as a rare but clinically important risk associated with transanal total mesorectal excision surgery. To date, there exists limited data describing the incidence, risk factors, and management of carbon dioxide embolus in transanal total mesorectal excision. OBJECTIVE: This study aimed to obtain data from the transanal total mesorectal excision registries to identify trends and potential risk factors for carbon dioxide embolus specific to this surgical technique. DESIGN: Contributors to both the LOREC and OSTRiCh transanal total mesorectal excision registries were invited to report their incidence of carbon dioxide embolus. Case report forms were collected detailing the patient-specific and technical factors of each event. SETTINGS: The study was conducted at the collaborating centers from the international transanal total mesorectal excision registries. MAIN OUTCOME MEASURES: Characteristics and outcomes of patients with carbon dioxide embolus associated with transanal mesorectal excision were measured. RESULTS: Twenty-five cases were reported. The incidence of carbon dioxide embolus during transanal total mesorectal excision is estimated to be ≈0.4% (25/6375 cases). A fall in end tidal carbon dioxide was noted as the initial feature in 22 cases, with 13 (52%) developing signs of hemodynamic compromise. All of the events occurred in the transanal component of dissection, with mean (range) insufflation pressures of 15 mm Hg (12-20 mm Hg). Patients were predominantly (68%) in a Trendelenburg position, between 30° and 45°. Venous bleeding was reported in 20 cases at the time of carbon dioxide embolus, with periprostatic veins documented as the most common site (40%). After carbon dioxide embolus, 84% of cases were completed after hemodynamic stabilization. Two patients required cardiopulmonary resuscitation because of cardiovascular collapse. There were no deaths. LIMITATIONS: This is a retrospective study surveying reported outcomes by surgeons and anesthetists. CONCLUSIONS: Surgeons undertaking transanal total mesorectal excision must be aware of the possibility of carbon dioxide embolus and its potential risk factors, including venous bleeding (wrong plane surgery), high insufflation pressures, and patient positioning. Prompt recognition and management can limit the clinical impact of such events. See Video Abstract at http://links. lww.com/DCR/A961.

AB - BACKGROUND: Carbon dioxide embolus has been reported as a rare but clinically important risk associated with transanal total mesorectal excision surgery. To date, there exists limited data describing the incidence, risk factors, and management of carbon dioxide embolus in transanal total mesorectal excision. OBJECTIVE: This study aimed to obtain data from the transanal total mesorectal excision registries to identify trends and potential risk factors for carbon dioxide embolus specific to this surgical technique. DESIGN: Contributors to both the LOREC and OSTRiCh transanal total mesorectal excision registries were invited to report their incidence of carbon dioxide embolus. Case report forms were collected detailing the patient-specific and technical factors of each event. SETTINGS: The study was conducted at the collaborating centers from the international transanal total mesorectal excision registries. MAIN OUTCOME MEASURES: Characteristics and outcomes of patients with carbon dioxide embolus associated with transanal mesorectal excision were measured. RESULTS: Twenty-five cases were reported. The incidence of carbon dioxide embolus during transanal total mesorectal excision is estimated to be ≈0.4% (25/6375 cases). A fall in end tidal carbon dioxide was noted as the initial feature in 22 cases, with 13 (52%) developing signs of hemodynamic compromise. All of the events occurred in the transanal component of dissection, with mean (range) insufflation pressures of 15 mm Hg (12-20 mm Hg). Patients were predominantly (68%) in a Trendelenburg position, between 30° and 45°. Venous bleeding was reported in 20 cases at the time of carbon dioxide embolus, with periprostatic veins documented as the most common site (40%). After carbon dioxide embolus, 84% of cases were completed after hemodynamic stabilization. Two patients required cardiopulmonary resuscitation because of cardiovascular collapse. There were no deaths. LIMITATIONS: This is a retrospective study surveying reported outcomes by surgeons and anesthetists. CONCLUSIONS: Surgeons undertaking transanal total mesorectal excision must be aware of the possibility of carbon dioxide embolus and its potential risk factors, including venous bleeding (wrong plane surgery), high insufflation pressures, and patient positioning. Prompt recognition and management can limit the clinical impact of such events. See Video Abstract at http://links. lww.com/DCR/A961.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Carbon Dioxide

KW - Carbon dioxide embolus

KW - Embolism, Air

KW - Female

KW - Hemorrhage

KW - Humans

KW - Insufflation

KW - Internationality

KW - Intraoperative Complications

KW - Male

KW - Middle Aged

KW - Patient Positioning

KW - Postoperative Care

KW - Rectal surgery

KW - Rectum

KW - Registries

KW - Registry report

KW - Retrospective Studies

KW - Risk Factors

KW - Transanal

KW - Transanal Endoscopic Surgery

KW - Transanal total mesorectal excision

KW - Veins

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Carbon Dioxide

KW - Carbon dioxide embolus

KW - Embolism, Air

KW - Female

KW - Hemorrhage

KW - Humans

KW - Insufflation

KW - Internationality

KW - Intraoperative Complications

KW - Male

KW - Middle Aged

KW - Patient Positioning

KW - Postoperative Care

KW - Rectal surgery

KW - Rectum

KW - Registries

KW - Registry report

KW - Retrospective Studies

KW - Risk Factors

KW - Transanal

KW - Transanal Endoscopic Surgery

KW - Transanal total mesorectal excision

KW - Veins

UR - http://hdl.handle.net/10807/170593

U2 - 10.1097/DCR.0000000000001410

DO - 10.1097/DCR.0000000000001410

M3 - Article

SN - 0012-3706

VL - 62

SP - 794

EP - 801

JO - DISEASES OF THE COLON & RECTUM

JF - DISEASES OF THE COLON & RECTUM

ER -

Carbon dioxide embolism associated with transanal total mesorectal excision surgery: A report from the international registries

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