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https://www.readbyqxmd.com/read/29237218/-cylindric-abdominoperineal-rectum-exstirpation-with-partial-vulvar-and-vaginal-resection-as-well-as-perineal-and-vaginal-defect-reconstruction-by-a-vertical-rectus-abdominis-myocutaneous-vram-flap
#1
Christian Krautz, Klaus Weber, Roland Croner, Axel Denz, Matthias Maak, Raymund E Horch, Robert Grützmann
Introduction Patients with low rectal cancer or anal cancer undergoing abdominoperineal excision (APE) benefit from extended surgery and the subsequent avoidance of surgical "waisting" at the level of the puborectalis muscle. The method of cylindrical APE was introduced by T. Holm and led to a reduction of intraoperative perforations and involvement of circumferential resection margins, and subsequently reduced the risk of local recurrence. The use of myocutaneous flaps reduces perineal wound complications, which occur in up to 60% of patients with primary closure of perineal defects, especially following neoadjuvant radiochemotherapy...
December 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29229359/pelvic-exenteration-with-rectal-resection-for-different-types-of-malignancies-at-two-tertiary-referral-centres
#2
Alvaro Garcia-Granero, Sebastiano Biondo, Eloy Espin-Basany, Ana González-Castillo, Silvia Valverde, Loris Trenti, Antonio Gil-Moreno, Esther Kreisler
INTRODUCTION: Pelvic exenteration (PE) offers the best chance of cure for locally advanced primary or recurrent pelvic organ malignancies invading adjacent organs. The aims of this study were to analyse results for any pelvic exenteration that includes rectal resection and the analysis of results of fecal and urinary reconstruction. METHOD: From January 2000 to April 2014, 111 PE with rectal resection for any pelvic cancer were analysed retrospectively at two national tertiary referral centers...
December 8, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29224706/prophylactic-placement-of-permanent-synthetic-mesh-at-the-time-of-ostomy-closure-prevents-formation-of-incisional-hernias
#3
Jeremy A Warren, Lucas R Beffa, Alfredo M Carbonell, Jennifer Cull, Brent Sinopoli, Joseph A Ewing, Cedrek McFadden, Jay Crockett, William S Cobb
BACKGROUND: Reversal of an enterostomy results in a high rate of incisional hernia at the ostomy site. Prophylactic mesh reinforcement of the fascial defect is typically not considered due to the contaminated nature of the case. We present the outcomes of a series of prophylactic mesh reinforcements with retromuscular, large-pore polypropylene at the time of enterostomy reversal. METHODS: Retrospective review of all ostomy reversals was performed. All cases with placement of synthetic mesh reinforcement were identified from a prospectively maintained, hernia database...
December 7, 2017: Surgery
https://www.readbyqxmd.com/read/29219924/combined-laparoscopic-and-perineal-approach-to-omental-interposition-repair-of-complex-rectovaginal-fistula
#4
Hester de Bruijn, Yasuko Maeda, Jamie Murphy, Janindra Warusavitarne, Carolynne J Vaizey
INTRODUCTION: Surgical repair of rectovaginal fistula remains a challenge. Complex and recurrent rectovaginal fistula repairs often fail because of scarring and devascularization of the surrounding tissue. Omental interposition may promote healing by introducing bulky vascularized tissue into the rectovaginal septum. TECHNIQUE: With the patient in the lithotomy position, the rectovaginal septum was dissected transperineally up to the fistula tract and the openings on both vaginal and rectal sides were closed using interrupted, absorbable sutures...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29204724/reversal-of-hartmann-s-procedure-still-a-complicated-operation
#5
REVIEW
N Horesh, Y Rudnicki, Y Dreznik, A P Zbar, M Gutman, O Zmora, D Rosin
Hartmann's procedure, colonic resection with an end colostomy and rectal closure, is used in a variety of surgical emergencies. It is a common surgical procedure that is often practiced in patients with colonic obstruction and colonic perforation, resolving the acute clinical situation in the majority of cases. Reversal of Hartmann's procedure with restoration of bowel continuity occurs in a significantly low percentage of patients. There are several reasons contributing to the fact that many patients remain with a permanent colostomy following Hartmann's procedure...
December 4, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/29203977/radical-treatment-of-rectal-cancer-in-elderly-is-feasible-than-feared-results-from-a-tertiary-care-centre
#6
Madhu Muralee, Rajesh Singh, Arun Peter Mathew, Kurian Cherian, K Chandramohan, Paul Augustine, S Roshni, Iqbal Ahamed
The thought of subjecting an elderly patient with rectal cancer to protocol-based neoadjuvant chemoradiation (NACTRT), surgery and adjuvant chemotherapy is sought with fear due to their multiple comorbidities and impaired functional status associated with the process of ageing. Hence, many a times the treatment is compromised and it is a fact that this subgroup of patients is underrepresented in most of the clinical trials. This study was aimed at analysing the perioperative and oncologic outcomes after protocol-based treatment of rectal cancer in the elderly patients, defined here as those with age ≥70 years...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29189646/the-impact-of-early-involvement-in-a-postdischarge-support-program-for-ostomy-surgery-patients-on-preventable-healthcare-utilization
#7
Sirikan Rojanasarot
PURPOSE: To evaluate the impact of a postdischarge ostomy support program as an adjunct to nurse-led ostomy care on preventable healthcare utilization. DESIGN: A cross-sectional study. SUBJECTS AND SETTING: A postdischarge support program offered by an ostomy product's manufacturer provides persons living with an ostomy with patient-centered and easily accessible assistance. Individuals who underwent ostomy surgery within 18 months prior to the survey date were selected from an ostomy patient database maintained by the ostomy patient support program provider...
November 20, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/29184868/long-term-recurrence-free-survival-of-a-patient-with-advanced-pure-primary-ovarian-squamous-cell-carcinoma-treated-with-dose-dense-paclitaxel-combined-with-carboplatin
#8
Hiroyuki Yazawa, Tsuyoshi Hiraiwa, Fumihiro Ito, Keiya Fujimori
We describe an extremely rare case of advanced pure primary ovarian squamous cell carcinoma (SCC), treated by adjuvant chemotherapy with dose-dense paclitaxel combined with carboplatin (dd-TC) plus the combination chemotherapy with irinotecan and cisplatin (CPT-P), with long-term recurrence-free survival. A 71-year-old woman complaining of lower abdominal pain was referred to our hospital and a 7-cm-diameter solid tumor was identified. She was diagnosed with a left ovarian tumor that was highly suspicious for malignancy based on ultrasonography, magnetic resonance imaging, and contrast-enhanced computed tomography...
November 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29184472/intersphincteric-resection-pushing-the-envelope-for-sphincter-preservation
#9
REVIEW
Quentin Denost, Eric Rullier
During the last 15 years, a significant evolution has emerged in the surgical treatment of rectal cancer and restoration of bowel continuity has been one of the main goals. For many years the treatment of distal rectal cancer would necessarily require an abdominoperineal resection and end colostomy. The surgical procedure of intersphincteric resection has been proposed to offer sphincter preservation in patients with low rectal cancer and has been legitimized if executed according to adequate oncologic criteria...
November 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29182902/a-clinical-case-of-perineal-invasion-from-rectal-carcinoma
#10
A Mitrushi, S Bilali, V Bilali, F Mitrushi, E Mehmeti
We report a case of 62-year old women with skin infiltration in the perineal area after anterior rectal resection due to upper rectal cancer. Computed Tomography (CT) shows an intense infiltrative aspect of the lesion. The patient had a diffuse perineal infiltration predominantly at Levator Ani muscles and adhesions to the posterior parts of urinary bladder, uterus, vagina and perineal skin. The patient underwent surgery with colostomy to relieve the colonic tract due to obstruction and later was treated with chemo-radiation...
July 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29180180/primary-repair-for-pediatric-colonic-injury-are-there-differences-among-adult-and-pediatric-trauma-centers
#11
Muhammad Khan, Faisal Jehan, Terence O'Keeffe, Viraj Pandit, Narong Kulvatunyou, Andrew Tang, Lynn Gries, Bellal Joseph
BACKGROUND: Management of colonic injuries (colostomy [CO] versus primary anastomosis [PA]) among pediatric patients remains controversial. The aim of this study was to assess outcomes in pediatric trauma patient with colonic injury undergoing operative intervention. METHODS: The National Trauma Data Bank (2011-2012) was queried including patients with isolated colonic injury undergoing exploratory laparotomy with PA or CO with age ≤18 y. Missing value analysis was performed...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29167976/temporary-closure-of-colostomy-with-suture-before-colostomy-takedown-improves-the-postoperative-outcomes
#12
Wan-Hsiang Hu, Ko-Chao Lee, Kai-Lung Tsai, Hong-Hwa Chen
PURPOSE: Temporary loop colostomy is a common surgical procedure used to avoid complications in high-risk distal anastomosis as well as pelvic inflammation. Issues regarding postoperative outcomes of colostomy takedown have been widely discussed in the literature, wound infection especially. Temporary closure of colostomy with suture before takedown was adopted in our study, which provided excellent traction to aid mobilization of stomy and avoided stool spillage to downgrade the wound classification to "clean contamination...
November 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29164476/diverticular-colitis-with-progression-to-ulcerative-colitis-after-sigmoidectomy
#13
Atsuyo Ikeda, Tsunekazu Mizushima, Yutaro Egashira, Hidekazu Takahashi, Norikatsu Miyoshi, Naotsugu Haraguchi, Taishi Hata, Chu Matsuda, Yuichiro Doki, Masaki Mori
Diverticular colitis is chronic inflammation of the colon where diverticula are present. The endoscopic and histopathological findings of this disease are sometimes similar to those of ulcerative colitis, and several reports describe cases of diverticular colitis that progressed to typical ulcerative colitis. A 77-year-old woman with intramesenteric penetration of the sigmoid diverticulum underwent low anterior resection. One month later, the patient experienced anastomotic leakage, and transverse colostomy was performed...
November 21, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29154517/a-proposal-for-a-tailored-approach-to-diverting-ostomy-for-colorectal-anastomosis
#14
Lisa Manzenreiter, Georg Spaun, Michael Weitzendorfer, Rosalia Luketina, Stavros A Antoniou, Helwig Wundsam, Oliver O Koch, Klaus Emmanuel
BACKGROUND: The use of a protective stoma represents an important issue in colorectal surgery. Although evidence suggests that loop ileostomy may be superior, the optimal method for temporary decompression of colorectal anastomosis still remains controversial. Aim of this study was to make an evidence-based proposal for a tailored approach to the use of diverting colostomy or ileostomy. METHODS: A retrospective analysis of all patients subjected to creation and closure of a diverting loop colostomy or loop ileostomy between May 2007 and November 2014 in our institution was performed...
November 20, 2017: Minerva Chirurgica
https://www.readbyqxmd.com/read/29143213/colorectal-surgery-fellowship-improves-in-hospital-mortality-after-colectomy-and-proctectomy-irrespective-of-hospital-and-surgeon-volume
#15
Julia T Saraidaridis, Daniel A Hashimoto, David C Chang, Liliana G Bordeianou, Hiroko Kunitake
BACKGROUND: General surgery residents are increasingly pursuing sub-specialty training in colorectal (CR) surgery. However, the majority of operations performed by CR surgeons are also performed by general surgeons. This study aimed to assess in-hospital mortality stratified by CR training status after adjusting for surgeon and hospital volume. METHODS: The Statewide Planning and Research Cooperative system database was used to identify all patients who underwent colectomy/proctectomy from January 1, 2000, to December 31, 2014, in the state of New York...
November 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29142183/worse-preoperative-status-based-on-inflammation-and-host-immunity-is-a-risk-factor-for-surgical-site-infections-in-colorectal-cancer-surgery
#16
Masano Sagawa, Kazuhiko Yoshimatsu, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Takebumi Usui, Kentaro Yamaguchi, Shunichi Shiozawa, Takeshi Shimakawa, Takao Katsube, Hiroyuki Kato, Yoshihiko Naritaka
OBJECTIVE: The modified Glasgow Prognostic Score (mGPS) is an inflammation-based measure of malnutrition that reflects a state of cachexia in cancer patients. We evaluated mGPS as an index to predict surgical site infection (SSI) incidence in patients undergoing colorectal cancer surgery. SUBJECTS AND METHODS: We retrospectively analyzed 351 patients who underwent colon cancer resection. Factors correlated with the incidence of SSIs were identified by logistic analysis and stepwise selection...
2017: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/29138603/fatal-collapse-due-to-autonomic-dysreflexia-during-manual-self-evacuation-of-bowel-in-a-tetraplegic-patient-living-alone-lessons-to-learn
#17
Subramanian Vaidyanathan, Bakul M Soni, Paul Mansour, Tun Oo
Background: To identify areas for improvement, the National Health Service in England mandates the review of case reports of patients who have died, which should be translated into improved care for other patients. Case report: A 49-year-old Caucasian man sustained C-7 tetraplegia in a motorcycle accident in 1992. In 2009, he developed seizures and collapsed in the lavatory on a number of occasions during manual self-evacuation of his bowel. A 24-hour electrocardiogram recording at that time showed sinus rhythm with a maximum heart rate of 97 and a minimum of 39 beats per minute; there were no significant arrhythmias that could have contributed to his episodes of collapse...
2017: International Medical Case Reports Journal
https://www.readbyqxmd.com/read/29134456/european-hernia-society-guidelines-on-prevention-and-treatment-of-parastomal-hernias
#18
REVIEW
S A Antoniou, F Agresta, J M Garcia Alamino, D Berger, F Berrevoet, H-T Brandsma, K Bury, J Conze, D Cuccurullo, U A Dietz, R H Fortelny, C Frei-Lanter, B Hansson, F Helgstrand, A Hotouras, A Jänes, L F Kroese, J R Lambrecht, I Kyle-Leinhase, M López-Cano, L Maggiori, V Mandalà, M Miserez, A Montgomery, S Morales-Conde, M Prudhomme, T Rautio, N Smart, M Śmietański, M Szczepkowski, C Stabilini, F E Muysoms
BACKGROUND: International guidelines on the prevention and treatment of parastomal hernias are lacking. The European Hernia Society therefore implemented a Clinical Practice Guideline development project. METHODS: The guidelines development group consisted of general, hernia and colorectal surgeons, a biostatistician and a biologist, from 14 European countries. These guidelines conformed to the AGREE II standards and the GRADE methodology. The databases of MEDLINE, CINAHL, CENTRAL and the gray literature through OpenGrey were searched...
November 13, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29125526/bowel-management-and-continence-in-adults-with-spina-bifida-results-from-the-national-spina-bifida-patient-registry-2009-15
#19
John S Wiener, Kristina D Suson, Jonathan Castillo, Jonathan C Routh, Stacy Tanaka, Tiebin Liu, Elisabeth Ward, Judy Thibadeau, David Joseph, National Spina Bifida Patient Registry
INTRODUCTION: Advances in care have allowed most children with spina bifida (SB) to live to adulthood. The majority have neuropathic bowel dysfunction (NBD), resulting in constipation, incontinence, and diminished quality of life. We sought to 1) describe contemporary NBD management and continence outcomes of adults with SB; 2) describe differences from younger patients; and 3) assess for association with socio-economic factors. METHODS: We analyzed data on NBD management and continence from the National Spina Bifida Patient Registry (NSBPR)...
October 20, 2017: Journal of Pediatric Rehabilitation Medicine
https://www.readbyqxmd.com/read/29125521/variation-in-surgical-management-of-neurogenic-bowel-among-centers-participating-in-national-spina-bifida-patient-registry
#20
Jonathan C Routh, David B Joseph, Tiebin Liu, Michael S Schechter, Judy K Thibadeau, M Chad Wallis, Elisabeth A Ward, John S Wiener
PURPOSE: Optimal management of neurogenic bowel in patients with spina bifida (SB) remains controversial. Surgical interventions may be utilized to treat constipation and provide fecal continence, but their use may vary among SB treatment centers. METHODS: We queried the National Spina Bifida Patient Registry (NSBPR) to identify patients who underwent surgical interventions for neurogenic bowel. We abstracted demographic characteristics, SB type, functional level, concurrent bladder surgery, mobility, and NSBPR clinics to determine whether any of these factors were associated with interventions for management of neurogenic bowel...
October 20, 2017: Journal of Pediatric Rehabilitation Medicine
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