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https://www.readbyqxmd.com/read/27928668/alvimopan-in-the-setting-of-colorectal-resection-with-an-ostomy-to-use-or-not-to-use
#1
Yuxiang Wen, Murad A Jabir, Michael Keating, Alison R Althans, Justin T Brady, Bradley J Champagne, Conor P Delaney, Scott R Steele
BACKGROUND: Postoperative ileus (POI) is a major cause of morbidity, increased length of stay (LOS) and hospital cost after colorectal surgery. Alvimopan is a µ-opioid antagonist used to accelerate upper and lower gastrointestinal function after bowel resection. We hypothesized that alvimopan would reduce LOS in patients undergoing colorectal resection with stoma, a situation that has not been evaluated. METHODS: A retrospective review (2010-2015) identified 58 patients who underwent colorectal resection for benign or malignant disease with stoma creation and received alvimopan...
December 7, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27926564/systematic-review-and-meta-analysis-of-prophylactic-mesh-during-primary-stoma-formation-to-prevent-parastomal-hernia
#2
Stephen J Chapman, Benjamin Wood, Thomas M Drake, Neville Young, David G Jayne
BACKGROUND: Implantation of mesh at the time of stoma formation may reduce the rate of parastomal hernia. Until recently, the evidence has been limited to only a few small randomized controlled trials. OBJECTIVE: We present an updated systematic review and meta-analysis to assess the effect of mesh prophylaxis on rates of parastomal hernia. We examine ongoing and unpublished trials via online registries and propose recommendations for future research. DATA SOURCES: MEDLINE, EMBASE, and the Cochrane Library were searched up to March 2016 for published randomized controlled trials...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27917665/the-potential-effect-of-biological-sealants-on-colorectal-anastomosis-healing-in-experimental-research-involving-severe-diabetes
#3
K Stergios, K Kontzoglou, V Pergialiotis, L M Korou, M Frountzas, O Lalude, N Nikiteas, D N Perrea
Colorectal anastomoses continuous to pose a significant challenge in current surgical practice. Anastomotic leakage remains one of the most frequent and dramatic complications of colorectal surgery, even in centres of high specialisation. Diabetes is a well-established independent factor which results in higher anastomotic leakage rates. Fibrin sealants have been applied in experimental and clinical studies for the prevention of anastomotic dehiscence. However, little is known regarding their impact on diabetic patients...
December 5, 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/27916369/expression-of-connexin-26-and-connexin-43-is-reduced-in-hirschsprung-s-disease
#4
David Coyle, Brian Doyle, Justin M Murphy, Anne Marie O'Donnell, John Gillick, Prem Puri
BACKGROUND: Despite having an optimal pull-through operation, some children with Hirschsprung's disease (HSCR) continue to experience persistent bowel symptoms. Coordinated colonic electrical activity depends on intercellular communication between the enteric nerves, interstitial cells of Cajal (ICCs), smooth muscle cells, and fibroblast-like (platelet-derived growth factor receptor-alpha-positive) cells. Gap junctions are low-resistance channels composed of connexin (Cx) proteins which couple cells electrically and chemically...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916359/long-term-follow-up-of-fournier-s-gangrene-in-a-tertiary-care-center
#5
David R Rosen, Mitchell E Brown, Kyle G Cologne, Glenn T Ault, Aaron M Strumwasser
BACKGROUND: After surgical debridement, the use of fecal diversion systems (such as an endo-rectal tube or surgical colostomy) in Fournier's Gangrene (FG) to assist with wound healing remains controversial. METHODS: A 6-y retrospective review of a tertiary medical center emergency surgery database was conducted. Variables abstracted from the database include patient demographics, laboratory and physiological profiles, hospital length-of-stay, intensive care unit length-of-stay, operative data, time to healing, morbidity, and mortality...
November 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27916080/-clinical-effect-of-preservation-of-the-left-colonic-artery-in-laparoscopic-anterior-resection-for-rectal-cancer
#6
J W Niu, W Ning, W Y Wang, D P Pei, F Q Meng, Z Z Liu, D G Cai
Objective: To evaluate the value and feasibility of preservation of the left colonic artery (LCA) in laparoscopic anterior resection for rectal cancer. Methods: The clinical data of 97 patiens who received laparoscopic anterior resection of rectal cancer from 2009.3 to 2015.3 were randomly divided into two groups, including 52 cases with preservation of LCA and 45 cases without preservation of LCA. The operation time, quantity of bleeding, number of lymph nodes removed around the root of inferior mesenteric artery (IMA), the rate of lymph node metastasis around the root of IMA, the incidence of transverse colostomy and anastomotic leak were compared between the two groups...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27911064/-intestinal-stomas-are-they-as-simple-as-they-seem
#7
P Bragagnini Rodríguez, Y González Ruiz, R Fernández Atuán, N González Martínez-Pardo, P Burgués Prado, J Elías Pollina
OBJECTIVES: To examine the morbidity and mortality of the formation and closure of enterostomies. METHODS: Retrospective study between 2000-2014 of patients younger than 14 years old who underwent an enterostomy. We evaluated: surgical technique, underlying pathology, general and stoma complications, sex, age and weight at the time of formation. At the closure we evaluated: surgical technique, age, weight, hemoglobin, hematocrit and albumin, as well as complications...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27894765/outcome-in-adults-with-anorectal-malformations-in-relation-to-modern-classification-which-patients-do-we-need-to-follow-beyond-childhood
#8
Johan Danielson, Urban Karlbom, Wilhelm Graf, Tomas Wester
BACKGROUND/PURPOSE: Knowledge about the functional outcome in adults with anorectal malformations is essential to organize structured transition to adult care for this patient group. The aim of this study was to investigate the functional outcome and quality of life in adults with anorectal malformations characterized according to the Krickenbeck classification. METHODS: Of 256 patients diagnosed with anorectal malformations at our institution in 1961-1993, 203 patients could be traced and were invited to participate in the study...
November 15, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27891285/complex-perineal-trauma-with-anorectal-avulsion
#9
Adelina Maria Cruceru, Ionut Negoi, Sorin Paun, Sorin Hostiuc, Ruxandra Irina Negoi, Mircea Beuran
Introduction. The objective of this case report is to illustrate a severe perineal impalement injury, associated with anorectal avulsion and hemorrhagic shock. Results. A 32-year-old male patient was referred to our hospital for an impalement perineal trauma, associated with complex pelvic fracture and massive perineal soft tissue destruction and anorectal avulsion. On arrival, the systolic blood pressure was 85 mm Hg and the hemoglobin was 7.1 g/dL. The patient was transported to the operating room, and perineal lavage, hemostasis, and repacking were performed...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/27888440/primary-and-repeated-perineal-stapled-prolapse-resection
#10
D Raahave, A K Jensen, L Dammegaard, I K Pedersen
BACKGROUND: Previous studies of the outcome after perineal stapled prolapse resection (PSPR) have included a limited number of patients with a short follow-up and high recurrence rates. The present study was designed to assess the initial results, complications, recurrence rate, and outcomes up to 4 years after PSPR, as well as the need for a repeated procedure. METHODS: Fifty-four consecutive patients with rectal prolapse (mean age 77.2 years, range 46-93 years; n = 3 men) were selected for PSPR between May 2009 and February 2015...
November 25, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27887014/intra-abdominal-myositis-ossificans-in-an-asymptomatic-patient-during-closure-of-a-hartmann-s-colostomy
#11
Georgios Sahsamanis, Panagiotis Triantafylakis, Konstantinos Gkouzis, Konstantinos Katis, Georgios Dimitrakopoulos
Intra-abdominal myositis ossificans, also known as heterotopic mesenteric ossification, defines the formation of bone-like lesions inside the abdominal cavity. It is a rare medical condition, usually following abdominal surgery or trauma. A 55-year-old male presented for closure of a Hartmann's colostomy, created 6 months ago because of sigmoid adenocarcinoma. Intraoperative findings consisted of an elongated bone-like lesion attached on the peritoneum and protruding inside the abdominal cavity, while two more stiff calcified nodules were found in the mesocolon...
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27885481/post-operative-recurrence-of-crohn-s-disease-after-definitive-stoma-an-underestimated-risk
#12
Dine Koriche, Corinne Gower-Rousseau, Charbel Chater, Alain Duhamel, Julia Salleron, Noémie Tavernier, Jean-Frédéric Colombel, Benjamin Pariente, Antoine Cortot, Philippe Zerbib
INTRODUCTION: Crohn's disease (CD) is a progressive inflammatory disease affecting the entire gastrointestinal tract. The need for a definitive stoma (DS) is considered as the ultimate phase of damage. It is often believed that the risk of further disease progression is small when a DS has been performed. AIMS: The goals of the study were to establish the rate of CD recurrence above the DS and to identify predictive factors of CD recurrence at the time of DS. METHODS: We retrospectively reviewed all medical records of consecutive CD patients having undergone DS between 1973 and 2010...
November 24, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27883253/the-colostomy-impact-score-development-and-validation-of-a-patient-reported-outcome-measure-for-rectal-cancer-patients-with-a-permanent-colostomy-a-population-based-study
#13
Anne Thyø, Katrine J Emmertsen, Thomas D Pinkney, Peter Christensen, Søren Laurberg
AIM: The aim was to develop and validate a simple scoring system evaluating the impact of colostomy dysfunction on quality of life (QOL) in patients with a permanent stoma after rectal cancer treatment. METHOD: In this population-based study, 610 patients with a permanent colostomy after previous rectal cancer treatment during the period 2001-2007 completed two questionnaires: i) the 'Basic Stoma Questionnaire' consisting of 22 items about stoma-function with one anchor-question addressing the overall stoma-impact on QOL, and ii) the EORTC-QLQ-C30-questionnaire...
November 24, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27863343/acrometastasis-following-colorectal-cancer-a-case-report-and-review-of-literature
#14
Kozar Agha, Khalid Akbari, Syed Husain Abbas, Simon Middleton, Daniel McGrath
INTRODUCTION: Colorectal cancer commonly metastasises to the liver, peritoneum and lungs. Bony metastases are uncommon in colorectal cancer and in particular metastases to the hands or feet (acrometastasis) are an extremely rare occurrence. CASE PRESENTATION: A 65-year-old male with a colonic malignancy underwent elective anterior resection. Intra-operatively he was found to have a pelvic collection necessitating an end colostomy. Histology confirmed complete Dukes B tumour excision with no evidence of lymph node metastases...
November 10, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27858861/laparoscopic-assisted-low-anterior-resection-for-advanced-rectal-cancer-in-a-kidney-transplant-recipient-a-case-report
#15
Zenan Xia, Weijie Chen, Ru Yao, Guole Lin, Huizhong Qiu
INTRODUCTION: Development of de novo malignancy has become a major cause of late mortality in solid organ transplant recipients. Surgery is currently the most important treatment of choice for transplant patients with resectable CRC. However, conventional open surgery represents a great risk to these high-risk patients. They seem to benefit more from laparoscopic surgery, based on the favorable oncological outcome and remarkable short-term advantages of this approach. PATIENT CONCERNS: In this study, we have reported a case of a 50-year-old man who had underwent kidney transplantation for 4 years...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27857647/nutrition-chez-le-br%C3%A3-l%C3%A3
#16
G Perro
Nutrition is a challenge for burn patients. Emphasized points are early enteral amounts by means of a naso-gastric tube, semi-recumbent position > 30°, gastro-intestinal survey improved by kinetics, weight evolution, nutritional amounts assessment to prevent proteino-energetic deficiency. Feeding is difficult with children, as with seniors often associating a preexisting starvation. Nutritional supplements are useful in medium severity patients. For overweight patients, hypo caloric and hyperprotidic diet is the better choice...
March 31, 2016: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/27849331/-fournier-s-gangrene-after-anorectal-surgery-in-infant-two-case-reports
#17
Murat Sütçü, Güntulu Duran Şık, Feryal Gün, Ayper Somer, Nuran Salman
Necrotizing fasciitis is a life-threatening soft tissue infection characterized by progressive necrosis of the skin, subcutaneous tissues and fascia. Fournier's gangrene (FG) is a serious and aggressive form of infective necrotizing fasciitis involving perineal region and genitalia. Presently described are 2 pediatric cases of FG with widespread necrosis of surrounding tissue following anorectal surgery, causing severe septic shock. Case 1: Six-month-old female patient with anal stenosis and duplication presented at emergency clinic with fever, somnolence, irritability, and feeding difficulty...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27843749/mortality-markers-in-nosocomial-klebsiella-pneumoniae-bloodstream-infection
#18
Bulent Durdu, Ismail Necati Hakyemez, Sibel Bolukcu, Gulay Okay, Bilge Gultepe, Turan Aslan
PURPOSE: Klebsiella pneumoniae is the most common endogen agent for nosocomial infections. In this study, mortality markers were investigated in patients with nosocomial K. pneumoniae blood stream infection (NKp BSI). METHODS: The characteristics of patients >16 years who had NKp BSI diagnosis by daily active surveillance between January 2012 and January 2016 were retrospectively evaluated. Patients who died until 28th day of the clinical follow up and those who survived until this time were statistically compared in terms of various risk factors...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27836361/ultrasound-guided-intrasphincteric-botulinum-toxin-injection-relieves-obstructive-defecation-due-to-hirschsprung-s-disease-and-internal-anal-sphincter-achalasia
#19
Joseph T Church, Samir K Gadepalli, Toghrul Talishinsky, Daniel H Teitelbaum, Marcus D Jarboe
PURPOSE: Chronic obstructive defecation can occur in patients with Hirschsprung Disease (HD) and internal anal sphincter (IAS) achalasia. Injection of Botulinum Toxin (BoTox) into the IAS can temporarily relieve obstructive defecation, but can be challenging when performed by tactile sense alone. We compared results of BoTox injections with and without ultrasound (US) guidance. METHODS: We retrospectively reviewed BoTox injections into the IAS for obstructive defecation over 5years...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27828857/protection-of-low-rectal-anastomosis-with-a-new-tube-ileostomy-using-a-biofragmentable-anastomosis-ring-a-retrospective-study
#20
Liming Liu, Qi Huang, Jialiang Wang, Quanning Chen, Rui Lin, Bujun Ge
A temporarily defunctioning stoma, while effective at reducing symptomatic anastomotic leakage after low anterior resection (LAR) of rectal cancer, and its subsequent closure, is associated with significant morbidity. Here, we devised a new tube ileostomy using a biofragmentable anastomosis ring (TIB) with no need for reversal.This is a retrospective cohort study. From June 2011 to March 2015, TIBs were performed on 31 consecutive patients with mid- or low-rectal cancer who underwent elective laparoscopic LARs...
November 2016: Medicine (Baltimore)
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