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https://www.readbyqxmd.com/read/28315811/variant-two-stage-ileal-pouch-anal-anastomosis-an-innovative-and-effective-alternative-to-standard-resection-in-ulcerative-colitis
#1
Jennifer Samples, Krista Evans, Nicole Chaumont, Paula Strassle, Timothy Sadiq, Mark Koruda
BACKGROUND: Ulcerative colitis patients have been historically treated with standard single, two and three stage operative approaches. We perform a variant two-stage procedure beginning with total abdominal colectomy and end ileostomy followed by completion proctectomy and ileal pouch-anal anastomosis without a diverting loop ileostomy. The present study evaluates the effectiveness of this innovative alternative. STUDY DESIGN: Patients with ulcerative colitis admitted to UNC Hospital between 2003 and 2010 for IPAA were eligible for inclusion...
January 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28299472/is-an-ostomy-rod-useful-for-bridging-the-retraction-during-the-creation-of-a-loop-ileostomy-a-randomized-control-trial
#2
Motoi Uchino, Hiroki Ikeuchi, Toshihiro Bando, Teruhiro Chohno, Hirofumi Sasaki, Yuki Horio
BACKGROUND: A loop ileostomy is generally created during restorative proctocolectomy (RPC) for treating ulcerative colitis (UC), and an ostomy rod is often used to prevent stoma retraction. However, its usefulness or harmfulness has not been proven. We performed a prospective randomized control study to investigate the non-inferiority of ostomy creation without a rod to prevent stoma retraction. METHODS: Patients with UC who underwent RPC were enrolled and randomly divided into groups either with or without ostomy rod use...
March 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28295952/long-term-outcomes-of-living-related-small-intestinal-transplantation-in-children-a-single-center-experience
#3
Sandra Garcia Aroz, Ivo Tzvetanov, Elizabeth Anne Hetterman, Hoonbae Jeon, Jose Oberholzer, Giuliano Testa, Eunice John, Enrico Benedetti
Pediatric patients with irreversible intestinal failure present a significant challenge to meet the nutritional needs that promote growth. From 2002 to 2013, 13 living-related small intestinal transplantations were performed in 10 children, with a median age of 18 months. Grafts included isolated living-related intestinal transplantation (n=7), and living-related liver and small intestine (n=6). The immunosuppression protocol consisted of induction with thymoglobulin and maintenance therapy with tacrolimus and steroids...
March 12, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28283734/intestinal-perforation-due-to-hemorrhagic-cytomegalovirus-enteritis-in-a-patient-with-severe-uncontrolled-lupus-nephritis-a-case-and-review-of-the-literature
#4
REVIEW
Keigo Ikeda, Shihoko Nakajima, Kana Tanji, Takuya Hirai, Kaori Uomori, Shinji Morimoto, Shigeki Tomita, Masaki Fukunaga, Naoto Tamura, Iwao Sekigawa
A 31-year-old woman with systemic lupus erythematosus and lupus nephritis was treated with prednisone and immunosuppressants. After her lupus nephritis symptoms worsened, both high-dose steroid and cyclophosphamide pulse therapy were administered. The patient developed an intestinal perforation, and laparoscopic Hartmann's surgery was performed on the sigmoid colon. Serum Cytomegalovirus (CMV) antigen C7HRP was detected, and the patient was diagnosed with CMV colitis and underwent a colon resection. Severe hematochezia continued despite ganciclovir administration, and the patient underwent laparoscopic total colectomy and partial ileostomy...
March 11, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28281233/common-channel-length-in-bypass-surgery-does-not-impact-t2dm-in-diabetic-zucker-rats
#5
Claudia Laessle, Sven Michelmichel, Goran Marjanovic, Simon Kuesters, Gabriel Seifert, Ulrich T Hopt, Jodok Matthias Fink
INTRODUCTION: Metabolic surgery is known to impact glucose tolerance but the exact mechanism is still unclear. Based on recently-published data, especially the role of the hindgut may require redefinition. METHODS: Either a loop duodeno-jejunostomy (DJOS) with exclusion of one third of total intestinal length, a loop duodeno-ileostomy (DiOS, exclusion of two thirds), or SHAM operation was performed in 9-week-old Zucker diabetic fatty rats. One, 3, and 6 months after surgery, an oral glucose tolerance test (OGTT) and glucose-stimulated hormone analyses were conducted...
March 9, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28280983/the-influence-of-specific-technical-maneuvers-utilized-in-the-creation-of-diverting-loop-ileostomies-on-stoma-related-morbidity
#6
Masaaki Miyo, Ichiro Takemasa, Masataka Ikeda, Masaki Tujie, Junichi Hasegawa, Masayuki Ohue, Takeshi Kato, Tsunekazu Mizushima, Yuichiro Doki, Masaki Mori
PURPOSE: The association between technical maneuvers in fashioning a diverting loop-ileostomy and stoma-related complications remains unclear. Thus, this study aimed to evaluate their relevance to stoma-related morbidity. METHODS: This retrospective multicenter study was designed to collect data from 37 institutions. We evaluated the perioperative outcomes of consecutive patients who underwent surgery to create a diverting loop-ileostomy in 2013. RESULTS: A total of 4137 patients with colorectal disease underwent colorectomy, 279 of whom received an ileostomy...
March 9, 2017: Surgery Today
https://www.readbyqxmd.com/read/28267992/clostridium-difficile-disease-diagnosis-pathogenesis-and-treatment-update
#7
REVIEW
Lena M Napolitano, Charles E Edmiston
Clostridium difficile infections are the leading cause of health care-associated infectious diarrhea, posing a significant risk for both medical and surgical patients. Because of the significant morbidity and mortality associated with C difficile infections, knowledge of the epidemiology of C difficile in combination with a high index of suspicion and susceptible patient populations (including surgical, postcolectomy, and inflammatory bowel disease patients) is warranted. C difficile infections present with a wide spectrum of disease, ranging from mild diarrhea to fulminant colitis or small bowel enteritis and recurrent C difficile infections...
March 3, 2017: Surgery
https://www.readbyqxmd.com/read/28252348/an-unusual-haemorrhagic-complication-of-an-anastomotic-leak-and-a-novel-method-of-controlling-the-haemorrhage
#8
S Martin, A Armstrong
Introduction Restorative proctocolectomy (RP) is undertaken for patients with familial adenomatous polyposis (FAP) and ulcerative colitis, but is associated with a risk of anastomotic leak. Case history A 20-year-old male with a family history of FAP had a RP with a double-stapled J-pouch and covering loop ileostomy. At ileostomy reversal 21 months later, he presented with significant anal bleeding. He proceeded to theatre for endoscopy. Pouchoscopy showed a pouch full of blood and a foreign object trapped in a diverticulum...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28247831/-ileostomy-versus-colostomy-which-is-preferable
#9
F J Amelung, C P D Van 't Hullenaar, P M Verheijen, E C J Consten
OBJECTIVE: To investigate whether an ileostomy or colostomy should be preferred in patients requiring temporary double-barrel stoma construction and in whom it is technically possible to construct both types. DESIGN: Systematic literature search and retrospective comparative analysis. METHOD: PubMed, Embase and the Cochrane Library were searched for all literature comparing loop ileostomy and loop colostomy. In addition, we retrospectively analysed 361 patients who had received a loop ileostomy or loop colostomy designed to be temporary between 2009 and 2015 in our hospital, Meander Medisch Centrum, Amersfoort, the Netherlands...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28209955/-the-complications-of-intestinal-stoma-in-children
#10
S V Minaev, N I Bykov, A V Isaeva, A V Kachanov, E A Tovkan, N V Filip'yeva, I N Gerasimenko
AIM: To investigate the complications of intestinal stoma in children and to develop measures for decrease of their incidence. MATERIAL AND METHODS: The study included 152 children with congenital and acquired gastrointestinal pathology requiring surgical treatment with the imposition of intestinal stoma. Atresia of intestinal tube was observed in 28 (18.4%) children, meconium ileus - in 10 (6.6%) cases, Hirschsprung's disease - in 11 (7.2%)cases, anorectal malformations - in 39 (25...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28203133/simultaneously-diagnosed-and-successfully-treated-rectovaginal-and-vesicovaginal-fistulae-after-low-anterior-resection-with-concomitant-resection-of-female-genitalia
#11
Chisato Takagi, Hideo Baba, Kazuo Yamafuji, Atsunori Asami, Kaoru Takeshima, Nobuhiko Okamoto, Hidena Takahashi, Kiyoshi Kubochi
Rectovaginal fistula (RVF) and vesicovaginal fistula (VVF) are infrequent but distressing complications after pelvic surgery. However, their adequate treatment is not well described. Here, we simultaneously encountered and successfully treated RVF and VVF after radical surgery for rectal cancer. A 70-year-old woman underwent low anterior resection (LAR) combined with resection of the uterus, the bilateral adnexa, and the upper side of the vagina, as well as diverted ileostomy for rectal cancer. A month after the surgery, she developed urinary incontinence and underwent medical treatment, but her symptoms did not improve...
January 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28192627/home-visits-as-part-of-a-new-care-pathway-iaid-to-improve-quality-of-care-and-quality-of-life-in-ostomy-patients-a-cluster-randomised-stepped-wedge-trial
#12
M F Sier, R J Oostenbroek, M G W Dijkgraaf, G J Veldink, W A Bemelman, A Pronk, E J Spillenaar-Bilgen, W Kelder, C Hoff, D T Ubbink
BACKGROUND: Morbidity in patients with an 'ostomy is high. A new care pathway, including perioperative home visits by enterostomal therapists, was studied to assess whether more elaborate education and closer guidance could reduce stoma-related complications and improve quality of life, at acceptable cost. METHODS: Patients requiring an ileostomy or colostomy, for any inflammatory or malignant bowel disease, were included in a 15-centre cluster-randomised 'stepped-wedge' study...
February 13, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28174187/duodenocolic-fistula-diagnosed-by-endoscopy-a-rare-complication-of-colon-cancer
#13
Aeden Bernice G Timbol, Vanessa Charlene O Co, Angela V Djajakusuma, Virgilio P Banez
Duodenocolic fistula (DCF) is a rare complication of colon cancer with only 70 cases reported since its first description in 1862. Owing to its rarity, current knowledge on DCF still relies on single case reports. We present 2 cases of DCF from a hepatic flexure adenocarcinoma demonstrated initially by endoscopy. 2 adult male patients were admitted due to a 2-3-month history of right-upper quadrant pain, vomiting, diarrhoea and a palpable right upper quadrant mass. In both cases, a circumferential, friable mass was noted on upper endoscopy at the second portion of the duodenum, leading to the ascending colon...
February 7, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28144745/intraoperative-colonoscopy-for-the-assessment-and-prevention-of-anastomotic-leakage-in-low-anterior-resection-for-rectal-cancer
#14
Seung Yoon Yang, Jeonghee Han, Yoon Dae Han, Min Soo Cho, Hyuk Hur, Kang Young Lee, Nam Kyu Kim, Byung Soh Min
PURPOSE: Anastomotic leakage (AL) after stapled anastomosis in rectal cancer surgery is a major concern. Various types of intraoperative anastomotic air leakage tests (ALTs) have been proposed to reduce AL. This study aimed to evaluate the impact of intraoperative colonoscopy (IOC) as an intraoperative ALT in low anterior resection for rectal cancer. METHODS: A total of 1266 patients were retrospectively reviewed. Among them, 215 patients who underwent IOC as an ALT in rectal cancer surgery were identified...
January 31, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28144122/cost-effectiveness-of-a-novel-attempt-to-reduce-readmission-after-ileostomy-creation
#15
Atif Iqbal, Ahsan Raza, Emina Huang, Lindsey Goldstein, Steven J Hughes, Sanda A Tan
BACKGROUND AND OBJECTIVES: Dehydration is a common complication after ileostomy creation and is the most frequent reason for postoperative readmission to the hospital. We sought to determine the clinical and economic impact of an outpatient intervention to decrease readmissions for dehydration after ileostomy creation. METHODS: All new ileostomates from 09/2011 through 10/2012 at the University of Florida were enrolled to receive an ileostomy education and management protocol and a daily telephone call for 3 weeks after discharge...
January 2017: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28139856/epidemiological-investigation-of-candida-species-causing-bloodstream-infection-in-paediatric-small-bowel-transplant-recipients
#16
Mallory J Suhr, João Carlos Gomes-Neto, Nabaraj Banjara, Diana F Florescu, David F Mercer, Peter C Iwen, Heather E Hallen-Adams
Small bowel transplantation (SBT) can be a life-saving medical procedure. However, these recipients experience high risk of bloodstream infections caused by Candida. This research aims to characterise the SBT recipient gut microbiota over time following transplantation and investigate the epidemiology of candidaemia in seven paediatric patients. Candida species from the recipients' ileum and bloodstream were identified by internal transcribed spacer sequence and distinguished to strain by multilocus sequence typing and randomly amplified polymorphic DNA...
January 31, 2017: Mycoses
https://www.readbyqxmd.com/read/28133356/-laparoscopic-resection-in-a-case-of-local-recurrence-of-rectal-cancer
#17
Kiminori Yanagisawa, Shinichi Yoshioka, Mutsumi Fukunaga, Shoko Honda, Ryohei Yukimoto, Shinji Tokuyama, Akina Saito, Kazuyuki Okada, Ken Konishi, Hideo Ota, Shigekazu Yokoyama, Hirofumi Miki, Kenji Kobayashi
A 65-year-old man had undergone high anterior resection for rectal cancer. Seven years after the surgery, a liver metastasis was identified, and the metastasis was surgically resected. A year after the liver surgery, blood testing showed high carcinoembryonic antigen(CEA). A fluorodeoxyglucose(FDG) / -positron emission tomography(PET)/CT examination showed a high FDG accumulation at the rectal anastomosis site, and we diagnosed local recurrence of rectal cancer and prostate invasion. Because there were no distant metastases, he underwent laparoscopic lower anterior resection, radical prostatectomy, and ileostomy...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133353/-a-case-of-curatively-resected-ascending-colon-cancer-invading-the-duodenum-after-neoadjuvant-chemotherapy
#18
Takafumi Yachi, Akihiko Murata, Shinsuke Nishikawa, Kenichi Takahashi, Takayuki Morita, Kenichi Hakamada
A 64-year-old woman with anorexia and anemia was diagnosed with ascending colon cancer invading the duodenum. Considering the difficulty of curative resection, we first performed gastrojejunostomy and ileostomy. After surgery, the patient received FOLFIRI with cetuximab as neoadjuvant chemotherapy. After 9 courses of the regimen, enhanced computed tomography revealed shrinkage of the lesion, with the efficacy evaluated as a partial response. The patient underwent right hemico- lectomy and partial resection of the duodenum...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133307/-a-case-of-familial-adenomatous-polyposis-with-a-desmoid-tumor-probably-communicating-to-the-intestinal-lumen-that-was-successfully-treated-with-non-surgical-therapy
#19
Tetsuya Ito, Noriyasu Chika, Azusa Yamamoto, Toshiro Ogura, Kunihiko Amano, Toru Ishiguro, Minoru Fukuchi, Youichi Kumagai, Keiichiro Ishibashi, Hidetaka Eguchi, Yasushi Okazaki, Erito Mochiki, Hideyuki Ishida
A 44-year-old man with familial adenomatous polyposis underwent laparoscopic-assistedtotal proctocolectomy with ilealpouch anal anastomosis(IPAA). Computed tomography conducted 21 months after IPAA demonstrated bilateral hydronephrosis andan intra-abdominal mass with a maximal diameter of 22 cm, leading to a diagnosis of stage IV desmoid disease, according to the classification by Church and associates. Six courses of combination chemotherapy with doxorubicin plus dacarbazine were administered. Computed tomography after chemotherapy demonstrated marked shrinkage of the desmoidtumor with intraabdominal air andfluidcollection extending just below the skin of the ileostomy closure site...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133271/-case-of-colon-metastasis-from-early-gastric-cancer-4-years-after-laparoscopic-assisted-distal-gastrectomy
#20
Kosuke Ikeda, Tsutomu Sato, Yukio Maezawa, Kazuki Kano, Tetsuta Satoyoshi, Kenki Segami, Tetsushi Nakajima, Takashi Ogata, Haruhiko Cho, Takaki Yoshikawa
A 69-year-old woman who underwent laparoscopic assisted distal gastrectomy for early gastric cancer(pathological T1bN1M0)in June 2011was admitted to the hospital because of abdominal pain in May 2015.A n abdominal CT scan showed ileus caused by a transverse colon tumor and ascending colon perforation.We performed emergency right hemicolectomy and diverting ileostomy.The postoperative pathological findings revealed poorly differentiated adenocarcinoma and signetring cell carcinoma similar to the gastric cancer resected 4 years ago...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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