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https://www.readbyqxmd.com/read/28197671/-rectal-perforation-a%C3%A2-rare-complication-following-radiotherapy
#1
M Binnebösel, A Lambertz, C D Klink, U P Neumann
BACKGROUND: Radiotherapy in the treatment of prostate cancer is well established. Intestinal complications following radiotherapy are divided into acute and chronic toxicity. Chronic complications like perforation and fistula formation to the rectum are rare and difficult to treat. MATERIALS AND METHODS: In case of chronic radiotherapy complications and particularly chronic fistula formation to the rectum, evidence is low. Therefore, an overview of the available literature of surgical therapy strategies is given...
February 14, 2017: Der Urologe. Ausg. A
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
#2
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/28188511/non-occlusive-mesenteric-ischemia-localized-in-the-transverse-colon-a-case-report
#3
Koji Murono, Soichiro Ishihara, Kazushige Kawai, Manabu Kaneko, Kazuhito Sasaki, Koji Yasuda, Kensuke Otani, Takeshi Nishikawa, Toshiaki Tanaka, Tomomichi Kiyomatsu, Keisuke Hata, Hiroaki Nozawa, Akimasa Hayashi, Tetsuo Ushiku, Masashi Fukayama, Toshiaki Watanabe
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is ischemia of the mesentery that is caused by hypoperfusion or vasospasm without any thrombosis. NOMI is difficult to diagnose by physical examination alone. Although angiographic examination of the superior mesenteric artery (SMA) is the usual diagnostic method used, it is an invasive examination. Usually, a long range of the bowel becomes discontinuously necrotic in NOMI. Here, we report a rare case of NOMI localized in the transverse colon that was diagnosed by computed tomography (CT) angiography which is a minimally invasive examination...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28130593/functional-outcome-following-rectal-surgery-predisposing-factors-for-low-anterior-resection-syndrome
#4
Daniel Ll Hughes, Julie Cornish, Chris Morris
PURPOSE: Developments in surgical techniques and neoadjuvant treatment have enabled an increasing proportion of patients with rectal cancer to undergo sphincter-sparing resections. The avoidance of a permanent stoma can come at the cost of poor bowel function which can significantly impact patients' quality of life. The objective of this study was to identify the incidence and risk factors for the development of bowel dysfunction following rectal cancer surgery. METHODS: Patients undergoing anterior resection for rectal cancer between January 2009 and January 2015 were identified from a rectal cancer database at a single centre...
January 27, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28118819/short-bowel-syndrome-results-in-increased-gene-expression-associated-with-proliferation-inflammation-bile-acid-synthesis-and-immune-system-activation-rna-sequencing-a-zebrafish-sbs-model
#5
Kathy A Schall, Matthew E Thornton, Mubina Isani, Kathleen A Holoyda, Xiaogang Hou, Ching-Ling Lien, Brendan H Grubbs, Tracy C Grikscheit
BACKGROUND: Much of the morbidity associated with short bowel syndrome (SBS) is attributed to effects of decreased enteral nutrition and administration of total parenteral nutrition (TPN). We hypothesized that acute SBS alone has significant effects on gene expression beyond epithelial proliferation, and tested this in a zebrafish SBS model. METHODS: In a model of SBS in zebrafish (laparotomy, proximal stoma, distal ligation, n = 29) or sham (laparotomy alone, n = 28) surgery, RNA-Seq was performed after 2 weeks...
January 25, 2017: BMC Genomics
https://www.readbyqxmd.com/read/28115491/development-and-external-validation-of-a-nomogram-and-online-tool-to-predict-bowel-dysfunction-following-restorative-rectal-cancer-resection-the-polars-score
#6
Nick J Battersby, George Bouliotis, Katrine J Emmertsen, Therese Juul, Rob Glynne-Jones, Graham Branagan, Peter Christensen, Søren Laurberg, Brendan J Moran
OBJECTIVE: Bowel dysfunction is common following a restorative rectal cancer resection, but symptom severity and the degree of quality of life impairment is highly variable. An internationally validated patient-reported outcome measure, Low Anterior Resection Syndrome (LARS) score, now enables these symptoms to be measured. The study purpose was: (1) to develop a model that predicts postoperative bowel function; (2) externally validate the model and (3) incorporate these findings into a nomogram and online tool in order to individualise patient counselling and aid preoperative consent...
January 23, 2017: Gut
https://www.readbyqxmd.com/read/28105620/-effect-of-a-clinical-pathway-in-patients-with-crohn-s-disease-complicated-with-intestinal-obstruction
#7
Zhen Guo, Lei Cao, Jianfeng Gong, Yi Li, Lili Gu, Weiming Zhu, Jieshou Li
OBJECTIVE: To evaluate the effect of a clinical pathway for Crohn disease (CD) complicated with intestinal obstruction. METHODS: CD patients complicated with intestinal obstruction in Inflammatory Bowel Disease(IBD) Center of Jinling Hospital were enrolled. One hundred and nineteen CD patients from March 2014 to September 2015 received treatment with the clinical pathway (CP), which was developed based on medical evidence and experience of the IBD center in February 2014, as CP group...
January 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28097296/long-term-postprocedural-outcomes-of-palliative-emergency-stenting-vs-stoma-in-malignant-large-bowel-obstruction
#8
Jonathan S Abelson, Heather L Yeo, Jialin Mao, Jeffrey W Milsom, Art Sedrakyan
Importance: Colonic stenting was introduced for palliation of malignant large-bowel obstruction (MLBO) more than 20 years ago but remains controversial. Objective: To compare outcomes after palliative stenting vs stoma creation in patients with MLBO requiring emergency management. Design, Setting, and Participants: This observational cohort study assessed 345 patients from New York State with an urgent or emergency admission to the hospital for obstruction secondary to colorectal cancer and who underwent stenting or stoma creation from October 1, 2009, through December 31, 2013...
January 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28094015/a-nordic-multicenter-survey-of-long-term-bowel-function-after-transanal-endorectal-pull-through-in-200-patients-with-rectosigmoid-hirschsprung-disease
#9
Kristin Bjørnland, Mikko P Pakarinen, Pernilla Stenstrøm, Kjetil J Stensrud, Malla Neuvonen, Anna L Granström, Christina Graneli, Are H Pripp, Einar Arnbjörnsson, Ragnhild Emblem, Tomas Wester, Risto J Rintala
OBJECTIVE: Transanal endorectal pull-through (ERPT) is the most popular technique to treat Hirschsprung disease (HD). Still, there is limited knowledge on long-term bowel function. This cross-sectional, multicenter study assessed long-term bowel function in a large HD population and examined predictors of poor outcome. METHODS: Patients older than four years or their parents filled out a validated questionnaire on bowel function. Clinical details were recorded retrospectively from medical records...
January 5, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28093117/the-biological-prosthesis-is-a-viable-option-for-abdominal-wall-reconstruction-in-pediatric-high-risk-defects
#10
Osnat Zmora, Shannon L Castle, Stephanie Papillon, James E Stein
BACKGROUND: Our aim was to explore the indications for and outcome of biological prostheses to repair high risk abdominal wall defects in children. METHODS: A retrospective chart review was performed of all cases of abdominal wall reconstruction in a single institution between 2007 and 2015. Demographic and clinical variables, technique and complications were described and compared between prosthesis types. RESULTS: A total of 23 patients underwent abdominal wall reconstruction using a biological prosthesis including 17 neonates...
January 6, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28067986/prospective-randomised-controlled-trial-comparing-early-post-operative-complications-in-patients-undergoing-loop-colostomy-with-and-without-a-stoma-rod
#11
Joshua Franklyn, Gigi Varghese, Rohin Mittal, Grace Rebekah, Mark Ranjan Jesudason, Benjamin Perakath
AIM: A stoma rod or bridge has been traditionally placed under the bowel loop while constructing loop colostomies. This is believed to prevent stomal retraction and provide better faecal diversion. However, the rod can cause complications such as mucosal congestion, oedema and necrosis. This single centre prospective randomized controlled trial compared outcomes after loop colostomy creation with and without a supporting stoma rod. The primary outcome studied was stoma retraction rate, and other stoma related complications were studied as secondary outcomes...
January 9, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28060005/exploration-of-health-status-illness-perceptions-coping-strategies-psychological-morbidity-and-quality-of-life-in-individuals-with-fecal-ostomies
#12
Simon R Knowles, Davina Tribbick, William R Connell, David Castle, Michael Salzberg, Michael A Kamm
PURPOSE: In a previous paper focusing on the common sense model (CSM) for ostomies in people with inflammatory bowel disease, cancer, and diverticular disease, we reported that (1) illness perceptions were directly related to illness status, and both illness perceptions and coping strategies (maladaptive coping) directly influenced anxiety and depression; (2) self-efficacy and emotion-focused coping style ameliorated depression but not anxiety; and (3) time since surgery was associated with improved health status, a reduction in negative illness perceptions, and increased emotional-focused coping...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28045769/diverting-ileostomy-for-the-treatment-of-severe-refractory-pediatric-inflammatory-bowel-disease
#13
Elizabeth C Maxwell, Noor Dawany, Robert N Baldassano, Petar Mamula, Peter Mattei, Lindsey Albenberg, Judith R Kelsen
OBJECTIVES: Diverting ileostomy is used as a temporizing therapy in patients with perianal Crohn disease; however, little data exist regarding its use for colonic disease. The primary aim of the present study was to determine the role of diversion in severe refractory colonic inflammatory bowel disease (IBD) in a pediatric population. METHODS: Retrospective study of patients who underwent diverting ileostomy at The Children's Hospital of Philadelphia from 2000 to 2014 for the management of severe, refractory colonic IBD...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28039168/correlation-of-the-rutgeerts-score-and-recurrence-of-crohn-s-disease-in-patients-with-end-ileostomy
#14
Vasutakarn Chongthammakun, Andre Fialho, Andrea Fialho, Rocio Lopez, Bo Shen
BACKGROUND: Recurrence of Crohn's disease (CD) can occur after surgery, including end ileostomy (EI). The Rutgeerts score (RS) was developed to predict postsurgical CD recurrence via ileocolonoscopy in patients having ileocolonic resection. The role of ileoscopic evaluation via stoma for assessing recurrence of CD has not been investigated. The aim of this study was to evaluate the role of ileoscopy for predicting disease recurrence in CD patients after EI with the use of RS. METHODS: A total of 73 eligible CD patients with at least two ileoscopies in our institution following EI were included...
December 30, 2016: Gastroenterology Report
https://www.readbyqxmd.com/read/28028560/pathophysiology-prevention-treatment-and-outcomes-of-intestinal-failure-associated-liver-disease
#15
REVIEW
Noora H Al-Shahwani, David L Sigalet
BACKGROUND: Intestinal failure-associated liver disease (IFALD) remains a serious problem in the treatment of infants with nutritional problems and short bowel syndrome. METHODS: A review of the recent literature from 2010 to 2016, concentrating on articles related to the pathophysiology of IFALD and to outcomes of novel nutritional and pharmacological therapies for neonatal cholestasis in the post-surgical neonate. RESULTS: The pathophysiology of IFALD relates to an increase sensitivity of the neonatal liver to cholestasis in the non-fed state; prolonged cholestasis almost inevitably results in liver damage which will progress from fibrosis to cirrhosis...
December 27, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/28028380/small-bowel-obstruction-secondary-to-adhesions-after-open-or-laparoscopic-colorectal-surgery
#16
Sebastian Smolarek, Mostafa Shalaby, Giulio Paolo Angelucci, Giulia Missori, Ilaria Capuano, Luana Franceschilli, Silvia Quaresima, Nicola Di Lorenzo, Pierpaolo Sileri
BACKGROUND AND OBJECTIVES: Small-bowel obstruction (SBO) is a common surgical emergency that occurs in 9% of patients after abdominal surgery. Up to 73% are caused by peritoneal adhesions. The primary purpose of this study was to compare the rate of SBOs between patients who underwent laparoscopic (LPS) and those who had open (OPS) colorectal surgery. The secondary reasons were to evaluate the rate of adhesive SBO in a cohort of patients who underwent a range of colorectal resections and to assess risk factors for the development of SBO...
October 2016: JSLS: Journal of the Society of Laparoendoscopic Surgeons
https://www.readbyqxmd.com/read/28011012/intestinal-adaptation-in-proximal-and-distal-segments-two-epithelial-responses-diverge-after-intestinal-separation
#17
Kathy A Schall, Kathleen A Holoyda, Mubina Isani, Christopher Schlieve, Tasha Salisbury, Thien Khuu, Justine W Debelius, Rex A Moats, Harvey A Pollack, Ching-Ling Lien, Kathryn Fowler, Xiaogang Hou, Rob Knight, Tracy C Grikscheit
BACKGROUND: In short bowel syndrome, luminal factors influence adaptation in which the truncated intestine increases villus lengths and crypt depths to increase nutrient absorption. No study has evaluated the effect of adaptation within the distal intestine after intestinal separation. We evaluated multiple conditions, including Igf1r inhibition, in proximal and distal segments after intestinal resection to evaluate the epithelial effects of the absence of mechanoluminal stimulation. METHODS: Short bowel syndrome was created in adult male zebrafish by performing a proximal stoma with ligation of the distal intestine...
December 20, 2016: Surgery
https://www.readbyqxmd.com/read/28000186/-value-of-anorectal-manometry-in-defecation-disorders-and-its-clinical-interpretation
#18
Shuqing Ding
Bowel dysfunction affected by functional factors, mechanical factors or surgical damage may lead to constipation, fecal incontinence and other overlapped symptoms, which is only the tip of the iceberg. Anorectal manometry can provide combined dysfunction information of four subtypes, including sphincter dysfunction, dyssynergic defecation, sensory disability and insufficient rectal expel force, which are underlying pathophysiology of defecation dysfunction. Anorectal manometry can be helpful in optimizing protocol or predicting success in pelvic floor dyssynergic syndrome of defecation, fecal incontinence or anorectal pain, stoma closure and pediatric intractable constipation...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27996184/anastomotic-stenosis-after-coloanal-colorectal-and-ileoanal-anastomosis-what-is-the-best-management
#19
A Kraenzler, L Maggiori, O Pittet, M S Alyami, J Prost À la Denise, Y Panis
AIM: To assess the results of treatment for colorectal (CRA), coloanal (CAA) or ileal pouch-anal (IPAA) anastomotic stenosis (AS). METHOD: All patients operated on for AS from 1995 to 2014 were included. Success was defined as the absence of an additional surgical procedure for AS during 12 months after the last procedure and the absence of a stoma at the end of follow-up. RESULTS: Fifty consecutive patients presenting with AS after CRA (n = 16, 32%), CAA (n = 18, 36%) or IPAA (n = 16, 32%), performed for colorectal cancer (n = 28, 56%), familial adenomatous polyposis (n = 5, 10%), inflammatory bowel disease (n = 8, 16%), diverticulitis (n = 4, 8%), benign colorectal neoplasia (n = 3, 6%) or other (n = 2, 4%) underwent a total of 99 procedures including digital (n = 14, 14%), instrumental (n = 38, 38%) or endoscopic dilatation (n = 5, 5%), transanal AS stricturoplasty (n = 9, 10%), transanal circular stapler resection (n = 11, 11%) or transabdominal redo-anastomosis (n = 22, 22%)...
February 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27935344/safe-management-of-ileostomates-with-high-output-stomas
#20
Ann Goodey, Sharon Colman
An ileostomy is where the small bowel is diverted to the abdominal surface resulting in the formation of a stoma. An Ileostomy can be temporary or permanent and produces loose faeces. Some ileostomates can develop high output in the early postoperative stage. Most will resolve, some will require ongoing treatment and management. While patients are monitored closely according to protocol in hospital once discharged into the community, there appears to be little standardisation. A literature search revealed that existing guidelines are for management of patients in the acute care setting...
December 8, 2016: British Journal of Nursing: BJN
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