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https://www.readbyqxmd.com/read/28435128/randomized-trial-on-fast-track-care-in-colorectal-surgery-for-deep-infiltrating-endometriosis
#1
Marco Scioscia, Marcello Ceccaroni, Irene Gentile, Roberto Rossini, Roberto Clarizia, Davide Brunelli, Giacomo Ruffo
STUDY OBJECT: To study the application of a fast-track care protocol in colorectal surgery for deep infiltrating endometriosis. Bowel endometriosis is an infrequent but not rare condition that often needs intestinal surgery and imposes a high economic burden on society. DESIGN: Prospective randomized trial (Canadian Task Force I). SETTING: Tertiary referral center. PATIENTS: We randomly assigned 227 patients with preoperative evidence of bowel endometriosis to a fast-track (no preoperative bowel preparation, early restoration of diet, no postoperative antibiotics, and early post-operative mobilization) or conventional care for laparoscopic intestinal surgery...
April 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28433044/-laparoscopic-diverting-ileostomy-in-rectal-cancer-surgery
#2
P Ihnát, P Vávra, P Guňková, A Zatloukal, S Czudek, P Zonča
INTRODUCTION: Low anterior resection (LAR) with total mesorectal excision (TME) represents the gold standard for patients with low rectal carcinoma. Protective ileostomy (PI) is commonly performed during LAR in an effort to protect low rectal anastomosis. The aim of this study is to analyse outcomes in our own patient population, focusing on morbidity associated with PI. METHOD: A retrospective clinical study of patients operated on between 2013 and 2015 was conducted in University Hospital Ostrava...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28413306/urogenital-management-in-cloaca-an-alternative-approach
#3
Harshjeet Singh Bal, Sudipta Sen, Cenita Sam, Jacob Chacko, John Mathai, S R Regunandan
INTRODUCTION: In the management of cloaca, there is concern that dissection of the urogenital sinus in early childhood with the aim of total anatomical correction is hazardous. Avoiding such mobilization and providing mitrofanoff channel, when needed, till peripubertal period reduces complications and is technically easier. MATERIALS AND METHODS: Forty-three cases of cloaca were managed in the period 2004-2016. Case records and radiology were reviewed retrospectively...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28413305/solitary-functioning-kidney-in-high-anorectal-malformation
#4
Kanishka Das, Srinivas Raju Rajkiran
AIM: A solitary functioning renal unit in high anorectal malformation may harbor anomalies in the upper/lower urinary tract that further compromise renal function and accelerate hyperfiltration injury. We aimed to analyze the clinical course, management, and outcome of children with a solitary renal unit and high anorectal malformation. MATERIALS AND METHODS: A cohort of solitary renal units in anorectal malformation managed between 2000 and 2015 with a defined protocol at a pediatric nephro-urology clinic are included in the study...
April 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28403973/a-national-snapshot-of-the-surgical-management-of-deep-infiltrating-endometriosis-of-the-rectum-and-colon-in-france-in-2015-a-multicenter-series-of-1135-cases
#5
H Roman
OBJECTIVE: To perform a survey on the characteristics of the surgical management of patients with deep infiltrating endometriosis of the rectum and the sigmoid colon (DIERS) in France in 2015. METHOD: Case-series study enrolling patients with DIERS involving muscularis, submucosa or mucosa, operated on from January 1st to December 31st 2015, in 56 healthcare facilities in France. Surgeons filled in questionnaires concerning the number of patients, deep endometriosis localizations, surgical route and techniques used on digestive tract, associated surgical procedures and major complications...
February 2017: J Gynecol Obstet Hum Reprod
https://www.readbyqxmd.com/read/28399874/early-closure-of-defunctioning-stoma-increases-complications-related-to-stoma-closure-after-concurrent-chemoradiotherapy-and-low-anterior-resection-in-patients-with-rectal-cancer
#6
Tzu-Chieh Yin, Hsiang-Lin Tsai, Ping-Fu Yang, Wei-Chih Su, Cheng-Jen Ma, Ching-Wen Huang, Ming-Yii Huang, Chun-Ming Huang, Jaw-Yuan Wang
BACKGROUND: After a low anterior resection, creating a defunctioning stoma is vital for securing the anastomosis in low-lying rectal cancer patients receiving concurrent chemoradiotherapy. Although it decreases the complication and reoperation rates associated with anastomotic leakage, the complications that arise before and after stoma closure should be carefully evaluated and managed. METHODS: This study enrolled 95 rectal cancer patients who received neoadjuvant concurrent chemoradiotherapy and low anterior resection with anastomosis of the bowel between July 2010 and November 2012...
April 11, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28399840/a-multicentre-randomised-controlled-trial-to-evaluate-the-efficacy-morbidity-and-functional-outcome-of-endoscopic-transanal-proctectomy-versus-laparoscopic-proctectomy-for-low-lying-rectal-cancer-etap-greccar-11-trial-rationale-and-design
#7
Bernard Lelong, Cécile de Chaisemartin, Helene Meillat, Sandra Cournier, Jean Marie Boher, Dominique Genre, Mehdi Karoui, Jean Jacques Tuech, Jean Robert Delpero
BACKGROUND: Total mesorectal excision is the standard surgical treatment for mid- and low-rectal cancer. Laparoscopy represents a clear leap forward in the management of rectal cancer patients, offering significant improvements in post-operative measures such as pain, first bowel movement, and hospital length of stay. However, there are still some limits to its applications, especially in difficult cases. Such cases may entail either conversion to an open procedure or positive resection margins...
April 11, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28392363/stent-as-bridge-to-surgery-for-left-sided-malignant-colonic-obstruction-reduces-adverse-events-and-stoma-rate-compared-with-emergency-surgery-results-of-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#8
REVIEW
Alberto Arezzo, Roberto Passera, Giacomo Lo Secco, Mauro Verra, Marco Augusto Bonino, Eduardo Targarona, Mario Morino
BACKGROUND AND AIMS: Twenty years after the first description of the technique, the debate is still open on role of self-expandable metallic stent (SEMS) placement as a bridge to elective surgery for symptomatic left-sided malignant colonic obstruction. The aim was to compare morbidity rates after colonic stenting bridge to surgery (SBTS) versus emergency surgery (ES) for left-sided malignant obstruction. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) on SBTS or ES for acute symptomatic malignant left-sided large bowel obstruction...
April 6, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28389778/resection-enterostomy-versus-hartmann-s-procedure-for-emergency-colonic-resections
#9
M Grott, K Horisberger, C Weiß, P Kienle, J Hardt
BACKGROUND: If a primary anastomosis is considered too risky after emergency colon resection either a resection enterostomy or an end stoma with closure of the distal bowel (Hartmann's procedure) is possible. This study analyzes the rate of restoration of intestinal continuity and other surgical outcomes after resection enterostomy placement versus Hartmann's procedure for emergency colon resections. METHODS: All patients who underwent emergency colorectal resections between August 2009 and June 2014 at the University Medical Center Mannheim were reviewed in regard to therapeutic approach, rate of restoration of bowel continuity, and surgical morbidity after the primary operation and after reversal surgery...
April 7, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28377939/endoscopic-treatment-of-bleeding-diversion-pouchitis-with-high-concentration-dextrose-spray
#10
Custon T Nyabanga, Bo Shen
Surgical closure of stoma with the reestablishment of gut continuity is the only curative intervention available for inflammatory bowel disease patients with diversion pouchitis, proctitis, or colitis. For patients who are not candidates for surgical reestablishment of bowel continuity, the alternative nonsurgical approaches, such as topical therapy with mesalamine, corticosteroids, or short-chain fatty acids, have only shown modest efficacy. The management of massive bleeding from diversion pouchitis has not been described...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28342688/in-hospital-mortality-30-day-readmission-and-length-of-hospital-stay-after-surgery-for-primary-colorectal-cancer-a-national-population-based-study
#11
S Pucciarelli, M Zorzi, N Gennaro, G Gagliardi, A Restivo, M Saugo, A Barina, M Rugge, M Zuin, I Maretto, D Nitti
INTRODUCTION: The simultaneous assessment of multiple indicators for quality of care is essential for comparisons of performance between hospitals and health care systems. The aim of this study was to assess the rates of in-hospital mortality and 30-day readmission and length of hospital stay (LOS) in patients who underwent surgical procedures for colorectal cancer between 2005 and 2014 in Italy. METHODS: All patients in the National Italian Hospital Discharge Dataset who underwent a surgical procedure for colorectal cancer during the study period were included...
March 16, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28338510/laparoscopic-lavage-versus-primary-resection-for-acute-perforated-diverticulitis-review-and-meta-analysis
#12
Marta Penna, Sheraz R Markar, Hugh Mackenzie, Roel Hompes, Chris Cunningham
OBJECTIVE: To compare clinical outcomes after laparoscopic lavage (LL) or colonic resection (CR) for purulent diverticulitis. BACKGROUND: Laparoscopic lavage has been suggested as an alternative treatment for traditional CR. Comparative studies to date have shown conflicting results. METHODS: Electronic searches of Embase, Medline, Web of Science, and Cochrane databases were performed. Weighted mean differences (WMD) were calculated for effect size of continuous variables and pooled odds ratios (POR) calculated for discrete variables...
March 23, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28290468/ageing-with-neurogenic-bowel-dysfunction
#13
S D Nielsen, P M Faaborg, N B Finnerup, P Christensen, K Krogh
STUDY DESIGN: Longitudinal study with postal survey. OBJECTIVES: To describe changes in the patterns of neurogenic bowel dysfunction and bowel management in a population of people with spinal cord injury (SCI) followed for two decades. SETTING: Members of the Danish SCI Association. METHODS: In 1996, a validated questionnaire on bowel function was sent to the members of the Danish SCI Association (n=589). The same questionnaire was sent to all the surviving members in 2006 (n=284) and in 2015 (n=178)...
March 14, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28267123/conservative-measures-for-managing-constipation-in-patients-living-with-a-colostomy
#14
Barbara Kuczynska, Adam Bobkiewicz, Adam Studniarek, Krzsztof Szmyt, Łukasz Krokowicz, Konrad Matysiak, Jacek Szmeja, Jarosław Walkowiak, Michał Drews, Tomasz Banasiewicz
PURPOSE: The purpose of this study was to determine the effect of a conservative regimen for the treatment of constipation in persons living with a colostomy. DESIGN: Prospective, noncontrolled, single-center study. SUBJECTS AND SETTING: The study sample comprised 35 patients with a colostomy who were diagnosed with constipation. Subjects with morphologic changes causing constipation such as stomal stenosis and neoplastic and inflammatory changes were excluded...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28255493/treatment-of-complete-anal-stricture-after-diverting-colostomy-for-fournier-s-gangrene
#15
Kenji Okumura, Tadao Kubota, Kazuhiro Nishida, Alan Kawarai Lefor, Ken Mizokami
Background. Anal stenosis is a rare but serious complication of anorectal surgery. Severe anal stenosis is a challenging condition. Case Presentation. A 70-year-old Japanese man presented with a ten-hour history of continuous anal pain due to incarcerated hemorrhoids. He had a history of reducible internal hemorrhoids and was followed for 10 years. He had a fever and nonreducible internal hemorrhoids surrounding necrotic soft tissues. He was diagnosed as Fournier's gangrene and treated with debridement and diverting colostomy...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28247106/timing-and-outcome-of-stoma-closure-in-very-low-birth-weight-infants-with-surgical-intestinal-disorders
#16
Kyoko Mochizuki, Masahiro Hayakawa, Naoto Urushihara, Hiromu Miyake, Akiko Yokoi, Jun Shiraishi, Hideshi Fujinaga, Kensuke Ohashi, Genshiro Esumi, Satoko Ohfuji, Shintaro Amae, Toshihiro Yanai, Taizo Furukawa, Yuko Tazuke, Kyoko Minagawa, Hiroomi Okuyama
PURPOSE: Very low birth weight infants (VLBWIs) are at risk of surgical intestinal disorders including necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI). We conducted this study to verify whether the timing of stoma closure and that of enteral nutrition establishment after stoma closure in VLBWIs differ among the most common disorders. METHODS: A retrospective multicenter study was conducted at 11 institutes. We reviewed the timing of stoma closure and enteral nutrition establishment in VLBWIs who underwent stoma creation for intestinal disorders...
February 28, 2017: Surgery Today
https://www.readbyqxmd.com/read/28197671/-rectal-perforation-a%C3%A2-rare-complication-following-radiotherapy
#17
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
#18
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
#19
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
#20
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...
May 2017: International Journal of Colorectal Disease
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