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https://www.readbyqxmd.com/read/28105620/-effect-of-a-clinical-pathway-in-patients-with-crohn-s-disease-complicated-with-intestinal-obstruction
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
Axel Kraenzler, Léon Maggiori, Olivier Pittet, Mohammad Saleh Alyami, Justine Prost À la Denise, Yves Panis
AIM: To assess the results of treatment for colorectal (CRA), coloanal (CAA), or ileal pouch-anal (IPAA) anastomotic stenosis (AS). METHODS: All patients operated on for AS from 1995 to 2014 were included. Success was defined as the absence of 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 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%)...
December 20, 2016: 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
#14
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
https://www.readbyqxmd.com/read/27928668/alvimopan-in-the-setting-of-colorectal-resection-with-an-ostomy-to-use-or-not-to-use
#15
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/27926562/long-term-experience-of-magnetic-anal-sphincter-augmentation-in-patients-with-fecal-incontinence
#16
Jeremy Sugrue, Paul-Antoine Lehur, Robert D Madoff, Shane McNevin, Steen Buntzen, Søren Laurberg, Anders Mellgren
BACKGROUND: Magnetic anal sphincter augmentation is a novel technique for the treatment of patients with fecal incontinence. OBJECTIVE: The current study reports the long-term effectiveness and safety of this new treatment modality. DESIGN: This was a prospective multicenter pilot study. SETTINGS: The study was performed at 4 clinical sites in Europe and the United States. PATIENTS: The cohort included patients with severe fecal incontinence for ≥6 months who had previously failed conservative therapy and were implanted with a magnetic anal sphincter device between 2008 and 2011...
January 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/27924392/colonic-stenting-as-a-bridge-to-surgery-versus-emergency-surgery-for-malignant-colonic-obstruction-results-of-a-multicentre-randomised-controlled-trial-esco-trial
#17
Alberto Arezzo, Carmen Balague, Eduardo Targarona, Felice Borghi, Giorgio Giraudo, Luigi Ghezzo, Antonio Arroyo, Javier Sola-Vera, Paolo De Paolis, Maurizio Bossotti, Elisa Bannone, Edoardo Forcignanò, Marco Augusto Bonino, Roberto Passera, Mario Morino
BACKGROUND: The aim of colonic stenting with self-expandable metallic stents in neoplastic colon obstruction is to avoid emergency surgery and thus potentially reduce morbidity, mortality, and need for a stoma. Concern has been raised, however, about the effect of colonic stenting on short-term complications and long-term survival. We compared morbidity rates after colonic stenting as a bridge to surgery (SBTS) versus emergency surgery (ES) in the management of left-sided malignant large-bowel obstruction...
December 6, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27919575/a-prospective-algorithm-to-reduce-anastomotic-leaks-after-rectosigmoid-resection-for-gynecologic-malignancies
#18
E Kalogera, C C Nitschmann, S C Dowdy, W A Cliby, C L Langstraat
OBJECTIVE: Determine whether a standardized protocol for temporary bowel diversion after rectosigmoid resection (RSR) for cytoreduction can reduce the rate of anastomotic leak (AL). METHODS: A prospective quality improvement project for patients undergoing RSR during debulking surgery from 07/2013 to 01/2016 was conducted. Patients with any of the following underwent temporary diversion: preoperative albumin ≤3.0g/dL, prior pelvic radiation, RSR plus additional large bowel resection (LBR), anastomosis (AS) ≤6cm from the anal verge, failed leak test or contamination of the pelvis with stool...
December 2, 2016: Gynecologic Oncology
https://www.readbyqxmd.com/read/27912977/functional-outcomes-in-hirschsprung-disease-a-single-institution-s-12-year-experience
#19
Hemanshoo S Thakkar, Christopher Bassett, Andy Hsu, Riccardo Manuele, Dorothy Kufeji, Catherine A Richards, Meena Agrawal, Alireza S Keshtgar
AIMS: Hirschsprung disease (HD) is a chronic condition associated with long-term morbidity. We assessed the short and long-term functional outcomes of operated patients in a single institution over a 12-year period. MATERIALS AND METHODS: We conducted a retrospective review of all children operated for HD between 2002 and 2014. Postoperative functional outcomes were assessed using the Rintala Bowel Function Score (BFS, 0-20, 20=best score). We assessed hospital admissions, complications including Hirschsprung associated enterocolitis (HAEC) and the need for further surgical procedures...
November 14, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27912975/patient-reported-swedish-nationwide-outcomes-of-children-and-adolescents-with-total-colonic-aganglionosis
#20
Pernilla Stenström, Matilda Brautigam, Helena Borg, Christina Graneli, Helene Engstrand Lilja, Tomas Wester
BACKGROUND: The aim of this study was to evaluate the nationwide outcome of children with total colonic aganglionosis (TCA) during the last 20years. METHODS: This was an observational, cross-sectional study where all patients with TCA, including aganglionosis of 0-50cm of ileum, born in Sweden 1995-2014 were included. Data were collected from the medical records. Patients >4years old without stoma answered a questionnaire regarding bowel function (bowel function score, BFS, score 1-20), medical treatment and nutrition...
November 17, 2016: Journal of Pediatric Surgery
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