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Colostomy closure

Maximilian Sohn, I Iesalnieks, A Agha, P Steiner, A Hochrein, J Pratschke, P Ritschl, F Aigner
PURPOSE: Optimal surgical management of perforated diverticulitis of the sigmoid colon has yet to be clearly defined. The purpose of this study was to evaluate efficacy of a "Damage Control Strategy" (DCS). MATERIALS AND METHODS: Patients with perforated diverticulitis of the sigmoid colon complicated by generalized peritonitis (Hinchey III and IV) surgically treated according to a damage control strategy between May 2011 and February 2017 were enrolled in the present multicenter retrospective cohort study...
March 14, 2018: World Journal of Surgery
Imad El Moussaoui, Augustin Limbga, Manke Dika, Abdelilah Mehdi
Introduction Rectal prolapse is the complete protrusion of the rectum through the anal canal, incarceration rarely complicates rectal prolapse. Even more rarely, it becomes strangulated and gangrenous, necessitating emergency surgery. Case presentation We present the first reported case of strangulated acute rectal prolapse as the first manifestation of rectal prolapse. The patient was a 26-year-old man who presented with a 20×6 cm semi-spherical mass extra-anally. Rectosigmoidectomy with sacral rectopexy was performed, resecting 20 cm of the incarcerated rectum and sigmoid colon...
January 1, 2018: Scottish Medical Journal
Teppei Kono, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Masaya Satake, Yasufumi Yamada, Arika Ida, Takebumi Usui, Kentaro Yamaguchi, Shunichi Shiozawa, Kazuhiko Yoshimatsu, Takeshi Shimakawa, Takao Katsube, Hiroyuki Kato, Yoshihiko Naritaka
The patient was 55-year-old woman, undergoing Hartmann operation by the sigmoid colon diverticulum perforation, 2 years later visited our hospital with abdominal pain. Although lower endoscopy and histological examination could not be performed due to stoma stenosis, we diagnosed cecal carcinoma, liver metastasis, distant lymph node metastasis from CT and PET-CT, CapeOX plus Bmabtherapy and IRIS plus Bmabtherapy were performed. After that, repeated intestinal obstruction due to exacerbated stoma stenosis, metastatic lesion increased in CT examination, furthermore the patient had hope of stoma closure, we decided to resect the primacy tumor, performed subtotal colonectomy and stoma closure...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Kazuhito Uemura, Hiroaki Takahashi, Kazuhiro Mino, Takuji Ota, Shunsuke Shichi
Four cases of gastrointestinal perforation associated with bevacizumab(BEV)were examined. Case 1: A 82-year-old male received FOLFIRI plus BEV for recurrent liver metastasis after rectal cancer resection. A lower esophageal perforation occurred 22 days after BEV administration and drainage was performed. Case 2: A 69-year-old female received FOLFOX4 plus BEV for unresectable rectal cancer and liver and lung metastasis. A rectal perforation occurred 6 days after BEV administration and suturing closure of the hole and colostomy was performed...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Xiaofang Sun, Shaohan Wu, Ting Xie, Jianping Zhang
RATIONALE: An open abdomen complicated with small-bowel fistulae becomes a complex wound for local infection, systemic sepsis and persistent soiling irritation by intestinal content. While controlling the fistulae drainage, protecting surrounding skin, healing the wound maybe a challenge. PATIENT CONCERNS: In this paper we described a 68-year-old female was admitted to emergency surgery in general surgery department with severe abdomen pain. Resection part of the injured small bowel, drainage of the intra-abdominal abscess, and fashioning of a colostomy were performed...
December 2017: Medicine (Baltimore)
Francisco E Martins, Natália M Martins, Luís Campos Pinheiro, Luís Ferraz, Luís Xambre, Tomé M Lopes
INTRODUCTION: Urorectal fistula (URF) is a devastating complication of pelvic cancer treatments and a surgical challenge for the reconstructive surgeon. We report a series of male patients with URF resulting from pelvic cancer treatments, specifically prostate (PCa), bladder (BCa), and rectal cancer (RCa), and explore the differences and impact on outcomes between purely surgical and non-surgical treatment modalities. METHODS: Between October 2008 and June 2015, 15 male patients, aged 59-78 years (mean 67), with URF induced by pelvic cancer treatments were identified in our institutions...
September 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Hideaki Kawakita, Kenji Katsumata, Yoshiaki Osaka, Hitoshi Saito, Kazuhiko Tamura, Tomoki Shirota, Kenta Kasahara, Minoru Kuwabara, Masatoshi Shigoka, Takaaki Matsudo, Masanobu Enomoto, Tetsuo Ishizaki, Masayuki Hisada, Kazuhiko Kasuya, Akihiko Tsuchida
A46 -year-old man developed ulcerative colitis at the age of 19 years. Although the colitis was medically treated, it relapsed and repeated over time. Periodic lower gastrointestinal endoscopy revealed lower rectal cancer, and he was referred to our department of surgery. Previous steroid therapy induced diabetes, and he was obese, with a height of 170.3 cm, weight of 89.6 kg, and BMI of 30.89 kg/m2, indicating that laparoscopic dissection near the anus would be difficult to perform. Therefore, the patient was scheduled for transanal minimally invasive surgery(TAMIS)...
January 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Alexandre Z Fonseca, Edson Uramoto, Otto M Santos-Rosa, Stephanie Santin, Marcelo Ribeiro
BACKGROUND: : The restoration of intestinal continuity is an elective procedure that is not free of complications; on the contrary, many studies have proven a high level of morbidity and mortality. It is multifactorial, and has factors inherent to the patients and to the surgical technique. AIM: : To identify epidemiological features of patients that underwent ostomy closure analyzing the information about the surgical procedure and its arising complications. METHOD: : It was realized a retrospective analysis of medical records of patients who underwent ostomy closure over a period of seven years (2009-2015)...
October 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Christian Krautz, Klaus Weber, Roland Croner, Axel Denz, Matthias Maak, Raymund E Horch, Robert Grützmann
Introduction Patients with low rectal cancer or anal cancer undergoing abdominoperineal excision (APE) benefit from extended surgery and the subsequent avoidance of surgical "waisting" at the level of the puborectalis muscle. The method of cylindrical APE was introduced by T. Holm and led to a reduction of intraoperative perforations and involvement of circumferential resection margins, and subsequently reduced the risk of local recurrence. The use of myocutaneous flaps reduces perineal wound complications, which occur in up to 60% of patients with primary closure of perineal defects, especially following neoadjuvant radiochemotherapy...
December 2017: Zentralblatt Für Chirurgie
Jeremy A Warren, Lucas R Beffa, Alfredo M Carbonell, Jennifer Cull, Brent Sinopoli, Joseph A Ewing, Cedrek McFadden, Jay Crockett, William S Cobb
BACKGROUND: Reversal of an enterostomy results in a high rate of incisional hernia at the ostomy site. Prophylactic mesh reinforcement of the fascial defect is typically not considered due to the contaminated nature of the case. We present the outcomes of a series of prophylactic mesh reinforcements with retromuscular, large-pore polypropylene at the time of enterostomy reversal. METHODS: Retrospective review of all ostomy reversals was performed. All cases with placement of synthetic mesh reinforcement were identified from a prospectively maintained, hernia database...
December 7, 2017: Surgery
Hester de Bruijn, Yasuko Maeda, Jamie Murphy, Janindra Warusavitarne, Carolynne J Vaizey
INTRODUCTION: Surgical repair of rectovaginal fistula remains a challenge. Complex and recurrent rectovaginal fistula repairs often fail because of scarring and devascularization of the surrounding tissue. Omental interposition may promote healing by introducing bulky vascularized tissue into the rectovaginal septum. TECHNIQUE: With the patient in the lithotomy position, the rectovaginal septum was dissected transperineally up to the fistula tract and the openings on both vaginal and rectal sides were closed using interrupted, absorbable sutures...
January 2018: Diseases of the Colon and Rectum
N Horesh, Y Rudnicki, Y Dreznik, A P Zbar, M Gutman, O Zmora, D Rosin
Hartmann's procedure, colonic resection with an end colostomy and rectal closure, is used in a variety of surgical emergencies. It is a common surgical procedure that is often practiced in patients with colonic obstruction and colonic perforation, resolving the acute clinical situation in the majority of cases. Reversal of Hartmann's procedure with restoration of bowel continuity occurs in a significantly low percentage of patients. There are several reasons contributing to the fact that many patients remain with a permanent colostomy following Hartmann's procedure...
February 2018: Techniques in Coloproctology
Wan-Hsiang Hu, Ko-Chao Lee, Kai-Lung Tsai, Hong-Hwa Chen
PURPOSE: Temporary loop colostomy is a common surgical procedure used to avoid complications in high-risk distal anastomosis as well as pelvic inflammation. Issues regarding postoperative outcomes of colostomy takedown have been widely discussed in the literature, wound infection especially. Temporary closure of colostomy with suture before takedown was adopted in our study, which provided excellent traction to aid mobilization of stomy and avoided stool spillage to downgrade the wound classification to "clean contamination...
November 22, 2017: International Journal of Colorectal Disease
Lisa Manzenreiter, Georg Spaun, Michael Weitzendorfer, Rosalia Luketina, Stavros A Antoniou, Helwig Wundsam, Oliver O Koch, Klaus Emmanuel
BACKGROUND: The use of a protective stoma represents an important issue in colorectal surgery. Although evidence suggests that loop ileostomy may be superior, the optimal method for temporary decompression of colorectal anastomosis still remains controversial. Aim of this study was to make an evidence-based proposal for a tailored approach to the use of diverting colostomy or ileostomy. METHODS: A retrospective analysis of all patients subjected to creation and closure of a diverting loop colostomy or loop ileostomy between May 2007 and November 2014 in our institution was performed...
November 20, 2017: Minerva Chirurgica
Burkhard Ubrig, Ekkehard Schmidt-Heikenfeld, Stephan Degener, Alexander Roosen, Anselm Boy
Background: Fistulae between the prostatic urethra and the rectum are rare. They may result from prostatic or rectal surgery. Predisposing factors are previous radiation or immunosuppression. The repair of such fistulae usually involves major surgery. Recently, clips that can be deployed over an endoscope have been developed to close gastrointestinal fistulae or access points for natural orifice surgery. We report the first case of effective treatment of a prostatorectal fistula with a rectal "over-the-scope" clip...
2017: Journal of Endourology Case Reports
Gyoung Tae Noh, Jeonghee Han, Chinock Cheong, Yoon Dae Han, Nam Kyu Kim
Purpose: Tumors at the level of the anorectal junction had required total levator-ani muscle excision to achieve an adequate resection margin. However, in the cases of tumor invading ipsilateral levator-ani muscle and intact external sphincter, en bloc resection of rectum with levator-ani muscle including tumor would be possible. This hemilevator excision (HLE) technique enables preserving the anal sphincter function while obtaining oncologic clearance and avoiding permanent colostomy in those patients...
October 2017: Annals of Surgical Treatment and Research
Shinya Abe, Kazushige Kawai, Hiroaki Nozawa, Keisuke Hata, Tomomichi Kiyomatsu, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Kazuhito Sasaki, Manabu Kaneko, Koji Murono, Shigenobu Emoto, Toshiaki Watanabe
INTRODUCTION: Although temporary ileostomy is widely used to prevent complications due to anastomotic leakage after middle and low rectal cancer surgery, some patients fail to achieve stoma closure after primary surgery. The aim of this study was to identify the risk factors for permanent stoma following low anterior resection (LAR) or intersphincteric resection (ISR) with a temporary ileostomy for rectal cancer, while focusing on the time course, to develop a nomogram that can predict the rate of unreversed ileostomy 1 year after initial surgery...
November 2017: International Journal of Surgery
Kyung Sook Hong, Hee Jung Yi, Ryung-Ah Lee, Kwang Ho Kim, Soon Sup Chung
Fournier's gangrene is a gas-forming, necrotising soft tissue infection affecting the perineum. It spreads rapidly along the deep fascial planes and is associated with a high mortality rate. With a growing elderly population with comorbidities, the frequency of severe cases of Fournier's gangrene is expected to increase. We retrospectively reviewed 20 patients diagnosed with Fournier's gangrene at our institution from 2003 to 2014 and analysed data. Thirteen patients had diabetes mellitus, two had been diagnosed with liver cirrhosis, and four were chronic alcoholics...
December 2017: International Wound Journal
Wulfran Cacheux, Thibaud Koessler, Giacomo Puppa, Eugenio Fernandez, Lisa Ho, Pierre-Yves Dietrich, Thomas Zilli, Abdelkarim Said Allal, Bruno Roche, Frederic Ris, Arnaud Roth
BACKGROUND: Locally advanced anal cancer patients, especially with T4 disease and fistula, have a dismal prognosis. Neo-adjuvant intra-arterial chemotherapy before standard chemoradiation has been shown to be promising in this setting. AIMS: We are reporting results from a larger patient population. METHODS: From 2005 to 2015, 25 consecutive patients with locally advanced anal cancer, 18 of them fistulised, received intra-arterial chemotherapy...
September 5, 2017: Digestive and Liver Disease
Nir Horesh, Yonatan Lessing, Yaron Rudnicki, Ilan Kent, Haguy Kammar, Almog Ben-Yaacov, Yael Dreznik, Hagit Tulchinsky, Shmuel Avital, Eli Mavor, Nir Wasserberg, Hanoch Kashtan, Joseph M Klausner, Mordechai Gutman, Oded Zmora
PURPOSE: Hartmann's procedure is commonly practiced in emergent cases with the restoration of bowel continuity planned at a second stage. This study assessed the rate of restorations following Hartmann's procedure and evaluated factors affecting decision-making. METHODS: Data on patient demographics, comorbidities, causes for Hartmann's procedure, reversal rate, and complications were collected in a multicenter retrospective cohort study of patients who underwent Hartmann's procedure in five medical centers...
November 2017: International Journal of Colorectal Disease
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