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Colostomy closure

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https://www.readbyqxmd.com/read/29167976/temporary-closure-of-colostomy-with-suture-before-colostomy-takedown-improves-the-postoperative-outcomes
#1
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
https://www.readbyqxmd.com/read/29154517/a-proposal-for-a-tailored-approach-to-diverting-ostomy-for-colorectal-anastomosis
#2
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
https://www.readbyqxmd.com/read/29098198/minimally-invasive-repair-of-a-prostatorectal-fistula-with-an-over-the-scope-rectal-clip
#3
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
https://www.readbyqxmd.com/read/29094029/novel-anal-sphincter-saving-procedure-with-partial-excision-of-levator-ani-muscle-in-rectal-cancer-invading-ipsilateral-pelvic-floor
#4
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
https://www.readbyqxmd.com/read/28951289/use-of-a-nomogram-to-predict-the-closure-rate-of-diverting-ileostomy-after-low-anterior-resection-a-retrospective-cohort-study
#5
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
https://www.readbyqxmd.com/read/28944569/prognostic-factors-and-treatment-outcomes-for-patients-with-fournier-s-gangrene-a-retrospective-study
#6
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...
September 25, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28935189/early-closure-of-fistula-using-neo-adjuvant-intra-arterial-chemotherapy-in-locally-advanced-anal-cancer
#7
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
https://www.readbyqxmd.com/read/28879552/considerations-for-hartmann-s-reversal-and-hartmann-s-reversal-outcomes-a-multicenter-study
#8
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
https://www.readbyqxmd.com/read/28836252/-comparison-of-oncology-outcomes-and-anal-function-among-laparoscopic-partial-subtotal-and-total-intersphincteric-resection-for-low-rectal-cancers
#9
Bin Zhang, Quanlong Liu, Yujuan Zhao, Guangzuan Zhuo, Shuhui Yin, Jun Zhu, Ke Zhao, Jianhua Ding
OBJECTIVE: To compare the oncology outcomes and anal function among laparoscopic partial, subtotal and total intersphincteric resection(ISR) for low rectal cancers. METHODS: From June 2011 to February 2016, a total of 79 consecutive patients with low rectal cancers underwent laparoscopic ISR with hand-sewn coloanal anastomosis at our department. According to the distal tumor margin, partial ISR (internal sphincter resection at the dentate line) was used to treat tumors with distance <1 cm from the anal sphincter (n=28), subtotal ISR was adopted for the tumors locating between the dentate line and intersphincteric groove (n=34), and total ISR (resection at the dentate line) was applied in the treatment of intra-anal tumors (n=17)...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28792191/withdrawn-comparison-of-vacuum-assisted-closure-therapy-and-debridement-with-primer-surgical-closure-for-fournier-s-gangrene-treatment-10-years-experience-of-a-single-centre
#10
Mustafa Ozan Horsanali, Utku Eser, Burcu O Horsanali, Omer Altas, Huseyin Eren
The International Brazilian Journal of Urology will retract this article because the authors were not authorized to publish the data according to the Department of Urology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey, where the paper was done.
August 8, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28755086/racial-disparities-after-stoma-construction-exist-in-time-to-closure-after-1%C3%A2-year-but-not-in-overall-stoma-reversal-rates
#11
Drew J Gunnells, Lauren N Wood, Lauren Goss, Melanie S Morris, Gregory D Kennedy, Jamie A Cannon, Daniel I Chu
INTRODUCTION: Conflicting data exist on racial disparities in stoma reversal (SR) rates. Our aim was to investigate the role of race in SR rates, and time to closure, in a longitudinal, racially diverse database. METHODS: All adult patients (>18 years) who received an ileostomy or colostomy from 1999 to 2016 at a single institution were identified. Primary outcomes were SR rates and time to closure. Failure to reverse and time to closure was modeled using Cox regression...
July 28, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28753847/incidence-risk-factors-management-and-complications-of-rectal-injuries-during-radical-prostatectomy
#12
Philipp Mandel, Anna Linnemannstöns, Felix Chun, Thorsten Schlomm, Raisa Pompe, Lars Budäus, Clemens Rosenbaum, Tim Ludwig, Roland Dahlem, Margit Fisch, Markus Graefen, Hartwig Huland, Derya Tilki, Thomas Steuber
Rectal injury (RI) during radical prostatectomy (RP) is a severe complication. So far, only limited data describing the incidence, risk factors, management, and complications of RI are available. In an analysis of data for 24178 patients, we identified 113/24076 patients (0.47%) undergoing open or robotic RP and 7/102 patients (6.86%) after salvage RP who experienced an RI. Besides salvage RP, local tumor stage, Gleason grade, lymph node status, and surgical experience, but not surgical approach (robotic vs open), could be identified as risk factors for RI in univariate and multivariate analysis...
February 7, 2017: European Urology Focus
https://www.readbyqxmd.com/read/28413301/anorectal-malformations-in-males-pros-and-cons-of-neonatal-versus-staged-reconstruction-for-high-and-intermediate-varieties
#13
Prema Menon, Katragadda Lakshmi Narasimha Rao, Amit Kumar Sinha, K Lokesha, Ram Samujh, Jai Kumar Mahajan, Ravi Prakash Kanojia, Monika Bawa
BACKGROUND: High and intermediate types of anorectal malformations (ARMs) in male neonates may be managed either by primary neonatal reconstruction without colostomy cover or by traditional policy of staged reconstruction after neonatal colostomy. Posterior sagittal anorectoplasty (PSARP) is the current widely practiced reconstructive technique with varied results. AIM: To assess our functional results of PSARP without colostomy in male neonates with high and intermediate ARMs compared to 3-stage (neonatal colostomy - PSARP - colostomy closure) methodology in a high volume tertiary care institution of a developing country...
April 2017: Journal of Indian Association of Pediatric Surgeons
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
#14
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/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/28133315/-a-case-of-ascending-colon-cancer-with-extensive-abdominal-wall-abscess
#16
Taichi Kuwahara, Yoshihiro Tokuhisa, Nobuaki Suzuki, Shinobu Tomochika, Yuka Inoue, Hironori Tanaka, Mitsuo Nishiyama, Shinsuke Kanekiyo, Michihisa Iida, Kazuhiko Sakamoto, Shigeru Takeda, Tomio Ueno, Shigefumi Yoshino, Shoichi Hazama, Hiroaki Nagano
A 51-year-old woman was seen in our hospital because an ascending colon tumor with extensive abdominal wall abscess was detected on computed tomography(CT). On the same day, we performed open drainage and laparoscopic assisted ileocolostomy. Postoperative day 35, we performed right hemicolectomy with abdominal wall resection and closure of the colostomy as a radical surgery. After surgery, we started(negative pressure wound therapy: NPWT)to the surgical wound site; hence, the abdominal wall defect could be healed without a musculocutaneous flap...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133297/-a-case-where-rectal-cancer-ileus-caused-perforation-in-the-ascending-colon
#17
Tomohiko Machida, Masayoshi Kobayashi, Kazuki Sakai, Kunihiko Hiraoka, Takao Ichihara
The patient was a 65-year-old man. He had not defecated for a week in early December 2015, and had noticed abdominal pain and abdominaldistension from 4 days prior. The pain and distension worsened, and the patient was rush transported to our hospital. Via abdominal CT we found free air in the upper abdomen, expansion of the small and large intestines, and notably, significant intestinal tract expansion and a gas reservoir in the ascending colon. We found significant narrowing as well as hypertrophy along the entire circumference of the rectum and suspected gastrointestinal perforation due to rectal cancer ileus...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133146/-damage-control-surgery-for-perforation-of-colon-cancer
#18
Takeshi Ebihara, Motohiko Yamada, Katsushu Simizu, Koji Amano, Masahiro Kawada, Genta Sawada, Yusuke Tsunetoshi, Ken Nakata, Akihiro Usui, Masaki Tujie, Yutaka Kimura, Satoru Munakata, Yasuki Nakata, Junya Fujita
Perforation due to colon cancer maycause peritonitis and septic shock. In these cases, we maynot be able to rescue the patients in spite of emergencysurgical intervention; in these conditions, owing to limitations of operation time, it is difficult for us to assess the state or extent of the disease and to perform an ideal oncological surgerywith dissection of lymph nodes. To overcome these limitations, we introduce the concept of "damage control surgery" developed in the trauma region to treat perforations of colon cancer...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133082/-four-patients-who-underwent-lateral-lymph-node-dissection-by-an-extraperitoneal-approach-for-lateral-lymph-node-recurrence-followingsurg-ery-for-rectal-cancer
#19
Takahiro Wada, Tetsuo Ishizaki, Hiroshi Kuwabara, Takaaki Matsudo, Masanobu Enomoto, Kazuhiko Kasuya, Kenji Katsumata, Akihiko Tsuchida
To date, the surgical approach for recurrent rectal cancer has often involved highly invasive procedures. We report our experience of 4 patients who underwent lateral lymph node dissection via an extraperitoneal approach for lateral lymph node recurrence following surgery for rectal cancer. Patient 1 was a 60-year-old woman who, 6 months after surgery, underwent surgery for lateral lymph node recurrence in 1 node. Patient 2 was a 71-year-old man who underwent surgery after colostomy for rectal cancer and 4 courses of FOLFIRI+panitumumab resulted in a PR...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28087137/decreased-expression-of-kv7-channels-in-hirchsprung-s-disease
#20
Anne-Marie O'Donnell, David Coyle, Prem Puri
PURPOSE: Voltage-dependent K(+) channels (Kv channels) participate in electrical rhythmicity and smooth muscle responses and are regulated by excitatory and inhibitory neurotransmitters. Kv channels also participate in the interstitial cell of Cajal (ICC) and smooth muscle cell (SMC) responses to neural inputs. The Kv family consists of 12 subfamilies, Kv1-Kv12, with five members of the Kv7 family identified to date: Kv7.1-Kv7.5. A recent study identified the potassium channel Kv7.5 as having a role in the excitability of ICC-IM in the mouse colon...
July 2017: Journal of Pediatric Surgery
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