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https://www.readbyqxmd.com/read/28994873/anal-imperforation-in-adults-diagnostic-difficulties-and-therapeutic-options
#1
Houcine Maghrebi, Rachid Ksantini, Amin Makni, Helmi Slama, Meriem Jrad, Amine Daghfous, Wael Rebai, Fadhel Fteriche, Faouzi Chebbi, Mohamed Jouini, Kacem Montassar, Zoubeir Ben Safta
Anorectal malformations are congenital anomalies ranging from simple perineal fistulas to complex malformations. They are usually treated inchildhood, and exceptionally in adult. We herein report the case of a 22 years aged patient and relate the diagnosis difficulties and therapeuticoptions. She consulted for anal imperforation discovered since birth. Initially, His parents refused the surgical management. It was an analimperforation with a vestibular fistula. The patient was operated by a low approach. She had a disconnection of the recto-vestibular fistula,dissection of the anal canal and a perineal posterior transposition...
November 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28991089/retained-needle-following-transanal-hemorrhoidal-dearterialization
#2
Valerio Celentano, Anjan Banerjee, Federico Luvisetto, Syed Naqvi, Jim Khan
INTRODUCTION: A needle was retained during transanal hemorrhoidal dearterialization. This rare complication has not been described before. TECHNIQUE: A spinal needle was inserted from the perianal skin to localize the retained foreign body that was located at 7 cm from the anal margin. A decision was made to proceed to intersphincteric dissection, and a 3-cm incision was made in the perianal skin from 2 to 4 o'clock. Deep pararectal dissection continued, and the needle was eventually found lying in the muscular layer, parallel to the plane of the dissection...
November 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28940230/outcome-after-restorative-proctocolectomy-and-ileal-pouch-anal-anastomosis-in-children-and-adults
#3
K Diederen, S S Sahami, M M Tabbers, M A Benninga, A Kindermann, P J Tanis, M W Oomen, J R de Jong, W A Bemelman
BACKGROUND: Studies comparing the outcome of ileal pouch-anal anastomosis (IPAA) in children and adults are scarce. This complicates decision-making in young patients. The aim of this study was to compare adverse events and pouch function between children and adults who underwent IPAA. METHODS: This cross-sectional cohort study included all consecutive children (aged less than 18 years) and adults with a diagnosis of inflammatory bowel disease or familial adenomatous polyposis who underwent IPAA in a tertiary referral centre between 2000 and 2015...
September 20, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28935189/early-closure-of-fistula-using-neo-adjuvant-intra-arterial-chemotherapy-in-locally-advanced-anal-cancer
#4
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/28929316/mucinous-adenocarcinoma-on-perianal-fistula-a-rising-entity
#5
C J Alvarez-Laso, S Moral, D Rodríguez, A Carrocera, E Azcano, A Cabrera, R Rodríguez
INTRODUCTION: Mucinous adenocarcinoma on perianal fistula is a rare entity; it could be underdiagnosed because it behaves often as a regular perianal fistula. MATERIALS AND METHODS: We have recently treated four cases in our unit. We present them and review the literature, emphasizing on clinical characteristic and therapeutic options. The four patients were male with a mean age of 64. Three of them were classified as locally advances cases and therefore treated with neoadjuvant therapy...
September 19, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28929282/anoperineal-lesions-in-crohn-s-disease-french-recommendations-for-clinical-practice
#6
REVIEW
D Bouchard, L Abramowitz, G Bouguen, C Brochard, A Dabadie, V de Parades, M Eléouet-Kaplan, N Fathallah, J-L Faucheron, L Maggiori, Y Panis, F Pigot, P Rouméguère, A Sénéjoux, L Siproudhis, G Staumont, J-M Suduca, B Vinson-Bonnet, J-D Zeitoun
BACKGROUND: Anoperineal lesion (APL) occurrence is a significant event in the evolution of Crohn's disease (CD). Management should involve a multidisciplinary approach combining the knowledge of the gastroenterologist, the colorectal surgeon and the radiologist who have appropriate experience in this area. Given the low level of evidence of available medical and surgical strategies, the aim of this work was to establish a French expert consensus on management of anal Crohn's disease. These recommendations were led under the aegis of the Société Nationale Française de Colo-Proctologie (SNFCP)...
September 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28918703/a-randomized-multicenter-clinical-trial-of-rph-with-the-simplified-milligan-morgan-hemorrhoidectomy-in-the-treatment-of-mixed-hemorrhoids
#7
Yong-Heng He, Zhi-Jun Tang, Xiang-Tong Xu, De-Quan Huang, Li-Shun Zhang, Qing-Zhu Tang, Zhi-Min Fan, Xian-Jun Zou, Guo-Jun Zou, Chong-Yang Zhang, Fan Hu, Biao Xie, Yan-Hua Li, Yao Tong, Hong-Chang Liu, Ke Li, Yu-Lian Luo, Fei Liu, Guang-Wei Situ, Zuo-Long Liu
PURPOSE: To explore the safety and efficacy of Ruiyun procedure for hemorrhoids (RPH) or RPH with the simplified Milligan-Morgan hemorrhoidectomy (sMMH) in the treatment of mixed hemorrhoids. METHODS: This is a randomized, controlled, balanced, multicenter study of 3000 patients with mixed hemorrhoids. The outcomes and postoperative complications were compared between 5 types of surgeries. RESULTS: The efficacy rate was the highest in patients who received RPH+sMMH and decreased in the following order: patients who received RPH alone, MMH alone, procedure for prolapse and hemorrhoids (PPH) alone, and PPH+sMMH ( P < ...
September 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28913139/mayer-rokitansky-kuster-hauser-syndrome-associated-with-rectovestibular-fistula
#8
Charu Tiwari, Hemanshi Shah, Mukta Waghmare, Kiran Khedkar
A female neonate with two openings in the introitus and an absent anal opening at the anal site presents a diagnostic challenge. Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome associated with rectovestibular fistula, though rare, should be kept in mind as a differential diagnosis of this presentation. We present such a case in a one-year-old female child with MRKH syndrome and rectovestibular fistula.
March 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28905805/a-novel-model-of-acellular-dermal-matrix-plug-for-anal-fistula-treatment-report-of-a-case-and-surgical-consideration-based-on-first-utility-in-poland
#9
Adam Bobkiewicz, Łukasz Krokowicz, Maciej Borejsza-Wysocki, Tomasz Banasiewicz
Anal fistula (AF) is a pathological connection between anus and skin in its surroundings. The main reason for the formation of anal fistula is a bacterial infection of the glands within the anal crypts. One of the modern techniques for the treatment of fistulas that do not interfere with the sphincters consists in implantation of a plug made from collagen material. We are presenting the first Polish experience with a new model of biomaterial plug for the treatment of anal fistula. We also point out key elements of the procedure (both preoperative and intraoperative) associated with this method...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28895031/utility-of-endoanal-ultrasonography-in-assessment-of-primary-and-recurrent-anal-fistulas-and-for-detection-of-associated-anal-sphincter-defects
#10
Sameh Hany Emile, Alaa Magdy, Mohamed Youssef, Waleed Thabet, Mahmoud Abdelnaby, Waleed Omar, Wael Khafagy
BACKGROUND: Tridimensional endoanal ultrasonography (3D-EAUS) has been used for the assessment of various anorectal lesions. Previous studies have reported good accuracy of 3D-EAUS in preoperative assessment of fistula-in-ano (FIA). This study aimed to assess the diagnostic utility of 3D-EAUS in preoperative evaluation of primary and recurrent FIA and its role in detection of associated anal sphincter (AS) defects. PATIENTS AND METHODS: Prospectively collected data of patients with FIA who were investigated with 3D-EAUS were reviewed...
September 11, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28894786/methylene-blue-effectiveness-as-local-analgesic-after-anorectal-surgery-a-literature-review
#11
REVIEW
Dewi Fransiska, Wifanto Saditya Jeo, Yefta Moenadjat, Dewi Friska
BACKGROUND: Methylene blue (MB) has been found to have unique analgesic property through temporary disruption of sensory nerve conduction. In anorectal surgery, MB is widely used as a biologic stain but the analgesic effect has never been studied. Thus, a literature review completed with critical appraisal is required to find out its efficacy. METHODS: A review has been run to find out its efficacy. Literature search proceeded in database sites, namely, PubMed, EBSCO, Cochrane, Wiley, and ProQuest using the following keywords: "anorectal" OR "hemorrhoid" OR "anal fistula" OR "anal fissure" OR "anal abscess" OR "anal pruritus" AND "methylene blue" AND "analgesic"; then the critical appraisal and its implication were discussed...
2017: Advances in Medicine
https://www.readbyqxmd.com/read/28891853/design-and-psychometric-evaluation-of-the-quality-of-life-in-patients-with-anal-fistula-questionnaire
#12
Manuel Ferrer-Márquez, Natalia Espínola-Cortés, Angel Reina-Duarte, José Granero-Molina, Cayetano Fernández-Sola, José Manuel Hernández-Padilla
BACKGROUND: Quality of life is often considered when deciding and evaluating the treatment strategy for patients diagnosed with anal fistula. OBJECTIVE: The purpose of this study was to develop and psychometrically test the Quality of Life in Patients with Anal Fistula Questionnaire. DESIGN: This was an observational cross-sectional study for the development and validation of a psychometric tool. SETTINGS: The study was conducted at a general hospital in the southeast of Spain...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28891851/sphincter-sparing-anal-fistula-repair-are-we-getting-better
#13
Jeremy Sugrue, Nathalie Mantilla, Ariane Abcarian, Kunal Kochar, Slawomir Marecik, Vivek Chaudhry, Anders Mellgren, Johan Nordenstam
BACKGROUND: Sphincter-sparing repairs are commonly used to treat anal fistulas with significant muscle involvement. OBJECTIVE: The current study evaluates the trends and efficacy of sphincter-sparing repairs and determines risk factors for fistula recurrence. DESIGN AND SETTINGS: A retrospective review was performed at 3 university-affiliated teaching hospitals. PATIENTS: All 462 patients with cryptoglandular anal fistulas who underwent 573 sphincter-sparing repairs between 2005 and 2015 were included...
October 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28888700/surgical-repair-of-rectovaginal-fistula-using-the-modified-martius-procedure-a-step-by-step-guide
#14
Dan Wang, Juan Chen, Lan Zhu, Mingchen Sang, Fan Yu, Qing Zhou
STUDY OBJECTIVE: to demonstrate the surgical repair of rectovaginal fistula by the modified Martius procedure. DESIGN: step by step presentation of the procedure using video. SETTING: Rectovaginal fistula (RVF) is abnormal epithelialized connections between the vagina and rectum. Causes of rectovaginal fistula include obstetrical trauma, Crohn disease, pelvic irradiation and postsurgical complications. Many surgical interventions have been developed, from laparoscopic technique to muscle transposition and even rectal resection...
September 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28884323/-proctology-for-internists
#15
J Feisthammel, J Mössner
In proctology patients can often be helped with very little effort. With knowledge of the most common disease symptoms the treating physician can in many cases correctly recognize the cause of the complaints and initiate the appropriate therapy or arrange referral to a proctological institution. This article aims to briefly and succinctly present the most common diseases in proctology (e.g. mariscae, hemorrhoids, anal fissures, perianal venous thrombosis, abscesses and fistulas, condyloma acuminatum and anal carcinoma) and to provide the treating internist, even outside of gastroenterology, assistance with the management of proctological symptoms...
September 7, 2017: Der Internist
https://www.readbyqxmd.com/read/28882770/video-assisted-anal-fistula-treatment-vaaft-in-cryptoglandular-fistula-in-ano-a-systematic-review-and-proportional-meta-analysis
#16
REVIEW
Pankaj Garg, Pratiksha Singh
BACKGROUND: Video-Assisted Anal Fistula Treatment (VAAFT) is a relatively new minimally invasive videoendoscopic procedure for treating fistula-in-ano. We reviewed and performed metaanalysis to evaluate the efficacy of this procedure. METHODS: Studies from the period 2010 to 2016 were searched in PubMed, Medline, Scopus, Embase, Ovid, SCI database, Cochrane Central Register of Controlled Trials (CENTRAL) & Google Scholar database. All studies which utilized VAAFT to treat fistula-in-ano were extracted...
September 4, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28871380/mri-of-anal-canal-common-anal-and-perianal-disorders-beyond-fistulas-part-2
#17
REVIEW
Ayşe Erden
A broad spectrum of disease, from benign processes to life-threatening pathologies, can cause anal pain. MR imaging (MRI) has become increasingly widely used method over the past two decades for the evaluation of individuals with anorectal symptoms. Although imaging is rarely necessary to determine the etiology of the majority of cases, MRI is particularly useful as a noninvasive method of excluding severe neoplastic conditions. In this article, MRI findings of a number of pathologies such as anal and perianal neoplasms, hemorrhoidal disease, arteriovenous malformation of the perianal region, and anal sphincter lesions (defects, scarring, atrophy) which may lead to fecal incontinence are presented...
September 4, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28840368/mri-of-anal-canal-normal-anatomy-imaging-protocol-and-perianal-fistulas-part-1
#18
REVIEW
Ayşe Erden
Anal complaints are very common in the general population and are caused by a variety of disorders mostly benign in nature. The aim of this article is to provide the radiologist with a detailed description of the MRI anatomy and technique, and an overview of the various diseases most commonly presenting with anal pain, by descriptions and illustrative examples of MRI features of each entity.
August 24, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28839437/elaboration-and-validation-of-crohn-s-disease-anoperineal-lesions-consensual-definitions
#19
Clémence Horaist, Vincent de Parades, Laurent Abramowitz, Paul Benfredj, Guillaume Bonnaud, Dominique Bouchard, Nadia Fathallah, Agnès Sénéjoux, Laurent Siproudhis, Ghislain Staumont, Manuelle Viguier, Philippe Marteau
AIM: To establish consensual definitions of anoperineal lesions of Crohn's (APLOC) disease and assess interobserver agreement on their diagnosis between experts. METHODS: A database of digitally recorded pictures of APLOC was examined by a coordinating group who selected two series of 20 pictures illustrating the various aspects of APLOC. A reading group comprised: eight experts from the Société Nationale Française de Colo Proctologie group of study and research in proctology and one academic dermatologist...
August 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28838787/surgical-interventions-and-the-use-of-device-aided-therapy-for-the-treatment-of-fecal-incontinence-and-defecatory-disorders
#20
Adil E Bharucha, Satish S C Rao, Andrea Shin
The purpose of this clinical practice update expert review is to describe the key principles in the use of surgical interventions and device-aided therapy for managing fecal incontinence (FI) and defecatory disorders. The best practices outlined in this review are based on relevant publications, including systematic reviews and expert opinion (when applicable). Best Practice Advice 1: A stepwise approach should be followed for management of FI. Conservative therapies (diet, fluids, techniques to improve evacuation, a bowel training program, management of diarrhea and constipation with diet and medications if necessary) will benefit approximately 25% of patients and should be tried first...
August 22, 2017: Clinical Gastroenterology and Hepatology
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