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Bowel resection

S Renshaw, I L Silva, A Hotouras, S D Wexner, J Murphy, C Bhan
The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulcerative Colitis"). Two investigators screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were presented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis...
March 15, 2018: Techniques in Coloproctology
Vikram Khanna, Kashish Khanna, Maddur Srinivas
A day-old neonate presented with bowel obstruction and an abdominal mass. Exploratory laparotomy revealed complete tubular midgut duplication from duodeno-jejunal junction up to terminal ileum which was communicating with the ileum distally. At the proximal end, another 5×5 cm duplication cyst was identified and excised. Postoperatively, complaints were relieved. During follow-up, 99m-Tc-pertechnetate-SPECT scan showed ectopic gastric mucosa in lower abdomen and in the right hemithorax. CECT-chest showed a 3×3 cm foregut duplication cyst, but there were no respiratory symptoms...
March 15, 2018: BMJ Case Reports
Alessandra Di Giovanni, Lucia Casarella, Marina Coppola, Domenico Iuzzolino, Marianna Rasile, Mario Malzoni
STUDY OBJECTIVE: To assess sensitivity and accuracy of combined transvaginal/transabdominal ultrasonography for evaluation of deep infiltrating bowel endometriosis nodules measured after surgery. DESIGN: A prospective study (Canadian Task Force classification II.1). SETTING: A Center for Advanced Endoscopic Gynecologic Surgery from January 2014 to December 2016. PATIENTS: All women undergoing laparoscopic surgery and scheduled for segmental resection for clinically suspected bowel endometriosis...
March 12, 2018: Journal of Minimally Invasive Gynecology
Claudia Schadow, Hanna Schmidt, Alexander Schorcht, Frank Meyer
MEDICAL HISTORY AND CLINICAL FINDINGS:  A 43-year old male patient was admitted because of diffuse abdominal discomfort for two days, which had started in the upper abdomen; medical history, no previous surgical interventions at the abdomen. INVESTIGATIONS:  Gastroscopy and abdominal ultrasound revealed only a mild gastritis. Laboratory parameters: showed only a slight leucocytosis (10 610/µL). On the 1st day of the hospital stay, the patient developed a worsening of the abdominal symptoms with distended abdomen, sounding bowel movements and recurrent vomiting, which were interpreted as acute abdomen by the surgeon on call leading to the indication of a surgical intervention...
March 2018: Deutsche Medizinische Wochenschrift
Kapo Saukkonen, Jaana Hagström, Harri Mustonen, Laura Lehtinen, Olli Carpen, Leif C Andersson, Hanna Seppänen, Caj Haglund
Expression of regenerating islet-derived protein 4 (REG4), a secretory protein involved in cell differentiation and proliferation, is upregulated in inflammatory bowel diseases and in many gastrointestinal malignancies. The prognostic significance of its expression in pancreatic ductal adenocarcinoma is unknown. Our aim was to investigate tumor tissue and serum REG4 expression in pancreatic ductal adenocarcinoma patients. We also evaluated as a control the diagnostic value of serum REG4 level in patients with chronic pancreatitis...
March 2018: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
Juliane Kupsch, Thomas Jackisch, Klaus E Matzel, Joerg Zimmer, Andreas Schreiber, Anja Sims, Helmut Witzigmann, Sigmar Stelzner
PURPOSE: Severity of anorectal dysfunction after low anterior resection is associated with various patient- and treatment-related factors. We aimed to quantify anorectal dysfunction after treatment for rectal cancer using the low anterior resection syndrome (LARS) score. METHODS: We retrieved from a prospective database 331 eligible patients on whom anterior resection for rectal cancer had been performed from 2000 to 2014. All patients were sent a LARS score accompanied by a supplementary questionnaire...
March 15, 2018: International Journal of Colorectal Disease
Daniele Alberti, Laura Righetti, Adrian Bianchi, Gian Luigi de'Angelis, Giovanni Boroni
BACKGROUND: Bowel dilatation is a common adaptive mechanism after intestinal resection. The symptomatic dilated dysmotile duodenum is difficult to manage, since conventional bowel tailoring and lengthening techniques are potentially hazardous because of the anatomy of the duodenal blood supply, the proximity to the pancreas, and the risk of injury to the common bile duct. METHODS: A 2-month-old child with short bowel and a symptomatic massively dilated duodenum was treated with a Transverse Flap Duodenoplasty (TFD)...
March 14, 2018: Pediatric Surgery International
Nauman Ahmed, Hammad Naeem Rana
Primary Small bowel adenocarcinoma, a rare entity and having varied clinical presentation, makes its clinical detection a diagnostic challenge. Moreover, its true prevalence in sub-continent population has not yet been established, which makes it more difficult for its detection. We present the case of a 60 year old male who came with abdominal pain and weight loss for two years as the only symptoms. A series of tests in the two year period remained inconclusive. Later Computed tomography showed a suspicious mass at the terminal ileum...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Yuji Otsuki, Hirofumi Konn, Keisa Takeda, Masahiko Koike
Obturator hernia (OH) is a rare condition that accounts for 0.073-1% of abdominal hernias and 0.48% of bowel obstructions. OH frequently occurs in elderly women, with an incidence that increases with age. The only treatment for OH is surgical intervention, and the approaches used vary greatly. Consequently, a well-defined consensus has not yet emerged. We assessed the efficiency and safety of the midline extraperitoneal approach for OH. Six patients with OH repaired using the midline extraperitoneal approach at KKR Sapporo Medical Center between April 2011 and January 2016 were included in the study...
March 14, 2018: Keio Journal of Medicine
Matthew C Hernandez, Brandon R Bruns, Nadeem Haddad, Margaret Lauerman, David S Morris, Kristen Arnold, Herb A Phelan, David Turay, Jason Murry, John S Oh, Toby Enniss, Matthew M Carrick, Thomas M Scalea, Martin Zielinski
INTRODUCTION: Threatened, perforated, and infarcted bowel is managed with conventional resection and anastomosis (hand sewn (HS) or stapled (ST)). The SHAPES analysis demonstrated equivalence between HS and ST techniques, yet surgeons appeared to prefer (HS) for the critically ill. We hypothesized that HS is more frequent in patients with higher disease severity as measured by the AAST EGS grading system. METHODS: We performed a post hoc analysis of the SHAPES database...
March 12, 2018: Journal of Trauma and Acute Care Surgery
Sajith C Senadeera, Simon V Vun, Nicholas Butterfield, Tim W Eglinton, Frank A Frizelle
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is a common acute general surgical condition that is typically self-limiting; however in refractory cases it can necessitate life-saving intervention. When bleeding is refractory, super-selective embolization (SSE) becomes an important management strategy. This study aims to evaluate outcomes of this procedure at our institution and identify predictors of clinical success. METHODS: A retrospective analysis of patients with positive computed tomography angiograms for LGIB at a tertiary centre between December 2007 and May 2017...
March 14, 2018: ANZ Journal of Surgery
S Löb, K Luetkens, K Krajinovic, A Wiegering, C-T Germer, F Seyfried
PURPOSE: Defunctioning ileostomies reduce the consequences of distal anastomotic leakage following bowel resections. Ileostomy reversal in itself, however, is associated with appreciable morbidity (3-40%) and mortality (0-4%). Despite being a common teaching procedure, there is limited information on the impact of surgical proficiency levels on postoperative outcome. METHODS: Adult patients undergoing closure of a defunctioning ileostomy between September 2008 and January 2017 were identified from a surgical administrative database that was collected prospectively (n = 558)...
March 13, 2018: International Journal of Colorectal Disease
Igors Iesalnieks, Melanie Hoene, Theresa Bittermann, Hans J Schlitt, Christina Hackl
Background: Studies addressing the role of mechanical bowel preparation (MBP) in Crohn's disease (CD) patients are lacking. Methods: Consecutive elective colorectal resections for CD have been included in the present analysis. Exclusion criteria were small bowel resections not including colon, urgent surgeries, surgeries for cancer, and abdominoperineal resections for perianal disease. MBP was performed routinely between 1992 and 2004, omitted between 2005 and 2015, and reintroduced in 2016...
February 24, 2018: Inflammatory Bowel Diseases
Hiroto Inoue, Yuto Sato, Shuuhei Shintani, Hiroki Tanabe, Hiromichi Bamba, Yasunobu Komai, Tomoaki Nakamura, Takayuki Imai, Akira Andou
We report the case of a 61-year-old man who experienced severe adverse effects of capecitabine because of dihydropyrimidine dehydrogenase (DPD) deficiency. In 2016, he visited our hospital for adenocarcinoma of the gastroesophageal junction and was prescribed neoadjuvant chemotherapy with capecitabine, cisplatin, and trastuzumab. On day 14 of chemotherapy, he developed severe diarrhea, canker sores, enterocolitis, febrile neutropenia, and thrombocytopenia. He was then urgently hospitalized, and anticancer treatment was stopped...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Katsunori Matsueda, Tatsuya Toyokawa, Masahiro Sakata, Isao Fujita, Jouichiro Horii
This case report refers to a 31-year-old patient with an 11-year history of Crohn's disease. The patient presented with an edematous elevated lesion in the splenic flexure. Two histological analyses revealed no signs of obvious dysplasia, and the patient subsequently began infliximab treatment. Nine months later, a worsening of the stricture of the edematous elevated lesion was observed in the splenic flexure, and transverse colonic resection was performed. A histological investigation of the lesion in the splenic flexure revealed advanced adenocarcinoma...
March 9, 2018: Internal Medicine
H Roman, M Ballester, J Loriau, M Canis, P A Bolze, J Niro, S Ploteau, C Rubod, C Yazbeck, P Collinet, B Rabischong, B Merlot, X Fritel
The article presents French guidelines for surgical management of endometriosis. Surgical treatment is recommended for mild to moderate endometriosis, as it decreases pelvic painful complaints and increases the likelihood of postoperative conception in infertile patients (A). Surgery may be proposed in symptomatic patients with ovarian endometriomas which diameter exceeds 20mm. Cystectomy allows for better postoperative pregnancy rates when compared to ablation using bipolar current, as well as for lower recurrences rates when compared to ablation using bipolar current or CO2 laser...
March 8, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Christopher Lowe, Oussama El Bakbachi, Damian Kelleher, Imran Asghar, Francesco Torella, George A. Antoniou
The aim of this review was to investigate presentation, aetiology, management, and outcomes of bowel ischaemia following EVAR. We present a case report and searched electronic bibliographic databases to identify published reports of bowel ischaemia following elective infra-renal EVAR not involving hypogastric artery coverage or iliac branch devices. We conducted our review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. In total, five cohort studies and three case reports were included...
March 12, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Andreas Lorenz, Pamela Kogler, Marcus Huth, Reinhold Kafka-Ritsch, Dietmar Öfner, Alexander Perathoner
PURPOSE: Resection of a long rectal stump after previous colectomy or Hartmann procedure often requires a combined transperitoneal and transperineal approach because of limited access through a perineal incision alone. Risks associated with this procedure include iatrogenic injury to bowels, nerves, ureters, vessels and sexual organs. This study reports on the feasibility and safety of perianal minimally invasive surgery (PAMIS) for the resection of long rectal stumps that would otherwise require a combined transperitoneal and perianal approach...
March 10, 2018: International Journal of Colorectal Disease
Lindsey M Charo, Adam M Burgoyne, Paul T Fanta, Hitendra Patel, Juliann Chmielecki, Jason K Sicklick, Michael T McHale
Gastrointestinal stromal tumors (GISTs) are rare in pregnancy, with only 11 reported cases. Adjuvant imatinib therapy, which targets the most common driver mutations in GIST ( KIT and PDGFRA) , is recommended for patients with high-risk GIST, but it has known teratogenicity in the first trimester. A 34-year-old G3P2 woman underwent exploratory laparotomy at 16 weeks' gestation for a presumed adnexal mass. Surgical findings included normal adnexa and a 14-cm solid small bowel mass. The mass was resected en bloc with a segment of jejunum followed by a primary anastomosis...
March 2018: Journal of the National Comprehensive Cancer Network: JNCCN
Hirofumi Kawanaka, Shoji Hiroshige, Nobuhide Kubo, Teijiro Hirashita, Takeshi Masuda, Yushi Kaisyakuji, Tadahiro Tajiri, Akinori Egashira, Toshifumi Matsumoto, Tokujiro Yano
BACKGROUND: Obturator hernia (OH) is a rare but serious disease associated with high morbidity and mortality because of patients' advanced age and comorbidities. This study evaluated the feasibility of a laparoscopic approach for OH. STUDY DESIGN: We retrospectively reviewed the records of 32 patients (median age: 84 years; 31 women) with OH treated between 2003 and 2016. RESULTS: Five patients with incidental OH underwent totally extraperitoneal (TEP) repair...
March 6, 2018: Journal of the American College of Surgeons
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