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https://www.readbyqxmd.com/read/28922306/do-the-surgical-outcomes-of-rectovaginal-fistula-repairs-differ-for-obstetric-and-nonobstetric-fistulas-a-retrospective-cohort-study
#1
Natalie E Karp, Emily K Kobernik, Mitchell B Berger, Chelsea M Low, Dee E Fenner
OBJECTIVES: Rectovaginal fistulas can occur from both obstetric and nonobstetric (eg, inflammatory bowel disease, iatrogenic, or traumatic) etiologies. Current data on factors contributing to rectovaginal repair success or failure are limited, making adequate patient counseling difficult. Our objective was to compare outcomes of transperineal rectovaginal fistula repair performed in a single referral center on women with obstetric and nonobstetric causes. METHODS: We performed a retrospective cohort study of women who had a transperineal rectovaginal fistula repair performed by a urogynecologist at the University of Michigan from 2005 to 2015...
September 15, 2017: Female Pelvic Medicine & Reconstructive Surgery
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
#2
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/28911880/pelvic-exenteration-for-gynecologic-malignancies-postoperative-complications-and-oncologic-outcomes
#3
A Romeo, M I Gonzalez, J Jaunarena, M E Zubieta, G Favre, J C Tejerizo
INTRODUCTION AND OBJECTIVE: To evaluate complications, morbidity and oncologic outcomes of pelvic exenteration as treatment for gynecologic malignancies. MATERIALS AND METHODS: Between 2008 and 2015, a total of 35 patients underwent pelvic exenteration, due to recurrence of gynecological cancer. Surgical outcomes, early and late postoperative complications, and recurrence/survival outcomes were assessed. RESULTS: Mean patient age was 53.8 years...
September 11, 2017: Actas Urologicas Españolas
https://www.readbyqxmd.com/read/28891850/ligation-of-intersphincteric-fistula-tract-for-fistula-in-ano-lessons-learned-from-a-decade-of-experience
#4
Songphol Malakorn, Tarik Sammour, Supakij Khomvilai, Irin Chowchankit, Shankar Gunarasa, Prapon Kanjanasilp, Charnjiroj Thiptanakij, Arun Rojanasakul
BACKGROUND: Ligation of intersphincteric fistula tract is a well-described sphincter-preserving technique for the management of fistula in ano. In 2007, we reported our early experience demonstrating a primary success rate of 94.4%. These findings have since been supported by several short-term studies, but long-term results and secondary cure rates after ligation of intersphincteric fistula tract failure remain unknown. OBJECTIVE: This study aims to report a 10-year experience of ligation of intersphincteric fistula tract with extended long-term follow-up...
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
#5
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/28884052/colovesical-fistula-an-unusual-complication-of-cytomegalovirus-colitis
#6
Talal Asif, Badar Hasan, Alisa Likhitsup, David Bamberger
Cytomegalovirus (CMV) is a double-stranded DNA virus that is associated with clinically significant disease in patients with advanced immunosuppression, particularly those with human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS). End-organ disease with CMV is classically associated with a CD4 cell count less than 50 cells/microliter. CMV colitis is the second most common manifestation of end-organ disease in this patient population. CMV-associated enteric fistula is a rare complication that has been described in only a few case reports in the literature...
July 5, 2017: Curēus
https://www.readbyqxmd.com/read/28860816/ct-guided-125-i-interstitial-brachytherapy-for-pelvic-recurrent-cervical-carcinoma-after-radiotherapy
#7
Lina Tong, Ping Liu, Bin Huo, Zhi Guo, Hong Ni
OBJECTIVE: This retrospective study aimed to evaluate the feasibility, safety, and clinical efficacy of computed tomography (CT)-guided (125)I seed interstitial brachytherapy for pelvic recurrent cervical cancer in patients with a history of pelvic radiotherapy. METHODS: From March 2011 to December 2015, 35 pelvic recurrent lesions (33 patients) were reirradiated using this type of salvage therapy. The medical history, dose-volume histogram parameters, complications, local control, overall survival (OS), and affected factors were analyzed...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/28838787/surgical-interventions-and-the-use-of-device-aided-therapy-for-the-treatment-of-fecal-incontinence-and-defecatory-disorders
#8
Adil E Bharucha, Satish S C Rao, Andrea Shin
DESCRIPTION: 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. METHODS: 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...
August 21, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28836241/-standardized-development-of-transanal-endoscopic-microsurgery
#9
Guole Lin
Transanal endoscopic microsurgery (TEM) is currently the only one-port system in endoscopic surgery, which a direct endoluminal approach can lead to the target organ through a natural opening of human body. TEM has been applied in colorectal surgery for over 3 decades. Compared with radical surgery, TEM has the advantages, such as quicker recovery, shorter hospital stay and fewer complications. One perfect TEM surgical system, which mainly consists of three parts, namely peculiar rectoscope for surgery, special surgical instruments and imaging system, is the foundation of standardized development of TEM...
August 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28803112/in-vivo-documentation-of-shape-and-position-changes-of-mri-visible-mesh-placed-in-rectovaginal-septum
#10
Iva Urbankova, Nikhil Sindhwani, Geertje Callewaert, Alice Turri, Rita Rinkijevic, Lucie Hympanova, Andrew Feola, Jan Deprest
BACKGROUND AND OBJECTIVE: Large deformations in synthetic meshes used in pelvic organ prolapse surgery may lead to suboptimal support for the underlying tissue, graft-related complications as well as recurrence. Our aim was to quantify in vivo longitudinal changes in mesh shape and geometry in a large animal model. We compare two commonly used mesh shapes, armed and flat, that are differently affixed. The secondary outcomes were active and passive biomechanical properties. METHODS: A total of 18 animals were used...
August 5, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28797517/gynecologic-anatomic-abnormalities-following-anorectal-malformations-repair
#11
Alejandra Vilanova-Sanchez, Carlos A Reck, Kate A McCracken, Victoria A Lane, Alessandra C Gasior, Richard J Wood, Marc A Levitt, Geri D Hewitt
BACKGROUND/AIM: Patients may present with gynecologic concerns after previous posterior sagittal anorectoplasty (PSARP) for repair of an anorectal malformation (ARM). Common findings include an inadequate or shortened perineal body, as well as introital stenosis, retained vaginal septum, and remnant rectovestibular fistula. An inadequate or shortened perineal body may impact fecal continence, sexual function and recommendations regarding obstetrical mode of delivery. We describe our experience with female patients referred to our center for evaluation of their previously repaired ARM, with a specific focus on perineal body anatomy and concomitant gynecologic abnormalities...
July 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28755790/correlation-between-disease-activity-and-endorectal-ultrasound-findings-of-chronic-radiation-proctitis
#12
Fei Cao, Teng-Hui Ma, Guang-Jian Liu, Yan-Lin Wen, Huai-Ming Wang, Ying-Yi Kuang, Si Qin, Xiao-Yin Liu, Bin-Jie Huang, Lei Wang
The aim of this study was to summarize the imaging features of chronic radiation proctitis (CRP) on endorectal ultrasound (ERUS) and investigate the value of ERUS in the evaluation of disease activity. 40 CRP patients and 30 control patients were investigated by ERUS. Rectal wall thickness and layers, ulcers and rectovaginal fistulas were evaluated by B-mode ultrasound. Power Doppler imaging was used to evaluate the vascularity of the rectal wall using a semiquantitative score. Disease activity was calculated according to the National Cancer Institute Common Terminology Criteria for Adverse Events 4...
July 26, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/28722084/-postoperative-complications-after-rectal-cancer-surgery-and-management
#13
Jin Gu, Qingkun Gao
Although neoadjuvant treatment such as radiotherapy, even chemoradiotherapy has already widely used in middle-low rectal cancer, surgery remains the mainstay of therapy for patients with rectal cancer. Because neoadjuvant chemoradiotherapy combined with surgery was adopted for the locally advanced rectal cancer as a standard treatment based on guidelines, postoperative complications of rectal cancer surgery caused surgeons attention and concern gradually. Some severe complications should seriously affect patient's quality of life, even patient's survival...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28703110/cell-therapy-in-surgical-treatment-of-fistulas-preliminary-results
#14
Marcin Piejko, Michał Romaniszyn, Julia Borowczyk-Michałowska, Justyna Drukała, Piotr Wałęga
Risk of recurrence after surgical treatment of a recurrent fistula is up to 50%. It has be known that more aggressive surgical treatment is associated with a high risk of anal sphincter damage and leads to incontinence. Several studies have been designed to elaborate minimally invasive treatment of rectovaginal and anal fistulas. The properties of Adipose-derived Stem Cells (ASC) significantly enhance a natural healing potency. Here, we present our experience with combined surgical and cell therapy in the treatment of fistulas...
June 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28695344/genital-tract-fistula-a-case-series-from-a-tertiary-centre-in-south-africa
#15
Thinagrin Dhasarathun Naidoo, Jagidesa Moodley, Saloshni Naidoo
INTRODUCTION AND HYPOTHESIS: We describe the demographic profile, aetiology, management and surgical outcomes in women with genital tract fistula presenting to a tertiary urogynaecology unit. METHODS: This retrospective audit included 87 patients managed in our unit between 2008 and 2015. Frequencies and means with standard deviations are presented for categorical and continuous data. Continuous dependent variables are categorized as above or below the median for bivariate analyses performed using the chi-squared test (α = 0...
July 10, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28694166/title-the-initial-accuracy-and-learning-curve-of-transvaginal-ultrasound-with-bowel-preparation-for-deep-endometriosis-in-a-united-states-tertiary-care-center
#16
Scott W Young, Nirvikar Dahiya, Maitray D Patel, Mauricio S Abrao, Javier F Magrina, M'hamed Temkit, Rosanne M Kho
STUDY OBJECTIVE: To evaluate the diagnostic accuracy and learning curve of a sonographic mapping protocol for deep endometriosis (DE). DESIGN: Patients with pelvic pain at our institution underwent transvaginal ultrasound with bowel-preparation (TVUS-BP) performed by a single radiologist. Findings suspicious for DE were reported and correlated to surgical and histopathologic findings. The exam duration and number of cases required to achieve proficiency were calculated for positive, equivocal and negative findings...
July 7, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28670596/actinomycosis-causing-recurrent-perianal-fistulae
#17
Mariana Ferreira Cardoso, Carla Carneiro, Luís Carvalho Lourenço, Catarina Graça Rodrigues, Sara Folgado Alberto, Ana Alagoa João, Ricardo Rocha, Vasco Geraldes, Ana Costa, Jorge Reis, Vítor Nunes
Actinomycosis is a rare but easily curable infection that should be considered in the differential diagnosis of perianal fistulizing disease. We present the case of a 26-year-old woman with complex perianal fistulae, including trans-sphincteric and suprasphincteric fistulous tracts and a rectovaginal fistula, requiring multiple abscess drainages, seton placement, and antibiotic courses, with little improvement. After extensive investigation, Actinomyces spp. was identified in anal cytology. The patient underwent a 6-week course of intravenous penicillin followed by oral amoxicillin, with remarkable improvement...
2017: ACG Case Reports Journal
https://www.readbyqxmd.com/read/28664485/-per-vaginam-topical-use-of-hormonal-drugs-in-women-with-symptomatic-deep-endometriosis-a-narrative-literature-review
#18
REVIEW
Laura Buggio, Caterina Lazzari, Ermelinda Monti, Giussy Barbara, Nicola Berlanda, Paolo Vercellini
PURPOSE: We aim to provide a comprehensive overview of the role of the vagina as a route for drug delivery and absorption, with a particular focus on the use of vaginal hormonal compounds for the treatment of deep infiltrating symptomatic endometriosis. METHODS: A MEDLINE search through PubMed was performed to identify all published studies in English language on vaginal hormonal treatments for symptomatic endometriosis. RESULTS: Main advantages of the vaginal route include avoidance of the hepatic-first pass metabolic effect, the possibility of using lower therapeutic dosages, and the reduction of side effects compared with the oral administration...
June 29, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28652096/mr-imaging-of-endometriosis-spectrum-of-disease
#19
C Bourgioti, O Preza, E Panourgias, K Chatoupis, A Antoniou, M E Nikolaidou, L A Moulopoulos
Endometriosis is a common gynecological disorder defined by the presence of endometrial tissue outside the uterus. It is the most common cause of chronic pelvic pain and typically affects the ovaries, uterine ligaments, peritoneum, tubes, rectovaginal septum and bladder. It may, however, be found at various extrapelvic sites, including the perineum, liver, pancreas, lung or even the central nervous system, and in such cases, diagnosis may be quite challenging. Even though definitive diagnosis requires laparoscopy, preoperative identification of endometriosis is important not only to differentiate it from other diseases with similar clinical presentations but also, for accurate presurgical mapping, since complete removal of all endometriotic foci is critical for the effective treatment of the patient's symptoms...
June 23, 2017: Diagnostic and Interventional Imaging
https://www.readbyqxmd.com/read/28647042/transanal-endoscopic-microsurgery-for-the-treatment-of-uncommon-rectal-lesions
#20
Manuel Ferrer-Márquez, Francisco Rubio-Gil, Sofía Ortega-Ruiz, Isabel Blesa-Sierra, Antonio Álvarez-García, Jaime Jorge-Cerrudo, Elisabet Vidaña-Márquez, Ricardo Belda-Lozano, Ángel Reina-Duarte
INTRODUCTION: Transanal endoscopic microsurgery (TEM) was developed as a less aggressive alternative treatment for rectal lesions (mainly adenomas and adenocarcinomas). However, its use for other rectal lesions has become more frequent, trying to reduce the morbidity associated with more invasive techniques. The aim of this study is to describe our experience in the use of TEM in other rectal lesions. METHODS: Retrospective and descriptive study including patients operated with TEM (from June 2008 to December 2016) for the treatment of rectal lesions different from adenomas or adenocarcinomas...
June 2017: Cirugía Española
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