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https://www.readbyqxmd.com/read/28838787/surgical-interventions-and-the-use-of-device-aided-therapy-for-the-treatment-of-fecal-incontinence-and-defecatory-disorders
#1
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/28745804/postprostatectomy-incontinence-is-related-to-pelvic-floor-displacements-observed-with-trans-perineal-ultrasound-imaging
#2
Ryan E Stafford, Wolbert van den Hoorn, Geoff Coughlin, Paul W Hodges
AIMS: To investigate the relationship between post-prostatectomy incontinence and dynamic features of activation of specific pelvic floor muscles in addition to anatomical parameters of the urethra. METHODS: Forty-two men aged 66 (7) years (incontinent [N = 19] and continent [N = 23]) who had undergone prostatectomy participated. Transperineal ultrasound imaging was used to record sagittal images of pelvic structures during involuntary coughing and sustained maximal voluntary contractions...
July 26, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28702189/a-case-report-of-pneumo-retro-peritoneum-an-unusual-presentation-of-ischio-rectal-abscess
#3
Usman Ismat Butt, Samiullah Bhatti, Abdul Wadood, Usman Ali Rehman, Shabbar Hussain Changazi, Kashif Malik, Shah Fahad, Anila Chughtai, Nauman Arif Jadoon, Mahmood Ayyaz
INTRODUCTION: Ano-rectal abscesses are common. They however usually do not present with abdominal symptoms. CT although useful is not routinely carried out. Finding of Pneumo-retro-peritoneum with ischio-rectal abscess is rare. CASE PRESENTATION: We present the case of a diabetic gentleman who presented with abdominal pain and distension and was found to have ischio-rectal abscess on perianal examination. Although initially suspected to have acute abdomen due to perforated viscus, CT scan revealed pneumo-retro-peritoneum which appeared to arise due to the abscess...
August 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28600166/transrectal-ultra-sonography-based-evidence-of-ksharasutra-therapy-for-fistula-in-ano-a-case-series
#4
Aditya Nema, Sanjay Kumar Gupta, Tukaram S Dudhamal, Vyasadeva Mahanta
Ksharasutra (parasurgical procedure using a thread treated by alkalies) is being practiced in Indian system of medicine since ancient time for management of ano-rectal disorders; particularly for Bhagandara, (fistula in ano), and generally difficult to treat. In this case series, standard Ksharasutra was prepared as per the Ayurvedic Pharmacopeia of India and used to treat the different cases of Bhagandara. In this case series total 6 patients of Bhagandara were treated with Ksharasutra and partial fistulectomy...
April 2017: Journal of Ayurveda and Integrative Medicine
https://www.readbyqxmd.com/read/28577539/inguinal-and-anorectal-lymphogranuloma-venereum-a-case-series-from-a-sexually-transmitted-disease-center-in-rome-italy
#5
Alessandra Latini, Mauro Zaccarelli, Maria Grazia Paglia, Maria Gabriella Donà, Amalia Giglio, Domenico Moretto, Antonella Vulcano, Massimo Giuliani, Manuela Colafigli, Marina Ambrifi, Fulvia Pimpinelli, Antonio Cristaudo
BACKGROUND: Lymphogranuloma venereum (LGV) is a sexually transmitted infection caused by L1, L2, L3 serovars of C. trachomatis (CT). Since 2003, LGV cases have been increasing in Europe. Aim of this report is to describe the LGV cases diagnosed in the largest STI center in Rome, Italy, from 2000 to 2016. This report shows that two clinically and epidemiologically different series of cases exist, and that, at present, the ano-rectal LGV represents the clinical variant occurring more frequently among men having sex with men (MSM), particularly those HIV-infected...
June 2, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28304143/anal-function-after-endoluminal-locoregional-resection-by-transanal-endoscopic-microsurgery-and-radiotherapy-for-rectal-cancer
#6
I Biviano, A Balla, D Badiali, S Quaresima, G D'Ambrosio, E Lezoche, E Corazziari, A M Paganini
AIM: In patients with rectal cancer, surgery and chemoradiotherapy may affect anal sphincter function. Few studies have evaluated anorectal function after neoadjuvant chemoradiotherapy (n-CRT) and/or transanal endoscopic microsurgery (TEM). The aim of this study was to evaluate the effects of n-CRT and TEM on anorectal function. METHOD: Thirty-seven patients with rectal cancer underwent anorectal manometry and Wexner scoring for faecal incontinence at baseline, after n-CRT (cT2-T3N0 cancer) and at 4 and 12 months after surgery...
June 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28259693/transanal-opening-of-intersphincteric-space-tropis-a-new-procedure-to-treat-high-complex-anal-fistula
#7
Pankaj Garg
BACKGROUND: The sepsis in intersphincteric space has important role in pathogenesis of most complex fistula-in-ano. This sepsis is like a small abscess in a closed space. This closed space needs to be drained adequately and then kept open for the fistula-in-ano to heal properly. The aim was to lay open and drain the intersphincteric space through internal opening via transanal approach. This has been tried in submucosal and intersphincteric rectal abscesses but has never been tried in complex fistula-in-ano...
April 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28247060/rectal-advancement-flap-for-the-treatment-of-complex-cryptoglandular-anal-fistulas-a-systematic-review-and-meta-analysis
#8
REVIEW
Zutoia Balciscueta, Natalia Uribe, Izaskun Balciscueta, Juan Carlos Andreu-Ballester, Eduardo García-Granero
PURPOSE: Rectal advancement flap is an accepted approach for treating complex fistula-in-ano. However, a diversity of technical modifications have been described. The aim of this study was to evaluate recurrence and fecal continence rates after performing rectal advancement flaps depending upon flap thickness (full-thickness, partial-thickness, or mucosal flaps) and treatment of the fistulous tract (core-out or curettage). METHODS: Medline (PubMed, Ovid), the Cochrane Library database, and ClinicalTrials...
May 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28228247/the-changes-in-resting-anal-pressure-after-performing-full-thickness-rectal-advancement-flaps
#9
Zutoia Balciscueta, Natalia Uribe, Miguel Mínguez, Eduardo García-Granero
BACKGROUND: Advancement flap is an accepted approach for treating complex fistula-in-ano.The purpose was to evaluate the changes in resting pressure along the anal canal after performing a full-thickness flap. METHODS: Manometric review of patients who have undergone a full-thickness rectal advancement flap procedure for complex anal fistulas of cryptoglandular origin. Recurrence and continence were evaluated. Resting Anal Pressure was assessed along the anal canal by two measures: maximum resting pressure(MRP) and inferior resting pressure(IRP) at 0...
September 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28161008/genito-urinary-sequelae-after-carcinological-rectal-resection-what-to-tell-patients-in-2017
#10
A Abdelli, X Tillou, A Alves, B Menahem
Although we have seen revolutionary changes with multi-disciplinary management of patients with rectal cancer, the evaluation of genito-urinary sequelae remains of great concern. Precise pre-operative evaluation with validated scores allows detection of urinary disorders in 16 to 23% of patients, and sexual disorders in nearly 35% of men and 50% of women. Regardless of the surgical approach, it is fundamental to respect the autonomic innervation during total mesorectal excision in order to prevent these sequelae...
February 1, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/28129884/incidence-and-survival-of-glandular-vulvar-malignancies-in-the-netherlands
#11
Michelle van der Linden, Melinda Schuurman, Johan Bulten, Maaike van der Aa, Leon Massuger, Joanne de Hullu
AIM: There is limited knowledge in the field of glandular vulvar malignancies. The aim of this study is to describe the incidence and survival of women with glandular vulvar malignancies. METHODS: We searched PALGA, a nation-wide database registering all histo- and cytopathology in the Netherlands, for all cases of glandular vulvar malignancies between 2000 and 2015. Additional data were retrieved via the Netherlands Cancer Registry. Incidence rates were calculated per 1,000,000 women per year...
March 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28101937/methods-of-anorectal-manometry-vary-widely-in-clinical-practice-results-from-an-international-survey
#12
E V Carrington, H Heinrich, C H Knowles, S S Rao, M Fox, S M Scott
BACKGROUND: Ano-rectal manometry (ARM) is the most commonly performed investigation for assessment of anorectal dysfunction. Its use is supported by expert consensus documents and international guidelines. Variation in technology, data acquisition, and analysis affect results and clinical interpretation. This study examined variation in ARM between institutions to establish the status of current practice. METHODS: A 50-item web-based questionnaire assessing analysis and interpretation of ARM was distributed by the International Anorectal Physiology Working Group via societies representing practitioners that perform ARM...
August 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28044239/transanal-total-mesorectal-excision-tatme-for-rectal-cancer-effects-on-patient-reported-quality-of-life-and-functional-outcome
#13
T W A Koedam, G H van Ramshorst, C L Deijen, A K E Elfrink, W J H J Meijerink, H J Bonjer, C Sietses, J B Tuynman
BACKGROUND: Transanal total mesorectal excision (TaTME) has rapidly become an important component of the treatment of rectal cancer surgery. Cohort studies have shown feasibility concerning procedure, specimen quality and morbidity. However, concerns exist about quality of life and ano(neo)rectal function. The aim of this study was to prospectively evaluate quality of life in patients following TaTME for rectal cancer with anastomosis. METHODS: Consecutive patients who underwent restorative TaTME surgery for rectal adenocarcinoma in an academic teaching center with tertiary referral function were evaluated...
January 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27934790/abdomino-endoscopic-perineal-excision-of-the-rectum-for-benign-and-malignant-pathology-technique-considerations-for-true-transperineal-verus-transanal-total-mesorectal-excision-endoscopic-proctectomy
#14
Hazar Al Furajii, Niall Kennedy, Ronan A Cahill
PURPOSE: Transanal minimally invasive surgery using single port instrumentation is now well described for the performance of total mesorectal excision with restorative colorectal/anal anastomosis most-often in conjunction with transabdominal multiport assistance. While non-restorative abdomino-endoscopic perineal excision of the anorectum is conceptually similar, it has been less detailed in the literature. METHODS: Consecutive patients undergoing non-restorative ano-proctectomy including a transperineal endoscopic component were analysed...
January 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27917348/resolution-of-constipation-anal-stricture-and-iron-deficiency-anemia-after-iron-infusion-an-analogy-with-plummer-vinson-syndrome
#15
Vijaypal Arya, Shikha Singh, Shashank Agarwal, Arjun Ohri
BACKGROUND: Anal stricture is a disabling condition which is often unresponsive to conservative medical management. The complications of surgical procedures such as dilatations and anoplasty make it a formidable treatment challenge. Through this case, we report and explore a new medical treatment for ano-rectal strictures with an analogy to Plummer Vinson syndrome. A 69-year-old male presented with chronic constipation, rectal pain, and easy fatigability. The physical exam was negative for anal fissure and a digital rectal examination could not be completed because an index finger could not be advanced through the narrowed anus...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27891706/rectal-intussusception-can-high-resolution-three-dimensional-ano-rectal-manometry-compete-with-conventional-defecography
#16
A Benezech, M Cappiello, K Baumstarck, J-C Grimaud, M Bouvier, V Vitton
BACKGROUND: Three-dimensional high-resolution anorectal manometry (3DHRAM), used for exploring anorectal disorders, was recently developed, providing interesting topographic data for the diagnosis of pelvic floor disorders such as excessive perineal descent. The aim of our study was to define a diagnostic strategy based on selected 3DHRAM parameters to identify rectal intussusceptions (RI), considering conventional defecography (CD) as the gold standard. METHODS: All patients referred to our center in the previous 6 months for 3DHRAM to explore fecal incontinence or constipation, and who previously achieved CD, were eligible...
November 27, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27857005/polypoid-anal-melanoma-a-case-report-and-review-of-the-literature
#17
Roberta Tutino, Giuseppe Clerico, Alberto Realis Luc, Gaetano Gallo, Mario Trompetto
INTRODUCTION: Ano-rectal melanoma is an uncommon finding in patients complaining of rectal bleeding and/or anal mass often misinterpreted as a haemorroidal pile. CASE REPORT: A 55-years-old woman, complaining of rectal bleeding, frequent anal pain and anal mass suspected for haemorroidal thrombosis was referred for evaluation and possible treatment. A brown polypoid mass arising from the anal canal/lower rectum with a maximum diameter of 6 cm was diagnosed. The hystological examination of the neoplasm, transanally removed, revealed the presence of a polypoid melanoma partially involving the resection margin...
November 12, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27759786/laparoscopically-assisted-anorectoplasty-and-the-use-of-the-bipolar-device-to-seal-the-rectal-urinary-fistula
#18
Robson Azevedo Dutra, Adriana Cartafina Perez Boscollo
Background: The anorectal anomalies consist in a complex group of birth defects. Laparoscopic-assisted anorectoplasty improved visualization of the rectal fistula and the ability to place the pull-through segment within the elevator muscle complex with minimal dissection. There is no consensus on how the fistula should be managed. Aim: To evaluate the laparoscopic-assisted anorectoplasty and the treatment of the rectal urinary fistula by a bipolar sealing device...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
https://www.readbyqxmd.com/read/27696277/anal-metastasis-from-rectal-adenocarcinoma
#19
Takeshi Nishikawa, Soichiro Ishihara, Tetsuo Ushiku, Keisuke Hata, Kazuhito Sasaki, Koji Murono, Koji Yasuda, Kensuke Otani, Toshiaki Tanaka, Tomomichi Kiyomatsu, Kazushige Kawai, Hiroaki Nozawa, Toshiaki Watanabe
The metastasis of rectal cancer to the anus is rare. Here, we report a case of advanced rectal cancer, which had a diffuse venous invasion with anal metastasis and multiple lymph node and liver metastases. The patient was a 72-year-old woman who complained of perianal pain and fresh blood in the stools for 6 months. She had neither history of fistula-in-ano nor anal surgery. Digital examination revealed a 2-cm tumor at the 7 o'clock position, and the barium enema and colonoscopy confirmed advanced rectal cancer...
December 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27527239/outcomes-after-acute-traumatic-spinal-cord-injury-in-botswana-from-admission-to-discharge
#20
I Löfvenmark, M Hasselberg, L Nilsson Wikmar, C Hultling, C Norrbrink
STUDY DESIGN: Prospective follow-up study. OBJECTIVES: To increase the knowledge regarding clinical and functional outcomes after traumatic spinal cord injuries (TSCI) in a resource-constrained setting. A special focus was placed on secondary complications such as pressure ulcers. SETTING: The national referral hospital in Gaborone, Botswana. METHODS: The study included all patients admitted with an acute TSCI during a 2-year period (n=39)...
February 2017: Spinal Cord
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