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Anals of Surgery

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https://www.readbyqxmd.com/read/29050194/update-on-the-pathophysiology-and-management-of-anorectal-disorders
#1
REVIEW
Tanisa Patcharatrakul, Satish S C Rao
Anorectal disorders are common and present with overlapping symptoms. They include several disorders with both structural and functional dysfunction(s). Because symptoms alone are poor predictors of the underlying pathophysiology, a diagnosis should only be made after evaluating symptoms and physiologic and structural abnormalities. A detailed history, a thorough physical and digital rectal examination and a systematic evaluation with high resolution and/or high definition three-dimensional (3D) anorectal manometry, 3D anal ultrasonography, magnetic resonance defecography and neurophysiology tests are essential to correctly identify these conditions...
October 23, 2017: Gut and Liver
https://www.readbyqxmd.com/read/29046093/video-assisted-anal-fistula-treatment-a-high-volume-unit-initial-experience
#2
F Y Cheung, N D Appleton, S Rout, R Kalaiselvan, J A Nicholson, A Samad, M Chadwick, R Rajaganeshan
Introduction Perianal fistulas are a common problem. Video-assisted anal fistula treatment is a new technique for the management of this difficult condition. We describe our initial experience with the technique to facilitate the treatment of established perianal fistulas. Methods We reviewed a prospectively maintained database relating to consecutive patients undergoing video-assisted anal fistula treatment in a single unit. Results Seventy-eight consecutive patients had their perianal fistulas treated with video-assistance from November 2014 to June 2016...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/29043690/-prevention-of-the-wound-infection-little-changes-huge-results
#3
I Martínez Castaño, M J Aranda García, J M Sánchez Morote, R Ruiz Pruneda, M Fernández Ibieta, J Rojas Ticona, V Villamil, A Sánchez Sánchez, M C Giménez Aleixandre, J I Ruiz Jiménez
INTRODUCTION: Neonatal surgical wound infection occurs in almost 50% of neonatal procedures. It increases the rates of morbimortality in neonatal units. There is no guidelines about prevention of wound infection in neonatal surgery. We present our results after changing our behaviour in neonatal surgery. MATERIALS AND METHODS: Comparative study between 2 groups. In order to decrease wound infection at the end of the procedure gloves, covertures and surgical instruments were changed and saline and antiseptic solutions were used during laparotomy closing...
July 20, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/29033223/who-gets-a-pouch-after-colectomy-in-new-york-state-and-why
#4
Christopher T Aquina, Fergal J Fleming, Adan Z Becerra, Bradley J Hensley, Katia Noyes, John R T Monson, Larissa K Temple, Christina Cellini
BACKGROUND: This study identified variation and factors associated with ileal pouch-anal anastomosis after total colectomy for ulcerative colitis. METHODS: The Statewide Planning & Research Cooperative System was used to identify patients with ulcerative colitis who underwent total colectomy in New York state from 2000-2013. Bivariate and mixed-effects multivariable analyses were performed to assess patient, surgeon, and hospital-level factors as well as surgeon and hospital-level variation associated with ileal pouch-anal anastomosis after total colectomy...
October 12, 2017: Surgery
https://www.readbyqxmd.com/read/29027878/are-prophylactic-antibiotic-agents-indicated-in-anorectal-surgery-for-patients-with-human-immunodeficiency-virus
#5
Shaivi A Patel, Robert J Kucejko, Edward A Fazendin, Juan L Poggio
BACKGROUND: With increased survival among patients with human immunodeficiency virus (HIV), surgeons have been seeing more cases of anal dysplasia and cancer. There is, however, no data on the incidence of surgical site infections (SSIs) in HIV-positive patients undergoing elective anorectal procedures, nor on the administration of prophylactic antibiotic agents. We reviewed a HIV-positive population that has undergone elective anorectal biopsy of areas of dysplasia observed on office anoscopy to assess the need for antibiotic prophylaxis...
October 13, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28991089/retained-needle-following-transanal-hemorrhoidal-dearterialization
#6
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/28985852/development-of-a-total-colectomy-and-ileorectal-anastomosis-rat-model-to-evaluate-colonic-metaplasia
#7
Kathleen M Schieffer, Lisa S Poritz, Gregory S Yochum, Walter A Koltun
BACKGROUND: Ulcerative colitis is an idiopathic inflammatory condition of the colon that may require surgical intervention including proctocolectomy and either ileal pouch-anal anastomosis or in the pediatric population, low ileorectal anastomosis (IRA). Often, subsequent physiologic alteration (or colonic metaplasia) occurs in the anastomosed small bowel that includes changes in mucin content, villous blunting, and increased expression of WNT5A, a marker of colonic crypt regeneration...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28985845/postoperative-paralytic-ileus-remains-a-problem-following-surgery-for-advanced-pelvic-cancers
#8
Jonas Amstrup Funder, Rikke Tolstrup, Betina Norman Jepsen, Lene Hjerrild Iversen
BACKGROUND: Paralytic postoperative ileus (POI) is associated with increased morbidity and mortality after abdominal surgery. Despite increased awareness and implementation of various measures, POI remains a problem, perhaps moreso for those patients undergoing extensive oncological surgical treatment. The aim of this study was to describe the extent of POI after advanced cancer surgery in the era of contemporary treatment modalities of POI. METHODS: A retrospective analysis of all patients who underwent either abdominoperineal excision with transpelvic vertical rectus abdominal musculocutaneous (VRAM)-flap after anal cancer or pelvic exenteration at single institution from January 2012 to November 2013 was carried out...
October 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28982895/cuff-less-j-pouch-anal-stapling-anastomosis-for-ulcerative-colitis
#9
Hidejiro Kawahara, Tadashi Akiba, Katsuhiko Yanaga
BACKGROUND/AIM: For ulcerative colitis, J pouch anal anastomosis with preserved rectal cuff had been popularized with its acceptable defecation function. However, some complications associated with rectal cuff after surgery have been reported. We are performing a novel procedure, laparoscopic cuff-less J pouch anal stapling anastomosis. PATIENTS AND METHODS: From January 2014 to December 2016, ten patients with ulcerative colitis, including three with concomitant cancer underwent this procedure...
October 2017: Anticancer Research
https://www.readbyqxmd.com/read/28969013/low-dose-of-dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-cesarean-surgery-provides-better-intraoperative-somato-visceral-sensory-block-characteristics-and-postoperative-analgesia
#10
Yong-Hong Bi, Xiao-Guang Cui, Rui-Qin Zhang, Chun-Yu Song, Yan-Zhuo Zhang
OBJECT: In this study, we aimed to investigate the beneficial effects of dexmedetomidine on somato-visceral sensory block characteristcs, postoperative analgesia and stress response of intrathecal bupivacaine administration in women undergoing cesarean section, and to find out which dose is better. METHODS: Sixty parturients with the American Society of Anesthesiologists (ASA) physical status I or II were anesthetized with intrathecal bupivacaine(10mg) alone or in combination with dexmedetomidine (3 μg and 5 μg) to undergo cesarean section...
September 8, 2017: Oncotarget
https://www.readbyqxmd.com/read/28956744/efficacy-and-safety-of-a-continuous-wound-catheter-in-open-abdominal-partial-hepatectomy
#11
Lu Che, Xin Lu, Li-Jian Pei
Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and controlled study. Patients undergoing open abdominal partial hepatectomy, according to their willingness, accepted one of the following managements for the postoperative pain: continuous wound catheter (CWC) infiltration, patient-controlled epidural analgesia (PCEA), patient-controlled intravenous analgesia of morphine (PCIAM), and patient-controlled intravenous analgesia of sufentanil (PCIAS)...
September 27, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28952827/screening-for-anal-cancer-in-hiv-positive-patients-should-we-make-it-a-standard-of-care
#12
Jian Xu, Haiyang Zhou
Anal cancer is biological similar to cervical cancer, and is preceded by anal intraepithelial neoplasia (AIN). Screening for AIN and treatments to reduce the risk of anal cancer are not established as guidelines of care for HIV-infected patients. It is mainly because screening and treating of AIN is not yet proven to reduce the incidence of anal cancer. The present study preliminarily demonstrated that a successful screening program in preventing squamous cell anal cancer in HIV positive patients. The authors achieved their purpose of controlling the evolution of all abnormalities identified during the anal cancer screening, preventing AIN to progress towards anal cancer, and reversing any form of AIN by surgery, ablation or medical therapy...
September 27, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28944332/the-whitehead-operation-procedure-is-it-a-useful-technique
#13
Kenan Erzurumlu, Kağan Karabulut, Gökhan Selçuk Özbalcı, İsmail Alper Tarım, Gökhan Lap, Bülent Güngör
OBJECTIVE: Hemorrhoidal disease is a very common entity in the general population; however, the therapeutic approaches to hemorrhoids remain controversial. The choice of treatment method depends on the grade of the hemorrhoid as well as the experience of the surgeon. The Whitehead hemorrhoidectomy procedure is often applied for grade IV hemorrhoids. MATERIAL AND METHODS: We studied 49 patients who underwent surgery between December 1982 and January 2013. The indications for the Whitehead procedure in all patients were grade IV hemorrhoidal disease...
2017: Turk J Surg
https://www.readbyqxmd.com/read/28943921/safety-and-feasibility-of-laparoscopic-intersphincteric-resection-for-a-lower-rectal-tumor
#14
Nobuhisa Matsuhashi, Takao Takahashi, Toshiyuki Tanahashi, Satoshi Matsui, Hisashi Imai, Yoshihiro Tanaka, Kazuya Yamaguchi, Shinji Osada, Kazuhiro Yoshida
The aim of the present study was to evaluate the short-term surgical outcomes of laparoscopic intersphincteric resection (ISR) for a lower rectal tumor in comparison with a case-control series of patients undergoing open ISR. Quality of life factors and anal function were also evaluated. Between July 2008 and April 2013, 103 patients with lower rectal cancer underwent laparoscopic surgery at the Surgical Oncology Department of Gifu University School of Medicine. A total of 25 patients with lower rectal cancer underwent ISR, and 19/25 patients who underwent laparoscopic ISR were compared with the control group of 6 patients who underwent open ISR...
October 2017: Oncology Letters
https://www.readbyqxmd.com/read/28940230/outcome-after-restorative-proctocolectomy-and-ileal-pouch-anal-anastomosis-in-children-and-adults
#15
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/28938543/predictive-clinical-model-of-tumor-response-after-chemoradiation-in-rectal-cancer
#16
Marisa D Santos, Cristina Silva, Anabela Rocha, Carlos Nogueira, Fernando Castro-Poças, António Araujo, Eduarda Matos, Carina Pereira, Rui Medeiros, Carlos Lopes
Survival improvement in rectal cancer treated with neoadjuvant chemoradiotherapy (nCRT) is achieved only if pathological response occurs. Mandard tumor regression grade (TRG) proved to be a valid system to measure nCRT response. The ability to predict tumor response before treatment may significantly have impact the selection of patients for nCRT in rectal cancer. The aim is to identify potential predictive pretreatment factors for Mandard response and build a clinical predictive model design. 167 patients with locally advanced rectal cancer were treated with nCRT and curative surgery...
August 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28929316/mucinous-adenocarcinoma-on-perianal-fistula-a-rising-entity
#17
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/28924962/the-impact-of-tumour-distance-from-the-anal-verge-on-clinical-management-and-outcomes-in-patients-having-a-curative-resection-for-rectal-cancer
#18
Muhammad Amir Saeed Khan, Chin W Ang, Abdul Rahman Hakeem, Nigel Scott, Rick Nigel Saunders, Ian Botterill
AIM: The clinico-oncological significance of the distance of rectal cancer from the anal verge is unclear and not well reported. The aim of this study is to assess the influence of the rectal cancer distance from the anal verge on clinical management and long-term outcomes after curative resection in a specialised colorectal cancer unit. METHODS: Prospectively collected data on patients who underwent primary rectal cancer treatment at our unit between January 2005 and December 2010 were analysed...
September 18, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28922706/functional-outcome-of-low-rectal-resection-evaluated-by-anorectal-manometry
#19
Peter Ihnát, Petr Vávra, Jiří Prokop, Anton Pelikán, Lucia Ihnát Rudinská, Igor Penka
BACKGROUND: Low anterior resection syndrome (LARS) covers disordered bowel function after rectal resection, leading to deterioration in patients' quality of life. The aim of this study was to evaluate anorectal function after laparoscopic low anterior resection (LAR) by means of standardized instruments. METHODS: This was a prospective clinical cohort study conducted in a single institution to assess functional outcome of patients 1 year after laparoscopic LAR by means of LARS score and high-resolution anorectal manometry...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28922462/vaginal-mesh-repair-systems-for-pelvic-organ-prolapse-anatomical-study-comparing-transobturator-trangluteal-versus-single-incision-techniques
#20
Giuseppe Campagna, Giovanni Panico, Andrea Morciano, Pierre Gadonneix, Vincent Delmas, Mauro Cervigni, Alfredo Ercoli, Giovanni Scambia
INTRODUCTION: The present study aim to compare the anatomic landmarks of two pelvic floor repair systems, in order to identify the potential neurovascular lesions related to different mesh fixation techniques. METHODS: Abdominal and perineal dissections of 10 fresh cadavers after prolapse surgery using transobturator/transgluteal versus single incision techniques. Neuro-vascular structures of obturator region and perineum were isolated. Distances between needles and anatomical structures were measured...
September 18, 2017: Neurourology and Urodynamics
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