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Anals of Surgery

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https://www.readbyqxmd.com/read/28729224/robotic-placement-of-fenix-continence-restoration-system-in-a-patient-with-previous-radiation-to-the-pelvis-a-case-report
#1
Mariana Espinal, Christopher C DeStephano, Paulami Guha, Shilpa P Gajarawala, Anita H Chen, Paul D Pettit
Fecal incontinence (FI) is a disabling problem affecting women. Conservative treatment includes dietary modification, antimotility agents, and pelvic floor physical therapy. If conservative medical management is unsuccessful, surgical intervention may be required. Surgical options include rectal sphincteroplasty, bulking agent injection, radiofrequency anal sphincter remodeling procedure and sacral nerve stimulation (SNS) therapy. Recently, a new therapy for FI, the FENIX Continence Restoration System has become available...
July 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28726144/anastomotic-stricture-after-ultralow-anterior-resection-or-intersphincteric-resection-for-very-low-lying-rectal-cancer
#2
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
BACKGROUND: Anastomotic stricture following colorectal cancer surgery is not a rare complication, but proper management of anastomotic stricture located close to the anal verge is uncertain. This study aimed to investigate risk factors and management strategies for anastomotic stricture after ultralow anterior resection (ULAR). METHODS: We retrospectively reviewed a database of patients with rectal cancer who underwent surgery between January 2007 and June 2015, and included patients with an anastomosis within 4 cm from the anal verge...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28724187/nasogastric-tube-as-abdominal-pressure-sensor-in-urodynamics-proof-of-concept-of-a-novel-approach
#3
Sundaramoorthy VijayGanapathy, Vilvapathy Senguttuvan Karthikeyan, Ashwin Mallya, Ali Poonawala, Ramaiah Keshavamurthy
AIMS: The standard sensor for abdominal pressure (Pabd) measurement in urodynamics (UD) is a rectal sensor. In patients where the rectum is not available due to prior surgery or when external anal sphincter (EAS) tone is poor, rectal sensor may slip, making Pabd recording unreliable. Vaginal Pabd measurement and wireless vaginal sensors have been tried. We present our preliminary series of a novel nasogastric tube (NG) sensor for Pabd measurement. METHODS: We identified patients undergoing UD with a NG Pabd sensor from a prospectively maintained UD database of a tertiary care urological center between July 2013 and December 2016...
July 19, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28723770/initial-application-of-transanal-endoscopic-microsurgery-for-high-risk-lower-rectal-gastrointestinal-stromal-tumor-after-imatinib-mesylate-neoadjuvant-chemotherapy-a-case-report
#4
Qiaofei Liu, Guangxi Zhong, Weixun Zhou, Guole Lin
RATIONALE: The lower rectal gastrointestinal stromal tumor (GIST) is a rare entity and warrants special attentions because of the considerations of preserving of anal and urinal functions. Neoadjuvant therapy with imatinib mesylate (IM) has achieved great success in GIST, which potentially extends the applications of function-preserving minimally invasive surgical procedures. Transanal endoscopic microsurgery (TEM) is a well-developed minimally invasive technique for benign tumors in lower rectum...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723750/sphincter-preserving-surgery-for-low-middle-rectal-cancer-can-we-predict-feasibility-with-high-resolution-magnetic-resonance-imaging
#5
Hai-Bin Zhu, Lin Wang, Zi-Yu Li, Xiao-Ting Li, Xiao-Yan Zhang, Ying-Shi Sun
The study proposed to evaluate the feasibility of predicting sphincter-sparing surgery (SSS) preoperatively in low-middle rectal cancer by using magnetic resonance (MR).The study included both retrospective and prospective design. In the retrospective design, the distance from lower edge of tumor to upper margin of the internal sphincter (Dis1) and distance to anal verge (Dis2) were measured on MR, the distance to anal verge recorded by colonoscopy (Dis3) and digital rectal examination (Dis4) were also obtained...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28722085/-anatomical-planes-and-landmarks-of-transanal-total-mesorectal-excision-for-rectal-cancer-and-prophylaxis-of-intraoperative-complications
#6
Zhanlong Shen, Yingjiang Ye, Shan Wang
Total mesorectal excision (TME) is a mile-stone procedure in the history of rectal cancer surgery, but the exposure of surgical field of distal rectum is usually poor in patients with male, obese and narrow pelvis, which may lead to tumor residue and relative complications. Recently, a new technique called transanal TME (taTME) is considered to solve the above problems, but most medical centers are still in the learning curve of this procedure. Therefore, anatomical planes and landmarks of taTME for rectal cancer and prophylaxis of intraoperative complications are induced in this paper, which includes posterior plane: angle of anus and distal mesorectum and bleeding of mesorectum; rectosacral fascia and presacral bleeding; lateral and posterior-lateral plane: posterior branches of pelvic plexus and damage of anal function; anterior plane: vessel branches of neurovascular bundle and bleeding...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28720315/-evaluation-of-the-antithrombotic-strategy-in-low-thrombotic-risk-patients-who-underwent-aortic-valve-replacement-wth-bioprosthesis
#7
Eduardo Aceves-Velázquez, Gerardo Vieyra-Herrera, Laura Rodríguez-Chávez, Valentín Herrera-Alarcón
According to current guidelines, in patients without additional risk factors who underwent aortic valve replacement with a bioprosthesis, anticoagulation in the first 3 months after surgery is still a matter of debate. According to current evidence, aspirin in low doses is a reasonable alternative to vitamin K antagonists (VKA). We compared the incidence of thrombotic and hemorrhagic complications in patients with low thrombotic risk who underwent aortic valve replacement with a bioprosthesis in the National Institute of Cardiology of Ignacio Chávez of Mexico...
July 15, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28705784/laparoscopic-proctocolectomy-with-ileal-j-pouch-anal-anastomosis-in-children
#8
Ufuk Ateş, Ergun Ergün, Gülnur Göllü, Gönül Küçük, Aydın Yağmurlu
BACKGROUND/AIMS: We aimed to evaluate postoperative fecal incontinence scales of children who underwent laparoscopic proctocolectomy and ileal J-pouch anastomosis for familial adenomateous polyposis (FAP) and inflammatory bowel disease (IBD). MATERIALS AND METHODS: Fecal incontinence scores were collected at 3 months post-surgery. A retrospective chart review was also performed to obtain the demographic data and operative technical details. RESULTS: The postoperative Wexner Fecal Incontinence Score was 0 in 9 of 11 patients and satisfactory in the remaining two...
July 13, 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28705774/asia-a-sensory-and-motor-complete-is-not-different-than-asia-b-sensory-incomplete-motor-complete-in-gunshot-related-spinal-cord-injury
#9
Eric McCoy, Nima Eftekhary, Kenneth Nwosu, Dudley Fukunaga, Charles Liu, Kevin Rolfe
Background Context We receive a large number of spinal cord injury (SCI) patients due to penetrating gunshot wounds (GSW) at our national rehabilitation center. Though many patients are labeled American Spinal Injury Association (ASIA) B sensory incomplete due to sensory sparing, especially deep anal pressure, with purported prognostic value, we have not observed a clinical difference from ASIA A completes. We hypothesized that sensory sparing, if meaningful, should reduce the occurrence of pressure ulcers...
July 10, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28702861/outcomes-of-a-single-surgeon-based-transanal-total-mesorectal-excision-tatme-for-rectal-cancer
#10
Antonio Caycedo-Marulanda, Henry Y Jiang, Erica L Kohtakangas
BACKGROUND: Several studies have shown the transanal total mesorectal excision (TATME) is emerging as a safe and effective technique for proctectomy. The majority of these studies to date, however, is based on procedures done in centers with teams of two surgeons working simultaneously. Few were performed by single-surgeon teams with sizeable case load. The objective of our study was to identify the feasibility and safety of a single-surgeon TATME. METHODS: Chart review of prospectively collected data on 27 patients who underwent TATME at our institution from June 2015 to September 2016 were included in this study...
July 13, 2017: Journal of Gastrointestinal Cancer
https://www.readbyqxmd.com/read/28698000/topical-diltiazem-ointment-in-post-hemorrhoidectomy-pain-relief-a-meta-analysis-of-randomized-controlled-trials
#11
Yan-Jiun Huang, Chien-Yu Chen, Ray-Jade Chen, Yi-No Kang, Po-Li Wei
BACKGROUND: Hemorrhoidectomy is commonly associated with postoperative pain. Calcium channel blockers are known to cause relaxation of gastrointestinal smooth muscle and oral diltiazem has also been shown to reduce the resting anal pressure. OBJECTIVE: We attempted to analyze efficacy and side effects of topical diltiazem oint. in post-operative pain control. METHODS: This is a meta-analysis of patients who underwent hemorrhoidectomy using topical diltiazem oint...
July 8, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28697913/uterine-transposition-technique-and-a-case-report
#12
Reitan Ribeiro, Juliano Camargo Rebolho, Fernanda Keiko Tsumanuma, Giovana Gugelmin Brandalize, Carlos Henrique Trippia, Karam Abou Saab
OBJECTIVE: To report the first uterine transposition for fertility preservation in a patient with rectal cancer. DESIGN: Case report. SETTING: Community hospital. PATIENT(S): A 26-year-old patient with stage cT3N1M0 rectal adenocarcinoma located 5 cm from the anal margin. INTERVENTION(S): Laparoscopic transposition of the uterus to the upper abdomen, outside of the scope of radiation, was performed to preserve fertility...
July 8, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28695880/hand-assisted-laparoscopic-restorative-proctocolectomy-with-ileal-pouch-anal-anastomosis-for-ulcerative-colitis
#13
Pengcheng Zhu, Chungen Xing
INTRODUCTION: In this study, we aimed to evaluate the feasibility and safety of undergoing restorative proctocolectomy through ileal pouch-anal anastomosis (RPC-IPAA) with hand-assisted laparoscopic (HALS) in patients with ulcerative colitis (UC). PATIENTS AND METHODS: We reviewed 40 consecutive patients who underwent RPC-IPAA with HALS or open technique for treatment of UC between 2010 and 2013. Moreover, the intra-/post-operative outcomes were compared. RESULTS: We found the median operative time was significantly longer in the HALS group while the blood loss was significantly less in patients with HALS than with open surgery...
July 7, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28694669/magnetic-resonance-imaging-may-predict-deep-remission-in-patients-with-perianal-fistulizing-crohn-s-disease
#14
Lucie Thomassin, Laura Armengol-Debeir, Cloé Charpentier, Valerie Bridoux, Edith Koning, Guillaume Savoye, Céline Savoye-Collet
AIM: To evaluate the imaging course of Crohn's disease (CD) patients with perianal fistulas on long-term maintenance anti-tumor necrosis factor (TNF)-α therapy and identify predictors of deep remission. METHODS: All patients with perianal CD treated with anti-TNF-α therapy at our tertiary care center were evaluated by magnetic resonance imaging (MRI) and clinical assessment. Two MR examinations were performed: at initiation of anti-TNF-α treatment and then at least 2 years after...
June 21, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28693959/value-and-limits-of-stapled-transanal-rectal-repair-for-obstructed-defecation-syndrome-10-years-experience-with-450-cases
#15
Angelo Guttadauro, Marco Chiarelli, Matteo Maternini, Melissa Baini, Nicoletta Pecora, Francesco Gabrielli
BACKGROUND/OBJECTIVE: In the late's 90' a new surgical treatment, the stapled trans-anal rectal resection (STARR) was born to treat obstructed defecation syndrome (ODS). In this study we retrospectively analyze a series of 450 cases that underwent STARR in 10 years. METHODS: Between January 2001 to December 2011, 450 patients, diagnosed with ODS syndrome caused by rectocele or intussusception, underwent to STARR procedure. The presence of rectocele and/or intussusception was verified by dynamic defecography...
July 7, 2017: Asian Journal of Surgery
https://www.readbyqxmd.com/read/28688109/root-causes-and-social-consequences-of-birth-injuries-in-western-uganda
#16
Jennifer N Angell, Priscilla Busingye, Gabriel Y-K Ganyaglo, Cheryl A Moyer
Incontinence-inducing delivery injuries, such as obstetric fistula and anal-sphincter tears, are devastating sequelae of prolonged and obstructed labor, and can only be repaired through surgery. Such injuries are most prevalent in settings where delays and limitations in accessing emergency obstetric services are common [1, 2]. The 2011 Demographic and Health Survey of Uganda [3] estimated that 2% of Ugandan women have experienced obstetric fistula and resulting trans-vaginal urine or fecal incontinence. This article is protected by copyright...
July 8, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28682002/laparoscopic-low-anterior-resection-for-rectal-cancer-after-whitehead-s-hemorrhoidectomy-a-case-report
#17
Yoshihiro Takemoto, Eijiro Harada, Yuriko Takeuchi, Daichi Kawamura, Yuuki Suehiro, Naruji Kugimiya, Kimikazu Hamano
A 65-year-old man presented with bloody stool. Colonoscopy revealed a raised tumor in the rectum, above the peritoneal reflection. He underwent endoscopic mucosal resection, but the pathological findings suggested the possibility of residual cancer. We performed laparoscopic low anterior resection using a circular stapling instrument for additional curative surgery. However, we could not insert the shaft of the endoscopic circular stapler from the anus because of anal stenosis due to Whitehead's hemorrhoidectomy the patient had undergone 20 years earlier...
July 6, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28669408/patterns-of-recurrence-persistence-of-criptoglandular-anal-fistula-after-the-lift-procedure-long-term-observacional-study
#18
Carlos Placer Galán, Claudia Lopes, José Andrés Múgica, Yolanda Saralegui, Nerea Borda, José M Enriquez Navascues
OBJECTIVE: To study the recurrence/persistence rate of complex cripotoglandular anal fistula after the LIFT procedure and analyse the patterns of recurrence/persistence. PATIENTS AND METHODS: Observational study of patients with transe-sphincteric or supra-sphincteric anal fistula treated using the LIFT procedure from December 2008 to April 2016. Variables studied included clinical characteristics, surgical technique and results. Clinical cure was defined and imaging studies were used in doubtful cases...
June 29, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28667683/pouch-failures-following-ileal-pouch-anal-anastomosis-for-ulcerative-colitis
#19
Anders Mark-Christensen, Rune Erichsen, Søren Brandsborg, Frederik Rønne Pachler, Charlotte Buchard Nørager, Niels Johansen, Jørn Helmut Pachler, Ole Thorlacius-Ussing, Mie Dilling Kjaer, Niels Qvist, Louise Preisler, Jens Hillingsø, Jacob Rosenberg, Søren Laurberg
BACKGROUND: The ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain risk factors associated with failure. METHOD: 1,991 patients with ulcerative colitis operated with ileal pouch-anal anastomosis in Denmark in the period 1980-2013 were included. Pouch failure was defined as excision of the pouch or presence of a stoma un-reversed within one year after its creation...
July 1, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28657837/mckittrick-wheelock-syndrome-treated-by-transanal-minimally-invasive-surgery-a-single-center-experience-and-review-of-the-literature
#20
Anne Elisabeth Maria van der Pool, Eelco Jan Rade de Graaf, Maarten Vermaas, Renée Martine Barendse, Pascal Gabriël Doornebosch
INTRODUCTION: McKittrick Wheelock Syndrome (MKWS) is a rare syndrome characterized by secretory diarrhea, dehydration, prerenal acute kidney injury, and severe electrolyte abnormalities caused by a large hypersecretory villous adenoma located in the rectum or rectosigmoid junction. Transabdominal (laparoscopic) procedures are the most described procedures in the treatment of MKWS. We report an alternative surgical approach, transanal minimally invasive surgery (TAMIS), to solve this syndrome...
June 28, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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