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A1 Anals of Surgery

Charlène Brochard, Amandine Landemaine, Alexandre Merlini L'Heritier, Marie Provost Dewitte, Belinda Tchoundjeu, Tanguy Rohou, Aurélien Garros, Guillaume Bouguen, Laurent Siproudhis
Background & Aims: The European Crohn's and Colitis Organization recommends magnetic resonance imaging (MRI) of anal fistulas to decide on the drug/surgery strategy. No evidence is available on the long-term impact of MRI features on fistula healing. The aim of this study was to evaluate the benefit of combined drug/surgery strategies for the treatment of perianal Crohn's fistulas based on MRI factors at referral. Methods: The clinical event (anal abscess, new fistula tract, cellulitis), therapeutic intervention (introduction/optimization of immunosuppressant/biologics, anal surgery, intestinal resection, stoma), and MRI data were prospectively recorded for patients with Crohn's disease (CD) and anal fistulas...
June 8, 2018: Inflammatory Bowel Diseases
Sumiko Nakagawa, Masahiro Amano, Shinya Yamashita, Yasuaki Nishikawa, Naozumi Higaki, Hirohito Hayashida, Takahiro Niinobu, Yasuo Yoshioka, Masato Sakon
A male in his eighties underwent abdominoperineal resection under the diagnosis of adenocarcinoma associated with anal fistula (P0, H0, n (-), A1, stage II, ly0, v0). Ten years after the surgery, a painful lymph node swelling was noticed in the left inguinal region. Biopsy specimen showed adenocarcinoma consisting of severe dysplastic cells. Radiotherapy was performed in the pelvic region at a total dose of 50 Gy (2 Gy/day). After the radiotherapy, left inguinal and pelvic lymph nodes markedly shrank and became painless...
November 2006: Gan to Kagaku Ryoho. Cancer & Chemotherapy
M Yasutomi
Improvement in the cancer eradication and prevention of pelvic organ dysfunction are the most important strategy in rectal cancer surgery. More than 90% of rectal cancer in my experiences received APR resection before 1962. However, after 1963 anal function preserving operations were adopted 45% or more of rectal cancer. Pull-through was adopted at the beginning, however, anterior resection took the place of this procedure after 1969. When the suture instruments were applied to rectal surgery in 1984, 65% of patients were treated by instrumental end-to end reconstruction...
September 1988: Nihon Geka Gakkai Zasshi
S Chaussade, Y Denizot, P Valleur, J Nicoli, P Raibaud, J Guerre, P Hautefeuille, D Couturier, J Benveniste
Platelet-activating factor is an endogenous phospholipid produced by a wide variety of inflammatory cells. Platelet-activating factor induces severe pathological changes in various organs and, among numerous potent effects, causes bowel necrosis. Pouchitis is a poorly understood complication of ileoanal pouch anastomosis which occurs in patients who undergo surgery for ulcerative colitis. The aim of this study was to measure ileal or fecal platelet-activating factor and lyso platelet-activating factor contents in normal volunteers (n = 12), in patients with terminal ileostomy (n = 7), and in patients with ileoanal anastomosis (n = 15) (8 patients have pouchitis defined by the presence of ulcerations on the reservoir)...
June 1991: Gastroenterology
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