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https://www.readbyqxmd.com/read/29779245/laparoscopic-technique-of-modified-extraperitoneal-retrotransversalis-end-colostomy-for-abdomino-perineal-resection
#1
I A Tulina, Y E Kitsenko, M N Ubushiev, S K Efetov, S Wexner, P V Tsarkov
AIM: To describe the technique of a modified extraperitoneal retrotransversalis end colostomy as part of a laparoscopic abdomino-perineal resection (APR). METHOD: The colostomy site is preoperatively chosen and intraoperatively used for a trocar. After the rectum has been mobilized the descending colon is freed. The peritoneal margin is gently grasped and the parietal peritoneum, extraperitoneal together with the transversalis fascia are separated from the transverse abdominal muscle fibres upwards for 3-4 cm aiming at the trocar site to form the extraperitoneal retrotransversalis canal...
May 19, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29752845/perineal-closure-following-extralevator-abdominoperineal-excision-for-cancer-of-the-rectum
#2
Jenifer Barrie, Adam Haque, David Andrew Evans
AIM: Extralevator abdominoperineal resection (ELAP) may be complicated by perineal wound healing problems and herniation. We report a consecutive series of 38 such patients with selective use of a fasciocutaneous V-Y buttock advancement flap (BAF). METHOD: Data were collected on a series of patients undergoing ELAP for rectal malignancy between August 2011 and July 2017. Demographics, management and outcomes were recorded prospectively. Perineal wound problems were considered 'major' if they required packing, otherwise being classed as 'minor'...
May 12, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29707565/maternal-body-mass-index-and-anovaginal-distance-in-active-phase-of-term-labor
#3
Linda Hjertberg, Eva Uustal, Sofia Pihl, Marie Blomberg
Introduction: To evaluate if there was a difference in the anovaginal distance (AVD) measured by transperineal ultrasound between obese and normal weight women. Material and Methods: A prospective observational study including 207 primiparous women at term in first stage of labor. Transperineal ultrasound with a vaginal probe was used to measure the AVD. Maternal, pregnancy, and delivery characteristics potentially associated with perineal thickness were extracted from woman's medical records...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29705985/systematic-review-of-pelvic-floor-interventions-during-pregnancy
#4
REVIEW
Lucas Schreiner, Isabel Crivelatti, Julia M de Oliveira, Christiana C Nygaard, Thais G Dos Santos
BACKGROUND: Pelvic floor interventions during pregnancy could reduce the impact of pregnancy and delivery on the pelvic floor. OBJECTIVE: To determine the effects of pelvic floor interventions during pregnancy on childbirth-related and pelvic floor parameters. SEARCH STRATEGY: PubMed, Embase, and LILACS were searched for reports published during between 1990 and 2016 in English, Spanish, or Portuguese. The search terms were "pregnancy," "pelvic floor muscle training," and related terms...
April 28, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29693307/trans-anal-total-mesorectal-excision-is-it-really-safe-and-better-than-laparoscopic-total-mesorectal-excision-with-perineal-approach-first-in-patients-with-low-rectal-cancer-a-learning-curve-with-case-matched-study-in-68-patients
#5
Diane Mege, Elisabeth Hain, Zaher Lakkis, Léon Maggiori, Justine Prost À la Denise, Yves Panis
AIM: To compare learning curve of trans-anal total mesorectal excision (TATME) with laparoscopic TME started by perineal approach (LTME). METHOD: The first 34 consecutive patients who underwent TATME for low rectal cancer were matched with LTME performed by the same surgeon, for gender, body mass index and chemoradiation. RESULTS: 34 patients undergoing TATME (23 males; 58±14 years) were matched with 34 undergoing LTME (23 males; 59±13 years)...
April 25, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29652745/severe-perineal-lacerations-after-vaginal-delivery-are-they-an-anesthesiologist-s-problem
#6
Feyce Peralta, Joseph Bradley Bavaro
PURPOSE OF REVIEW: Perineal tears or lacerations are common occurrences after vaginal delivery. Understanding the degree of severity of these tears and the immediate and long-term complications of severe perineal lacerations can assist anesthesiologists with the management of these patients in the immediate postpartum period. RECENT FINDINGS: Severe perineal lacerations have a high degree of association with postpartum depression. The presence of neuraxial labor analgesia decreases the odds of severe perineal lacerations...
June 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29648935/episiotomy-and-perineal-tear-risk-factors-in-a-group-of-4493-women
#7
Grażyna Gebuza, Marzena Kaźmierczak, Alicja Gdaniec, Estera Mieczkowska, Małgorzata Gierszewska, Agnieszka Dombrowska-Pali, Mariola Banaszkiewicz, Marek Maleńczyk
Episiotomy belongs to the most frequent procedures carried out during delivery. Performing episiotomy should be reduced as there is scientific evidence indicating that it can cause pain, sexual problems, and serious, long-term health consequences. The aim of the researchers is to identify factors associated with episiotomy and the perineal tear. Analyses were performed using a model of a logistic regression. The study involved 4493 women. The episiotomy risk was related to: a birth weight exceeding 3500 grams, an instrumental delivery by means of forceps or vacuum extraction...
April 12, 2018: Health Care for Women International
https://www.readbyqxmd.com/read/29599387/clinical-and-sexual-risk-correlates-of-mycoplasma-genitalium-in-urban-pregnant-and-non-pregnant-young-women-cross-sectional-outcomes-using-the-baseline-data-from-the-women-s-biohealth-study
#8
Maria Trent, Jenell S Coleman, Justin Hardick, Jamie Perin, Lisa Tabacco, Steven Huettner, Jocelyn Ronda, Rebecca Felter-Wernsdorfer, Charlotte A Gaydos
OBJECTIVE: Research exploring the clinical and sexual risk correlates is essential to define universal standards for screening and management for Mycoplasma genitalium (MG). The objective of this study is to determine the baseline prevalence of MG and associated clinical risks using cross-sectional data. METHODS: Adolescent and young adult women 13-29 years were recruited during clinical visits during which biological specimens were collected for Neisseriagonorrhoeae (NG) and Chlamydia trachomatis (CT) testing to provide vaginal specimens for MG and Trichomonasvaginalis (TV) testing...
March 29, 2018: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/29577777/factors-associated-with-spontaneous-perineal-lacerations-in-deliveries-without-episiotomy-in-a-university-maternity-hospital-in-the-city-of-recife-brazil-a-cohort-study
#9
Vanessa Maria Laranjeiras Lins, Fernanda Barros Lima Vasconcelos, Leila Katz, Isabela Coutinho, Melania Amorim
OBJECTIVES: To determine factors associated with spontaneous perineal laceration in low-risk pregnant women who delivered vaginally without episiotomy in a university maternity hospital in Recife, Pernambuco, Brazil. METHODS: A prospective cohort study was conducted with 222 low-risk, full-term pregnant women admitted in labor with a single fetus in cephalic presentation. Women with malformed fetuses were excluded from the study. The variables analyzed were: the frequency and severity of lacerations, the women's biological, sociodemographic, clinical and obstetrical characteristics, neonatal characteristics and data on their deliveries and procedures...
March 25, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29575180/sonographic-assessment-of-the-anal-sphincter-after-obstetric-anal-sphincter-injury-oasi-using-transperineal-ultrasound-tpus
#10
EDITORIAL
Vered H Eisenberg, Dan V Valsky, Simcha Yagel
Obstetric anal sphincter injury (OASI) is the most common cause of anal incontinence and ano-rectal symptoms in women1 . Reported rates of anal incontinence following primary repair of OASI range between 15-61%, with a mean of 39%2, 3 . Other possible complications of OASI include perineal pain, dyspareunia, and less commonly, abscess formation, wound breakdown, and rectovaginal fistulae. Symptom onset may occur immediately, several years postpartum, or only late in life when aging of tissues adds to the delivery insult...
March 24, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29573536/outcome-of-surgery-for-recurrent-anal-cancer-results-from-a-tertiary-referral-centre
#11
M Bignell, H Chave, G Branagan
AIM: Chemoradiotherapy remains the first line treatment for anal cancer with surgery reserved for cancer recurrence or persistence. The low incidence of anal cancer means the numbers undergoing surgery is small with centralization for excision to regional cancer centres. We present our experience of abdominal perineal excision, with reconstruction of the perineal defect (APERR), within a tertiary centre. METHOD: Over a fifteen year period data were collected retrospectively from notes of patients who underwent an APERR...
March 24, 2018: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/29571123/implementation-of-the-rcog-guidelines-for-prevention-of-obstetric-anal-sphincter-injuries-oasis-at-two-london-hospitals-a-time-series-analysis
#12
Henna Mohiudin, Sajjad Ali, Pradyna N Pisal, Rose Villar
OBJECTIVE: To audit the impact of implementation of the RCOG guidelines for prevention of Obstetric anal sphincter injuries (OASIS) by introducing antenatal perineal massage, manual perineal protection, and cutting episiotomies at 60° to the midline at the time of crowning. DESIGN: Time series analysis; Setting - Two London teaching hospitals; Royal Free London (RFL) and Barnet; Population or Sample - All nulliparous women undergoing vaginal birth; Methods - Training was provided for above techniques...
March 15, 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29505059/synthesis-and-antioxidant-capacity-of-novel-stable-5-tellurofuranose-derivatives
#13
Elton L Borges, Marta T Ignasiak, Yuliia Velichenko, Gelson Perin, Craig A Hutton, Michael J Davies, Carl H Schiesser
Novel stable tellurium-containing carbohydrate derivatives are prepared from hexitols and pentitols through a double nucleophilic substitution with NaHTe in PEG-400. These tellurosugars react at very high rates with two-electron oxidants, including hypochlorous and peroxynitrous acid, formed at sites of inflammation, and show considerable promise as protective agents against oxidative damage.
March 25, 2018: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/29497909/vertical-rectus-abdominis-musculocutaneous-flap-repair-improves-perineal-wound-healing-after-abdominoperineal-resection-for-irradiated-locally-advanced-rectal-cancer
#14
Milan Spasojevic, Anthony B Mariathasan, Mariusz Goscinski, Ebbe B Thorgersen, Arne M Solbakken, Hans-Petter Gullestad, Truls Ryder, Kjersti Flatmark, Stein G Larsen
BACKGROUND: Radiotherapy (RT) and subsequent abdominoperineal resection (APR) for locally advanced rectal cancer (LARC) is associated with significant perineal wound morbidity. The aim of the present study was to investigate if vertical rectus abdominis musculocutaneous (VRAM) flap repair after APR in LARC patients improves perineal wound healing compared with direct perineal wound closure (non-VRAM). METHODS: LARC patients (n = 329) operated with APR between January 2006 and December 2015 after neoadjuvant RT of ≥ 25 Gy were identified, including 260 and 69 patients in the non-VRAM and VRAM groups, respectively...
May 2018: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29474285/incidence-of-obstetric-anal-sphincter-injuries-after-training-to-protect-the-perineum
#15
Jennifer Yeung, Anna Stecher, Catrina C Crisp, Donna Mazloomdoost, Benjamin Smith, Steven D Kleeman, Rachel N Pauls
OBJECTIVES: Obstetric anal sphincter injuries (OASISs) are a devastating postpartum complication; reducing rates is paramount to improving quality of care. In Norway, implementation of a perineal protection program decreased the incidence of OASIS by 48%. We sought to assess impact on OASIS rates following a similar program. METHODS: This institutional review board-approved, retrospective cohort study was performed in an academic hospital system. The periods of analysis were November 2014 through October 2015 for the preintervention arm and November 2015 through October 2016 for the postintervention arm...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29464744/primary-peri-anal-adenocarcinoma-of-intestinal-type-a-new-proposed-entity
#16
Pelvender S Gill, Newton A C S Wong
AIMS: The currently recognised subtypes of anal canal/peri-anal adenocarcinoma are those arising from low rectal mucosa or columnar cuff, fistula-related tumours and anal gland carcinoma. This report presents two examples of a hitherto undescribed subtype of peri-anal adenocarcinoma with an intestinal phenotype. METHODS AND RESULTS: A 74-year-old man had a peri-anal tumour locally excised, whereas a 73-year-old female underwent an abdominoperineal resection for peri-anal Paget's disease with an underlying carcinoma...
February 21, 2018: Histopathology
https://www.readbyqxmd.com/read/29453137/scientific-evidence-on-perineal-trauma-during-labor-integrative-review
#17
REVIEW
Flaviana Vieira, Janaina V Guimarães, Marcia C S Souza, Poliana M L Sousa, Rafaela F Santos, Agueda M R Z Cavalcante
OBJECTIVE: To assess the scientific evidence for management and preservation of perineal integrity during the expulsive stage of labor. STUDY DESIGN: Integrative review that employed the Population, Intervention, Comparison, Outcome strategy to formulate the research question: Which perineal measure(s) is(are) effective in maintaining perineal integrity during labor? The search was performed in the databases MEDLINE, LILACS, BDENF and SciELO. The ten selected studies were analyzed based on their level of evidence and grade of recommendation...
April 2018: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29423180/evidence-from-household-surveys-for-measuring-coverage-of-newborn-care-practices
#18
Deborah Sitrin, Jamie Perin, Lara Me Vaz, Liliana Carvajal-Aguirre, Shane M Khan, Joy Fishel, Agbessi Amouzou
Background: Aside from breastfeeding, there are little data on use of essential newborn care practices, such as thermal protection and hygienic cord care, in high mortality countries. These practices have not typically been measured in national household surveys, often the main source for coverage data in these settings. The Every Newborn Action Plan proposed early breastfeeding as a tracer for essential newborn care due to data availability and evidence for the benefits of breastfeeding...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29420771/genitourinary-injuries-among-female-u-s-service-members-during-operation-iraqi-freedom-and-operation-enduring-freedom-findings-from-the-trauma-outcomes-and-urogenital-health-tough-project
#19
Amy M Reed, Judson C Janak, Jean A Orman, Steven J Hudak
Introduction: Until recently, female U.S. service members (SMs) have not been permitted to serve in direct combat roles. However, during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF), a large number of female SMs have been wounded while serving in combat support roles. This included an unprecedented number of women with genitourinary (GU) injuries. No previous studies have reported either the incidence or clinical picture of these injuries. The objective of this study is to describe the epidemiology of GU injuries among female U...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29411423/the-anatomy-of-the-perineal-branch-of-the-sciatic-nerve
#20
Christopher M Gibbs, Alexander D Ginsburg, Thomas J Wilson, Nirusha Lachman, Mario Hevesi, Robert J Spinner, Aaron J Krych
A "perineal" branch of the sciatic nerve has been visualized during surgery, but there is currently no description of this nerve branch in the literature. Our study investigates the presence and frequency of occurrence of perineal innervation by the sciatic nerve and characterizes its anatomy in the posterior thigh. Fifteen cadavers were obtained for dissection. Descriptive results were recorded and analyzed statistically. Twenty-one sciatic nerves were adequately anatomically preserved. Six sciatic nerves contained a perineal branch...
April 2018: Clinical Anatomy
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