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https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#1
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29130230/-protective-measures-in-laparoscopic-resection-for-upper-or-mid-rectal-cancer-and-sigmoid-colon-cancer-with-transrectal-specimen-extraction-surgery
#2
Chuangang Fu, Zhuqing Zhou, Junyi Han, Bin Lu, Wei Gao, Zhe Zhu, Qixin Jiang, Fang Ji, Tao Du
OBJECTIVE: To introduce the use of a self-made specimen protective sleeve in laparoscopic resection for upper or mid rectal cancer and sigmoid colon cancer with transrectal specimen extraction surgery and the improvement of implantation method, so as to avoid and reduce bacterial contamination and tumor cell dissemination in abdominal cavity. METHODS: During June 2015 and May 2017, 48 cases of high located rectal or sigmoid colon cancer were operated laparoscopically with natural orifices specimen extraction surgery (NOSES) using a self-made specimen protecting sleeve...
October 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28969732/delayed-reconstruction-of-a-traumatic-cloaca-following-obstetric-anal-sphincter-rupture
#3
Ali Ezer, Alper Parlakgumus
Permanent communication between the rectum and the vagina along with full thickness of anal sphincter faults can be a result of an unsuccessful primary repair of fourth degree obstetric trauma. This results into complete fecal incontinence and impaired quality of life. Anterior overlapping sphincteroplasty can be chosen as a method of treatment for fecal incontinence due to obstetric injuries. However, large perineal body reconstructions are generally pretty challenging tasks for surgeons. What we will describe here for the repair of a traumatic cloaca, occurred 23 years ago during vaginal delivery, is the use of a transpositional flap following overlapping sphincteroplasty...
September 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28914704/rectoneovaginal-fistula-in-a-transgender-woman-successfully-repaired-using-a-buccal-mucosa-graft
#4
Molly Abbott Elmer-DeWitt, Hadley M Wood, Tracy Hull, Cecile A Unger
BACKGROUND: Rectoneovaginal fistulae (RnVFs) are abnormal connections between the rectum and a surgically created neovagina. Although very uncommon, they confer significant morbidity in patients and may require a multidisciplinary team approach to the repair. Risk factors for RnVF include rectal injury at the time of neovaginoplasty, malignancy in the neovagina, trauma (iatrogenic or otherwise), radiation, and neovaginal revision surgery. CASE DESCRIPTION: The patient is a 64-year-old transgender woman with recurrent RnVF following penile skin inversion neovaginoplasty, which was complicated by an intraoperative rectal injury...
September 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28905802/coccygodynia-pathogenesis-diagnostics-and-therapy-review-of-the-writing
#5
Bogumiła Dampc, Krzysztof Słowiński
Coccygodynia is a problem with a small percentage (1%) of the population suffering from musculoskeletal disorders. This pain is often associated with trauma, falling on the tailbone, long cycling, or by women after childbirth. The reason for the described problem can be the actual morphological changes. Idiopathic coccygodynia causes therapeutic difficulties to specialists of many fields. Unsatisfactory treatment, including coccygectomy tends to seek new solutions. They belong to them techniques exploited in the manual therapy which in their spectrum hold: direct techniques - per rectum as well as indirect techniques taking into account distant structures of the motor organ, remaining in dense interactions with the coccygeal part...
August 31, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28888700/surgical-repair-of-rectovaginal-fistula-using-the-modified-martius-procedure-a-step-by-step-guide
#6
Dan Wang, Juan Chen, Lan Zhu, Mingchen Sang, Fan Yu, Qing Zhou
STUDY OBJECTIVE: to demonstrate the surgical repair of rectovaginal fistula by the modified Martius procedure. DESIGN: step by step presentation of the procedure using video. SETTING: Rectovaginal fistula (RVF) is abnormal epithelialized connections between the vagina and rectum. Causes of rectovaginal fistula include obstetrical trauma, Crohn disease, pelvic irradiation and postsurgical complications. Many surgical interventions have been developed, from laparoscopic technique to muscle transposition and even rectal resection...
September 6, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28854406/laparoscopic-extraction-of-a-giant-peritoneal-loose-body-case-report-and-review-of-literature
#7
Keiso Matsubara, Yuji Takakura, Takashi Urushihara, Takashi Nishisaka, Toshiyuki Itamoto
INTRODUCTION: A peritoneal loose body is a rare finding and is sometimes founded incidentally during laparotomy or autopsy. A giant peritoneal loose body, measuring more than 50mm, is very rare, and only a few cases of laparoscopic extraction of these giant bodies have been reported in the literature. PRESENTATION OF CASE: A 70-year-old man presented for evaluation of urinary frequency. He had no history of previous abdominal surgery or trauma. Computed tomography of the abdomen and pelvis showed a giant oval-shaped mass with calcification of the luminal core, measuring 58mm in diameter...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28470438/a-novel-physical-colonoscopy-simulator-based-on-analysis-of-data-from-computed-tomography-colonography
#8
Katsuhisa Noda, Takatoshi Kitada, Yasumoto Suzuki, Hugh Shunsuke Colvin, Taishi Hata, Tsunekazu Mizushima
PURPOSE: Laparoscopic surgery is now practiced widely because of its lower postoperative morbidity. As flexible endoscopy during laparoscopic surgery minimizes surgical trauma further, training in endoscopy will become more important for surgeons. Thus, we designed a physical simulator, the Noda-Kitada-Suzuki (NKS) model, which could provide the more realistic insertion of a colonoscope. METHODS: We designed a colonoscopy simulator, based on information from computed tomography colonography scans of the anatomy and kinetic properties of the colon and rectum...
September 2017: Surgery Today
https://www.readbyqxmd.com/read/28292518/the-management-of-penetrating-rectal-and-anal-trauma-a-systematic-review
#9
Daniel P Ahern, Michael E Kelly, Danielle Courtney, Emanuele Rausa, Des C Winter
INTRODUCTION: Traumatic injuries to the lower gastrointestinal tract (rectum and anus) have been largely reported in the military setting with sparse publications from the civilian setting. Additionally, there remains a lack of international consensus regarding definitive treatment pathways. This systematic review aimed to assess the current literature and propose a standardised treatment algorithm to aid management in the civilian setting. METHODS: A systematic review of available literature from 1999 to 2016 that was performed...
June 2017: Injury
https://www.readbyqxmd.com/read/28281483/an-adolescent-with-prolapsed-omentum-per-rectum-spontaneous-rectal-perforation-managed-laparoscopically
#10
Ameet Kumar, Chandra K Jakhmola, Yogesh Kukreja, S S Kumar, Arjun Singh Sandhu
Spontaneous rupture of the rectum is a rare occurrence. A total laparoscopic approach to rectal perforation has only occasionally been reported. We report an unusual case of a young boy who developed a spontaneous rupture of the rectum following a trivial fall. A magnetic resonance imaging revealed a tear in the rectum at the peritoneal reflection with the omentum plugging it. He denied any history of rectal instrumentation or abnormal sexual activity. He had no history of constipation or rectal prolapse. The tear was repaired laparoscopically and a covering loop sigmoid colostomy was added...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28001112/microwave-ablation-for-treatment-of-hepatic-neoplasia-in-five-dogs
#11
Toni Yang, J Brad Case, Sarah Boston, Michael J Dark, Beau Toskich
CASE DESCRIPTION 5 dogs between 9 and 11 years of age were evaluated for treatment of primary (n = 2) or metastatic (3) hepatic neoplasia. CLINICAL FINDINGS Patients were evaluated on an elective (n = 3) or emergency (2) basis. Two dogs with primary hepatic neoplasia were evaluated because of lethargy and inappetence. One dog was referred after an enlarged anal sac was detected via palpation per rectum during a routine physical examination. Two dogs were evaluated on an emergency basis because of lethargy and weakness, and hemoabdomen in the absence of a history of trauma was detected...
January 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28000647/an-adolescent-with-prolapsed-omentum-per-rectum-spontaneous-rectal-perforation-managed-laparoscopically
#12
Ameet Kumar, Chandra K Jakhmola, Yogesh Kukreja, S S Kumar, Arjun Singh Sandhu
Spontaneous rupture of the rectum is a rare occurrence. A total laparoscopic approach to rectal perforation has only occasionally been reported. We report an unusual case of a young boy who developed a spontaneous rupture of the rectum following a trivial fall. A magnetic resonance imaging revealed a tear in the rectum at the peritoneal reflection with the omentum plugging it. He denied any history of rectal instrumentation or abnormal sexual activity. He had no history of constipation or rectal prolapse. The tear was repaired laparoscopically and a covering loop sigmoid colostomy was added...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27749800/a-case-of-child-physical-abuse-with-a-rolling-pin-insertion-resulting-in-bladder-and-rectal-perforation
#13
Meda Kondolot, Selim Doganay, Cüneyt Turan, Hasim Asil, Didem B Oztop, Caglar Ozdemir
Visceral injuries are not uncommon in nonaccidental trauma and often require emergent operative intervention. However, sometimes it can be difficult to assess the extent of injury. In this report, we present a case of child physical abuse resulting in bladder and rectal perforations, which was initially referred to our hospital as acute abdomen with intraperitoneal free fluid on ultrasonography. An exploratory laparotomy revealed the perforations and surgical repair was performed. The patient was evaluated by the Hospital Child Protective team and it was revealed that bladder and rectum perforations were due to insertion of rolling pin into the rectum by the stepmother...
October 4, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27689515/presacral-retroperitoneal-hematoma-after-blunt-trauma-presents-with-rectal-bleeding-a-case-report
#14
Sanne Jensen Dich, Alaa El-Hussuna
INTRODUCTION: We present a case of a presacral hematoma, which penetrated into the rectum resulting in rectal bleeding. This is an unusual presentation of a presacral hematoma. PRESENTATION OF THE CASE: A 76-year-old woman, using warfarin anticoagulant prophylaxis, presented with a rectal bleed two days after a fall. A sigmoidoscopy revealed that the source of bleeding was a presacral hematoma penetrating into the rectum. A Computed Tomography scan of the pelvis confirmed the presence of a hematoma measuring 10×9...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27603349/successful-repair-of-recurrent-rectovaginal-fistula-by-stratified-suture-using-transanal-endoscopic-microsurgery-a-care-compliant-case-report
#15
Weijie Chen, Xin Chen, Guole Lin, Huizhong Qiu
BACKGROUND: Rectovaginal fistulas (RVFs) are abnormal connections between the rectum and vagina. Although many surgical approaches to correct them have been attempted, management of RVFs still remains a challenge, especially for recurrent RVFs. METHODS: In the present study, we report a case in a 22-year-old female with a chief complaint of obvious passages of flatus or stool through the vagina for 10 years. She had suffered a vaginal trauma from a violent accident 10 years prior, and gradually noticed the uncontrollable passage of gas or feces from the vagina 2 weeks later...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27599704/rectal-prolapse-traumatizes-rectal-neuromuscular-microstructure-explaining-persistent-rectal-dysfunction
#16
Matthias Kraemer, Werner Paulus, David Kara, Saskia Mankewitz, Stephanie Rozsnoki
PURPOSE: Internal rectal prolapse is common and correlates with age. It causes a plug-like physical obstruction and is a major cause of defecation disorder. The progressive distortion of the prolapsing rectum likely causes secondary defects in the rectal wall, which may exacerbate rectal dysfunction. We undertook a prospective observational study to detect and quantify the neurologic and histopathologic changes in the rectal wall. METHODS: We examined dorsal and ventral rectal wall specimens from consecutive patients with internal rectal prolapse undergoing stapled transanal rectal resection (STARR)...
December 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27437297/a-case-of-recto-vesico-cutaneous-fistula-following-perineal-injury-by-wild-boar
#17
Pravin D Bhingare, Umesh Ravikant Shelke, Yogesh A Bang
It is very uncommon for a boar to become aggressive in nature against human unless they are cornered. A wild boar attacked a 24-year-old male from behind in perineal region. At presentation, he had continuous dribbling of urine and fecal matter from perineal wound. On CT-scan, a well defined tract delineated by contrast was seen between postero-lateral aspect of bladder and anterior wall of rectum, and there was contrast extravasation through perineal wound. After resuscitation, fistula was repaired through abdominal approach, and perineal wound was debrided...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27200319/delayed-retropneumoperitoneum-following-vaginal-laceration-in-a-7-year-old-girl
#18
Kyung-Jin Min, Hyesook Im, Sanghoon Lee, Jin Hwa Hong, Jae-Yun Song, Jae-Kwan Lee, Nak Woo Lee
We describe an unusual case of delayed retropneumoperitoneum caused by a deep vaginal laceration as a result trauma from a water jet in a fountain. A 7-year-old premenarcheal girl presented to the emergency department after experiencing an injury from a water jet at a fountain park. Initially, the patient's vital sign and perineum were within normal range. Because the patient's vital signs became unstable 12 hours after vaginal injury, we carried out abdomino-pelvic computed tomography resulting in retropneumoperitoneum...
May 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/27193985/high-velocity-missile-related-colorectal-injuries-in-theatre-application-of-injury-scores-and-their-effects-on-ostomy-rates
#19
Şahin Kaymak, Aytekin Ünlü, Ali Harlak, Nail Ersöz, Rahman Şenocak, Ali Kağan Coşkun, Nazif Zeybek, Emin Lapsekili, Orhan Kozak
BACKGROUND: Treatment of colorectal injuries (CRIs) remains a significant cause of morbidity and mortality. The aim of the present study was to analyze treatment trends of Turkish surgeons and effects of the American Association for the Surgery of Trauma (AAST), Injury Severity (ISS), and Penetrating Abdominal Trauma Index (PATI) scoring systems on decision-making processes and clinical outcomes. METHODS: Data regarding high velocity missile (HVM)-related CRIs were retrospectively gathered...
March 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27033375/-emergencies-of-the-external-genital-area
#20
A Kaminsky, H Sperling
BACKGROUND: In addition to epididymitis and testicular torsion, emergencies of the external genital are rare. Rapid diagnosis and therapy are essential so that immediate therapy can be provided, which is important for survival (Fournier gangrene) of the patient or for the preservation of erectile function (priapism and penile fracture). A detailed patient history and clinical examination are generally sufficient for correct diagnosis. RESULTS: Under certain circumstances, it might be useful to perform ultrasound, computed tomography scan or magnetic resonance imaging or retrograde urethrography...
April 2016: Der Urologe. Ausg. A
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