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Perineal colostomy

Osama Ibrahim Almosallam, Ali Aseeri, Saud Al Shanafey
BACKGROUND: Colostomy is a common part of the management of high anorectal malformation (ARM) in the pediatric population. OBJECTIVE: To evaluate whether the type of colostomy (loop vs divided) has an impact on outcome in patients with ARM. DESIGN: A retrospective study. SETTING: King Faisal Specialist Hospital and Research Center, a tertiary care center. PATIENTS AND METHODS: All patients who were managed with colostomy for ARM and had definitive repair during the period of January 2000 to December 2014...
September 2016: Annals of Saudi Medicine
A L A Bloemendaal, R Kraus, N C Buchs, F C Hamdy, R Hompes, L Cogswell, R J Guy
AIM: In advanced pelvic cancer it may be necessary to perform a total pelvic exenteration. In such cases urinary tract reconstruction is usually achieved with the creation of an ileal conduit with a urinary stoma on the right side of the patient's abdomen and an end colostomy separately on the left. The potential morbidity from a second stoma, may be avoided by the use of a double-barrelled wet colostomy (DBWC), as a single stoma. Another advantage is the possibility to use a vertical rectus abdominis muscle (VRAM) flap for perineal reconstruction...
September 13, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Yu Yoshino, Kimihiko Funahashi, Rei Okada, Yasuyuki Miura, Takayuki Suzuki, Takamaru Koda, Kimihiko Yoshida, Junichi Koike, Hiroyuki Shiokawa, Mitsunori Ushigome, Tomoaki Kaneko, Yasuo Nagashima, Mayu Goto, Akiharu Kurihara, Hironori Kaneko
BACKGROUND: Fournier's gangrene in the setting of rectal cancer is rare. Treatment for Fournier's gangrene associated with rectal cancer is more complex than other cases of Fournier's gangrene. We report on a patient with severe Fournier's gangrene in the setting of locally advanced rectal cancer who was treated with a combined modality therapy. CASE PRESENTATION: A 65-year-old man presented with general fatigue and anal pain. The medical and surgical histories were unremarkable...
2016: World Journal of Surgical Oncology
Noelia Ibañez, Jesús Abrisqueta, Juan Luján, Quiteria Hernández, Pascual Parrilla
OBJECTIVES: Some perianal pathologies require aggressive surgery that will need techniques to allow to re-establish the integrity of the perianal region. The purpose is to analyze short and long term results after perineal reconstruction with V-Y flaps. METHODS: A retrospective review of prospectively collected database was conducted at Virgen de la Arrixaca's Hospital in Murcia (España) between January 2000 and December 2013. The study includes all patients who underwent a perineal reconstruction with V-Y flaps...
August 20, 2016: Cirugía Española
Mesut Sipahi, Ergin Arslan, Hasan Börekçi, Faruk Önder Aytekin, Bahadır Külah, Oktay Banlı
Perineal procedures have higher recurrence and lower mortality rates than abdominal alternatives for the treatment of rectal prolapse. Presence of incarceration and strangulation also influences treatment choice. Perineal rectosigmoidectomy is one of the treatment options in patients with incarceration and strangulation, with low mortality and acceptable recurrence rates. This operation can be performed especially to avoid general anesthesia in old patients with co-morbidities. We aimed to present perineal rectosigmoidectomy and diverting loop colostomy in a patient with neurological disability due to spinal trauma and incarcerated rectal prolapse...
2016: Ulusal Cerrahi Dergisi
Kathryn Lynes, Norman S Williams, Christopher L Chan, Mohamed A Thaha
INTRODUCTION: The Anterior Perineal PlanE for ultra-low Anterior Resection of the rectum (APPEAR) technique utilises a perineal incision to facilitate resection of the distal rectum. The aim of this study was to review use of the APPEAR technique, assessing patient selection, indications, complications and outcomes, both oncological and functional. MATERIALS AND METHODS: A systematic review was carried out to identify studies reporting outcomes following rectal resection via an anterior perineal incision, with no limits on year or language...
September 2016: International Journal of Surgery
Amine Souadka, Mohammed Anass Majbar, Laila Amrani, Abdelilah Souadka
BACKGROUND AND STUDY AIM: The aim of this study was to analyze objectively the role of the muscular graft in the continence using manometric study in the patients who underwent pseudocontinent perineal colostomy after abdominoperineal resection for rectal adenocarcinoma. PATIENTS AND METHODS: This was a retrospective study including all the patients from January 2002 to December 2009 who underwent an abdominoperineal resection followed by perineal pseudocontinent colostomy for ultra-low rectal adenocarcinoma and agreed to perform the manometric evaluation of the muscular graft...
July 29, 2016: Acta Chirurgica Belgica
Giuseppe Carbotta, Pierluca Sallustio, Antonio Prestera, Rita Laforgia, Pierluigi Lobascio, Nicola Palasciano
INTRODUCTION: Extramammary Paget's disease (EMPD) occurs commonly in perineum, vulva and perineal region and is considered as a complex disorder due to different clinical and histological features. PRESENTATION OF CASE: A 61 years old woman had a dermatologic evaluation for anal itch and underwent a skin biopsy with diagnostic of Paget disease in perianal region. Pelvic magnetic resonance showed a huge tumor which involved skin, derma and gluteus and she firstly refused any surgical treatment...
August 2016: Annals of Medicine and Surgery
Kenneth Smedh, Ingvar Sverrisson, Abbas Chabok, Maziar Nikberg
BACKGROUND: The use of Hartmann's procedure in the old and frail and/or in patients with fecal incontinence is increasing, even though some data have reported high postoperative rates of pelvic abscesses. Abdominoperineal excision with intersphincteric dissection has been proposed as a better alternative and is performed increasingly both nationally and internationally. However, no studies have been performed to support this. The aim of this study is to randomize patients between Hartmann's procedure and abdominoperineal excision with intersphincteric dissection and compare post-operative surgical morbidity and quality of life...
2016: BMC Surgery
Ricardo Baldonedo Cernuda, Janet Pagnozzi Ángel, Nuria Truan Fernández, José Herminio Sánchez-Farpón, Jose Antonio Álvarez Pérez
Incarceration of a rectal prolapse is an unusual entity that represents a surgical emergency. Even more rarely, it becomes strangulated, requiring emergency surgery. When surgery becomes inevitable, the choice of procedure varies. A 57-year-old man who presented with strangulated rectal prolapse is described. The patient underwent emergency perineal proctosigmoidectomy, the Altemeier operation, combined with diverting loop sigmoid colostomy. The postoperative course was uneventful. After a 6-month follow-up, there was no recurrence, but the patient continued with fecal incontinence...
July 6, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jiten Kulkarni, Anuradha J Patil, Bhaskar Musande, Abhishek B Bhamare
BACKGROUND: Although gracilis muscle transposition for faecal incontinence has been well-described method, its literature for use in obstetric perineal tear without colostomy is sparse. In this study, we have tried to analyse its use in fourth-degree obstetric perineal tears. PATIENTS AND METHODS: A total of 30 patients with recto-vaginal fistula with faecal incontinence secondary to obstetric perineal tear were retrospectively studied between February 2003 and May 2014...
January 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Okechukwu Hyginus Ekwunife, Eric Okechukwu Umeh, Jideofor Okechukwu Ugwu, Uzoamaka Rufina Ebubedike, Chinedu Christian Okoli, Victor Ifeanyichukwu Modekwe, Kelechi Collins Elendu
BACKGROUND: In children with high and intermediate anorectal malformation, distal colostography is an important investigation done to determine the relationship between the position of the rectal pouch and the probable site of the neo-anus as well as the presence or absence of a fistula. Conventionally, this is done using contrast with fluoroscopy or still X-ray imaging. This, however, has the challenges of irradiation, availability and affordability, especially in developing countries...
January 2016: African Journal of Paediatric Surgery: AJPS
Dimitrios Sfoungaris, Vassilios Mouravas, Vassilios Lambropoulos, Chrysostomos Kepertis, Ioannis Spyridakis
We present the case of a male neonate with imperforate anus and a fistula exiting on the penile skin. Anorectal malformations in boys often present themselves with an entero-perineal or entero-urinary tract fistula, the type of which is a key feature for the classification and the treatment plan. A fistula exiting in front of the scrotum, such as described in our case, is very rare and is not incorporated in the current classification and treatment algorithms. Scarce reports on misjudgment concerning the position of the blind rectal pouch in similar cases, led us to perform a colostomy instead of a one-stage correction...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
Hirohiko Kamiyama, Kazuhiro Sakamoto, Toshiyuki China, Jun Aoki, Koichiro Niwa, Shun Ishiyama, Makoto Takahashi, Yutaka Kojima, Michitoshi Goto, Yuichi Tomiki, Shigeo Horie
Here we report a combined laparoscopic abdominoperineal resection and robotic-assisted prostatectomy. A 74-year-old man was diagnosed with T4b low rectal and prostate cancer. The operation was performed after neoadjuvant chemotherapy for the rectal cancer. The procedure used eight ports in total, five for laparoscopic abdominoperineal resection and six for robotic-assisted prostatectomy. First, laparoscopic total mesorectal excision including division of the inferior mesenteric artery was performed, and then, robotic dissection of the prostate was performed...
May 2016: Asian Journal of Endoscopic Surgery
Zeynep Meltem Akkurt, Veysi Fidan, Derya Uçmak, Tuba Dal, Selvi Kelekçi, Haydar Uçak
Ecthyma gangrenosum is a skin lesion associated with Pseudomonas aeruginosa. A previously healthy one-year-old boy who had been diagnosed with varicella 10 days ago was admitted to our hospital with complaints of diarrhea, green ear discharge and new lesions in the diaper area. Intravenous meropenem and amikacin had been previously initiated. Physical examination revealed greenish, well bordered necrotic ulcers on both gluteal areas and the perianal area. Pseudomonas aeruginosa grew in wound culture. A colostomy was opened due to recalcitrant diarrhea and ulcers...
March 2016: Türk Pediatri Arşivi
F Dumont, D Goéré, L Benhaim, C Honoré, D Elias
No abstract text is available yet for this article.
February 2016: Journal of Visceral Surgery
Evelyn Hemper, Mathias Wittau, Johannes Lemke, Marko Kornmann, Doris Henne-Bruns
A condylomata acuminata infection is caused by human papillomaviridae (HPV). This sexually transmitted condition most often affects the perineal region. Importantly, infections with types 16 and 18 are associated with an increased risk for anal and cervix cancer. In most cases topical therapy is sufficient for successfully treating condylomata acuminata. Here, we report the case of a 51-year old patient who suffered from a giant perianal located condylomata acuminata which had developed over a period of more than 10 years...
2016: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
Henry Tran, Ryan Flannigan, Daniel Rapoport
INTRODUCTION: We sought to present our experience and outcomes in patients with complex rectourethral fistulae (RUF) treated using the transperineal approach with gracilis muscle flap interposition. Complex RUF was defined as having prior radiation, failed repair attempts, and large size (>2 cm). METHODS: A retrospective review identified 10 patients presenting with complex RUF between July 2009 and November 2013. Three were excluded due to large fistula defects managed with urinary diversion...
November 2015: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
J W G Ng, S A Cairns, C P O'Boyle
BACKGROUND: Burn produces complex gastrointestinal (GI) responses. Treatment, including large volume fluid resuscitation and opioid analgesia, may exacerbate GI dysfunction. Complications include constipation and opioid-induced bowel dysfunction (OBD), acute colonic pseudo-obstruction (ACPO), bacterial translocation and sepsis, and abdominal compartment syndrome (ACS). Contamination of perineal burns contributes to delayed healing, skin graft failure and sepsis and may impact upon morbidity and mortality...
June 2016: Burns: Journal of the International Society for Burn Injuries
Luigi Rizzi, Claudio Castelli
Open pelvic fractures are caused by high-energy trauma. Injuries to other organs are common and the mortality rate can be as high as 50%. Perineal injury is reported in 5% of open pelvic fractures. We report a case of a 31-year-old man that had an open pelvic injury with Denis zone III fracture of the sacrum, lumbosacral dislocation, symphysis dislocation, bilateral pubic rami fractures and an extensile perineal wound. He underwent an early diverting colostomy in order to prevent pelvic sepsis and subsequent stage reconstruction of the pelvic ring...
December 2015: Injury
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