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Perineal reconstruction

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https://www.readbyqxmd.com/read/29451644/scrotal-reconstruction-with-superomedial-fasciocutaneous-thigh-flap
#1
Daniel Francisco Mello, Americo Helene Júnior
OBJECTIVE: to describe the use of a superomedial fasciocutaneous thigh flap for scrotal reconstruction in open areas secondary to the surgical treatment of perineal necrotizing fasciitis (Fournier's gangrene). METHODS: retrospective analysis of cases treated at the Plastic Surgery Service of Santa Casa de Misericórdia, São Paulo, from 2009 to 2015. RESULTS: fifteen patients underwent scrotal reconstruction using the proposed flap. The mean age was 48...
2018: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/29426576/primary-female-epispadias-perineal-approach-or-kelly-repair
#2
Marc-David Leclair, Sébastien Faraj, Thierry Villemagne, Julie Carrouget, Alexis Arnaud, Yves Heloury
OBJECTIVES: Primary female epispadias encompasses a spectrum of disease, presenting with a variable degree of incontinence. We hypothesized that although perineal urethrocervicoplasty can be a successful first-line procedure in patients with normal bladder, a more radical reconstruction was necessary to achieve continence in cases lying at the most severe end of the spectrum. Our aim was to assess the results of a surgical management using perineal approach in girls with normal bladder capacity, and Kelly radical soft-tissue mobilization (RSTM) in patients with inadequate bladder, based on the assumption that bladder capacity (BC) is a reliable marker of epispadias severity...
October 9, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29423355/coverage-of-the-scrotum-after-fournier-s-gangrene
#3
Ahmed Hassan El-Sabbagh
Background: Fournier's gangrene is a necrotizing fasciitis caused by mixed aerobic and anaerobic bacteria and results in loss of skin and subcutaneous tissue in the perineal area. Coverage of testis varies from closure of the defect primarily, burying inside the thigh, using the remnants of the scrotum for tissue expansion and coverage by flaps. In this manuscript, scrotal advancement flaps and pudendal thigh flaps were used for coverage of the testis unilaterally or bilaterally according to the size of the defect following Fournier gangrene...
2018: GMS Interdisciplinary Plastic and Reconstructive Surgery DGPW
https://www.readbyqxmd.com/read/29398784/reconstruction-of-acquired-ischiatic-and-perineal-defects-an-anatomical-and-clinical-comparison-between-gluteal-thigh-and-inferior-gluteal-perforator-flaps
#4
Eduardo Montag, Thiago Ueda, Alberto Okada, Bruno Onishi, Rolf Gemperli
Background: Flap coverage is the gold standard in treating pressure sores, and due to the high recurrence rate, the possibility of multiple surgical procedures should be considered during flap selection. The gluteal thigh (GT) flap has become a workhorse for ischiatic pressure sore treatment at our hospital. Follow-up revealed a group of patients presenting recurrence of the pressure sore that needed a second flap. The inferior gluteal artery perforator (IGAP) flap was chosen in this series...
2018: European Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29394843/-a-case-of-anal-canal-cancer-with-skin-invasion-to-which-abdominoperineal-resection-and-perineum-reconstruction-were-performed-after-neoadjuvant-chemoradiotherapy
#5
Ayumi Yamaguchi, Masakazu Miyake, Sumiko Yoshitatsu, Mamoru Uemura, Masataka Ikeda, Takeshi Kato, Takuya Hamakawa, Sakae Maeda, Naoki Hama, Kazuhiro Nishikawa, Atsushi Miyamoto, Michihiko Miyazaki, Motohiro Hirao, Shoji Nakamori, Mitsugu Sekimoto
A 74-year-old man visited our hospital with an awareness of anal mass and bleeding. He was diagnosed as adenocarcino- ma of anal canal with wide spreading skin invasion. After neoadjuvant chemoradiotherapy(radiationtotal 45 Gy/25 Fr; cape- citabine 825mg/m2)was performed to reduce the mass volume, laparoscopic abdominoperineal resection with large perineum skin resection and lateral lymph node dissection was carried out. The perineal defect was repaired with a rectus abdominis musculocutaneous flap. Six days after surgery, the rectus abdominis musculocutaneous flap necrotized, and second perineum reconstruction by the bilateral gracilis musculocutaneous flaps was performed after debridement of necrotic tissue...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29394689/-a-case-of-laparoscopic-surgery-performed-for-locally-advanced-rectal-cancer-suspected-of-invasion-to-prostate
#6
Hisashi Nagahara, Shigetomi Nakao, Tatsunari Fukuoka, Masatsune Shibutani, Kiyoshi Maeda, Shinji Matsutani, Yosuke Doi, Hiroshi Ohtani, Takeshi Yamazaki, Ryosuke Amano, Hiroaki Tanaka, Kazuya Muguruma, Masakazu Yashiro, Kosei Hirakawa, Masaichi Ohira
A-58-year-old man was admitted to other hospital with complaints of anal pain and bloody stools, diagnosed as rectal cancer with invasion to prostate, and performed sigmoid colostomy. After taking 6 courses of mFOLFOX6 as preoperative chemotherapy, he introduced our hospital for the purpose of operation. Preoperative evaluation of chemotherapy was PR, but infiltration of the prostate remained. Therefore, laparoscopic abdomino-perineal resection of rectum, prostatectomy and urethral reconstruction by urethral-bladder anastomosis were performed...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/29379404/anal-and-perineal-injuries
#7
REVIEW
Arjun N Jeganathan, Jeremy W Cannon, Joshua I S Bleier
With increased use of explosive devices in warfare, anal trauma is often seen coupled with more complex pelviperineal injury. While the associated mortality is high, casualties that survive are often left with disabling fecal incontinence from damage to the anosphincteric complex. After resolution of the acute insult, the initial evaluation mandates a thorough physical exam, including endoscopic evaluation with rigid proctoscopy and flexible sigmoidoscopy, as well as adjunctive testing, specifically anal manometry and endoanal ultrasound...
January 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29374769/fournier-s-gangrene-clinical-presentation-of-13-cases
#8
Bolesław Kuzaka, Marta M Wróblewska, Tomasz Borkowski, Dariusz Kawecki, Piotr Kuzaka, Grażyna Młynarczyk, Piotr Radziszewski
BACKGROUND Fournier's gangrene (FG) is a fulminant form of infective, polymicrobial, necrotizing fasciitis of the perineal, genital, and perianal regions. It commonly affects men, but women and children may also develop this type of tissue necrosis. MATERIAL AND METHODS This study is a retrospective analysis of the management of 13 cases of Fournier's gangrene, diagnosed from among about 45 000 patients (men, women, and children) treated in the Department of General, Oncological, and Functional Urology (Medical University of Warsaw) from 1995 to 2013...
January 28, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29354904/-clinical-application-of-pelvic-floor-reconstruction-in-extralevator-abdominoperineal-excision-for-low-rectal-cancer
#9
Wei Ge, Gang Chen, Songsong Jiang, Hao Wang
OBJECTIVE: To investigate the safety and clinical significance of pelvic floor reconstruction in extralevator abdominoperineal excision(ELAPE) for advanced low rectal cancer. METHODS: The clinical efficacy was retrospectively analyzed in 30 patients with low rectal cancer who underwent ELAPE from January 2013 to December 2016 in Nanjing Drum Tower Hospital, the affiliated Hospital of Nanjing University Medical School. There were 21 male patients and 9 female, with an average age of 61...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29315090/incidence-and-risk-factors-for-anastomotic-failure-in-1594-patients-treated-by-transanal-total-mesorectal-excision-results-from-the-international-tatme-registry
#10
Marta Penna, Roel Hompes, Steve Arnold, Greg Wynn, Ralph Austin, Janindra Warusavitarne, Brendan Moran, George B Hanna, Neil J Mortensen, Paris P Tekkis
OBJECTIVE: To determine the incidence of anastomotic-related morbidity following Transanal Total Mesorectal Excision (TaTME) and identify independent risk factors for failure. BACKGROUND: Anastomotic leak and its sequelae are dreaded complications following gastrointestinal surgery. TaTME is a recent technique for rectal resection, which includes novel anastomotic techniques. METHODS: Prospective study of consecutive reconstructed TaTME cases recorded over 30 months in 107 surgical centers across 29 countries...
January 5, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29284150/men-main-victims-of-hidradenitis-suppurativa-a-prospective-cohort-study
#11
Hemmat Maghsoudi, Hojjat Almasi, Mahmood Reza Miri Bonjar
BACKGROUND: hidradenitis suppurativa (HS) is a chronic inflammatory disease presenting as painful subcutaneous nodules, characterized by multiple abscess, inter-networking sinus tracts. We present the option of surgical treatment involving wide surgical excision and methods of reconstruction as well as the rate of recurrence. METHOD: This study reviewed 44 sites in 21 patients with moderate to extensive HS treated surgically in our hospital from 2000 to 2016, with a follow up of at least 24 months...
December 25, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29280119/-efficacy-of-altemeier-procedure-in-the-treatment-of-rectal-prolapse
#12
Yonglei Cao, Yan Zhou, Congqing Jiang, Guiyi Yang, Hui Song, Lvfeng Liu, Xu Ai, Jing Zhong, Zhilin Gong, Jianhua Ding, Wei Fu, Qun Qian
OBJECTIVE: To evaluate the safety and efficacy of the perineal rectosigmoidectomy (Altemeier procedure) in the treatment of full thickness rectal prolapse. METHODS: Clinical and follow-up data of 52 patients with full thickness rectal prolapse undergoing Altemeier procedure in 9 hospitals from September 2010 to July 2016 were analyzed retrospectively. Of which 38 cases were from Zhongnan Hospital of Wuhan University, 1 case from Suizhou Central Hospital of Hubei province, 1 case from Jingzhou Second People's Hospital of Hubei province, 3 cases from Wuxue First People's Hospital of Hubei province, 1 case from Jingmen First People's Hospital of Hubei province, 1 case from Tuanfeng County Hospital of Hubei province, 4 cases from Jingzhou Central Hospital of Hubei province, 2 from PLA Rocket Army General Hospital, 1 case from the Affiliated Hospital of Xuzhou Medical University in Jiangsu province...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29250312/severe-fournier-s-gangrene-a-conjoint-challenge-of-gynaecology-and-plastic-surgery
#13
M Wähmann, M Wähmann, F Schütz, C Sohn, S Schott, T Kremer, J F Hernekamp, U Kneser
Necrotizing fasciitis (NF) is a rare soft tissue infection characterized by rapidly progressing necroses and a high mortality. Prompt diagnosis and immediate medical treatment including radical debridement and broad spectrum antibiotics are the key to successful management. We report on a 46-year-old diabetic female who developed extensive, deep necroses in the perineal area and proximal thighs within a few days. After initial gynaecological consultation, she was transferred directly to our department. Due to the suspicion of NF, an immediate radical debridement was performed...
December 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/29238441/reconstruction-of-an-irradiated-perineal-wound-with-a-superior-gluteal-artery-perforator-flap
#14
Yangshu L Pan, Albert H Chao
No abstract text is available yet for this article.
2017: Eplasty
https://www.readbyqxmd.com/read/29237218/-cylindric-abdominoperineal-rectum-exstirpation-with-partial-vulvar-and-vaginal-resection-as-well-as-perineal-and-vaginal-defect-reconstruction-by-a-vertical-rectus-abdominis-myocutaneous-vram-flap
#15
Christian Krautz, Klaus Weber, Roland Croner, Axel Denz, Matthias Maak, Raymund E Horch, Robert Grützmann
Introduction Patients with low rectal cancer or anal cancer undergoing abdominoperineal excision (APE) benefit from extended surgery and the subsequent avoidance of surgical "waisting" at the level of the puborectalis muscle. The method of cylindrical APE was introduced by T. Holm and led to a reduction of intraoperative perforations and involvement of circumferential resection margins, and subsequently reduced the risk of local recurrence. The use of myocutaneous flaps reduces perineal wound complications, which occur in up to 60% of patients with primary closure of perineal defects, especially following neoadjuvant radiochemotherapy...
December 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29204168/pre-plan-technique-feasibility-in-multi-interstitial-endocavitary-perineal-gynecological-brachytherapy
#16
Silvia Rodriguez, Antonio Otal, Jose Richart, Jose Perez-Calatayud, Manuel Santos
Purpose: To present the implementation of a magnetic resonance imaging (MRI) pre-planning technique in multi-interstitial perineal and endocavitary gynecological brachytherapy. Material and methods: We used a new fully MRI-compatible applicator that is capable to engage titanium needles, and an intrauterine tandem, developed in our department for the treatment of gynecological cervical cancer patients. This applicator is an attempt to combine the technical advantages of the Martinez universal perineal interstitial template (MUPIT) with the improvement in dose distribution by adding an intrauterine probe with the imaging advantages of MRI-based brachytherapy, thus preserving the stability, geometry, and robustness of the implant, avoiding possible errors of free-hand needle placement...
October 2017: Journal of Contemporary Brachytherapy
https://www.readbyqxmd.com/read/29198998/surgical-approaches-and-long-term-outcomes-in-adults-with-complex-re-operative-hypospadias-repair
#17
Christopher D Morrison, Davide P Cinà, Christopher M Gonzalez, Matthias D Hofer
PURPOSE: Patients with failed hypospadias repair are a challenging population for both pediatric and reconstructive urologists. In this study, we describe our long-term outcomes and factors associated with complications in repeat hypospadias repairs. MATERIAL AND METHODS: A retrospective review of 32 adult patients with a history of hypospadias repair who required subsequent urethroplasty between 2002 and 2012 was performed. Presenting complaint, past medical and surgical history, demographic data, surgical approach, intraoperative findings, and complications were collected and analyzed...
November 30, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29175024/y-type-urethral-duplication-with-rectal-implantation-of-the-urethra-which-is-the-best-approach
#18
Antonio Macedo, Sérgio Leite Ottoni, Marcela Leal da Cruz, Jorge Antonio Pompermaier, Maria Isabel S Silva, Riberto Liguori, Gilmar Garrone
INTRODUCTION: Y-type urethral duplication describes the condition in which a functional urethra is implanted in the rectum, and there is also a dysplastic topic urethra which produces mostly urinary dribbling. These patients are at risk of urinary tract complications and UTI. We aimed to present the surgical steps of a case treated by ASTRA approach in which we separated the urethra from the rectum and created a perineal urethrostomy. MATERIAL AND METHODS: We treated a 5-month-old boy with Y-type (IIA-2) urethral duplication, in whom the orthotopic urethra was patent just in the penile segment...
November 10, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29174477/the-effect-of-hip-reconstruction-on-gross-motor-function-levels-in-children-with-cerebral-palsy
#19
Mutlu Cobanoglu, Emre Cullu, Imran Omurlu
OBJECTIVE: The aim of this study was to determine whether the hip reconstruction has an effect on gross motor function classification system (GMFCS) levels in patients with hip instability in cerebral palsy (CP). METHODS: A total of 45 hips of 30 patients (mean age: 8.7 (4-17) years) with CP operated due to hip instability with a minimum of 2 years of follow-up were included into the study. Migration index was used for classification of the severity of hip instability...
November 23, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29166313/the-perineal-turnover-perforator-flap-a-new-and-simple-technique-for-perineal-reconstruction-after-extralevator-abdominoperineal-excision
#20
Maria Chasapi, Mohamed Maher, Peter Mitchell, Milind Dalal
BACKGROUND: Extralevator abdominoperineal excision (ELAPE) is increasingly used to treat locally advanced low rectal cancer as it has been related to superior oncological outcomes than traditional abdominoperineal excision.However, ELAPE also has been associated with high perineal wound morbidity rates as it creates a larger perineal cavity than standard abdominoperineal excision. This greater defect, along with the effects of preoperative chemoradiation on wound healing, makes uneventful perineal reconstruction post-ELAPE a real challenge for the plastic surgeon...
November 21, 2017: Annals of Plastic Surgery
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