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Perineal reconstruction

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https://www.readbyqxmd.com/read/28088711/surgery-for-chronic-mesh-infection-occurred-10-years-after-sacrectomy-mesh-resection-and-mesentric-leaf-repair-a-case-report
#1
Makoto Koyama, Yusuke Miyagawa, Yuta Yamamoto, Masato Kitazawa, Akira Suzuki, Satoshi Ishizone, Shinichi Miyagawa
INTRODUCTION: Sacrectomy to treat malignant tumors is often results in large pelvic defects to require reconstruction, using a prosthetic mesh. Importance is to avoid its direct contact of mesh with intestine to prevent adhesion between them. PRESENTATION OF CASE: An 83-year old woman who was diagnosed with a mesh infection caused by a small bowel penetration 10 years after sacrectomy combined with mesh reconstruction for chordoma. In the first operation, because of incomplete re-peritonealization due to a large defect in the retroperitoneum, a mesh unavoidably was compelled to contact with the small intestine...
October 26, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28057997/male-urethral-diverticulum-uncommon-entity-our-experience
#2
Naveen Thakur, Vilas Pandurang Sabale, Deepak Mane, Abhirudra Mullay
Out pouching of the urethral wall could be congenital or acquired. Male urethral diverticulum (UD) is a rare entity. We present 2 cases of acquired and 1 case of congenital male UD. Case 1A: 40 year male presented with SPC and dribbling urine. Clinically he had hard perineal swelling. RGU revealed large diverticulum in proximal bulbar, irregular narrow distal urethra and stricture just beyond diverticulum. Managed with perineal exploration, stone removal, diverticulum repair and urethroplasty using excess diverticular wall...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28057125/-treatment-and-outcome-of-polypropylene-mesh-or-tape-related-pain-after-reconstructive-pelvic-surgery
#3
Y Q Wang, X Yang, J L Wang
Objective: To investigate clinical treatment and outcome of mesh-related pain after pelvic floor reconstruction. Methods: Twelve patients were referred to Peking University People's Hospital for post-operation pain related to polypropylene mesh or tape used in pelvic floor reconstruction and received reoperation from January 2007 to December 2014. The demographic characteristics, clinical manifestation, operation method and follow-up outcome were retrospectively analyzed, and current literature was also reviewed...
December 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/28052404/perineal-reconstruction-with-multiple-perforator-flaps-based-on-anatomical-divisions
#4
Joon P Hong, Chang G Kim, Hyun S Suh, Hoon Kim, Chi S Yoon, Kyu N Kim
PURPOSE: Reconstruction of perineal defects remains a challenge because such defects can be extensive, complex, and three-dimensional. This report presents a retrospective review of our past 5 years of experience in perineal reconstruction, and suggests a simple algorithmic approach according to anatomical divisions with multiple pedicled perforator flaps for extensive perineal defects. METHODS: From January 2011 to December 2015, 16 patients, including 5 men and 11 women, underwent reconstruction of extensive perineal defects...
January 4, 2017: Microsurgery
https://www.readbyqxmd.com/read/28051050/our-experience-of-proximal-hypospadias-repair-using-the-cloutier-bracka-technique-at-the-gynaeco-obstetric-and-paediatric-hospital-yaounde-cameroon
#5
Mouafo Tambo Faustin Felicien, A S Nwaha Makon, C Kamadjou, G Fossi, C Le Coultre, O G Andze, M A Sosso, P Y Mure
BACKGROUND: In parts of Africa, routine circumcision is practised and sometimes even on children with hypospadias. The lack of preputial foreskin renders urethroplasty more difficult and often requires to use of a mucosal graft as described by Bracka. OBJECTIVE: The authors describe their experience of hypospadias repair using Bracka's technique. MATERIALS AND METHODS: Over a period of 5 years, 100 cases of proximal hypospadias were operated in our institution...
October 2016: African Journal of Paediatric Surgery: AJPS
https://www.readbyqxmd.com/read/28043293/-reconstruction-of-perineal-obliteration-deformity-after-extensive-deep-burn-with-ilioinguinal-flap
#6
Y M Shen, C X Ma, F J Qin, C Wang, W L Du, C Zhang
Objective: To explore the effect of ilioinguinal flap on reconstruction of perineal obliteration deformity after extensive deep burn. Methods: Five patients with perineal obliteration deformity after extensive deep burn were hospitalized from January 2010 to June 2015, with total burn area ranging from 35% to 55% total body surface area, depth of full-thickness burn and wound deep to bone, and course of scar from 6 months to 3 years. Scars of patients were involved in bilateral groins, inner thighs, monsveneris, sacrococcygeal region, and central area of perineum...
December 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27993712/perineal-hernia-is-an-unusual-complication-post-perineal-bladder-neck-closure-a-case-report
#7
Helmy Omar, Tamer E Helmy, Ashraf T Hafez, Mohamed E Dawaba
Bladder neck closure (BNC) is the ultimate bladder neck reconstruction. If reconstruction fails, closure must be considered as it gives the highest continence rate. The vast majority of BNCs are performed through an abdominal approach (either transvesical or extravesical approach), but perineal approach remains an option for BNC with considerable success rate. Perineal hernia, which is defined as protrusion of abdominal contents through the perineal defect, is a very rare complication after urologic procedures...
December 16, 2016: Urology
https://www.readbyqxmd.com/read/27975030/reconstruction-after-excision-of-hidradenitis-suppurativa-are-skin-grafts-better-than-flaps
#8
Yuta Sugio, Koichi Tomita, Ko Hosokawa
After surgical excision of hidradenitis suppurativa, reconstruction with a skin graft or a flap is performed when primary closure is not possible. However, the recurrence rate is reportedly high even after wide surgical excision. It is still unclear which reconstruction method provides the lowest recurrence rate. In this report, we present a case of intractable hidradenitis suppurativa in the bilateral perineal region. After wide excision and repair with bilateral groin flaps, a unilateral groin flap was replaced with a split-thickness skin graft because of flap necrosis...
November 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/27935547/flap-design-and-perfusion-are-keys-of%C3%A2-success-axial-fasciocutaneous-posterior-thigh-flaps-for-deep-small-pelvic-defect-reconstruction
#9
Andreas Kehrer, Philipp Lamby, Benjamin H Miranda, Lukas Prantl, Juergen H Dolderer
BACKGROUND AND OBJECTIVES: Radical excisions of the rectum often result in large perineal and intrapelvic defects. Compromised wound healing can delay adjuvant therapies and limit the patient's prognosis. With current treatment, integrity of the abdominal wall may be maintained. The defect geometry is unique and requires extensive volume for reconstruction. This study describes the surgical technique and reports clinical outcomes of fasciocutaneous posterior thigh flaps as preliminary data for this indication...
December 8, 2016: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/27912972/fate-of-males-with-urethral-y-duplication-40-year-long-follow-up-in-8-patients
#10
Mario Lima, Francesca Destro, Neil Di Salvo, Tommaso Gargano, Giovanni Ruggeri
PURPOSE: The spectrum of male urethral duplication is heterogeneous and it includes the Y-duplication. The malformation is rare and there is only a few case series reported in the literature. The management of Y-forms remains challenging for the surgeon and the long-term follow-up is still scarcely investigated. We report our 40-year experience in the management of patients with Y-duplication. MATERIALS AND METHODS: We conducted a restrospective analysis collecting information of patients with urethral Y-duplication treated at our department from April 1975 to April 2015...
November 17, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27908374/effect-of-lichen-sclerosis-on-success-of-urethroplasty
#11
REVIEW
Michael A Granieri, Andrew C Peterson, Ramiro J Madden-Fuentes
Lichen sclerosis (LS) is a chronic, relapsing disease with a variable presentation. In men, genitourinary LS may affect the penile foreskin, glans, meatus, and urethra. Treatment is multifaceted, ranging from pharmacotherapy to surgery. Urethral reconstruction due to stricture disease from LS is frequently plagued by a high recurrence rate. At the authors' institution, the high recurrence rate has shifted their practice toward potent steroids and minimally invasive surgical techniques. Management of recurrence includes dilation, meatotomy/meatoplasty, 1-stage and 2-stage repairs...
February 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/27898453/resolution-of-rectal-prolapse-by-vaginal-reconstruction
#12
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy. Rectal and vaginal prolapse can often coexist. However, to our knowledge, there are no reported cases of rectal prolapse resolved by the repair of a compressive enterocele abutting the anterior rectal wall through a vaginal approach alone...
January 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27894384/-reconstruction-of-anal-stenosis-induced-by-scar-contracture-after-repair-of-defect-in-perineal-region-with-paraumbilical-flap-using-random-pattern-flap
#13
Q Liu, X B You, Z Cai, K Y Tang, H Zhang
Objective: To investigate the method and timing of reconstruction of anal stenosis induced by scar contracture after repair of defect in perineal region with paraumbilical flap using random pattern flap. Methods: Ten patients who suffered anal stenosis induced by scar contracture after the first phase repair of defect of perineal region with paraumbilical flap were hospitalized from July 2009 to September 2015. Eight patients were with central type scar contracture of perineal region after healing of burn wound, and two patients were with lesion of perineal region which had been excised...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27889218/single-stage-urethroplasty-for-perineal-hypospadias-in-a-horse-a-case-report
#14
Jade Harrison, Imran Mushtaq
INTRODUCTION: Within the veterinary world, data regarding the surgical management of hypospadias is lacking. Reports within equines have documented resective phallectomy procedures rather than urethral reconstruction. This case report documents the first ever urethroplasty for an equine hypospadias, performed by a consultant paediatric surgeon. The urethroplasty was achieved by applying the same surgical principles mastered from paediatric urology to a horse. The indication for surgery was contact dermatitis of the hind-leg, which impaired the thoroughbred foal's racing potential...
November 9, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/27887019/first-case-of-penile-metastasis-following-abdominoperineal-resection-with-vram-flap-reconstruction
#15
Andrei A Kozan, Adrian M Smith, David W Ilsley, Nicholas Rhodes
Penile metastases are rare in colorectal cancer. We report the first case of such a recurrence in a patient who had undergone an extralevator abdominoperineal resection with vertical rectus abdominis myocutaneous flap perineal reconstruction. The patient was treated with curative intent by total penectomy.
November 24, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27846665/menstrual-sexual-and-obstetrical-outcomes-after-vaginal-replacement-for-vaginal-atresia-associated-with-anorectal-malformation
#16
Clare Skerritt, Alejandra Vilanova Sánchez, Victoria Alison Lane, Richard J Wood, Geri D Hewitt, Lesley L Breech, Marc Levitt
The authors of this article became aware of significant differences in the management of two females with a rectovestibular fistula and associated vaginal agenesis. In one patient, a sigmoid colovaginoplasty was performed at the time of the posterior sagittal anorectoplasty (PSARP), and the other underwent repair of the rectovestibular fistula with a primary PSARP, but the surgeons elected to delay the timing of vaginal reconstruction. We decided to review the literature, to establish if recommendations could be made to optimize the management of these children based on current evidence...
November 15, 2016: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27833904/surgical-treatment-after-failed-primary-correction-of-urogenital-sinus-in-female-patients-with-virilizing-congenital-adrenal-hyperplasia-are-good-results-possible
#17
Maria Helena Palma Sircili, Tania Sartori Sanchez Bachega, Guiomar Madureira, Larissa Gomes, Berenice Bilharinho Mendonca, Francisco Tibor Dénes
PURPOSE: Genital reconstruction in female patients with virilizing congenital adrenal hyperplasia (CAH) is very challenging. Our aim was to evaluate the techniques employed to treat complications after failure of primary urogenital sinus (UGS) surgery, as well as the result of these reoperations. PATIENTS AND METHODS: Twenty girls with virilizing CAH who were previously submitted to genitoplasty in our service and elsewhere had recurrent UGS stenosis and vaginal introitus stenosis that required surgical treatment...
2016: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/27829942/safety-and-usefulness-of-needle-guided-resection-of-levator-muscles-in-laparoscopic-abdominoperineal-resection-for-low-rectal-cancer
#18
Takehito Yamamoto, Akiyoshi Kanazawa, Hiroyuki Matsubara, Takuya Okamoto
INTRODUCTION: During laparoscopic abdominoperineal resection (APR) for low rectal cancer, it is difficult to resect the levator muscles and remove a cylindrical specimen without venturing close to the rectal wall to ensure negative circumferential resection margins (CRM). To solve this problem, we developed a needle-guided, laparoscopic, abdominoperineal resection (LAPR) technique. AIM: To present the safety and superiority of our technique, "needle-guided LAPR"...
2016: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/27769545/v-y-fasciocutaneous-flap-closure-technique-is-a-safe-and-efficacious-alternative-to-primary-closure-of-the-perineal-wound-following-abdominoperineal-resection
#19
George Kokosis, Zhifei Sun, Yash J Avashia, Mohamed A Adam, Howard Levinson, Detlev Erdmann, Christopher R Mantyh, John Migaly
BACKGROUND: The aim of this study was to compare wound complications from V-Y flap vs primary closure in the setting of abdominoperineal resection. METHODS: This was a single institution retrospective review (1999-2014). The main outcome measures were any wound complication, hospital length of stay, and unplanned readmissions. RESULTS: Among 80 patients included, 21 (26%) received reconstruction with V-Y flap. Compared with those who received primary closure, patients who underwent V-Y flap reconstruction had lower rates of overall wound complications (14...
July 21, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27760964/-a-case-of-early-anal-canal-cancer-with-pagetoid-spread-with-different-antitumor-effects-of-chemotherapy-on-different-metastatic-sites
#20
Kazuhiko Yoshimatsu, Gakuji Osawa, Hajime Yokomizo, Yuki Yano, Sachiyo Okayama, Akiko Sakuma, Masaya Satake, Yasufumi Yamada, Shinichi Asaka, Takebumi Usui, Kentaro Yamaguchi, Shunichi Shiozawa, Takeshi Shimakawa, Takao Katsube, Yoshihiko Naritaka
A 78-year-old man visited our hospital with a prolapsed hemorrhoid. He was referred to the dermatology unit due to the thickness and redness of the perianal skin. He was diagnosed as having extra mammary Paget's disease by skin biopsy. After a biopsy of the anal polyp was performed to investigate the primary site, he was diagnosed with early anal canal cancer with Pagetoid spread and underwent a radical operation. Abdominoperineal resection with skin(D2 prx D3 lymphadenectomy) was performed with perineal reconstruction using a gracilis muscle graft...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
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