摘要:

&NA;From October 1, 1984 to December 31, 1991 at the Clinica Chirurgica II of the University of Bologna, 140 patients submitted to ileal pouch‐anal anastomosis for ulcerative colitis (UC) and familial adenomatous polyposis (FAP). Nineteen patients (13.5 percent) developed septic complications. Of these, 11 patients (7.8 percent) had pelvic sepsis. Eight patients required further surgical intervention. Five patients underwent the redo pouch procedure. Another redo pouch was performed in a patient who had previously, in another hospital, had an ileal pouch‐anal anastomosis placed and then removed because of ischemic necrosis of the reservoir. No deaths are reported in the reoperated patients. Currently, five of the six patients who underwent the redo pouch procedure have a well‐functioning ileoanal anastomosis. The redo pouch procedure should always be attempted prior to the establishment of pelvic fibrosis.

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

&NA;There have been no reports on the relationship between serum gastrin level and liver metastasis in human colorectal cancer. One hundred forty patients who underwent surgery for colorectal cancer (T2 or more) were enrolled in this study. Fasting serum gastrin level was determined prior to the surgery. Incidence of liver metastasis was significantly(P<0.01) higher in patients with a serum gastrin level of ≥150 pg/ml (37 percent; 14/38) than in those with a serum gastrin level of <150 pg/ml (12 percent; 12/102). As for the tumors with venous invasion, liver metastasis was detected in 11 of 55 patients (20 percent) with a serum gastrin level of <150 pg/ml; however, it was detected in 11 of 19 patients (58 percent) with a serum gastrin level of ≥150 pg/ml(P<0.01). These results suggest that serum gastrin serves as a useful predictor of liver metastasis from colorectal cancer and that the predictability of liver metastasis can be improved when both serum gastrin level and venous invasion are considered.

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

&NA;The operation of choice for complete rectal prolapse is controversial. We reviewed 169 patients undergoing 185 surgical procedures for rectal prolapse over a 27‐year period. The most common surgical procedure employed was the Ripstein procedure (n=142) and is the focus of this report. Other surgical procedures used included resection rectopexy (n=18), anterior resection (n=7), Altemeier's (n=9), Delorme's (n=2), and anal encirclement (n=7). The median age was 59 years (range, 12‐94 years), and the female‐to‐male ratio was 5:1. The incidence of fecal incontinence, solitary rectal ulcer syndrome, and prior surgery elsewhere for rectal prolapse was 40 percent, 12 percent, and 19 percent, respectively. Operative mortality was 0.6 percent; morbidity was 16 percent. Median follow‐up was 4.2 years (range, 1‐15 years). Complete recurrence of prolapse after the Ripstein procedure was 8 percent; one‐third of these patients recurred 3 to 14 years after surgery. Fecal incontinence improved after the Ripstein procedure or resection rectopexy in about half the patients. Persistence of prior constipation was more common after the Ripstein procedure than after resection rectopexy (57 percentvs.17 percent;P=0.03, chi‐squared). Fifteen patients developed constipation for the first time after the Ripstein procedure. About one in three patients, irrespective of surgical procedures, remained dissatisfied with the final outcome despite anatomic correction of the prolapse. The Ripstein procedure has proven to be a safe procedure with good anatomic repair of the prolapse and may improve continence. In the presence of constipation, procedures other than the Ripstein procedure may be preferable.

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

&NA;In recent years, several reports on the experimental and clinical applications of the Gianturco stent (self‐expanding stainless steel stent) have been published. However, to our knowledge, the use of stents in rectosigmoid strictures has not been reported. We used self‐expanding stainless steel stents to dilate rectosigmoid strictures caused by nonresectable recurrent neoplasm. Insertion and dilation (sigmoid colon and rectum) in two patients were successful. Accordingly, these patients were able to maintain bowel activity and avoid palliative loop colostomy. We believe that this procedure is effective for nonresectable rectosigmoid stricture due to recurrent neoplasm.

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1993

数据来源: OVID