摘要:

&NA;Thirty patients undergoing anterior resection of the rectum were randomized for postoperative drainage with either corrugated (N=14) or corrugated plus Shirley sump drain (N=16). Drainage volume per 24 hours was measured, and volume of residual pelvic fluid collection estimated by CT scan on the seventh postoperative day. A mean of 591.9 ±415.2 ml of fluid drained during the first seven postoperative days. There was a significant (P<0.01) increase in 24 hour drainage volume between the fourth and sixth postoperative days. There was no significant difference in drainage volumes between the two drainage methods. Residual pelvic fluid collection (median volume, 16 ml) was detected in 80 percent of patients at one week after operation. While this was larger (24 ml median) for the corrugated only group compared with the corrugated plus sump drain group (11.5 ml median), the difference was not significant. Fluid loss during the first postoperative week (616.6±424.2 ml) was significantly (P<0.05) less when the anastomosis was situated higher than 12 cm (294±192 ml) compared with 6 to 12 cm from the anal margin (496±210 ml), or after coloanal anastomosis (1077±432 ml). Residual pelvic fluid collection was larger after coloanal anastomosis (median, 33 ml; range, 1.5 to 90 ml) compared with 6 to 12 cm (median, 11 ml; range, 0‐124 ml) or higher than 12 cm (median 9 ml; range, 0 to 16 ml) from the anal margin, but the difference was not significant. Drainage after anterior resection is important because large volumes of serosanguineous fluid collect, especially after resection of low tumors. Neither of the drainage methods tested in this study prevented persisting pelvic fluid collection at the seventh postoperative day.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;In Western communities diverticular disease occurs mainly in the sigmoid colon. This contrasts with Oriental populations, in which diverticular occur mainly in the right colon. Diverticular disease has recently emerged in black South Africans. This study shows that diverticula in this population occurs predominantly in the descending colon. The variable anatomic distribution of diverticula in different ethnic groups implies that fiber deficiency is not the only factor responsible for this condition. It is suggested that diverticular disease may comprise several entities with different causes.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Bile acid absorption was investigated using75Se Taurohomocholate (SeHCAT) in controls and patients who had undergone total colectomy with either conventional ileostomy or pouch‐anal anastomosis for ulcerative colitis or adenomatous polyposis. Whole‐body retention of SeHCAT after 168 hours was greater in the controls than the patients who had undergone colectomy (P<.05). Retention of SeHCAT did not differ significantly between patients with an ileostomy and patients with pouch‐anal anastomosis, but patients with an ileostomy and ileal resection of more than 20 cm retained less SeHCAT than patients with a pouch‐anal anastomosis (P<.01). Analysis of fecal bile acids from ileostomies and pouches showed that bacterial metabolism of primary conjugated bile acids was greater in patients with a pouch. It was concluded that bile acid absorption was not significantly impaired by construction of a pouch compared with conventional ileostomy but bacterial metabolism of bile acids was greater in the pouches.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;The occurrence of large‐bowel melanosis was evaluated by microscopy in 200 large bowels at autopsy. Melanin was seen as yellow‐brown pigment in the macrophages of the lamina propria. The pigment stained with diastase‐alcian blue PAS, Fontana, and iron stains. One hundred nineteen of 200 (59.5 percent) bowels showed melanosis, which was equally common in both sexes. Usually more than one segment was involved (most commonly, four segments). Melanosis was common in the proximal part of the colon, but much rarer in distal parts (sigmoid and rectum). Affected segments were successive; negative segments between positive ones were exceptional. If the rectum was affected, all five proximal segments were affected in 11 of 12 cases. The intensity of melanosis was directly related to the number of segments involved. In the oral part of the colon, affected males had a higher intensity of melanosis than affected women, but about the same intensity in the sigmoid and rectum. The fraction of patients with melanosis increased with age. Of men and women in the age group of 20 to 54 years, 32 and 44 percent were affected, and above the age of 75 years, 76 and 67 percent, respectively.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Familial adenomatosis coli (FAC) traditionally has been diagnosed as the presence of more than 100 colonic adenomas, even if no familial occurrence is present. In the present communication, clinical features of FAC have been compared in detail to detect differences between familial and nonfamilial cases with regard to colonic and extracolonic lesions and to discover whether they constitute the same disease entities. No significant difference was found in the incidence of extracolonic lesions. The average number of colonic polyps in the nonfamilial cases of patients over 30 years old was 1128, the number of polyps was significantly higher in the familial cases (3154). When three patients with approximately 100 polyps were excluded, the mean number of colonic polyps in nonfamilial cases became 2608. This was similar to that of familial cases. Furthermore, the occurrence of approximately 100 polyps was extremely rare in familial patients who were over 30 years old. Therefore, most of the nonfamilial cases can be considered to be familial probands of FAC, but some, such as the three cases in the present study, may be a different disease entity, such as recessive adenomatous polyposis or multiple colonic adenomas.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A rare case of mucinous cystadenocarcinoma arising in the sigmoid colon, found accidentally during an operation for cholecystolithiasis, is reported. The tumor was located 40 cm from the anal verge, and had two histologic variations consisting of a large distended cystic lesion and branching cystic channels with papillary proliferation of the epithelium. Serial sections revealed the existence of a luminal communication between the two lesions. The tumor tissue was seen mainly in the muscularis propria with no mucosal involvement. The papillary portion had a highly differentiated appearance, giving rise to considerable difficulty in determining whether it was benign or malignant. In a localized area, however, the tumor invaded into the subserosa and showed distinctive atypical changes. The tumor cells showed intense reactivity for carcinoembryonic antigen. This mucinous cystadenocarcinoma was considered to be originated from an enterogenous cyst, a possible derivative of duplication of the colon. The differential diagnosis concerning this rare tumor is also discussed.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Adenocarcinoma of the colon developing at or about the sites of ureterosigmoid anastomoses for urinary diversion has been documented in the literature. A case report is presented that illustrates that a carcinoma can develop in a large bowel urinary conduit not exposed to the fecal stream. Colonic bladders are being used with increasing frequency, making observation for this delayed complication necessary. How this neoplastic transformatin might occur is discussed. Suggestions for the management of this problem and guidelines for follow‐up are also presented.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A 24‐year‐old woman with a two‐year history of inflammatory bowel disease, with no anal or perineal involvement, underwent a proctocolectomy and ileostomy. Pathologic evaluation of the specimen revealed Crohn's colitis and unsuspected perianal Bowen's disease. The patient is free of Crohn's and Bowen's disease 6.5 years later. The association of perianal Bowen's disease with Crohn's colitis is discussed.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Malignant fibrous histiocytoma is a pleomorphic sarcoma that classically arises in the extremities and metastasizes to the lungs and regional lymph nodes. A review of the literature revealed only four previous cases of primary gastrointestinal malignant fibrous histiocytoma, all of which were treated by resection. This report describes a unique case arising in the anal sphincter that was treated by abdominoperineal resection and radiotherapy. The pathology of the condition, including immunocytochemical methods used to identify the tumor and its likely cell of origin, is discussed. The importance of long‐term follow‐up with repeated chest x‐ray andlocal lymph‐node examination is emphasized.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID