摘要:

&NA;Stoma creation often involves a separate laparotomy incision. Recently, laparoscopy was suggested to minimize the morbidity associated with conventional open stomal techniques. We describe and evaluate a technique of stoma creation done directly through the stoma site, avoiding both laparotomy and laparoscopy.METHODS:Charts of 36 patients who underwent attempted stoma creation using this closed technique were retrospectively reviewed.RESULTS:A total of 32 patients had stomas successfully created in this fashion (closed group); although four patients failed and required laparotomy (open group), there was an overall success rate of 89 percent. Blood loss (17±5vs.350±130 ml;P<.001), operative time (52±8vs.169±35 minutes;P<0.001), and complications (3/32vs.4/4;P<0.001) favored the closed group. No factors, including diagnosis, obesity, or previous abdominal surgery were identified that contraindicated use of the closed technique.CONCLUSIONS:Stomas can be safely made in a high proportion of patients without the need for laparotomy or laparoscopy. Failure of the closed technique identifies a group of patients who have a high associated operative time, blood loss, and morbidity when laparotomy is used for stoma creation and in whom laparoscopic procedures may improve results.

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

&NA;Difficulty in access for local resection of broad‐base rectal polyps in the mid rectum can present a management problem. Transanal use of the MULTIFIRE ENDO GIA®provides a hemostatic excision of these rectal polyps.

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

&NA;Standard linear staplers for transverse occlusion of the rectum is sometimes too large to be applied in a narrow pelvis. A proximate TL 30TM(Ethicon, Inc., Somerville, NJ) is easily introduced and applied twice for occlusion of the rectum, followed by anastomosis with a circular stapler. This triplestapling technique is a safe and easy procedure for low colorectal anastomosis in a narrow pelvis.

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1997

数据来源: OVID