摘要:

&NA;The accuracy and usefulness of indium‐111 oxine‐labeled autologous leukocyte scans in the management of infectious complications of colon and rectal surgery and of inflammatory diseases of the colon have been studied by review of the records of all patients undergoing such scans at Morristown Memorial Hospital during the first six months such scans were performed there. A total of 20 scans was performed on 18 patients. Twelve scans were performed on 11 patients being treated for diseases of the colon and rectum. Of these 12 scans, one was normal, four demonstrated intra‐abdominal abscesses, three demonstrated wound infections (two abdominal, one perineal), one was positive for granulomatous colitis, one for pseudomembranous colitis, one for chronic diverticulitis, and one for enterocutaneous fistula. One allergic reaction to the labeled leukocytes occurred. Comparisons with other corroborative localizing diagnostic tests were made. Subsequent treatment was reviewed. Analysis of these cases indicates that the majority of all scans were performed to evaluate complications of colorectal surgery or inflammatory diseases of the colon and that these scans were highly accurate. In all instances where appropriate, delineation of a lesion in the colorectal cases was followed by corrective treatment.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;The usefulness of isolated intestinal pouches of an intestinal allograft for monitoring mucosal histoloty during rejection episodes was studied in a canine model.Total small intestinal autotransplantation was performed in four dogs, and allotransplantation in 18 dogs. Isolated pouches from the proximal and distal ends of the allografts were brought to the skin as stomas. Serial biopsies were obtained from these pouches. Nine allotransplants were treated with a suboptimal dose of cyclosporine. Nine allografied dogs were not immunosuppressed.Biopsies from all animals were normal the first two days postoperatively, and remained so in the autotransplants. Mononuclear cell infiltration in the lamine propria and submucosa was seen up to five days before death from rejection of the allograft in dogs on cyclosporine. At autopsy, all dogs had histologic findings in the transplanted bowel similar to those of simultaneously obtained pouch biopsies.The results show that histologic changes in isolated pouches from intestinal allotransplants reflect changes in the incontinuity segment of the graft and, therefore, such pouches can be used for histologic monitoring of the graft.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;A two‐part silicone device for stoma control is presented. Methods for implantation and use are described. Initially used in five patients, it has proven safe and effective.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;Kock's continent ileostomy is a well‐established technique, however, it is technically difficult to construct and has a high incidence of complications. This study evaluates a new type of mucosal valve constructed in continuity with an intestinal reservoir. The valve is created along the antimesenteric border of the efferent limb 0.5 cm distal to the reservoir. The seromuscular layer is “stripped” from the mucosal layer for 50 per cent of the bowel circumference and then excised. The remaining seromuscular borders are then sutured to the apex of the pouch and along the antimesenteric border of the afferent limb. In this way the valve is created and, upon distention of the afferent limb and apex of the pouch, the valve closes. In seven dogs such a continent ileostomy was constructed and all were clinically continent. The reservoirs were intubated through the ileostomy two to three times a day. The mean volume aspirated was 143 ml/day. After eight weeks, radiographic and volume‐pressure studies were performed. Prior to sacrifice, increasing volumes of barium were instilled into each pouch via the afferent limb and radiographs were taken: these studies confirmed the continence in all seven ileostomies. Following this the reservoirs were intubated and the instilled barium was aspirated. Then Ringer's solution was instilled into each pouch with continuous intrapouch pressure measurements. The pressure remained at 0 cm H2O until a mean volume of 243 ml was exceeded. The mean volume at which incontinence occurred was 415 ml.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

&NA;The technique of intersphincteric excision of the rectum in patients with inflammatory bowel disease was introduced with the aim of avoiding postoperative sexual dysfunction and, combined with primary perineal suture, should decrease morbidity from delayed perineal wound healing. In a series of 98 patients so treated at St. Mark's Hospital, permanent sexual dysfunction from sympathetic nerve damage occurred in one male patient among 23 aged 60 years or less assessed postoperatively. No patient exhibited evidence of permanent parasympathetic nerve damage. Primary healing of the perineal wound was successful in 50 per cent of the cases and in 69 per cent the wound healed within three months of operation. It is suggested that this combination of operative techniques significantly decreases morbidity from rectal excision compared with more extensive procedures and should be more widely adopted.

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1984

数据来源: OVID