ISSN:0007-1323    

DOI:10.1002/bjs.1800820402

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820403

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractAbdominal stomas carry a considerable physical and psychological morbidity. Several authors have attempted total anorectal reconstruction (TAR) to avoid a permanent stoma for patients undergoing abdominoperineal excision of the rectum (APER). The published series of TAR are reviewed. There is no evidence that TAR adversely affects survival in patients with cancer. Patients who have undergone reconstruction have variable anorectal function, most suffering from anorectal incontinence to some degree. It appears, however, that the psychological benefit of avoidance of an abdominal stoma outweighs the inconvenience of incontinence for almost all. Refinements in surgical technique, allied with novel methods of achieving neorectal emptying, make TAR a viable alternative to APER in selected patients.

ISSN:0007-1323    

DOI:10.1002/bjs.1800820404

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThis review assesses whether the risk of ileoanal pouch construction in patients with ulcerative colitis, compared with that of ‘less dangerous’ operations, is compensated by a better postoperative outcome. Even though the mortality rate is not greater for pouch construction, the risk of pelvic sepsis and pouchitis increase morbidity. Bowel function after construction of the ileal pouch, although better than that before operation, is not as good as that of normal controls and does not, in itself, justify increased morbidity. Quality of life measurements suggest that the benefit of the ileal pouch procedure is not much greater than that of ileostomy, even though some dimensions of quality of life are improved. However, most patients wish to avoid an ileostomy and surgeons should respect this wish, remembering that the pouch procedure has some risks and that the gain for the patient may be sm

ISSN:0007-1323    

DOI:10.1002/bjs.1800820405

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractSeton techniques have been used in the successful management of fistulain anofor thousands of years. In particular, the cutting seton is useful for complex high anal fistula, and drainage setons may have a significant role in the treatment of sepsis related to Crohn's disease and in immunocompromised patients.

ISSN:0007-1323    

DOI:10.1002/bjs.1800820406

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820407

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820408

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820409

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

摘要:

AbstractThe influence of intraoperative lavage with various solutions was tested on the healing of experimental colonic anastomoses performed in the presence of obstruction. After 24 h of ligature obstruction to the pelvic colon, male Wistar rats (n= 108) underwent colonic resection and primary anastomosis, using lavage with one of four different fluids: saline, povidone‐iodine, 10 per cent hypertonic glucose and short‐chain fatty acids (SCFA). Controls had no lavage. The anastomotic segment was excised and studied after 3 or 6 days. At day 3, mean(s.d.) bursting pressure was significantly greater in animals receiving SCFA compared with controls (81.2(23.0)mmHgversus34.8(34.0)mmHg). Mean(s.d.) bowel wall tension was higher in rats with SCFA (30.6(8.1) N/m × 10−4) or hypertonic glucose (29.5(10.1) N/m × 10−4) compared with controls (12.2(12.1) N/m × 10−4). By day 6, the anastomosis was more resistant to intraluminal pressure in each lavage group; mean(s.d.) hydroxyproline concentration at the anastomosis was greater in rats with SCFA (12.4(1.5) μg/mg) or hypertonic glucose (11.6(2.9) μg/mg) than in controls (8.9(1.5)μg/mg). Anastomotic healing is improved by all types of intraoperative colonic lavage, particularly with SCFA and hypertonic gl

ISSN:0007-1323    

DOI:10.1002/bjs.1800820410

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800820411

出版商:John Wiley&Sons, Ltd.    

年代:1995

数据来源: WILEY