ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;Between January 1975 and July 1977, 26 patients, who underwent combined synchronous removal of the rectum and anus, were managed within guidelines aimed at achieving primary closure and healing of their operative wounds. The guidelines include preoperative mechanical and luminal antibiotic bowel preparation, perioperative systemic chemoprophylaxis, a combined synchronous ablative procedure in Lloyd‐Davies position, short‐term sump drainage of the presacral space, meticulous hemostatis, and primary closure of both the pelvic defect above (utilizing an omental pedicle graft to obliterate the pelvic dead space) and the perineal defect below (by primary suture or with gracilis myocutaneous flap). All wounds healed totally within the first six weeks postoperatively, with a mean time to healing of 3.5 weeks in the six patients whose wounds failed to heal primarily. There were no instances of late wound breakdown with follow‐up from six months to two years.

ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;Long‐tube bowel splinting at operation, with use of a gastrostomy for introduction of the tube, has many advantages in varying conditions. Results are evaluated in 79 patients undergoing operations, over a 10‐year period, for first or recurrent intestinal adhesive obstruction, complicated Crohn's disease, peritonitis, ventral hernia repair, ileostomy, radiation enteritis, etc. Technique and complications are reviewed. Advantages of a recently‐developed bi‐lumen tube over a single‐lumen tube are discussed.

ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;Thirteen cases of emergency left colon resection with primary anastomosis are presented. Production of an empty bowel and use of parenteral hyperalimentation, to delay oral intake until healing is evidenced by bowel function, are absolutely necessary, The “elective environment,” assuring primary healing of the left colon anastomosis, consists of several factors: an empty decompressed bowel with adequate lumen, an antibiotic‐depressed colon bacterial flora, assured blood supply, healthy bowel wall, and absence of anastomotic tension. The importance of not extraperitonealizing the anastomosis and the danger of long‐term drains are emphasized.

ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;Spasm of the proximal sigmoid colon has been a major hindrance in the use of the EEA stapler in low anterior resections. Intravenous glucagon, by causing rapid relaxation and hypotonicity of the sigmoid colon, appears to help correct this problem and allows for a safer and more atraumatic anastomosis.

ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A retrospective study of 300 patients with chronic anal fisure is presented. Lateral internal sphincterotomy offers shorter hospital stay, rapid wound healing, low recurrence rate, and no permanent defect in continence, and is, therefore, the procedure of choice in uncomplicated anal fissures. Fissurectomy‐midline sphincterotomy should be reserved for patients in whom local fistulization has complicated anal fissure.

ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;The role of the external and internal anal sphincters in the mechanism of anal continence is presented. The external sphincter induces continence by 1) preventing internal sphincter relaxation, what I have called the “voluntary inhibition action,” and 2) mechanical compression of the rectal neck and anal canal proper. The mechanism of both actions is described. The internal sphincter plays a significant role not only in involuntary, but also in voluntary, continence. The importance of this role in the correction of anal incontinence is clarified. “Stress defecation,” a condition which follows internal sphincter damage, is discussed. A “single loop continence” theory is presented, based on the fact that each of the three loops of the external sphincter has its own innervation, attachment, and direction of muscle bundles; each loop thus acts as a separate sphincter. The clinical application of this theory is presented.

ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A case of spontaneous colocutaneous fistula arising from the transverse colon is reported and the literature is reviewed.

ISSN:0012-3706    

出版商:OVID    

年代:1980

数据来源: OVID