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Prognostic significance of superficial fissuring ulceration in patients with severe "indeterminate" colitis.

Some colectomy specimens from patients with severe colitis contain superficial fissuring-type ulcers but do not have any other features of C … ped a pouch-cutaneous fistula, and 1 control patient developed an enterocutaneous fistula to a loop ileostomy. Finally, 1 control patient ultimately had her pouch excised because of recurrent intractable pouchitis. However, none of the other study or control patients developed any clinical or pathologic manifestations of CD. We conclude that superficial fis …

[The application of submental island flap in head and neck surgery].

Ulcerative colitis (UC) and Crohn disease (CD) are chronic intestinal inflammatory diseases that can present as bloody diarrhea, abdominal p … ase against a patient's desire to retain their colon and avoid a temporary or potentially permanent ileostomy. Decisions about drug therapy in the management of patients with CD are more complex and depend on both the location (e.g. gastroduodenal vs small intestinal vs colonic), as well as the behavior of the disease (inflammatory/mucosal vs stricturing vs …

Colostomy reversal after a Hartmann's procedure Effects of experience on mortality and morbidity.

AIM: Hartmann's procedure (HP) is mostly lifesaving procedure especially for obstructive colorectal carcinomas, but remains bothersome requiring staged operation and subsequent reversal colostomy. We aimed to investigate risk factors for unfavorable surgical outcome after Hartmann's reversal. MATERIALS AND METHODS: Between September 2003 and September 2014, all patients who underwent colostomy reversal surgery after HP were enrolled into the study. Retrospective data collection included demographics (age, gender, body mass index (BMI), ASA scores) primary pathologies, interval period, surgeon

Colorectal resection in deep pelvic endometriosis: Surgical technique and post-operative complications.

AIM: To investigate the impact of different surgical techniques on post-operative complications after colorectal resection for endometriosis. METHODS: A multicenter case-controlled study using the prospectively collected data of 90 women (22 with and 68 without post-operative complications) who underwent laparoscopic colorectal resection for endometriosis was designed to evaluate any risk factors of post-operative complications. The prospectively collected data included: gender, age, body mass index, American Society of Anesthesiologists risk class, endometriosis localization (from anal verge

Hepatobiliary complications in healthy, intra-abdominally infected, and high-output fistula rats receiving total parenteral nutrition.

This study examines the pathophysiology of hepatobiliary complications induced by total parenteral nutrition (TPN) by using animal models that underwent cecal ligation to produce intra-abdominal infection and received an enterostomy to mimic a high-output fistula, which causes the interruption of enterohepatic circulation of bile salt. Aspartate transaminase was elevated after TPN (p < .05). Alkaline phosphatase was increased in animals receiving TPN plus an enterostomy (p < .05). Serum albumin was significantly decreased in animals receiving TPN plus undergoing cecal ligation or enterostomy (

Long-term stabilization of stage 4 colon cancer using sodium dichloroacetate therapy.

Oral dichloroacetate sodium (DCA) has been investigated as a novel metabolic therapy for various cancers since 2007, based on data from Bonnet et al that DCA can trigger apoptosis of human lung, breast and brain cancer cells. Response to therapy in human studies is measured by standard RECIST definitions, which define "response" by the degree of tumour reduction, or tumour disappearance on imaging. However, Blackburn et al have demonstrated that DCA can also act as a cytostatic agent in vitro and in vivo, without causing apoptosis (programmed cell death). A case is presented in which oral DCA

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… Functional enquiry revealed some mild mouth sores related to the ongoing chemotherapy, mild diarrhea (expected with an ileostomy) and mild intermittent rectal bleeding. … Treatment Loop ileostomy followed by chemotherapy consisting of 5-fluorouracil, irinotecan, leucovorin and bevacizumab, then addition of dichloroacetate sodium (DCA), then DCA without chemo for nearly 4 years. …

Language Models for Multilabel Document Classification of Surgical Concepts in Exploratory Laparotomy Operative Notes: Algorithm Development Study.

BACKGROUND: Operative notes are frequently mined for surgical concepts in clinical care, research, quality improvement, and billing, often r … nstructions may be found on GitHub. RESULTS: The prevalence of labels ranged from 0.05 (colostomy, ileostomy, active bleed from named vessel) to 0.50 (running fascial closure). Llama 3.3 was the overall best-performing model (micro F1-score 0.88, 5-fold range: 0.88-0.89; HL 0.11, 5-fold range: 0.11-0.12). The BoW model (micro F1-score 0.68, 5-fold range: 0 …

[Short-term complications after transanal total mesorectal excision for mid-low rectal cancer].

Objective: To summarize short-term postoperative complications of transanal total mesorectal excision (taTME) in the treatment of middle-low … . Seventy-five cases (75 /78, 96.2%) underwent defunctioning stoma, including 74 cases of diverting ileostomy, 1 case of diverting transverse colostomy and 3 cases without stoma. The morbidity of complication within 30 days after operation was 38.6% (32/83), and the morbidity of complication after discharge was 8.4% (7/83). Minor complications accounted for …

Comparison of delayed versus immediate coloanal anastomosis in patients with low rectal cancer: a recent meta-analysis.

BACKGROUND: In sphincter-preserving surgery for low rectal cancer (LRC), Immediate coloanal anastomosis (ICA) combined with prophylactic ileostomy remains the standard approach. However, this procedure is associated with the need for a second operation to reverse the stoma and risks of stoma-related complications. Delayed coloanal anastomosis (DCA) has recently regained attention as an alternative strategy, particularly in the context of evolving principles of minimally invasive surgery and enhanced recovery after surgery (ERAS). This meta-analysis aimed to systematically evaluate and compare …

Feasibility and Safety of Ambulatory Surgery as the Next Management Paradigm in Colorectal Resection Surgery.

BACKGROUND: Current clinical dogma favors universal inpatient admission after colorectal resection particularly in the presence of an anasto … s fistula repair, reoperative pelvic surgery, multiple resections) and/or ostomy creation (loop/end ileostomy, Hartmann's, abdominoperineal resection) were exclusions. Discharge was at 6 to 8 hours postoperatively if all predetermined factors (no ostomy teaching needed, ambulating comfortably, tolerating diet, stable vitals, and blood-work) were met and pat …

Prophylactic biological mesh reinforcement versus standard closure of stoma site (ROCSS): a multicentre, randomised controlled trial.

BACKGROUND: Closure of an abdominal stoma, a common elective operation, is associated with frequent complications; one of the commonest and impactful is incisional hernia formation. We aimed to investigate whether biological mesh (collagen tissue matrix) can safely reduce the incidence of incisional hernias at the stoma closure site. METHODS: In this randomised controlled trial (ROCSS) done in 37 hospitals across three European countries (35 UK, one Denmark, one Netherlands), patients aged 18 years or older undergoing elective ileostomy or colostomy closure were randomly assigned using a comp…

[Surgical management of bevacizumab-associated peritonitis due to perforation].

INTRODUCTION: Bevacizumab (Avastin, Fa. Roche, Genentech) is the first anti-angiogenic agent to be approved for the routine clinical treatment of cancer. Its toxicity profile is different to that of standard chemotherapeutic substances. Despite the rarity of gastrointestinal (GI) perforation in patients treated with bevacizumab, this serious adverse event results in significant morbidity and mortality. It was the aim of this study, based on exemplary cases of the reporting clinic as well as on published experiences, to characterise the specific clinical findings, the extraordinary pathogenesis

Vacuum-assisted closure for complicated neonatal abdominal wounds.

BACKGROUND: Neonatal experience in vacuum-assisted closure (VAC) for complex abdominal wounds remains scant. METHODS: A neonatal VAC protocol was instituted in 2004. The medical records of patients treated with this protocol for the ensuing 3 years were retrospectively reviewed. Continuous data are reported as mean +/- SD (range). RESULTS: Ten VAC applications occurred in 8 neonates for a 3-year period. Gestational age and age at VAC application were 30 +/- 6.9 (24-40) weeks and 84.5 +/- 51 (21-165) days, respectively. Birth weight and weight at VAC application were 1495 +/- 1118 (615-3415)

Laparostomy for severe intra-abdominal infection complicating colorectal disease.

PURPOSE: The aim of this study was to evaluate the use of laparostomy in the management of patients with severe intra-abdominal infection resulting from colorectal disease. METHODS: Seven patients, four with inflammatory bowel disease, two with colorectal carcinoma, and one with diverticular perforation, underwent laparostomy during a six-year period for postoperative, severe, intra-abdominal infection. RESULTS: The median age was 42 years, the mean Acute Physiology and Chronic Health Evaluation II score was 22.7, and the observed mortality was 28.6 percent (2/7 patients). In one patient the

Cumulative Incidence and Risk Factors of Permanent Stoma After Intersphincteric Resection for Ultralow Rectal Cancer.

BACKGROUND: A permanent stoma is an unintended consequence that cannot be avoided completely after intersphincteric resection for ultralow r … TIENTS: A total of 185 consecutive patients who underwent intersphincteric resection with diverting ileostomy from 2011 to 2019 were included. MAIN OUTCOME MEASURES: The primary outcome was the incidence of and risk factors for the permanent stoma. The secondary outcome included differences in stoma formation between patients with partial, subtotal, and to …

Prolonged Postoperative Ileus Significantly Increases the Cost of Inpatient Stay for Patients Undergoing Elective Colorectal Surgery: Results of a Multivariate Analysis of Prospective Data at a Single Institution.

BACKGROUND: Prolonged postoperative ileus is a common major complication after abdominal surgery. Retrospective data suggest that ileus doubles the cost of inpatient stay. However, current economic impact data are based on retrospective studies that rely on clinical coding to diagnose ileus. OBJECTIVE: The aim of this study was to determine the economic burden of ileus for patients undergoing elective colorectal surgery. DESIGN: Economic data were audited from a prospective database of patients who underwent surgery at Auckland City Hospital between September 2012 and June 2014. SETTINGS: A

[Surgical treatment and prognosis of rectovaginal fistulae according to their origin].

INTRODUCTION: The rectovaginal fistula is a rare entity with heterogenic causality. Its genesis seems to predict the extent of operative treatment and the prognostic outcome. The aim of this study was to present different surgical techniques in the treatment of rectovaginal fistulas and their results in correspondence to the genesis. MATERIAL AND METHODS: Between 1 / 2000 and 1 / 2010, the data of patients with rectovaginal fistulas were collected. The retrospective analysis included biographic and anamnestic data as well as clinical parameters, general and specific complications and postoper

Long term persistence and risk factors for anorectal symptoms following low anterior resection for rectal cancer.

BACKGROUND: Rectal cancer is commonly treated by chemoradiation therapy, followed by the low anterior resection anal sphincter-preserving surgery, with a temporary protecting ileostomy. After reversal of the stoma a condition known as low anterior resection syndrome (LARS) can occur characterized by a combination of symptoms such as urgent bowel movements, lack of control over bowel movements, and difficulty fully emptying the bowels. These symptoms have a significant negative impact on the quality of life for individuals who have survived the cancer. Currently, there is limited available data…