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Management of cloacal exstrophy: Experience from tertiary hospital, Tanzania. Case series.

INTRODUCTION AND IMPORTANCE: Cloacal exstrophy (CE) is defined as a complex anomaly that affects the urogenital and intestinal tracts. It is … inguinal region, and right abdominal undescended testis. He first underwent surgery, which involved ileostomy, omphalocele closure and proper bladder exstrophy construction. The second patient, a 6-day-old female, had a similar presentation and physical findings as the first patient did, except that she had elephantoid trunk deformity with a cecal fistula, …

[Per os early nutrition for colorectal pathology susceptible of laparoscopy-assisted surgery].

UNLABELLED: Current less invasive surgical techniques, the use of new analgesic and anesthetic drugs, and early mobilization ("multimodal su … ectomies, 4 low anterior resections with protective colostomy, and subtotal colectomies and lateral ileostomy were done. Final diagnoses were: 3 diverticular diseases; 3 adenomas; 7 rectosigmoidal neoplasms; and 12 large bowel neoplasms in other locations. The pathology study confirmed: pT3N0 (n = 7), pT3N1 (n = 3), pT3N2 (n = 1), and pT3N1M1 (n = 1), pT1N0 …

Spectrum of disease and outcome of complicated diverticular disease.

BACKGROUND: Diverticular disease is a common entity. The presentation, investigations performed, and management are variable. Our objectives … iverticulitis has an acceptable morbidity and mortality. For high-risk anastomoses, a covering loop ileostomy and not a Hartmann's procedure is preferred. Surgery remains safe for the majority of patients and is associated with resolution of symptoms. We believe that because of the high number of patients in our series who had a previous attack of diverticu …

Long-term prospective assessment of functional results after proctectomy with coloanal anastomosis.

The objective of this study was to prospectively assess the long-term functional results after restorative proctectomy with coloanal anastom … ic J-pouch was fashioned in 11 patients. The coloanal anastomosis was protected by a diverting loop ileostomy in 22 patients. All patients were evaluated using a prospective patient-completed protocol to record daily bowel activity over a 1-week period at 3, 6, and 12 months, and yearly thereafter. Mean follow-up extends to 55.5 +/- 27 months (range 7 to 11 …

[Specimen extraction through natural orifices with Cai tubes in gastrointestinal surgery: a single-institute series of 234 cases].

Objective: To investigate the feasibility of Cai tube-assisted natural orifice specimen extraction surgery (NOSES) in gastrointestinal surge … infection. Reoperations were required in 7 patients (3.0%), all of whom consented to creation of an ileostomy after anastomotic leakage. The total readmission rate within 30 days after surgery was 0.9% (2/234). After a follow-up of (18.3±3.6) months, the 1-year RFS was 94.7%. Five of 209 patients (2.4%) with gastrointestinal tumors had local recurrence, all …

Clinical features, outcome and risk factors in cervical cancer patients after surgery for chronic radiation enteropathy.

BACKGROUND: Radical hysterectomy and radiotherapy have long been mainstays of cervical cancer treatment. Early stage cervical cancer (FIGO stage IB1-IIA) is traditionally treated using radical surgery combined with radiotherapy, while locally advanced cervical cancer is treated using radiotherapy alone or chemoradiotherapy. In this retrospective study, we describe and analyse the presenting clinical features and outcomes in our cohort and evaluate possible risk factors for postoperative morbidity in women who underwent surgery for chronic radiation enteropathy (CRE). METHODS: One hundred sixt

Single-layer vs Double-layer Intestinal Anastomosis: A Prospective Comparative Study.

OBJECTIVES: The purpose of our study was to compare single-layer and double-layer anastomosis in terms of anastomotic leak, length of hospit … 2020 to 2022. Patients of either sex, in the age range of 20-75 years with various conditions like ileostomy, colostomy, strangulated hernias, intestinal malignancies, and adhesion/band obstruction of the bowel etc., requiring intestinal anastomosis were included in the study. Children <20 years of age and elderly >75 years of age, patients with biliary an …

Transition of care in a case of obesity with metabolic surgery.

UNLABELLED: The World Health Summit 2011 confirmed the epidemic-like occurrence of diabetes mellitus and obesity. In Germany, 62.7 % and 21. … ine (left side: colon; right flexure: at infralienal position) prompting single-anastomosis duodeno-ileostomy (SADI)-procedure, leaving the stomach in situ with simultaneous cholecystectomy and herniotomy in sublay technique.. Outcome (early postoperative and mid- to long-term): The patient tolerated the intervention well. Postoperative course was uneventfu …

Sequential boost in neoadjuvant irradiation for T3N0-1 rectal cancer: long-term results from a single-center experience.

PURPOSE: To evaluate the influence of radiation dose on tumor regression grade (TRG) and sphincter preservation rate in a series of cT3N0-1 rectal cancer patients treated with neoadjuvant chemoradiotherapy (CT-RT) with or without a sequential radiation boost. MATERIALS AND METHODS: Between May 2002 and September 2013, 116 cases were eligible for retrospective evaluation. Radiotherapy was delivered for a total dose of 45 Gy (no boost arm) or 50.4 Gy (boost arm). TRG was evaluated with the Dworak scale. RESULTS: Median follow-up was 62 months (range, 12-138 months). The 5-year overall survival

Effect of butyrate enemas on gene expression profiles and endoscopic/histopathological scores of diverted colorectal mucosa: A randomized trial.

BACKGROUND: A temporary stoma is often created to protect a distal anastomosis in colorectal surgery. Short-chain fatty acids, mainly butyrate, are the major fuel source for the epithelium and their absence in the diverted tract may produce mucosal atrophy and inflammation. AIMS: To investigate whether the administration of sodium butyrate enemas (Naburen(©), Promefarm, Italy) could prevent mucosal inflammation and atrophy and affect gene expression profiles after ileo/colostomy. METHODS: We performed a randomized, double-blind, placebo-controlled clinical trial, in patients with enterostomy

Prevention and reversal of intestinal failure-associated liver disease in premature infants with short bowel syndrome using intravenous fish oil in combination with omega-6/9 lipid emulsions.

Although premature infants with short bowel syndrome are at the highest risk of developing intestinal failure-associated liver disease (IFALD), they have great capacity for intestinal growth and adaptation if IFALD can be prevented. Conventional soybean oil-based intravenous lipid emulsions have been associated with IFALD. This study presents data on 5 premature neonates with short bowel syndrome treated with a combination of parenteral fish oil- and olive/soybean-based lipid emulsion for periods ranging between 7 and 17 months. Despite an enteral tolerance of less than 50% in 4 of these patie

Cecal Involvement of Diffuse Large B-Cell Lymphoma: A Rare Extra-Nodal Presentation.

We present the case of a 56-year-old male with cecal involvement of non-Hodgkin's lymphoma (NHL), whose tumor was refractory to multiple chemotherapy regimens and ultimately resulted in significant local complications due to tumor erosion, leading to considerable morbidity. NHL is the most common hematologic cancer with many subtypes of disease, with diffuse large B-cell lymphoma (DLBCL) being the most common. Extra-nodular presentation in the gastrointestinal tract is typical in many cases; however, the involvement of the colon is rare. This case details a patient with extra-nodal involvement

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… A diverting loop ileostomy was performed. Unfortunately, the patient did not respond to R-ICE chemotherapy. Given the lack of response to prior chemotherapy regimens, the decision was made to initiate treatment with rituximab and polatuzumab on a 6-week cycle, administered every 21 days. … colonoscopy | Infiltrative, ulcerated obstructing cecal mass (14 mm); rectal fistula Confirmed recurrent DLBCL; nephrostomy tube placement for obstructive uropathy Salvage therapy | R-ICE chemotherapy (two cycles) | - | Rituximab, ifosfamide, carboplatin, etoposide | Did not respond; diverting loop ileostomy …

Peristomal pyoderma gangrenosum: 12-year experience in a single tertiary referral centre.

BACKGROUND: Peristomal pyoderma gangrenosum (PPG) is an unusual but potentially devastating condition that is difficult to diagnose and manage. METHODS: This was a single centre, retrospective review of a prospectively collected database. Included were consecutive patients referred to a stoma therapy clinic at a single institution between 2005 and 2016. Main outcomes of interest were management strategies and outcome of patients with PPG including time to healing and recurrence. RESULTS: Of 1295 consecutive patients who underwent stoma formation, 12 patients with PPG were identified. The mea

Emulsifier Intake in Healthy Controls and Patients with Inflammatory Bowel Disease: A Cross-Sectional Comparative Study with Longitudinal Follow-Up of Long-Term Outcomes.

BACKGROUND: Ultra-processed foods (UPFs) and dietary emulsifiers have been linked to inflammatory bowel disease (IBD) pathophysiology, but i … nal assessment. Eligible patients were aged 18-65 years, excluding those who had undergone terminal ileostomy or ileo-anal pouch anastomosis, as well as pregnant or breastfeeding women. MAIN OUTCOME MEASURE: We cross-sectionally compared the intake of emulsifiers and UPFs between HCs and IBD patients and longitudinally assessed associations of intake of em …

2021 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Las Vegas, Nevada, 31 August–3 September 2021: Video Loops

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… The colorectal anastomosis was made with a 28 mm EEA stapler and a diverting loop ileostomy was matured. … The patient underwent a subsequent ileostomy takedown. 5 years later, he developed a small bowel obstruction that was identified as the site of his ileostomy takedown. No evidence of Crohn's disease was seen. A robotic Heinecke-Mikulicz strictureplasty was performed. …

[Effect of preservation of left colic artery on postoperative anastomotic leakage of patients with rectal cancer after neoadjuvant therapy].

Objective: To evaluate the effect of preservation of left colic artery (LCA) on postoperative anastomotic leakage in patients with rectal ca … t radiotherapy or chemoradiotherapy; (4) laparoscopic-assisted anterior rectal resection and distal ileostomy were performed simultaneously; (5) complete clinical data. Exclusion criteria: patients with extensive abdominal metastasis, or distant organ metastasis during operation, and combined organ resection. According to whether LCA was retained during ope …

Meconium obstruction in absence of cystic fibrosis in low birth weight infants: an emerging challenge from increasing survival.

BACKGROUND: Meconium abnormalities are characterized by a wide spectrum of severity, from the meconium plug syndrome to the complicated meco … ital (outborn). They were managed, after a Gastrografin enema with 90% success rate, by 1 temporary Ileostomy and 2 trans appendiceal irrigation. 25 cases with BW< 1500 g (LBW) had M/F ratio 11/14, Mean B.W. 818 g, Mean G.A. 27 w, Caesarean section rate 70%, assisted ventilation 16/25. There were 8 inborn and 17 outborn. Gastrografin enema was successful in …

Complications of newborn enterostomies.

AIM: To evaluate the occurrence and severity of enterostomy complications in newborns suffering from different intestinal disorders. METHODS: A 10-year retrospective cohort study (2008-2017) investigated newborns that underwent enterostomy formation and reversal for different intestinal disorders. Only infants less than 28 d old at the time of enterostomy creation were included in the study (corrected age was applied in the cases of preterm neonates). The patients were divided into two groups according to their underlying diseases. Group 1 included infants suffering from necrotizing enterocol

Oncological outcome of carcinomas in the rectosigmoid junction compared to the upper rectum or sigmoid colon - A retrospective cohort study.

INTRODUCTION: Although carcinomas of the rectosigmoid junction are frequent, specific data on these tumors are sparse because assignment either to the colon or rectum is common. The objective of this study is to determine whether carcinomas of the rectosigmoid junction can be assigned to the sigmoid colon or to the upper rectum in terms of tumor characteristics and oncological outcome. MATERIALS AND METHODS: 337 consecutive patients undergoing resection of carcinomas in the sigmoid colon, the rectosigmoid junction and the upper third of the rectum were analyzed retrospectively and additionall

[Perianal fistulas in Crohn's disease: treatment results at an interdisciplinary unit].

BACKGROUND: Approximately one third of patients with Crohn's disease develop perianal fistulas. This study was conducted to determinate outcome predictors in patients treated at a specialized multidisciplinary unit. PATIENTS AND METHODS: Between May 2005 and May 2008, all patients with perianal Crohn's fistulas were treated by the same surgeon and a gastroenterologist specialized in managing patients with Crohn's disease. Deep fistulas were treated by fistulotomy. For high fistulas, a noncutting seton was placed followed by maintenance treatment with azathioprine and/or infliximab. "Optimal o