Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    ISSN: 1128-045X
    Keywords: Key words Ileo-anal pouch ; Laparoscopy ; Familial adenomatous polyposis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We compared the intraoperative and early post-operative results of open (ORPC) and laparoscopic restorative proctocolectomy (LRPC) for familial adenomatous polyposis (FAP). We studied all our patients undergoing restorative proctocolectomy for FAP. The first 8 patients who underwent LRPC were prospectively studied and compared with the records of 27 patients who had undergone ORPC. Twenty-seven patients (5 males) and 8 patients (3 males) underwent ORPC and LRPC. The median length of time of surgery was 160 min (range 135–180 min) and 150 min (range 60–360 min) for LRPC and ORPC, respectively (P = ns). The median length of the wound was 8.5 cm (range 5–16 cm) and 25 cm (range 18–34 cm) for LRPC and ORPC, respectively (P 〈 0.0001). There was no significant differences in time to ileostomy function, first fluid intake or time to solid diet intake between the two groups. There was a significant improvement in hospital stay (median 7 days vs 10 days) in the LRPC group. Thus, LRPC may be performed with no significant increase in operative time compared to the open technique. Furthermore, the wound length is significantly shorter in LRPC and the time taken for hospital stay is significantly improved.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 2
    ISSN: 1128-045X
    Keywords: Key words Physiology ; Radiotherapy ; Rectal cancer ; Surgery ; Rectum
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: We compared bowel function and anorectal physiology testing in rectal cancer patients who had undergone surgery alone, i.e. low anterior resection with colonic pouch (SA), to those also having preoperative radiotherapy (PREOP) or postoperative radiotherapy (POSTOP). The PREOP group were recruited from those who received 50.4 Gy (28 daily fractions over 5 1/2 weeks), and had their ileostomies closed for at least 1 year. Equivalent gender- and age-matched SA and POSTOP (50.4–54 Gy) patients who were operated upon during the similar time period were recruited. Bowel function questionnaire, anorectal manometry, anal electrosensation, pudendal nerve motor terminal latencies, barostat rectal sensation measurements and endoanal ultrasound were performed. There were 6 patients in each group. Bowel function questioning revealed that PREOP had significantly more incontinent episodes than SA patients (SA 2.9 ± 1.3, PREOP 10.3 ± 3.4, POSTOP 3.8 ± 0.6 episodes per week: p 〈 0.05; values expressed as mean ± SEM). The rectal volume of initial distension sensation on barostat ramp program testing was more impaired in the POSTOP than in PREOP group (SA 27.4 ± 5.3, PREOP 17.8 ± 4.3, POSTOP 37.5 ± 6.8 ml; p 〈 0.05). The left pudendal nerve motor terminal latency was more prolonged in the POSTOP than in the SA patients (SA 1.9 ± 0.2, PREOP 2.3 ± 0.1, POSTOP 4.3 ± 0.7 ms; p 〈 0.05). Patients who had preoperative radiotherapy had more incontinent episodes, and the rectal sensation may be more impaired after postoperative radiotherapy.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 3
    Electronic Resource
    Electronic Resource
    Springer
    Techniques in coloproctology 4 (2000), S. 79-81 
    ISSN: 1128-045X
    Keywords: Key words Anal stenosis ; Sphincter spasm ; Radical hemorrhoidectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: Used in the treatment of gross circumferential hemorrhoidal prolapse. Whitehead hemorrhoidectomy is technically more demanding and has slightly more complications than four-quadrant hemorrhoidectomy. The former, however, offers a radical cure and is the better operation whereas the latter is often associated with considerable remaining skin tags and areas of residual hemorrhoidal tissue. Following the Whitehead operation, we have observed fewer complications in older patients compared to younger patients. Case notes and follow-up data of all patients who underwent a Whitehead hemorrhoidectomy in the period October 1995 to November 1999 were reviewed, and clinical presentation and outcome were analyzed. The study group consisted of 11 patients (8 males, 3 females), of median age 58 years (range, 41–,75 years). The median operation time was 30 min (range, 15–40 min). The median hospital stay was 3 days (range, 2–15 days). There was only early and one late complication, both with minimal related morbidity. In both these patients, appropriate treatment resulted in complete recovery. All othera patients had an uneventful course with no residual symptoms at the last visit. Elderly patients may be less prone to developing significant sphicter spasm due to a generally more lax sphincter tone. Therefore, they may be at less risk of suture line ischemia, breakdown and stenosis.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 4
    ISSN: 1128-045X
    Keywords: Key words Surgical technique ; Functional end-to-end anastomosis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: The use of staplers for ileostomy closure may facilitate the procedure and improve outcome by creating a wide, functional end-to-end anastomosis. We retrospectively compared 136 sutured ileostomy closures with 152 stapled closures. Perioperative data and outcome parameters were analyzed. Patient characteristics were similar in both groups. Highly significant reduction was found in operating time (p 〈 0.001) and hospitalization (p = 0.001) in the stapled group compared to the sutured group. Recovery of intestinal function and complication rates showed no differences. Our results show that both techniques are comparably safe but stapling is considerably faster to perform. The higher expenses of using a stapling device may be economically compensated by the shorter operation time under certain circumstances.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 5
    ISSN: 1128-045X
    Keywords: Key words Colorectal cancer ; Large bowel resection ; Elderly patients
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract: With an aging population and an alarmingly increasing rate of colorectal cancer, the number of octogenarians undergoing surgery for colorectal cancer in Singapore is increasing. The aim of the study was to determine the immediate and long-term outcomes of surgery on octogenarians with colorectal cancer. Between April 1989 and November 1996, 2 211 patients with newly diagnosed colorectal cancer operated on in the department were entered into a computer database. Of these, 213 (9.6%) were above the age of 80 (range 80–100)years; 150 (70.4%) patients underwent potentially curative resections while 57 (26.8%) had palliative procedures. Postoperatively 22 (10.3%) patients had to be monitored in surgical intensive care units. Of the patients 18 (8%) had Dukes A while 68 (32%), 70 (33%) and 57 (27%) had Dukes B, C and D, respectively. The median follow-up period was 29 months (range 2–88). The median hospital stay was 16 days (range 4–64). The perioperative mortality was 11 of 213 (5.2%), and 59 of 213 (29%) developed perioperative complications. At the last follow-up 110 (51.6%) patients were alive without recurrence, while 5 (2.3%) had local recurrence and 2 (0.9%) distant disease; 96 patients had died, 28 (29.2%) from cancer-related causes. In conclusion, octogenarians have a higher risk usually because of associated medical diseases. However, surgery can be performed with acceptable mortality and morbidity risk. Furthermore, one half of the patients will be able to continue to the end of their lives free from disease.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 6
    ISSN: 1432-1262
    Keywords: Key words Flat cancer ; Colorectal cancer ; Flat adenoma ; Colonic polyps
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A comparative study of polypoid and flat colorectal cancers less than 20 mm in size was made. A review of the characteristics of 56 polypoid cancers and 29 flat cancers treated between April 1989 and January 1996 was performed. Both groups of cancers showed similar age and location distribution. Polypoid cancers were more likely to be well differentiated (38%) than were flat cancers (17%) (P〈0.05). Flat cancers were more likely to have reached the serosa (52% vs 12%; P〈0.01) and also demonstrated a higher frequency of lymph node involvement (41% vs p 9%) (P〈0.01) when compared to polypoid cancers. Flat colorectal cancers belong to a distinct subset which demonstrates greater biological aggressiveness than polypoid cancers of equivalent size.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 7
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé 34 (4,1%) de 820 patients opérés de cancer colorectaux entre avril 89 et octobre 92 avaient des cancers synchrones. 20 (59%) étaient des hommes et 14 (41%) des femmes. L'âge moyen était de 69, 3 ans (25–89 ans). Les tumeurs synchrones étaient localisées dans le même segment ou les segments voisins du colon chez 24 (71%) des malades. Une résection curative a été réalisée chez 27 (79%) des patients, une résection palliative chez 8 (18%) et un malade (3%) a eu seulement une colostomie palliative. Le stade de Dukes du cancer le plus évolué des 2 montrait 1 (3%) Dukes A, 11 (32%) Dukes B, 14 (38%) Dukes C, et 9 (27%) avec une maladie disséminée. L'âge, le sexe et le stade de Dukes ne différaient pas significativement de ceux des patients qui avaient un cancer unique et le pronostic n'était pas pire.
    Notes: Abstract Thirty-four (4.1%) out of 820 patients operated for colorectal cancer between April 1989 and October 1992 were found to have synchronous cancers. Twenty (59%) were male and 14 (41%) were female. The mean age was 69.3 years (range=25 to 89 yr). Synchronous tumours were located in the same or adjacent segments of the large intestine in 24 (71%) of the patients. A curative resection was performed in 27 (79%) patients, a palliative resection in 8 (18%) and one (3%) patient had a palliative colostomy only. Dukes' staging based on the worse of the 2 cancers showed 1 (3%) Dukes' A, 11 (32%) Dukes' B, 14 (38%) Dukes' C and 9 (27%) with disseminated disease. Age, sex and Dukes' staging did not differ significantly from those of patients with solitary cancers and prognosis was also not adversely affected.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 8
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Entre janvier 1993 et juin 1994, 5 patients (4 hommes et 1 femme, moyenne d'âge=60 ans) ont été traités en raison de perforation intestinale secondaire à des colonoscopies. Un patient a subi une colonoscopie difficile alors que les 4 autres ont subi des polypectomies ou des biopsies. La douleur abdominale constituait le symptôme majeur survenant en moyenne 3 h après la colonoscopie (2 à 12 h). Quatre patients ont présenté un pneumopéritonie alors que l'un a développé un abcès pelvien. Suite à un traitement non chirurgical, les signes abdominaux ont régressé en 24 à 48 h et ont disparu au 5e jour chez tous les patients. Tous purent quitter l'Hôpital au 7e jour (entre 5 et 9 jours) et n'ont pas développé de nouvelles lésions au cours d'un suivi moyen de 12 mois (3 à 18 mois).
    Notes: Abstract Five patients (four males, and one female, median age of 60 years) with colonoscopy-related bowel perforations were managed between January 1993 and June 1994. One patient had a difficult colonoscopy whereas four patients had polypectomies or biopsies. Abdominal pain was the main presenting symptom at a median of 3 h (range 2 to 12 h) following colonoscopy. Four patients demonstrated free pneumoperitoneum whilst one showed a pelvic abscess. Following non-surgical management, abdominal signs diminished after 24 to 48 h and disappeared by the fifth day in all patients. All patients were discharged well at day seven (range 5 to 9 days) and have remained well at 12 months of follow-up (range 3 to 18 months).
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 9
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé. Le but de l'étude est de comparer une série con-sécutive de patients qui ont subi soit une résection ab-domino-périnéale laparoscopique (LAPR), soit une résection abdomino-périnéale conventionelle par laparotomie (CAPR). Materiel et methode: Seize patients (dont 8 femmes) et 11 patients (dont 4 femmes) ont subi respectivement une LAPR ou une CAPR. Resultats: La durée moyenne de l'opération était de 110 minutes (65 – 210) et 100 minutes (80 – 185) pour LAPR et CAPR respectivement (P = 0,43). La perte sanguine moyenne était de 200 (100 – 1000) ml et 100 (60 – 800) ml et 100 minutes (80 – 185) pour LAPR et CAPR respectivement. Il n'y avait pas de différence statistiquement significative dans la consommation d'analgésiques postopératoires et quant au délai jusqu'à la première émission de selles par la stomie mais le groupe LAPR montre une amélioration significative quant à la prise de boissons orale, l'alimentation, l'amulation et la sortie de l'hôpital. Conclusion: La technique laparoscopique peut être une alternative acceptable à la résection abdomino-périnéale conventionnelle pour des patients qui nécessitent un sacrifice sphinctérien pour cancer rectal.
    Notes: Abstract. Aim: To compare a consecutive series of patients who underwent laparoscopic abdomino-perineal resection (LAPR) versus conventional open abdomino-perineal resection (CAPR). Material and Methods: Sixteen patients (8 females) and 11 patients (4 females) underwent LAPR and CAPR respectively. Results: The median operative time was 110 (65 – 210) mins and 100 (80 – 185) mins for LAPR and CAPR respectively (P = 0.43). The median amount of blood loss were 200 (100 – 1000) mls and 100 (60 – 800) mls for LAPR and CAPR respectively. There was no significant difference in the need for post operative analgesics and time to first stoma function but the LAPR group showed significant improvement in starting fluids, diet, ambulation and discharge from hospital. Conclusion: The laparoscopic technique may be an acceptable alternative to conventional abdomino-perineal resection for the patient requiring anal resection for rectal cancer.
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
  • 10
    ISSN: 1432-1262
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    Signatur Availability
    BibTip Others were also interested in ...
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...