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Juan J Díaz-Osuna, Adolfo Leyva-Alvizo, Carlos E Chávez-Pérez
Background: Cholecystectomy is one of the most performed procedures worldwide. Many surgeons defend the use of routine intraoperative cholangiography (IOC), but this action is getting less practiced because other preoperative tools that can omit IOC. Objective: Evaluate the utility of performing intraoperative cholangiography in patients whom got a preoperative imaging or endoscopy study. We analized the association between the diagnostic-therapeutic approach and hospital readmissions because of bile duct obstruction...
2019: Cirugia y Cirujanos
Tetsutaro Nemoto, Shungo Endo, Noriyuki Isohata, Daisuke Takayanagi, Daiki Nemoto, Masato Aizawa, Kenichi Utano, Kazutomo Togashi, Kotaro Endo, Ikuro Oshibe, Nobutoshi Soeta, Takuro Saito
A 53-year-old woman was referred to our hospital with melena. Examinations revealed advanced rectal cancer involving the anal canal with invasion of the left-sided levator ani muscle. Neoadjuvant chemotherapy was administered to preserve anal function. A first course of capecitabine and oxaliplatin(CapeOX)plus bevacizumab was administered. CapeOX plus panitumumab was administered from the 2nd to the 8th courses after confirming the absence of RAS mutation. Endoscopy and computed tomography confirmed the disappearance of the tumor after completion of the chemotherapy...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Maiko Hongo, Yoko Inaba, Kenjiro Kotake
A 78-year-old man was referred to our hospital with diarrhea, melena, and weight loss. During a digital rectal examination, a protuberant mass located 7-8 cm above the anal verge was palpable. Computed tomography(CT)scans of his chest, abdomen, and pelvis revealed an intestinal obstruction with a target sign in the lower rectum, indicating intussusception due to a sigmoid colon mass. A gastrografin enema examination revealed a typical filling defect with a crab claw sign in the rectum. However, the enema did not reduce the intussusception...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Tomohiko Machida, Shuhei Ohta, Yoshihito Kakimoto, Akira Toyoda, Yoshitake Endou, Osamu Murakami
An 81-year old man with a perirectal abscess was referred in May 2017 by another hospital. We observed swelling in the anal region at the 4 o'clock position and performed incisional drainage. Although this alleviated the pain and inflammation in the anal region, the irritation recurred in early June. The patient presented with bloody stools and a low-grade fever since late June. Pelvic magnetic resonance imaging(MRI)confirmed a solid tumor in the center of the lower rectum(Rb), outside of the anal fistula. We surmised this was rectal cancer...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Min-Min Xu, Ping Zhu, Hao Wang, Bo-Lin Yang, Hong-Jin Chen, Li Zeng
BACKGROUND: Clinical characteristics are keys to improve identification and treatment of Crohn´s disease (CD) so that large sample analysis is of great value. AIM: To explore the clinical characteristics of perianal fistulising CD. METHODS: Analysis of 139 cases focused on their clinical data. RESULTS: The proportion of males and females is 3.3:1; the mean age is 28.2 years; 47.5% of patients had anal fistula before CD diagnosis...
February 7, 2019: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
S Islam, S A Talukder, A A Mahmud, S C Das, S Bari, M S Ali, A B Shamsuzzaman, A S Hasnuzzaman
The standard treatment of high variety anorectal malformation (ARM) is the staged approach. A growing interest in one stage correction of high variety ARM was noted recently. The aim of this study was to examine the feasibility, safety and outcome of single stage correction of High variety ARM. This prospective study was carried out in the Department of Paediatric Surgery, Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from July 2012 to September 2013. It was conducted among 30 patients, all having high ARM...
January 2019: Mymensingh Medical Journal: MMJ
Dong Yoon Park, Joo Hyun Park
BACKGROUND: Anal sphincter needle electromyography (EMG) is a useful tool to evaluate various neurologic lesions. However, landmark-based needle placement has risks of missing the intended target including risk of bowel penetration. Ultrasound guidance has been widely used to enhance needle placement for various interventional procedures, but it has not been previously reported for use in anal sphincter EMG. OBJECTIVE: To demonstrate the accuracy of ultrasound-guided needle insertion into the external anal sphincter (EAS)...
November 29, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Peng Liu, Zheng Lou, Zubing Mei, Xianhua Gao, Liqiang Hao, Lianjie Liu, Haifeng Gong, Ronggui Meng, Enda Yu, Hantao Wang, Hao Wang, Wei Zhang
OBJECTIVE: To investigate the surgical efficacy and prognostic factors of T3NxM0 middle-low rectal cancer without neoadjuvant therapy. METHODS: Clinical data of patients with middle-low rectal cancer undergoing TME surgery with T3NxM0 confirmed by postoperative pathology at Colorectal Surgery Department of Changhai Hospital from January 2008 to December 2010 were analyzed retrospectively. INCLUSION CRITERIA: (1)no preoperative neoadjuvant chemoradiotherapy (nCRT); (2) complete preoperative evaluation, including medical history, preoperative colonoscopy or digital examination, blood tumor marker examination, and imaging examination; (3) distance between tumor lower margin and anal verge was ≤ 10 cm; (4) negative circumferential resection margin (CRM-)...
January 25, 2019: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Melissa Ledgerwood-Lee, Ali Zifan, David C Kunkel, Robert Sah, Ravinder K Mittal
INTRODUCTION: The current "gold standard" to diagnose anal sphincter morphology and disruptions utilizes low-frequency (3-9 MHz) ultrasound (US) imaging techniques that provide a general outline of the sphincter muscles, but not their microstructural details. High-frequency US transducers (7-15 MHz) have been used to study the muscle architecture (direction of muscle fascicles) in the limb muscle. AIMS: The goal of our study was to visualize the microstructural anatomy of the anal sphincters, specifically the external anal sphincter (EAS), using high-frequency US imaging...
January 24, 2019: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Shigehiro Kojima, Tsuguo Sakamoto, Yuko Nagai, Yutaka Matsui, Kyojiro Nambu, Ken Masamune
BACKGROUND: The main limitation of perfusion assessment with indocyanine green fluorescence angiography during colorectal surgery is that the surgeon assesses the quality of perfusion subjectively. The ideal intestinal viability test must be minimally invasive, objective, and reproducible. We evaluated the quantitativity and reproducibility of laser speckle contrast imaging for perfusion assessment during colorectal surgery. METHODS: This was a prospective, nonrandomized, pilot study of 8 consecutive patients who underwent elective left-sided colorectal resection...
January 13, 2019: Surgical Innovation
Robin R van Tol, Merel L Kimman, Jarno Melenhorst, Laurents P S Stassen, Carmen D Dirksen, Stéphanie O Breukink
AIM: There is considerable heterogeneity in outcomes in studies reporting on treatment of haemorrhoidal disease (HD). The aim of this study was to develop a Core Outcome Set (COS) for HD in cooperation with the European Society of Coloproctology (ESCP). METHOD: A Delphi study was performed according to the OMERACT methodology. In total 38 healthcare professionals and 30 patients were invited to the panel. Previously, 10 outcome Domains and 59 Outcomes were identified through a systematic literature review...
January 9, 2019: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Yong Ji, Youxin Zhou
RATIONALE: Adenocarcinoma of the anal canal is an uncommon malignancy. Primary adenocarcinoma, in particular, is extremely rare. PATIENT CONCERNS: A 61-year-old man was referred to our institution with complaints of repeated hematochezia. DIAGNOSIS: Digital rectal examination revealed a hard palpable ulcer in the anal canal, measuring 2 cm × 2 cm in size, at the 5 o'clock direction (in the lithotomy position). The pelvic enhanced magnetic resonance imaging revealed anal verge occupying mass...
January 2019: Medicine (Baltimore)
Antonio Brillantino, Francesca Iacobellis, Alfonso Reginelli, Luigi Monaco, Biagio Sodano, Giuseppe Tufano, Antonio Tufano, Mauro Maglio, Maurizio De Palma, Natale Di Martino, Adolfo Renzi, Roberto Grassi
PURPOSE: The purpose of the study is to evaluate the diagnostic value of tridimensional endoanal ultrasound (3D-EAUS) and magnetic resonance (MR) in the preoperative assessment of both simple and complex anorectal fistulas. METHODS: All the patients referred for the treatment of anal fistulas were enrolled in this study and underwent, as preoperative assessment, anamnestic evaluation, clinical examination, and unenhanced and H2O2-enhanced 3D-EAUS and MR. The results of imaging evaluation were compared with surgical findings, considered as reference standard...
January 3, 2019: La Radiologia Medica
Dechao Liu, Wenru Li, Xinhua Wang, Jianping Qiu, Ling Wang, Fei Xiong, Zhiyang Zhou
OBJECTIVE: To explore the diagnostic value of magnetic resonance imaging(MRI) in anal fistula. METHODS: A total of 2160 patients were clinically diagnosed with anal fistula at the Sixth Affiliated Hospital of Sun Yat-sen University from March 2010 to September 2015. Among them, 232 cases with operative history at other hospital, 218 with Crohn's disease, 6 with rectum cancer and 8 with other disease were excluded, and 1696 patients were finally enrolled and retrospectively analyzed...
December 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Sinan Balcı, Mehmet Ruhi Onur, Ali Devrim Karaosmanoğlu, Muşturay Karçaaltıncaba, Deniz Akata, Ali Konan, Mustafa Nasuh Özmen
Anal and perianal region is a commonly affected area in the course of several inflammatory, infectious, and neoplastic diseases. Several imaging modalities may be used in imaging evaluation of this area and magnetic resonance imaging (MRI) emerges as the imaging modality of choice due to its superb soft tissue resolution. MRI is not only useful for initial detection of anal/perianal pathologies but also in the follow-up of these disorders. In this article, we aimed to illustrate MRI findings of several diseases affecting this area including perianal fistula as well as anal fissure, hypertrophic myopathy of internal anal sphincter, hidradenitis suppurativa, pilonidal sinus, rectovaginal/anovaginal fistula and anal canal carcinoma...
December 24, 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
T Grigoriadis, S Athanasiou
Pelvic floor disorders (PFDs) are a common and complex problem encompassing a broad spectrum of conditions such as urinary incontinence, voiding difficulties, pelvic organ prolapse, anal incontinence, and chronic pelvic pain. The initial assessment of women with PFDs is based on a detailed and focused history and a holistic clinical evaluation of the pelvic floor. Other investigations may be used in clinical practice for the determination of the pathophysiology and the severity of the PFDs. In the field of urogynecology, urodynamic studies, ultrasound, and magnetic resonance imaging of the pelvic floor are currently implemented in the diagnostic work-up of women with PFDs...
December 21, 2018: Climacteric: the Journal of the International Menopause Society
Ali Zifan, Marco Reisert, Shantanu Sinha, Melissa Ledgerwood-Lee, Esther Cory, Robert Sah, Ravinder K Mittal
Despite the importance of pelvic floor muscles, significant controversy still exists about the true structural details of these muscles. We provide an objective analysis of the architecture and orientation of the superficial muscles of the perineum using a novel approach. Magnetic Resonance Diffusion Tensor Images (MR-DTI) were acquired in 10 healthy asymptomatic nulliparous women, and 4 healthy males. Global tractography was then used to generate the architecture of the muscles. Micro-CT imaging of a male cadaver was performed for validation of the fiber tracking results...
December 14, 2018: Scientific Reports
Takuya Sadahira, Yosuke Mitsui, Motoo Araki, Yuki Maruyama, Koichiro Wada, Kohei Edamura, Yasuyuki Kobayashi, Masami Watanabe, Toyohiko Watanabe, Yasutomo Nasu
OBJECTIVE: Urinary incontinence (UI) is a major prostate cancer (PCa) treatment-related morbidity. It has been reported that post-prostatectomy UI is related to the width of the pelvic floor muscles (PFM) and the length of the urethra. However, the details of these anatomical parameters are unknown. The aim of this study was to investigate whether preoperative pelvic parameters or anatomical parameters of the urethra, as measured by magnetic resonance imaging (MRI), are correlated with UI...
December 12, 2018: Lower Urinary Tract Symptoms
Abhijit Chandra, Brijesh Mishra, Saket Kumar, Nikhil Chopra, Vivek Gupta, Amit Dangi, Pavan Kumar Gorla, Vishal Gupta
BACKGROUND: Severe fecal incontinence has a significant negative impact on patient well-being. Current surgical methods of total anorectal reconstruction to substitute a colostomy have suboptimal results. A composite graft using antropyloric valve transposition and gracilis wrap has been described with good outcomes. However, this procedure requires extensive training of patients. Gluteus maximus, an accessory muscle for continence, may be better suited for this purpose. OBJECTIVE: The purpose of this study was to evaluate the outcomes of composite antropylorus-gluteus graft for intractable fecal incontinence...
January 2019: Diseases of the Colon and Rectum
Faith Qi-Hui Leong, Dedrick Kok Hong Chan, Ker-Kan Tan
Purpose: Perianal adenocarcinoma arising from a chronic anorectal fistula is a rare condition for which the natural history and optimal management are not well established. For that reason, we conducted a retrospective analysis of 5 consecutive patients with a perianal adenocarcinoma arising from a chronic anorectal fistula managed at our institution from January 2014 to December 2015. Methods: The patients were identified from a prospectively collected colorectal cancer database that included all patients managed for colorectal cancer at our institution...
December 3, 2018: Annals of Coloproctology
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