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Stomi and fistula

Masato Narita, Ryo Matsusue, Hiroaki Hata, Takashi Yamaguchi, Tetsushi Otani, Iwao Ikai
BACKGROUND: Pancreatoenteric anastomotic failure is the main cause of pancreatic fistula after pancreaticoduodenectomy (PD). Double purse-string telescoped pancreaticogastrostomy, reported by Addeo et al., is an easy and safe procedure.1 The aim of this article was to introduce our technique of pancreaticogastrostomy using an atraumatic self-retaining ring retractor (Alexis Wound Retractor) in a patient undergoing subtotal stomach-preserving PD (SSPPD). PATIENT AND METHODS: An 82-year-old woman presented with pancreatic cancer located in the uncinate process of pancreas...
March 2016: Annals of Surgical Oncology
Anton Maricić, Petar Orlić, Maksim Valencić, Romano Oguić, Stanislav Sotosek, Dean Markić, Josip Spanjol, Stela Zivcić-Cosić, Sanjin Racki, Zeljko Fuckar
Between January 30 1971 and January 30 2011 922 kidney transplants were performed at our center, 360 (39%) from living related donor and 562 (61%) from cadaver. During first eight years an ureteroureterostomy was routinely used. The notable incidence of urological complications (fistula 11%, complications of stenting 10.7%, stenosis and lithiasis 4%) was observed after 140 transplantations. Majority of these complications (60%) were treated conservatively. A significant reduction in this incidence (P<0.001) was achieved (fistula 1,28%, complications of stenting 0,26%, lithiasis 0...
October 2011: Acta Medica Croatica: C̆asopis Hravatske Akademije Medicinskih Znanosti
Jin-ping Ma, Chuang-qi Chen, Shi-rong Cai, Han-ping Shi, Yu-long He, Wen-hua Zhan
OBJECTIVE: To compare the nutritional status between pancreaticojejuno-stomy(PJ) and pancreaticogastrostomy(PG) following pancreaticoduodenectomy. METHODS: A retrospective clinical analysis was performed on 37 patients undergoing pancreaticoduodenectomy(PD) for duodenal carcinoma and pancreatic non-epithelial tumor with PG(n=19) and PJ(n=18) in the First Hospital of Sun Yat-sen University from April 2006 to December 2010. All the patients had a needle catheter jejunostomy inserted at the conclusion of laparotomy...
May 2012: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Michel Malafosse
Surgical treatment of Crohn's disease (CD) is purely symptomatic. In addition, medical therapy always precedes surgery and almost always continues afterwards. The indications for surgical treatment are failure of medical treatment and progressive complications such as chronic bowel obstruction and occlusion, internal abscesses and fistulae, and recurrences. Between 70 and 80% of patients with CD will undergo surgical treatment at some time, mainly reflecting the very high frequency of recurrences (50% at 10 years)...
June 2007: Bulletin de L'Académie Nationale de Médecine
Pan Chi, Hui-Ming Lin, Zhong-Bin Xu
OBJECTIVE: To investigate and compare the incidence rates of postoperative anastomotic leak following laparoscopic (LP) versus open (OP) lower anterior resection for rectal cancer. METHODS: Fifty-three cases of LP and 135 cases of OP lower anterior resection with rectal cancer site 5-8 cm away from anal edge were operated by the same surgeon team from Sep. 2000 to Dec. 2005. The differences of postoperative anastomotic leak of protective stomy and non-protective stomy between LP and OP groups were analysed...
January 2007: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
C Finco, G Sarzo, P Parise, S Savastano, F De Lazzari, F Polato, S Merigliano
Colonic diverticular disease is a benign condition typical of the Western world, but it is not rare for even the 1st episode of diverticulitis to carry potentially fatal complications. The evolution of a peridiverticular process generally poses problems for medical treatment and exposes patients to repeated episodes of diverticulitis, making surgical treatment necessary in approximately 30% of symptomatic patients. One of the most worrying complications of diverticulosis is internal fistula. The most common types of fistula are colovesical and colovaginal, against which the uterus can act as an important protective factor...
June 2004: Minerva Chirurgica
Hao Wang, Zhizhong Shen, Zhuohua Yao, Huaguang Qiu
OBJECTIVE: To find out the best surgical treatment for chronic severe aspiration with different pathogenesis. METHOD: Eight patients with severe aspiration were treated by 3 surgical methods. Six of 8 cases were perfomed tracheotomy. The cannula had a gasbag and the gasbag was inflated before eating food every time. Epiglottic flap closure for one patient with intractable aspiration. Stomach-stomy for the case with tracheoasophageal fistula. RESULT: There did not found aspiratory pneumonia in all cases after following up for 9 months to 4...
December 2003: Lin Chuang Er Bi Yan Hou Ke za Zhi, Journal of Clinical Otorhinolaryngology
V Moutardier, G Houvenaeghel, B Lelong, D Mokart, J R Delpero
OBJECTIVE: The objective of this study was to analyze our experience with colorectal function preservation at the time of pelvic exenteration. METHODS: Between January 1980 and December 2001, 201 pelvic exenterations for gynecologic malignancies were performed in our hospital. Ninety-eight were supralevator exenterations and 89 were selected for this study because low colorectal anastomosis (LCRA) was performed. There were locally advanced or recurrent cancers including 50 cervical, 28 ovarian, 11 endometrial, and 3 vaginal malignancies and 5 pelvic sarcomas...
April 2003: Gynecologic Oncology
P Martel, M Deslandes, L Dugue, A Sezeur, D Gallot, M Malafosse
UNLABELLED: From 1978 to 1992, 55 patients (48 women: 87%) with a mean age of 62 years (35-89) underwent 70 operations for radiation injury of the small bowel. Primary pathology treated with radiotherapy was gynecologic cancer (40: 72%), digestive malignancy (9: 16%), male genital cancer (4: 7%), carcinoma of the bladder (2: 3%). External radiation was performed alone (47: 85.5%) or associated with intracavitary radium or cesium (8: 14.5%), mean radiation dose was 50 Gy for 35 patients and not specified for 20 but greater than 45 Gy for all patients...
1996: Annales de Chirurgie
C Gygi, P Petropoulos, W Zimmerli
From 1976 to 1988, 123 emergency left colon procedures were carried out. 79 were single-step procedures, 34 were two-step and 10 were three-step. The presence or not of peritonitis was not systematically taken into consideration for procedure choice. Two of the 79 single-step patients presented an anastomosis leakage repair. Three of seven patients with postoperative peritonitis required reoperation for abscess formation. These figures are not significantly higher than those encountered in the two- or three-step procedure groups...
June 1993: Helvetica Chirurgica Acta
J Bures, R Postupa, L Sobotka, J Horácek, Z Zadák, B Cervenka, V Pidrman
The authors followed up 12 patients with dehiscences of surgical wounds and postoperative enterocutaneous fistulas treated by on a long-term basis by complete parenteral nutrition. Previous operations were performed on account of different non-tumorous (11/12) and tumourous (1/12) diseases of the gastrointestinal tract. Microbiological examinations were made in every patient on admission and during total parenteral nutrition, always once a week for a total period of 2-8 weeks (mean 4.4; median 4.5). The authors examined aerobic and facultatively anaerobic bacteria in smears from the fistulas, stomies, dehiscent surgical wounds and from the rectum...
October 25, 1993: Casopís Lékar̆ů C̆eských
R Detry, A Kartheuser, G Remacle
Classic treatment of high anal fistulas by the laying open technique requires total or subtotal section of the sphincter muscles and results in anal incontinence. This study assesses the efficacy of the flap advancement technique in these cases. It entails the resection of the crypt at the origin of the fistula, the area being covered by a mucomuscular flap of the rectal wall. From 1977 to early 1992, 18 patients (13 female and 5 male patients; mean age: 40 years) presenting with a deep anal fistula underwent such an operation...
1994: Annales de Chirurgie
C Viville
A retrospective survey of total prostatectomies performed for cancer was conducted by 30 urologists members of the French Association of Continuing Education (ANFUC). This survey was limited to the operation itself and perioperative complications observed during hospitalization. Urinary sequellae including incontinence and impotency were excluded and reported elsewhere. The follow-up has been considered insufficient to evaluate the effect of total prostatectomy on the cancer. Post-operative mortality was 1%, in agreement with previously reported series...
1994: Journal D'urologie
E Carlsen, A Bergan
During a period of 10 years (1980-1990) we constructed or reconstructed 358 end-ileostomies: 224 were primary constructions, 96 were reconstructed by laparotomy, and 38 were local reconstruction. Only 2 ileostomies were primarily located on the left side. The mean length was 5 cm. We had 11.6% reoperations after primary stomy and 7.3% and 7.9% reoperations after reconstruction by laparotomy and local approach, respectively. There were 12.9% and 8.7% reoperations after emergency and elective primary operations, respectively...
July 1995: World Journal of Surgery
F La Torre, A Nicastro, L Persico Stella, S Madrigali, M Pallotti
The restoration of continence is a fundamental step in the rehabilitation of stomised patients. The latest generation of continence prosthesis, represented by Conseal must be seen in this context. The authors performed a multicentre study based on a protocol using Conseal Uni in patients with low terminal digestive stomies (ileum or colostomy). The only criteria for patient selection was the absence of marked stomal and peristomal pathologies (large prolapse, fistula). The three centres taking part in the study inserted the new device in 50 patients (25 M; 25 F) with a mean age of 57...
April 1995: Minerva Chirurgica
C Matuchansky
In this overview article the author examines successively: (1) the effects expected from enteral nutrition in adults: general and/or local nutritional effects, temporary arrest in progressive intestinal lesions, partial intestinal function replacement; (2) indications in gastrointestinal and non-gastrointestinal pathologies and modalities of application to each indication (route of administration, elemental, semi-elemental or polymeric nutrients, incremental or non-incremental calorie intake, necessity or lack of necessity for addition of fibres, value of ambulatory methods); (3) results according to indications: chronic inflammatory intestinal diseases, notably Crohn's disease, short small bowel syndromes, fistulae and stomies, preoperative period in gastrointestinal surgery, support of heavy treatments in non-terminal cancers, hypermetabolic states, notably stress; (4) absolute or relative contraindications of enteral nutrition...
March 11, 1991: La Revue du Praticien
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