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12/31/1969 03:59 PM
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Colon & Rectal Surgery: THE CURRENT ROLE OF LAPAROSCOPY FOR FECAL DIVERSION AND STOMA REVERSAL
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Colon & Rectal Surgery: THE CURRENT ROLE OF LAPAROSCOPY FOR FECAL DIVERSION AND STOMA REVERSAL. ABSTRACTS OF SCIENTIFIC PAPERS: PDF Only Colon and Rectal Clinic of Orlando, Orlando, Fla.
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12/31/1969 03:59 PM
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Use of the Appendix for a Catheterization Stoma in Partial Quadriplegics
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colon; Continent reconstruction of the lower urinary tract using the appendicovesicostomy (Mitrofanoff principle) is an excellent means of managing many patients with altered bladder function, especially those with good bladder volume and low pressure. Motivated patients unable to perform urethral catheterization because of paresis or other reasons now have a method of urinary diversion free of an appliance, though additional procedures may be necessary if bladder volume is low and/or bladder pressure is high. We no longer routinely perform appendectomy during bladder substitution or bladder augmentation procedures. By removing the appendix, we may be discarding an appendage that might prove useful should future urinary reconstruction procedures be required.
(C) 1994 Southern Medical Association
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12/31/1969 03:59 PM
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Gasless Laparoscopic-Assisted Intestinal Stoma Creation Through A Single Incision
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GASLESS LAPAROSCOPIC-ASSISTED INTESTINAL STOMA CREATION THROUGH A SINGLE INCISION. Department of Surgery, Division of Colon and Rectal Surgery, University of Miami, Miami, Fla.
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12/31/1969 03:59 PM
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Outpatient Bowel Preparation For Elective Colon Resection
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colon; To determine the safety and cost-effectiveness of outpatient preoperative bowel preparation with polyethylene glycol-electrolyte lavage solution, we retrospectively analyzed 726 cases of colectomy done by colon and rectal surgeons between July 1987 and July 1991. Included were 319 patients who had elective segmental or total abdominal colectomy with primary anastomosis. Patients who required protective proximal stoma were excluded. Patients requiring emergency surgery, colostomy closure, and restorative proctocolectomy were excluded. Patients were separated into two groups equally matched by age, sex, procedure done, and comorbidity: 145 had bowel preparation as outpatients and 174 as inpatients. Both groups had similar numbers of days hospitalized, days receiving nothing by mouth, and days requiring nasogastric intubation or gastrostomy tube, as well as similar postoperative complications. There was one wound infection, one anastomotic leak, and one death in each group. Cost of outpatient preparation was approximately $40. Cost of inpatient preparation, including a semiprivate room, was approximately $400. Outpatient preparation with polyethylene glycol-electrolyte lavage solution and oral antibiotics before elective colon resection can be done with equivalent safety and at a substantial cost savings.
(C) 1997 Southern Medical Association
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12/31/1969 03:59 PM
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Biliary Atresia: An Evolving Perspective
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colon; From 1967 to 1984, 50 of our patients with extrahepatic biliary, atresia had surgical exploration. Of 40 biliary drainage procedures, bile drained in 21 (52%). Thirty-four patients had portoenterostpmy, three had portocholecystostomy, and the most recent six patients had a valved hepatoduodenal conduit. Successful biliary drainage was related to the presence of microscopic ducts at the porta hepatis in 20 of 21 infants. Twenty patients are alive, 12 from two to six years postpperatively (one with a liver transplant). Seven have normal serum bilirubin values. Height and weight exceed the 50th percentile in 5/15 patients studied. Multiple episodes of cholangitis have occurred in 11 patients with portoenterostomy and two with hepatoduodenal conduits. In 12 patients, hemorrhage from the stoma necessitated closure of the stoma before 1 year of age. Five of the six patients with hepatoduodenal conduit are alive two years postoperatively.
(C) 1986 Southern Medical Association
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12/31/1969 03:59 PM
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Gastroplasty in Morbid Obesity: Observations in 300 Patients
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colon; Morbid obesity is associated with a number of life-threatening complications. Medical treatment of morbid obesity is rarely successful. Gastric reduction has replaced intestinal bypass as the surgical treatment of choice. Indications for operation are fairly standardized, and complications and results are similar in most large series. In our series of 300 gastroplasties done during the past four years, weight loss compares favorably with that in other reported series. Our hospital complication rate has been low because of short operating time and early ambulation. Postoperative vomiting has been reduced by enlarging the stoma. Revision rate was between 1% and 2% per year. The surgical treatment of morbid obesity requires a great deal of personal contact between surgeon and patient in the preoperative and postoperative periods. Because these patients tend not to comply with the dietary restrictions of the operation, close follow-up care is required.
(C) 1985 Southern Medical Association
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12/31/1969 03:59 PM
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Loop IleoStomy: A Reliable Method of Diversion
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colon; Between September 1983 and March 1989, 36 loop ileostomies were performed on 34 patients (16 male and 18 female, mean age 36 years, range 11 to 68). Thirty-two patients had ileoanal pouch procedures (30 for ulcerative colitis and two for familial polyposis). One patient had a low anterior resection and another had a coloanal procedure. By the time of this review, 31 of the loop ileostomies were closed. The average time before closure was 5 months and the average length of follow-up was 37 months. All stomas were brought out through the rectus muscle in the right side of the abdomen, without ileal rotation, mesenteric fixation, or parastomal fascial sutures. A support rod was left in place for 3 to 4 weeks postoperatively. There were no major difficulties with skin irritation or appliance management and no instance of parastomal abscess and stoma retraction. Although no complications related to the ostomy or its closure were encountered in these patients, small bowel obstruction before closure (8 patients) or after takedown (5 patients) of the loop ileostomy required operative correction in one patient in each group.
(C) 1994 Southern Medical Association
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12/31/1969 03:59 PM
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Early Diagnosis of Parastomal Hernia
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2. Shellito PC. Complications of abdominal stoma surgery. Dis Colon Rectum 1998;41:1562-1572 An abscess was found to the right of the stoma at the lower end of the incision wound, and this was
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12/31/1969 03:59 PM
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Crohn's Disease Presenting as a Life-Threatening Retropharyngeal Abscess.: MED-9
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emergent colonoscopy, which revealed a blood-filled colon and deep punched-out ulcers throughout the proximal ascending colon with evidence of recent bleeding. The
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12/31/1969 03:59 PM
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Current Controversies in Pouch Surgery
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Restorative proctocolectomy with ileal pouch anal anastomosis has become the most commonly used procedure for elective treatment of patients with mucosal ulcerative colitis and familial adenomatous polyposis. Since its original description, the procedure has been modified in an attempt to obtain optimal functional results with low morbidity and mortality, and yet provide a cure for the disease. These modifications of the technique are discussed in this review, limited to the current points of controversy. We reviewed the current literature describing restorative proctocolectomy with ileal pouch anal anastomosis. The current "hot topics" for debate are transanal mucosectomy with hand-sewn anastomosis versus the double-stapled technique, the use of diverting ileostomy, indeterminate colitis, the role of laparoscopy, and indications for pouch surgery in the elderly. Longer follow-up of patients and increased knowledge and experience with pouch surgery, coupled with active prospective evaluation of the procedure are required to settle these issues. Patients must be fully informed to understand inherent risks of each choice.
(C) 2003 Southern Medical Association
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12/31/1969 03:59 PM
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Synchronous Occurrence of Colorectal Adenocarcinoma and Colonic Gastrointestinal Stromal Tumor
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of a woman with a GIST of the sigmoid colon and synchronous invasive adenocarcinoma at the ileocecal with a recently diagnosed GIST located in the colon was admitted to our department in February 2007
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12/31/1969 03:59 PM
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Subcutaneous Emphysema, Muscular Necrosis, and Necrotizing Fasciitis: An Unusual Presentation of Perforated Sigmoid Diverticulitis
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With advancing age and the affluent, low-fiber Western diet, the incidence of diverticular disease is increasing. Fortunately, most cases can be managed conservatively without resorting to surgical intervention. Life-threatening complications such as perforation, especially when it is associated with gross fecal contamination, requires urgent aggressive surgical intervention. A 75-year-old man with absolute constipation and pain in the left iliac fossa underwent urgent laparotomy following fluid and antibiotic resuscitation. A posterior perforated sigmoid diverticulitis associated with myofascial necrosis and generalized pelvic emphysema was identified. In cases where perforation occurs posteriorly and the only external manifestation is surgical emphysema, the outcome is generally favorable.
(C) 2010 Southern Medical Association
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