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Bladder and Sexual Dysfunction Following Laparoscopic and Open Mesorectal Excision for Rectal Cancer
Get PDFThe objective of this review is to analyze the bladder and sexual dysfunction after laparoscopic (LTME) and open total mesorectal excision (OTME) for rectal cancer. Electronic databases were searched to find relevant randomized controlled trials and their data were analyzed to generate a summative outcome. Three studies on LTME and OTME encompassing 258 patients were retrieved from the electronic databases. Two studies on 108 patients qualified for this review. There were 53 and 55 patients in LTME and OTME groups respectively. In the both fixed and random effects models, statistically there was no difference in bladder dysfunction, overall sexual dysfunction, overall male sexual dysfunction, overall female sexual dysfunction, male erectile dysfunction and male ejaculatory dysfunction between LTME and OTME. Both LTME and OTME are associated with equal risk of bladder and sexual dysfunction in both genders following resections for rectal cancer
Novel Use of the Heald Anal Stent after Transanal Endoscopic Microsurgery
Get PDFDistension of the rectum following transanal endoscopic microsurgery (TEMS) increases rectal intra-luminal pressure and may promote pelvic sepsis by contaminating the rectal defect [...
Surgical Perspective of Aneurysmal Bone Cyst of the Rib
Get PDFA retrospective study of aneurysmal bone cyst (ABCs) of the rib was conducted to review their clinical, radiological and pathological features, as well as the early and long-term results of surgical management. From 2000 through 2010, 5 patients (3 male, 2 female, aged 17–40 years) with ABCs of the rib were treated in our department. All patients with aneurysmal bone cyst (ABCs) of the rib diagnosed radiologically and confirmed histologically. Surgical treatment consisted of wide resection in all patients with the use of synthetic mesh in two cases. There was no perioperative mortality. Follow-up at 1–10 years revealed no local recurrence. All aneurysmal bone cysts (ABCs) of the rib should be treated by wide resection with tumor-free margins in order to provide the best chance for cure
Safer Technique for Passing Abdominal Trochar
Get PDFMany closed surgical drainage systems are delivered through the abdominal wall with a trochar [...
Surgery for Lung Herniation: A New Approach for an Old Problem
Get PDFLung herniation is frequently related to previous chest surgery or thoracic trauma. It can be symptomatic. Surgery with new titanium rib prosthesis is an interesting device to repair the chest wall in order to obtain better cosmetic and physiological results
Novel Use of Prolene Suture for Duct Delineation during Microductectomy
Get PDFClassically, microductectomy is performed using a probe inserted via the offending duct to delineate and identify the responsible duct [...
Recurrent Lower Gastrointestinal Bleeding Due to Angiodysplasia in the Rectum: Endoscopic Treatment with Heater Probe
Get PDFLower gastrointestinal bleeding due to vascular abnormalities is commonly found in the elderly and on the right side of the colon. Such lesions are still difficult to diagnose and manage. We report a case with recurrent and massive lower gastrointestinal bleeding due to angiodysplasia at an unusual age and localization, which was diagnosed and treated endoscopically
Mid-Term Outcomes of Endovascular Treatment for Symptomatic Chronic Mesenteric Ischemia
Get PDFThe authors would present the mid-term outcomes with the use of stent-supported angioplasty in the treatment of symptomatic chronic mesenteric ischemia (CMI). The present study is a retrospective analysis of 36 patients undergoing endovascular treatment of symptomatic CMI, between November 2000 and September 2009. Primary study endpoints were defined as primary patency, periprocedural and midterm mortality and complications, and symptom improvement after intervention. Forty-one mesenteric arteries (77.3% stenotic and 22.7% occluded vessels) were treated in 36 patients with 42 stents. In 30 patients (83.3%) one visceral artery and in 6 cases (16.7%) two visceral arteries were treated. Overall mortality was 16.7% (n = 6) after a 60-month follow-up (mean follow-up period 30.1 months). Two early (<30-day) deaths were caused by visceral ischemia (n = 2: 5.5%). Late death was procedure-related in one patient with re-occlusion of the superior mesenteric artery after 12 months. The other 3 patients died from non procedure-related causes; e.g., twice myocardial infarction. Initial symptom relief was observed in 29 patients (80.5%); 7 patients reported no change. Primary patency was 83.3% after 5 years and secondary patency was 90.5% (38 out of 42 stents) among all patients. Two conversions to open surgery were documented. First-line endovascular approach of CMI is a reasonable strategy. Close follow-up is mandatory due to symptom recurrence and restenosis
Topical Application of Ankaferd Blood Stopper® Modifies the Healing of Colon Snastomosis in Rats
Get PDFAnkaferd Blood Stopper® (ABS) offered as a hemostatic agent is a standardized herbal extract obtained from five different plants. The effects of ABS on colonic anastomosis are unknown. This study was designed to assess potential effects on the anastomosis of left colon in an experimental animal model. Thirtytwo male Wistar albino rats were randomized into two groups and subjected to colon anastomosis. The study group subjected to colon anastomosis with topical application of ABS to control of mucosal bleeding at the cut ends of the colon, and the control group subjected to colon anastomosis only. The rats were killed 3 and 7 days postoperatively. Four types of assessment were performed: bursting pressure, bursting wall tension, histopathology, and biochemical analysis. Compared to the control group, ABS used rats displayed a higher bursting pressure (p < 0.05) and anastomotic hydroxyproline content (p < 0.05). The use of ABS leads to a significant decrease in malondealdehyde levels (p < 0.05) and increase in paraoxonase activity (p < 0.05) at both time points. Histopathological analysis revealed that the use of ABS improves anastomotic healing in terms of reepithelialization, increased neovascularization, diminished ischemic necrosis, and inflammatory infiltration to muscle layer. Topical application of ABS to control of mucosal bleeding at the cut ends of the colon significantly improve the anastomotic wound healing by means of increasing mechanical strength and amount of tissue HPL level
Endoscopic Resection of Nasopharyngeal Angiofibroma: The Role of Radio-Frequency Coblation
Get PDFNasopharyngeal angiofibromas are histologically benign but locally aggressive vascular tumors that can result in major morbidity and mortality. They exclusively affect adolescent male and are rare in patients older than 25 years. The management of nasopharyngeal angiofibroma is primarily surgical. Most small and medium sized tumors are resected endoscopically with a microdebrider. Our presentation demonstrates the role of radio-frequency coblation in the endoscopic management of angiofibroma that is confined to the nasal cavity, nasopharynx and paranasal sinuses. Through a brief video presentation, viewers will be able to appreciate the role of this instrument. We reviewed the case of an adult male patient who presented to our institute with nasopharyngeal angiofibroma. He underwent pre-operative embolization followed by endoscopic coblation of the tumor. A video demonstration is presented of a patient with nasopharyngeal angiofibroma who underwent successful transnasal endoscopic coblation. The coblator was used to resect the tumour attachment at the posterior end of the middle turbinate and the nasopharynx. The tumor was resected en-bloc and pushed into the oropharynx and eventually removed trans-orally. The natural ostium of the sphenoid sinus was enlarged and the residual tumor was removed. Absorbable nasal packing was inserted for haemostasis. Intra-operative bleeding was negligible. Radio-frequency coblation has a definite role in the endoscopic resection of small and medium sized nasopharyngeal angiofibroma. This technique is easy to learn and is extremely efficient. Tumors can be removed with minimal or no damage to surrounding tissues and intra-operative bleeding is negligible