1,720,998 research outputs found
Appendicitis
No full textINTRODUCTION: Appendicitis is an inflammation of the appendix that may lead to an abscess, ileus, peritonitis, or death if untreated. Appendicitis is the most common abdominal surgical emergency. The current standard treatment of uncomplicated appendicitis is usually surgery, but there has been increasing evidence published on the use of antibiotics.METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical question: What are the effects of surgery compared with antibiotics for acute appendicitis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2014 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).RESULTS: We found four studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of surgery (including laparoscopic and open appendicectomy) compared with antibiotics.</p
Pathophysiology and nonsurgical treatment of anal incontinence
No full textFaecal incontinence has been previously defined as ‘the involuntary or inappropriate passage of faeces’. This definition, however, is considered to be incomplete as it does not include incontinence to flatus. Therefore many adopt the term anal incontinence to include flatus. The current recommended definition of anal incontinence is the involuntary loss of flatus, liquid or solid stool that is a social or hygienic problem
Rectocele pathophysiology and presentation
No full textA rectocele is defined as the herniation or bulging of the posterior vaginal wall. The posterior vaginal wall and the anterior rectal wall are in direct apposition, and this bulging may be thought of as the rectum pushing anteriorly into the vagina.</p
Anal cancer. Position statement of the Association of Coloproctology of Great Britain and Ireland introduction
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Open resection for colorectal cancer
No full textIn the UK open colorectal surgery is becoming less frequent in many centres where laparoscopic colorectal resection is being offered to most patients. However, the principles governing surgery for colorectal cancers remain the same in both modalities of treatment. The purpose of this article is to give the reader an overview of the types of operation used and the factors that are considered in approaching open colorectal cancer resections.</p
Results of salvage abdominoperineal resection for anal cancer after radiotherapy
No full textPURPOSE: Nonsurgical treatment of anal cancer by radiotherapy alone or combined with chemotherapy is the standard therapy for epidermoid carcinoma of the anal canal Surgery is only recommended for treatment failures. Very few studies have been devoted to the outcome of this salvage surgery The aim of this study is to evaluate these results METHODS: A retrospective review from 1986 to 1995 revealed 21 patients with residual or recurrent anal canal carcinoma after initial radiotherapy, operated on by abdominoperineal resection. Patients were reviewed as to age, gender, initial treatment, any symptoms of recurrence, duration until recurrence, any diagnosis imaging, treatment, and outcome. RESULTS: None of these 21 patients had known lymph node involvement or metastases at radiotherapy or at salvage abdominoperineal resection Eleven patients had residual disease (positive biopsy less than 6 months after the end of radiotherapy) and 10 had tumor recurrence (more than 6 months after cessation of treatment) Recurrence occurred at a mean of 15 (range, 9-41) months after radiotherapy. All 21 patients underwent an abdominoperineal resection. Pathologic examination of the 21 specimens showed complete excision in all cases except one and lymph node metastases in two cases. There was no perioperative mortality. The mean follow-up after surgery was 40 months, no patients were lost to follow-up Of the 21 patients, 10 died and 11 lived, of whom 9 are disease free. The overall survival rate at three years after salvage abdominoperineal resection was 58 percent The overall survival rate for patients with residual disease (vs. recurrence) at three years was 72 percent (vs. 29 percent) and at five years was 60 percent (vs 0 percent, P = 0.06) CONCLUSIONS: Salvage abdominoperineal resection for anal cancer can be expected to yield a number of survivors from residual disease, but the low rate of survival after abdominoperineal resection for recurrent disease suggests the need for additional postoperative treatment if salvage abdominoperineal resection is performed.</p
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