RESUMEN
To describe the management of sigmoid volvulus with reference to the type of surgical procedures performed and to determine the prognosis of sigmoid volvulus. A case series. Ghaem Hospital of Mashhad, University of Medical Sciences, Mashhad, Iran, from 1996 to 2008. A total of 944 cases of colon obstruction were reviewed. Demographic, laboratory and treatment results, mortality and complications were recorded. The data was analyzed using descriptive statistics as frequency and percentage for the qualitative variables and mean and standard deviation values for the quantitative variables. Also chisquare and Fisher's exact test were used for the association between the qualitative variables. SPSS statistical software [version 18] was used for the data analysis. In all patients except those with symptoms or signs of gangrenous bowel, a long rectal tube was inserted via the rectosigmoidoscope which was successful in 80 [36.87%] cases. Rectosigmoidoscopic detorsion was unsuccessful in 137 [63.13%] patients, who underwent an emergent laparotomy. The surgical procedures performed in these cases were resection and primary anastomosis in 40 [29.1%], Mikulicz procedure in 9 [6.6%], laparotomy detorsion in 37 [27.01%], Hartmann procedure in 47 [34.3%], mesosigmoidoplasty in 3 [2.19%] patients and total colectomy in one [0.73%] case. The overall mortality was 9.8% [22] patients. In sigmoid volvulus, the most important determinant of patient outcome is bowel viability. The initial treatment of sigmoid colon volvulus is sigmoidoscopy with rectal tube placement
RESUMEN
Long term vascular access has become more important as patients live longer on dialysis. Improved survival on hemodialysis has resulted in an increasing number of patients with failed vascular access, so an increasing number of options for vascular access have to be added to the surgeon's armamentarium. In a number of patients, basilic vein transposition is an often overlooked means of arteriovenous access that has a superior patency compared with bridge fistulas using polytetrafluoroethylene [PTFE]. And this brought vascular surgeons of Imam-Reza hospital to use this technique in patients with complications in normal fistulas. This article evaluates the survival rate of these fistulas and compares them with patency rates reported worldwide. This study was conducted on, 25 End Stage Renal Disease [ESRD] patients, undergone superficial basilic vein transposition from 2002 till 2005. In these patients, superficial basilic vein transposition method was performed for an arteriovenous fistula [AVF]. Demographic data were collected using medical records, and then patients were examined clinically. Patency rate was evaluated using life tables by SPSS version 13 and compared with similar results reported worldwide. Overall 70.8% were male patients and 29.2% were female. Hypertension was seen in 87.5% of cases and 37.5% suffered from diabetes. Seventy four percent of our cases underwent basilic vein transposition after a failing AVF, one case after a rejected transplant and one after a failed graft. The longest patency rate was 30 months and the shortest was 4 months. The patency rate for the first 6 months was 86% and after one year 77% and after 26 months 58%. The one year patency rate reported for fistulas by basilica vein transposition method is 90-60% which justifies the results of this article [62.5%]. these results suggest that this method can be used as a new access line for dialyzing ESRD patients before using graft fistulas