ABSTRACT
The operative results and complications after stoma closure in 548 patients operated on between 1972 and 1993 are described in this retrospective study. The patients were divided into three groups (group I,n = 74, 1972-1976; group II,n = 256, 1977-1985; group III,n = 218, 1986-1993) according to the year of operation and changing concepts in colorectal surgery. The overall mortality rate was 2.0%. The morbidity rate including minor complications was significantly reduced from 70.3% in group I to 27.1% in group III. Postoperative wound infections and fever were the most common complications. The location of the stoma and the operative technique did not markedly influence the morbidity rate. The most striking decrease in complications was achieved by the combined usage of orthograde lavage and perioperative antibiotic treatment (14.6% wound infections, 6.9% postoperative fever). In conclusion, a standardized perioperative treatment protocol including orthograde lavage and antibiotics is recommended.
Subject(s)
Colostomy , Ileostomy , Postoperative Complications/epidemiology , Antibiotic Prophylaxis , Colostomy/methods , Colostomy/mortality , Fever/epidemiology , Fever/etiology , Humans , Ileostomy/methods , Ileostomy/mortality , Morbidity , Preoperative Care , Surgical Wound Infection/epidemiologyABSTRACT
PURPOSE: This study was designed to investigate the reliability of three-dimensional vectormanometry for differential diagnosis of fecal incontinence. METHODS: Eight-channel, continuous pull-out perfusion manometry was performed on 23 female patients with traumatic (n = 11) or idiopathic (n = 12) incontinence, respectively. RESULTS: At rest, the minimum sector pressure of patients with traumatic incontinence (32 +/- 14 mmHg) was significantly lower than it was in the controls (76 +/- 16 mmHg) and in those with idiopathic incontinence (64 +/- 28 mmHg) (P < 0.001). At maximum squeezing, the minimum sector pressure was 57 +/- 22 mmHg in patients with traumatic incontinence and 79 +/- 33 mmHg in those with idiopathic incontinence, both being significantly lower than in the control group with 152 +/- 27 mmHg (P < 0.001). The asymmetry index of the patients with a sphincter defect was significantly higher, both at rest (23 +/- 13 percent) and squeeze (26 +/- 12 percent), in comparison with the control group (7 +/- 2 percent at rest and 6.2 +/- 1.6 percent at squeeze) and the patients with idiopathic incontinence (10 +/- 5 percent at rest and 8.4 +/- 4 percent at squeeze). CONCLUSION: Three-dimensional vectormanometry identifies localized pressure deficits in the anal canal, thereby differentiating between sectorial and global sphincter insufficiency.
Subject(s)
Anal Canal/physiopathology , Diagnosis, Computer-Assisted , Fecal Incontinence/diagnosis , Fecal Incontinence/physiopathology , Manometry/methods , Adult , Aged , Cross-Sectional Studies , Diagnosis, Differential , Fecal Incontinence/etiology , Female , Humans , Male , Middle Aged , Physical Exertion , Pressure , Reproducibility of Results , Rest , Sex FactorsABSTRACT
The incisive canal cyst is the most common non-odontogenic cyst of the oral cavity. While the cyst has frequently been described, the relationship between the lesion and adjacent periodontal osseous defects has rarely been reported. This paper describes the occurrence and treatment of incisive canal cysts in two patients with severe adult periodontitis on maxillary incisor teeth.
Subject(s)
Alveolar Bone Loss/etiology , Incisor/pathology , Maxillary Diseases/complications , Nonodontogenic Cysts/complications , Periodontal Diseases/etiology , Adult , Female , Humans , Male , Maxillary Diseases/pathology , Middle Aged , Nonodontogenic Cysts/pathology , Periodontal Pocket/etiology , Periodontitis/etiologyABSTRACT
The case of a signet ring cell carcinoma of the colon arising in an adenoma at the site of ureterosigmoidostomy after conversion to an ileal conduit is reported. Urine exposure to the colonic mucosa was present only for a short period before development of an adenoma with subsequent signet ring cell carcinoma transformation more than 15 years later. In the face of recent reports on adenocarcinoma in cases of bladder substitution or augmentation without any possible promoting influence of the fecal stream, the well known risk of neoplasia after sigmoidostomy remains unclear in its etiology.
Subject(s)
Adenocarcinoma, Mucinous/pathology , Colonic Neoplasms/pathology , Colonic Polyps/pathology , Neoplasms, Multiple Primary , Urinary Diversion/adverse effects , Adenocarcinoma, Mucinous/etiology , Adult , Colon, Sigmoid/surgery , Colonic Neoplasms/etiology , Colonic Polyps/etiology , Humans , Ileum/surgery , Male , ReoperationABSTRACT
Treatment for median knee-joint instability with a case history long time back may occasionally be time-consuming and dissatisfactory to patient and doctor. Several synthetic materials and autologous grafts are used in surgical therapy. Some of the methods are described in this paper. In one of them use of autologous tissue is combined with its "dynamisation".
