ABSTRACT
UNLABELLED: The aim of this study was to describe a single institution's experience with transanal endoscopic microsurgery (TEMS) in patients with benign and malignant rectal tumors. MATERIAL AND METHOD: This was a prospective descriptive survey. Between January 2006 and January 2010, 14 patients underwent transanal endoscopic microsurgery excision of benign (8) or malignant (6) rectal tumors, located 4 to 15 cm from the dentate line. Median age was 59.7 years and the mean follow up was 29 months. RESULTS: The average tumor size was 3.4 cm, median operating time was 40 min. Median length of hospital stay was 4.35 days. During the follow-up period, benign tumor recurrence was observed in one patient (7.14%), managed by repeated TEMS. Histologic staging of malignant tumors was T1 (2) and T2 (4). In two patients with inadequate resection margins open radical surgery was performed. One had recurrent disease, which was managed by radical surgery. No cancer-related deaths were observed during the follow-up period. There was no operative mortality. No major postoperative complications were recorded. Anal incontinence persisted for 3 weeks in one patient. CONCLUSION: Transanal endoscopic microsurgery excision is a safe and precise technique and should become a procedure of choice for benign rectal tumors and selected early malignant neoplasms.
Subject(s)
Anal Canal , Natural Orifice Endoscopic Surgery , Neoplasm Recurrence, Local/surgery , Rectal Neoplasms/surgery , Adult , Aged , Aged, 80 and over , Anus Neoplasms/surgery , Female , Follow-Up Studies , Humans , Length of Stay , Male , Microsurgery , Middle Aged , Natural Orifice Endoscopic Surgery/adverse effects , Natural Orifice Endoscopic Surgery/methods , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Prospective Studies , Rectal Neoplasms/pathology , Time Factors , Treatment OutcomeABSTRACT
UNLABELLED: The aim of the study was to evaluate the improvement in quality of life for patients that have undergone the laparoscopic gastric banding, using the BAROS and Moorehead-Ardelt II questionnaires. METHODS: We selected a 20 patient group (65% women) that underwent this surgical procedure in our clinic. The initial average weight was 123.45kg, and the body-mass index of 42.36. The average age was 29.25 years. The pars flaccida technique was used in 18, and the perigastric approach in 2 cases. RESULTS: No complications or intraoperative accidents occurred. The mean operation time was 115.5 minutes. Elective conversion was needed in one case with a BMI of 55. The average hospital stay was of 3.2 days. The follow-up was conducted at least through phone in 95% of cases, and its average duration was of 10 months. The only postoperative complications were infections of the subcutaneous port (5 cases - 25%) which needed removal of the port, but not of the banding. The average loss of excess weight was 48.23%. Using the BAROS score to determine the overall improvement of quality of life, 30% of the patients scored as "Very Good", 50% as "Good", 20% as "Fair". Using the Moorehead-Ardelt QLQ II score, 65% scored as "Very Good", 30% as "Good" and 5% as "Fair". CONCLUSION: The laparoscopic adjustable gastric banding significantly improves the quality of life for most patients with this procedure.
Subject(s)
Gastroplasty , Laparoscopy , Obesity, Morbid/surgery , Quality of Life , Adult , Body Mass Index , Female , Follow-Up Studies , Humans , Length of Stay , Male , Patient Satisfaction , Patient Selection , Retrospective Studies , Surveys and Questionnaires , Treatment Outcome , Weight LossABSTRACT
BACKGROUND: Ingested foreign bodies present problems due to the related complications, perforation being the most frequent. MATERIAL AND METHOD: This is a descriptive study of two cases of ascending colon perforation by numerous ingested fruit stones. The main symptoms were abdominal pain with tenderness in the lower right quadrant. RESULTS: In both cases the diagnosis was made at operation, with right hemicolectomy and termino-lateral ileo-colic anastomosis. Post-operative outcome was uneventful with the exception of a wound infection. The possible mechanism of the delayed perforation is discussed. Diagnosis and treatment modality alternatives in foreign body ingestion and the literature data are reviewed. CONCLUSIONS: Delayed perforations by ingested fruit stones can be difficult to diagnose preoperatively but if operated in due time are curable by resection of the affected bowel.
