Continued Care in Palliative Bowel Surgery: An Invited Brief Commentary on “Long-Term Functional Outcome After Internal Delorme's Procedure for Obstructed Defecation Syndrome and the Role of Post-Operative Rehabilitation”

Background/Aim. Relatively few studies have investigated the association of prestroke glycemic control and clinical outcome in acute ischemic stroke (IS) patients, regardless of presence of diabetes mellitus (DM). The aim of this study was to investigate the importance of prestroke glycemic control on survival, stroke severity, and functional outcome of patients with acute IS.Methods. We performed a retrospective survival analysis of 501 patients with IS admitted to Sahlgrenska University Hospital from February 15, 2005, through May 31, 2009. The outcomes of interest were acute and long-term survival; the stroke severity (NIHSS) and the functional outcome, mRS, at 12 months.Results. HbA1c was a good predictor of acute (HR 1.45; CI, 1.09 to 1.93,P=0.011) and long-term mortality (HR 1.29; CI 1.03 to 1.62;P=0.029). Furthermore, HbA1c >6% was significantly correlated with acute stroke severity (OR 1.29; CI 1.01 to 1.67;P=0.042) and predicted worse functional outcome at 12 months (OR 2.68; CI 1.14 to 6.03;P=0.024).Conclusions. Our study suggests that poor glycemic control (baseline HbA1c) prior to IS is an independent risk factor for poor survival and a marker for increased stroke severity and unfavorable long-term functional outcome.

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Role of MR Defecography in the Assessment of Obstructed Defecation Syndrome

The Medical Journal of Cairo University ◽

10.21608/mjcu.2018.55586 ◽

2018 ◽

Vol 86 (3) ◽

pp. 927-931 ◽

Cited By ~ 1

Author(s):

MOHAMED F. OSMAN, M.D.; AHMED F. AHMED, M.D.

Keyword(s):

Obstructed Defecation ◽

Mr Defecography ◽

Obstructed Defecation Syndrome

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The potential role of pain-related SSEPs in the early prognostication of long-term functional outcome in post-anoxic coma

European Journal of Physical and Rehabilitation Medicine ◽

10.23736/s1973-9087.17.04303-9 ◽

2017 ◽

Vol 53 (6) ◽

Author(s):

Alessandra Del Felice ◽

Stefano Bargellesi ◽

Federico Linassi ◽

Bruno Scarpa ◽

Emanuela Formaggio ◽

...

Keyword(s):

Functional Outcome ◽

Potential Role ◽

Anoxic Coma

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Delorme’s Procedure for Complete Rectal Prolapse: A Study of Recurrence Patterns in the Long Term

Surgery Research and Practice ◽

10.1155/2015/920154 ◽

2015 ◽

Vol 2015 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Carlos Placer ◽

Jose M. Enriquez-Navascués ◽

Ander Timoteo ◽

Garazi Elorza ◽

Nerea Borda ◽

...

Keyword(s):

Risk Factors ◽

Rectal Prolapse ◽

Recurrence Rate ◽

Complete Rectal Prolapse ◽

Kaplan Meier ◽

Delorme’S Procedure ◽

Recurrence Patterns ◽

Delorme's Procedure

Introduction. The objective of this study was to determine the recurrence rate and associated risk factors of full-thickness rectal prolapse in the long term after Delorme’s procedure.Patients and Methods. The study involved adult patients with rectal prolapse treated with Delorme’s surgery between 2000 and 2012 and followed up prospectively in an outpatient unit. We assessed epidemiological data, Wexner constipation and incontinence score, recurrence patterns, and risk factors. Data were analyzed by univariate and multivariate studies and follow-up was performed according to Kaplan-Meier technique. The primary outcome was recurrence.Results. A total of 42 patients, where 71.4% (n=30) were women, with a median age of 76 years (IQR 66 to 86), underwent Delorme’s surgery. The median follow-up was 85 months (IQR 28 to 132). There was no mortality, and morbidity was 9.5%. Recurrence occurred in five patients (12%) within 14 months after surgery. Actuarial recurrence at five years was 9.9%. According to the univariate analysis, constipation and concomitant pelvic floor repair were the only factors found to be associated with recurrence. Multivariate analysis showed no statistically significant differences among variables studied. Kaplan-Meier estimate revealed that constipation was associated with a higher risk of recurrence (log-rank test,p=0.006).Conclusions. Delorme’s procedure is a safe technique with an actuarial recurrence at five years of 9.9%. The outcomes obtained in this study support the performance of concomitant postanal repair and levatorplasty to reduce recurrences. Also, severe constipation is associated with a higher recurrence rate.

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