scholarly journals The Impact of Rectal Stump Inflammation After Subtotal Colectomy on Pouch Outcomes in Ulcerative Colitis Patients

2020 ◽  
Author(s):  
Karin A Wasmann ◽  
Eline M van der Does de Willebois ◽  
Lianne Koens ◽  
Marjolijn Duijvestein ◽  
Willem A Bemelman ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Subtotal Colectomy ◽  
Rectal Stump ◽  
Distal Margin ◽  
Diversion Colitis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Active Inflammation ◽  
The Impact ◽  
Pouch Surgery

Abstract Background and Aims Proctitis after subtotal colectomy with ileostomy for ulcerative colitis [UC] is common, but its impact on short- and long-term outcome after pouch surgery is unknown. The aim of this study was to determine the incidence of proctitis after subtotal colectomy and its impact on postoperative morbidity and pouchitis. Methods The distal margin of the rectal stump of all consecutive patients undergoing completion proctectomy and pouch procedure for UC, between 1999 and 2017, was revised and scored for active inflammation according to the validated Geboes score, and for diversion proctitis. Pathological findings were correlated to complications after pouch surgery and pouchitis [including therapy-refractory] using multivariate analyses. Results Out of 204 included patients, 167 [82%] had active inflammation in the rectal stump and diversion colitis was found in 170 specimens [83%]. Overall postoperative complications and anastomotic leakage rates were not significantly different between patients with and without active inflammation in the rectal stump [34.7% vs 32.4%, p = 0.79, and 10.2% vs 5.4%, p = 0.54, respectively]. Active inflammation of the rectal stump was significantly associated with the development of pouchitis [54.3% vs 25.5%, plog = 0.02], as well as with therapy refractory pouchitis [14% vs 0%, plog = 0.05]. Following multivariate analysis, active inflammation was an independent predictor for the development of pouchitis. Diversion proctitis showed no association with these outcome parameters. Conclusions Active inflammation in the rectal stump after subtotal colectomy occurs in 80% of UC patients and is a predictor for the development of pouchitis and therapy-refractory pouchitis.

Long-term outcome of treatment with cyclosporine IV for patients with intractable ulcerative colitis

2001 ◽  
Vol 120 (5) ◽  
pp. A624-A624 ◽  
Author(s):  
J ARTS ◽  
M ZEEGERS ◽  
G DHAENS ◽  
G VANASSCHE ◽  
M HIELE ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Term Outcome ◽  
Long Term Outcome

Prevalence and Long-Term Outcome of Sub-Clinical Primary Sclerosing Cholangitis in Patients with Ulcerative Colitis

2020 ◽  
Author(s):  
Emma Culver ◽  
Helen K. Bungay ◽  
Margaret Betts ◽  
Colm Forde ◽  
Otto Buchel ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Sclerosing Cholangitis ◽  
Term Outcome ◽  
Long Term Outcome

The management of Hemorrhoidal Disease by Dearterialization and Mucopexy.

2020 ◽  
Vol 15 ◽  
Author(s):  
Veronica De Simone ◽  
Francesco Litta ◽  
Angelo Parello ◽  
Paola Campennì ◽  
Raffaele Orefice ◽  
...  
Keyword(s):  
Postoperative Management ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Doppler Probe ◽  
Minimally Invasive Surgical ◽  
Bowel Movements ◽  
Excessive Strain ◽  
Life Threatening ◽  
Hemorrhoidal Prolapse ◽  
The Impact

: Several minimally invasive surgical procedures have been recently developed to treat hemorrhoids without any excision. About 25 years ago, a non-excisional procedure providing doppler-guided ligation of the hemorrhoidal arteries has been proposed - named “hemorrhoidal dearterialization”. The original technique has been modified over the years, and indications were expanded. In particular, a plication of the redundant and prolapsing mucosa/submucosa of the rectum (named “mucopexy”) has been introduced to treat hemorrhoidal prolapse, without excision of the hemorrhoidal piles. At present, the THD® Doppler procedure is one of the most used techniques to treat hemorrhoids. Aim of this technique is to realize a target dearterialization, using a Doppler probe with the final purpose to reduce the arterial overflow to the hemorrhoidal piles. In case of associated hemorrhoidal prolapse, a mucopexy is performed together with Doppler-guided dearterialization. The entity and circumferential extension of the hemorrhoidal prolapse guides the mucopexy, which can be considered tailored to a single patient; the dearterialization should be considered mandatory. Advantages of this surgical technique are the absence of serious and life-threatening postoperative events, chronic complications, and limited recurrence risks. The impact of the procedure on the anorectal physiology is negligible. However, a careful postoperative management is mandatory to avoid complications and to guarantee an improved long-term outcome. Therefore, regular physiologic bowel movements, excessive strain at the defecation and strong physical activity are advisable.

scholarly journals Long-Term Outcome of Patients with Ulcerative Colitis and Primary Non-response to Infliximab

2016 ◽  
Vol 10 (9) ◽  
pp. 1015-1023 ◽  
Author(s):  
Konstantinos Papamichael ◽  
Oliviane Rivals-Lerebours ◽  
Thomas Billiet ◽  
Niels Vande Casteele ◽  
Ann Gils ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Term Outcome ◽  
Long Term Outcome

Perinatal Care at the Threshold of Viability

PEDIATRICS ◽  
1995 ◽  
Vol 96 (5) ◽  
pp. 974-976
Author(s):  
◽  
◽  
◽  
Keyword(s):  
Perinatal Care ◽  
Survival Rates ◽  
Extremely Low Birth Weight ◽  
Low Birth Weight Infants ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Obstetric Management ◽  
The Cost ◽  
The Impact

The survival rate for infants at the threshold of viability has been improving. However, there are insufficient data regarding the cost(s) of initial and ongoing care of these infants and the long-term outcome of survivors. Furthermore, there has been little study of the impact of obstetric management on the survival rates of extremely low birth weight infants and on long-term morbidities. Continued research on these issues is imperative, and physicians need to remain informed of changing statistics.

scholarly journals Psychological profiles derived by cluster analysis of Minnesota Multiphasic Personality Inventory and long term clinical outcome after coronary artery by pass grafting

2015 ◽  
Vol 78 (1) ◽  
Author(s):  
Maddalena Modica ◽  
Roberta Carabalona ◽  
Rosa Spezzaferri ◽  
Monica Tavanelli ◽  
A. Torri ◽  
...  
Keyword(s):  
Cluster Analysis ◽  
Coronary Artery ◽  
Clinical Characteristics ◽  
Minnesota Multiphasic Personality Inventory ◽  
Personality Inventory ◽  
Psychological Characteristics ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Impact

Background: To evaluate the psychological characteristics of coronary heart disease (CHD) patients after coronary artery bypass grafting (CABG) by cluster analysis of Minnesota Multiphasic Personality Inventory (MMPI-2) questionnaires and to assess the impact of the profiles obtained on long-term outcome. Methods: 229 CHD patients admitted to cardiac rehabilitation filled in self-administered MMPI-2 questionnaires early after CABG. We assessed the relation between MMPI- 2 profiles derived by cluster analysis, clinical characteristics and outcome at 3-year follow-up. Results: Among the 215 patients (76% men, median age 66 years) with valid criteria in control scales, we identified 3 clusters (G) with homogenous psychological characteristics: G1 patients (N=75) presented somatoform complaints but overall minimal psychological distress. G2 patients (N=72) presented type D personality traits. G3 subjects (N=68) showed a trend to cynicism, mild increases in anger, social introversion and hostility. Clusters overlapped for clinical characteristics such as smoking (G1 21%, G2 24%, G3 24%, p ns), previous myocardial infarction (G1 43%, G2 47%, G3 49% p ns), LV ejection fraction (G1 60 [51 – 60]; G2 58 [49- 60]; G3 60 [55-60], p ns), 3-vessel-disease prevalence (G1 69%, G2 65%, G3 71%, p ns). Three-year event rates were comparable (G1 15%; G2 18%; G3 15%) and Kaplan- Meier curves overlapped among clusters (p ns). Conclusions: After CABG, the interpretation of MMPI- 2 by cluster analysis is useful for the psychological and personological diagnosis to direct psychological assistance. Conversely, results from cluster analysis of MMPI-2 do not seem helpful to the clinician to predict long term outcome.

scholarly journals The impact of individual extended donor criteria on short- and long-term outcome after liver transplant in the MELD-score era

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S1002
Author(s):  
V.J. Lozanovski ◽  
E. Khajeh ◽  
C.W. Michalski ◽  
H. Fonouni ◽  
R. von Haken ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Meld Score ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Short And Long Term ◽  
Donor Criteria ◽  
The Impact ◽  
Extended Donor Criteria

Fluvastatin reduces the impact of diabetes on long-term outcome after coronary intervention—A Lescol Intervention Prevention Study (LIPS) substudy

2005 ◽  
Vol 149 (2) ◽  
pp. 329-335 ◽  
Author(s):  
Chourmouzios A. Arampatzis ◽  
Dick Goedhart ◽  
Patrick W. Serruys ◽  
Francesco Saia ◽  
Pedro A. Lemos ◽  
...  
Keyword(s):  
Coronary Intervention ◽  
Prevention Study ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Impact
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