Entero-neovesical fistula after radical cystectomy and orthotopic ileal neobladder: A report of two cases requiring surgical management

Introduction: Entero-neovesical fistula is a rare complication after radical cystectomy and orthotopic ileal bladder substitution. Typical presenting symptoms are faecaluria, pneumaturia, recurrent urinary tract infections and abdominal pain. Risk factors include history of pelvic radiation, chemotherapy and abdominal surgery, as well as diverticular colonic disease, inflammatory bowel disease and traumatic pelvic injury. The paucity of cases reported in the literature makes the management of this threatening complication very challenging. Conservative treatment has only anecdotally been reported. Case description: We describe two cases of entero-neovesical fistula with different presentation, which both required an immediate surgical treatment. The former patient was admitted to the emergency room with faecaluria, complete urinary incontinence and fever 2 years after radical cystectomy, and a fistula between the Y-shaped neobladder and the bowel anastomosis was detected. He had previously undergone chemotherapy because of tumour progression. Undiversion into an ileal conduit was required. The latter patient presented with faecaluria 20 days after an uneventful radical cystectomy, and a fistula between the Vescica Ileale Padovana neobladder and the sigmoid was documented. Treatment included resection of the sigmoid with several small diverticula, temporary ileostomy and closure of the neobladder fistula. Conclusion: Conservative treatment of entero-neovesical fistula can be attempted only in patients with small openings in the small bowel and no systemic symptoms. In all other cases, surgical treatment with bowel resection and either closure of the neobladder opening or undiversion should be the preferred option.

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Perineal herniation of an ileal neobladder following radical cystectomy and consecutive rectal resection for recurrent bladder carcinoma

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2016.0102 ◽

2016 ◽

Vol 98 (04) ◽

pp. e62-e64

Author(s):

PA Neumann ◽

AS Mehdorn ◽

G Puehse ◽

N Senninger ◽

E Rijcken

Keyword(s):

Pelvic Floor ◽

Radical Cystectomy ◽

Rectal Resection ◽

Rare Complication ◽

Synthetic Mesh ◽

Perineal Hernia ◽

Ileal Neobladder ◽

Hernia Formation ◽

Perineal Herniation ◽

One Year

Secondary perineal herniation of intraperitoneal contents represents a rare complication following procedures such as abdominoperineal rectal resection or cystectomy. We present a case of a perineal hernia formation with prolapse of an ileum neobladder following radical cystectomy and rectal resection for recurrent bladder cancer. Following consecutive resections in the anterior and posterior compartment of the lesser pelvis, the patient developed problems emptying his neobladder. Clinical examination and computed tomography revealed perineal herniation of his neobladder through the pelvic floor. Through a perineal approach, the hernial sac could be repositioned, and via a combination of absorbable and non-absorbable synthetic mesh grafts, the pelvic floor was stabilised. Follow-up review at one year after hernia fixation showed no signs of recurrence and no symptoms.In cases of extensive surgery in the lesser pelvis with associated weakness of the pelvic compartments, meshes should be considered for closure of the pelvic floor. Development of biological meshes with reduced risk of infection might be an interesting treatment option in these cases.

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Chemical Ablation in Adenoid Surgery

Revista de Chimie ◽

10.37358/rc.18.10.6610 ◽

2018 ◽

Vol 69 (10) ◽

pp. 2722-2724

Author(s):

Teodora Ioana Ghindea ◽

Alexandru Dumitras Meius ◽

Dragos Cristian Stefanescu ◽

Catalina Pietrosanu ◽

Irina Ionita ◽

...

Keyword(s):

Surgical Treatment ◽

Conservative Treatment ◽

Chronic Inflammation ◽

Lymphatic Tissue ◽

Tissue Mass ◽

Surgical Method ◽

Endoscopic Control ◽

Chemical Ablation ◽

Pharyngeal Tonsil

The pharyngeal tonsil is a lymphatic tissue mass located in the roof of the nasopharynx. The function of the pharyngeal tonsil is to prevent infections with the help of antibodies. Chronic inflammation and allergies lead to hyperplasia of the adenoids that is found almost exclusively in children. The treatment of choice is surgical treatment; conservative treatment is only indicated preoperatively or if surgery is contraindicated. In this paper, we will present a new surgical method for adenoidectomy performed trans-orally with coblation, under endoscopic control.

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Efficacy and safety of condylectomy with minimally invasive surgery in the treatment of interdigital corns of the lesser toes compared to conservative treatment

Journal of Foot and Ankle Research ◽

10.1186/s13047-021-00460-0 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Luis M. Marti-Martinez ◽

Rubén Lorca-Gutierrez ◽

Salvador Pedro Sánchez-Pérez ◽

Jonatan Garcia-Campos ◽

Nadia Fernández Ehrling ◽

...

Keyword(s):

Minimally Invasive Surgery ◽

Surgical Treatment ◽

Treatment Group ◽

Conservative Treatment ◽

Minimally Invasive ◽

Functional Status ◽

Invasive Surgery ◽

Joint Stiffness ◽

Efficacy And Safety ◽

Clinical And Functional Status

Abstract Background Minimally invasive surgery (MIS) procedures cause less trauma to the patient and might improve recovery. This study aimed to determine the efficacy and safety of condylectomy with MIS to treat interdigital corns of the lesser toes. Methods This prospective cohort study was conducted in seven podiatry centers. Patients with interdigital corns of the lesser toes, progressing for more than a year, with one or more recurrences in the last year following conservative treatments were eligible. The recruited patients were classified according to their treatment: conservative or surgical (condylectomy with MIS) and were compared. Patient satisfaction, pain, the clinical and functional status of the foot and the appearance of sequelae were assessed at 3 and 6 months after treatment. Results At 6 months, patients in the surgical treatment group showed no pain on pressure, which significantly differed from the conservative treatment group (p < 0.001). They also improved clinical and functional status of the foot, reaching values comparable to those of the standard population. No paresthesia, joint stiffness or instability, toe malalignment, or corn transfer to a contiguous site resulted from the surgical treatment. Conclusions Condylectomy with MIS is effective and safe to treat interdigital corns of the lesser toes.

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Effect of childhood overweight on distal metaphyseal radius fractures treated by closed reduction

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02336-2 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Yu Liu ◽

Chunjie Liu ◽

Dongmei Guo ◽

Ning Wang ◽

Ying Zhao ◽

...

Keyword(s):

Risk Factors ◽

Surgical Treatment ◽

Conservative Treatment ◽

Closed Reduction ◽

Pediatric Population ◽

Normal Weight ◽

Medical Community ◽

Overweight Children ◽

Radius Fractures

Abstract Background The medical community has recognized overweight as an epidemic negatively affecting a large proportion of the pediatric population, but few studies have been performed to investigate the relationship between overweight and failure of conservative treatment for distal radius fractures (DRFs). This study was performed to investigate the effect of overweight on the outcome of conservative treatment for DRFs in children. Methods We performed a retrospective study of children with closed displaced distal metaphyseal radius fractures in our hospital from January 2015 to May 2020. Closed reduction was initially performed; if closed reduction failed, surgical treatment was performed. Patients were followed up regularly after treatment, and redisplacement was diagnosed on the basis of imaging findings. Potential risk factors for redisplacement were collected and analyzed. Results In total, 142 children were included in this study. The final reduction procedure failed in 21 patients, all of whom finally underwent surgical treatment. The incidences of failed final reduction and fair reduction were significantly higher in the overweight/obesity group than in the normal-weight group (P = 0.046 and P = 0.041, respectively). During follow-up, 32 (26.4%) patients developed redisplacement after closed reduction and cast immobilization. The three risk factors associated with the incidence of redisplacement were overweight/obesity [odds ratio (OR), 2.149; 95% confidence interval (CI), 1.320–3.498], an associated ulnar fracture (OR, 2.127; 95% CI, 1.169–3.870), and a three-point index of ≥ 0.40 (OR, 3.272; 95% CI, 1.975–5.421). Conclusions Overweight increases the risk of reduction failure and decreases the reduction effect. Overweight children were two times more likely to develop redisplacement than normal-weight children in the present study. Thus, overweight children may benefit from stricter clinical follow-up and perhaps a lower threshold for surgical intervention.

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MP-14.14: Surgical treatment for urethral recurrence of bladder cancer after ileal neobladder reconstruction

Urology ◽

10.1016/j.urology.2007.06.455 ◽

2007 ◽

Vol 70 (3) ◽

pp. 115

Author(s):

K. Yoshida ◽

H. Kinoshita ◽

T. Matsuda

Keyword(s):

Bladder Cancer ◽

Surgical Treatment ◽

Ileal Neobladder ◽

Urethral Recurrence

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782 A Rare Complication in A Post-Operative Bariatric Patient: COVID-19 Induced Mesenteric Venous Thrombosis

British Journal of Surgery ◽

10.1093/bjs/znab134.325 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

J Winstanley ◽

M Goodfellow

Keyword(s):

Gastric Bypass ◽

Abdominal Pain ◽

Ct Scan ◽

Acute Abdominal Pain ◽

Myeloproliferative Neoplasms ◽

Rare Complication ◽

Nasopharyngeal Swab ◽

Thrombotic Complications ◽

Tract Infections ◽

Mesenteric Thrombosis

Abstract Introduction The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has provided enormous challenges in the delivery of surgical care. In addition to respiratory tract infections, coronavirus disease 2019 (COVID-19) is associated with both arterial and venous thrombotic complications. Case Details: We present a case of acute superior mesenteric venous (SMV) thrombosis in a 36-year-old female patient who underwent Roux-en-Y gastric bypass three years previously. Her presentation with acute abdominal pain occurred 6 days after a positive nasopharyngeal swab. An admission CT scan demonstrated an abrupt cut off in the proximal SMV with resultant small bowel oedema. Subsequent thrombophilia screening and mutation testing for myeloproliferative neoplasms were all negative. She had also previously carried three pregnancies to term without any thrombotic complications. Hence, the high suspicion of acute COVID-19 induced mesenteric thrombosis. Conclusions In patients who have previously undergone Rouy-en-Y gastric bypass and lost significant weight, acute abdominal pain normally raises a high suspicion of internal hernia. However, as the pandemic progresses surgeons need to be mindful of COVID-19 induced mesenteric thrombosis as a differential diagnosis during the workup of acute abdominal pain. This was well demonstrated on a CT scan with intravenous contrast.

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Surgical treatment of acute abscesses and gangrene of the lungs

Kazan medical journal ◽

10.17816/kazmj59786 ◽

1982 ◽

Vol 63 (1) ◽

pp. 28-31

Author(s):

E. A. Wagner ◽

V. M. Subbotin ◽

V. D. Firsov ◽

V. A. Cherkasov ◽

V. I. Ilchishin ◽

...

Keyword(s):

Surgical Treatment ◽

Conservative Treatment ◽

Surgical Interventions

Abstract. The experience of treating 263 patients with acute abscesses and lung gangrene is generalized. Acute abscesses are mainly subject to conservative treatment; surgical interventions were performed in 13%. With gangrene of the lung, conservative treatment and palliative operations are futile. Preference is given to early radical operations performed before dangerous complications occur. Possible ways to reduce mortality in acute pulmonary suppuration are indicated.

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Features of surgical treatment of Brown's syndrome in children

Russian ophthalmology of children ◽

10.25276/2307-6658-2021-1-11-16 ◽

2021 ◽

pp. 11-16

Author(s):

N.A. Malinovskaya ◽

◽

E.V. Semyonova ◽

A. Toriya ◽

P.A. Nikonorova ◽

...

Keyword(s):

Surgical Treatment ◽

Conservative Treatment ◽

Binocular Vision ◽

Rectus Muscle ◽

Oblique Muscle ◽

Double Vision ◽

Inferior Rectus ◽

Inferior Oblique Muscle ◽

Straight Position ◽

Third Stage

Purpose. To study the features of surgical treatment of Brown's syndrome in children. Material and methods. 47 children with Brown's syndrome aged from one to 10 years were treated: 4 children had bilateral form, 43 had congenital form and 4 had acquired form. The operation was performed for 44 children. The indications for surgical treatment were double vision in a straight position, forced position of the head, impaired binocular vision. Results. Three children with acquired Brown's syndrome had a positive effect on the background of conservative treatment. Surgical treatment of Brown's syndrome was effective, but often required repeated interventions (31 patients, 70%): the first stage was weakening of the superior oblique muscle (tenotomy, recession, prolongation), the second stage was recession of the inferior oblique muscle, the third stage was recession of the contralateral inferior rectus muscles (4 patients, 9%). In a number of cases (5 children, 11%), at the outcome of surgical treatment, asymmetry of the palpebral fissures was noted due to mild enophthalmos in the operated eye (the result of weakening of the oblique muscles that «pull» the eyes out of the orbit and weakening of the contralateral inferior rectus muscle that «tightens» the eyeball). Conclusion. Surgery for Brown's syndrome is effective, but often requires reoperation. With acquired forms of Brown's syndrome, examination and the first stage of conservative treatment are required. The absolute indications for surgical treatment of Brown's syndrome are forced head position, double vision in a straight position and impaired binocular vision. Keywords: Brown's syndrome, double vision in a straight position, forced position of the head, impaired binocular vision, surgical treatment.

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