scholarly journals Delorme’s operation for internal rectal prolapse in an outpatient hospital

2016 ◽  
Vol 63 (1) ◽  
pp. 111-116
Author(s):  
Èrt Jamsek ◽  
Sojar Kosorok ◽  
Matic Buniè ◽  
Pavle Kosorok
Keyword(s):  
Rectal Prolapse ◽  
Obstructed Defecation ◽  
Outpatient Setting ◽  
Anaerobic Infection ◽  
Best Interest ◽  
Single Institution ◽  
Internal Rectal Prolapse ◽  
Satisfactory Outcome ◽  
Operation Results

Purpose: Internal rectal prolapse frequently occurs in older, sometimes polymorbid patients. Trans-abdominal operation is therefore not always in the patient?s best interest. The aim of this retrospective study was to demonstrate that the Delorme?s procedure is feasible and safe to be performed in an outpatient setting. Methods: This study is a retrospective review of a single-institution experience. Fifty-one patients (age 64.7 ? 12.5, range 35 to 90 years) with internal rectal prolapse were treated with Delorme?s procedure during 6-year period. Patients were assessed at follow-up 1 and 6 weeks after the surgery and phone interview was performed after 51.4 ? 16.5 months after operation. Results: All 51 patients were operated under spinal anesthesia and observed for approximately 6 hours before discharge. Six patients needed referral to inpatient hospital for safety observation after the procedure. There were no mortalities in our study. One patient developed anaerobic infection and needed a colostomy. Out of 34 presenting with sensation of incomplete evacuation, 28 (82.4%) reported improvement after procedure, 13 out of 15 (86.7%) reported improvement in obstructed defecation symptoms and 4 out of 7 patients (57.1%) reported improvement in incontinence. Average sick leave was 16.0 ? 4.3 days. Seven patients suffered from postoperative stenosis. Recurrence was seen in 5 cases (9.8%). Majority of the patients (73,3%) would recommend this procedure for problems similar to their own. Conclusion: Our study shows that the Delorme?s procedure is feasible in an outpatient setting, with reasonable complications and satisfactory outcome.

scholarly journals Sublobectomy is a safe alternative for localized cavitary pulmonary tuberculosis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yong Yang ◽  
Shaojun Zhang ◽  
Zhengwei Dong ◽  
Yong Xu ◽  
Xuefei Hu ◽  
...  
Keyword(s):  
Pulmonary Tuberculosis ◽  
Surgical Complication ◽  
Lung Parenchyma ◽  
Surgical Indications ◽  
Single Institution ◽  
Safe Alternative ◽  
Cross Sectional ◽  
Satisfactory Outcome ◽  
Operative Complications

Abstract Objective Surgical resection plays an essential role in the treatment of Pulmonary Tuberculosis (PTB). There are few reports comparing lobectomy and sublobectomy for pulmonary TB with cavity. To compare the advantages between lobectomy and sublobectomy for localized cavitory PTB, we performed a single-institution cross sectional cohort study of the surgical patients. Methods We consecutively included 203 patients undergoing lobectomy or sublobectomy surgery for localized cavitary PTB. All patients were followed up, recorded and compared their surgical complication, outcome and associated characteristics. Results Both groups had similar outcomes after follow up for 13.1 ± 12.1 months, however, sublobectomy group suffered fewer intraoperative blood losses, shorter length of stay, and fewer operative complications than lobectomy group (P <  0.05). Both groups obtained satisfactory outcome with postoperatively medicated for similar period of time and few relapse (P > 0.05). Conclusion Both sublobectomy and lobectomy resection were effective ways for cavitary PTB with surgical indications. If adequate anti-TB chemotherapy had been guaranteed, sublobectomy is able to be recommended due to more lung parenchyma retain, faster recover, and fewer postoperative complications.

scholarly journals Residual Prolapse in Patients with III-IV Degree Haemorrhoids Undergoing Stapled Haemorrhoidopexy with CPH34 HV: Results of an Italian Multicentric Clinical Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Giuliano Reboa ◽  
Marco Gipponi ◽  
Andrea Rattaro ◽  
Giovanni Ciotta ◽  
Marco Tarantello ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Rectal Prolapse ◽  
Obstructed Defecation ◽  
High Volume ◽  
High Index ◽  
Technical Failure ◽  
Stapled Haemorrhoidopexy ◽  
Fourth Degree ◽  
Clear Cut

CPH34 HV, a high volume stapler, was tested in order to assess its safety and efficacy in reducing residual/recurrent haemorrhoids. The clinical charts of 430 patients with third- to fourth-degree haemorrhoids undergoing SH in 2012-2013 were consecutively reviewed, excluding those with obstructed defecation (rectocele >2 cm; Wexner’s score >15). Follow-up was scheduled at six and 12 months. Rectal prolapse exceeding more than half of CAD was reported in 341 patients (79.3%); one technical failure was reported (0.2%) without any serious untoward effect; and 1.3 stitch/patient (SD, 1.7) was required to achieve complete haemostasis. Doughnuts volume was higher (13.8 mL; SD, 1.5) in patients with a large rectal prolapse than with smaller one (8.9 mL; SD, 0.7) (Pvalue <0.05). Residual and recurrent haemorrhoids occurred in 8 of 430 patients (1.8%) and 5 of 254 patients (1.9%), respectively. A high index of patient satisfaction (visual analogue scale = 8.9; SD, 0.9) coupled with a persistent reduction of constipation scores (CSS = 5.0, SD, 2.2) was observed. The wider prolapse resection well correlated with a clear-cut reduction of haemorrhoidal relapse, a high index of patient satisfaction, and clinically relevant reduction of constipations scores coupled with satisfactory haemostatic properties of CPH34 HV.

A Modification of the Stapled TransAnal Rectal Resection (STARR) Procedure for Rectal Prolapse

2018 ◽  
Vol 25 (6) ◽  
pp. 578-585 ◽  
Author(s):  
Hong-Cheng Lin ◽  
Hua-Xian Chen ◽  
Qiu-Lan He ◽  
Liang Huang ◽  
Zheng-Guo Zhang ◽  
...  
Keyword(s):  
Rectal Prolapse ◽  
Rectal Resection ◽  
Obstructed Defecation ◽  
Resected Specimen ◽  
Stapled Transanal Rectal Resection ◽  
Preoperative Symptom ◽  
Symptom Severity Score ◽  
Prospective Assessment ◽  
External Rectal Prolapse

Purpose. This study was designed to assess the safety, efficacy, and postoperative outcomes of the modified Stapled TransAnal Rectal Resection (modified STARR) in patients presenting with cases of limited external rectal prolapse. Methods. A prospective cohort of patients with mild rectal prolapse undergoing rectal resection with the Tissue-Selecting Technique Stapled TransAnal Rectal Resection Plus (TSTStarr Plus) stapler between February 2014 and September 2016 was reviewed retrospectively. Results. Twenty-five eligible patients underwent rectal resection with the TSTStarr Plus stapler. The median vertical height of the resected specimen was 5.0 cm (range = 3.1-10 cm) with all cases being confirmed histologically as full-thickness resections. Over a follow-up of 33.6 ± 9.4 months, only 1 case (4%) was encountered with recurrence. The mean postoperative Wexner score was significantly improved when compared with the preoperative scores (preoperative: median = 3, range = 0-20, vs postoperative: median = 2, range = 0-20, respectively; P = .010). The median preoperative Symptom Severity Score and Obstructed Defecation Score were both decreased compared with the postoperative scores ( P = .001). Conclusions. Modified STARR in management of mild rectal prolapse appear to be a safe and effective technique. The initial results would encourage a more formal prospective assessment of this technique as part of a randomized trial for the management of mild rectal prolapse.

scholarly journals Complete Rectal Prolapse in Children: Case Report, Review of Literature, and Latest Trends in Management

2018 ◽  
Vol 6 (9) ◽  
pp. 1694-1696 ◽  
Author(s):  
Girish Gulab Meshram ◽  
Neeraj Kaur ◽  
Kanwaljeet Singh Hura
Keyword(s):  
Case Report ◽  
Rectal Prolapse ◽  
Surgical Intervention ◽  
Obstructed Defecation ◽  
Complete Rectal Prolapse ◽  
Review Of Literature ◽  
Fibre Diet ◽  
Stool Softener ◽  
High Fibre

BACKGROUND: Complete rectal prolapse is the circumferential descent of all the layers of the rectum through the anus. It often leads to bleeding, obstructed defecation, incarceration or fecal incontinence. CASE REPORT: We present a rare case of a 4-year-old child with complete rectal prolapse of 12 cm in length. The prolapsed rectum was manually repositioned after reducing the oedema. The precipitating factor was identified as excessive straining while passing stools. A change in position while passing stools was advised along with a high fibre diet and a stool softener. Recurrence was not observed in the 3 month of follow-up. CONCLUSION: Most cases of pediatric rectal prolapse are managed conservatively by addressing the associated and precipitating etiological factors. Surgical intervention may be required for recurrent or persistent cases.

Robotic Combined Anterior & Posterior Repair of a Rectal Prolapse, Rectocele, and Sigmoidocele with a Mesh

2019 ◽  
Vol 91 (5) ◽  
pp. 34-37
Author(s):  
Daniel Borsuk ◽  
Adam Studniarek ◽  
Gerald Gantt ◽  
Kunal Kochar ◽  
Slawomir Marecik
Keyword(s):  
Rectal Prolapse ◽  
Obstructed Defecation ◽  
Leading Edge ◽  
Levator Ani ◽  
Autonomic Nerves ◽  
Perineal Body ◽  
Anterior Portion ◽  
Mesh Placement ◽  
Anterior Posterior

Rectal prolapse (RP) is often seen in patients over the age of fifty, particularly women. These patients frequently suffer from other concomitant pathologies like rectocele, sigmoidocele, cystocele, or even enterocele. Rectopexy with a mesh has been an established treatment for rectal prolapse. The utilization of the robotic system allows for a successful repair within a confined pelvic space, especially for precise suture placement when working with the mesh. A 77-year-old female presented with obstructed defecation syndrome (ODS) symptoms found to be caused by a progressive rectal prolapse. Her pre-operative ODS score was 9/20. Pelvic floor evaluation revealed concomitant rectocele and sigmoidocele. The patient was offered a robotic-assisted rectopexy with mesh placement to address the three concomitant pathologies. During the procedure, a posterior mesorectal mobilization with autonomic nerves preservation was performed to address the posterior leading edge of the prolapse. Subsequently, the vagina was separated from the anterior portion of the rectum and dissected down to the levator ani muscles and the perineal body. This allowed for the affixation of a polypropylene mesh to the anterior portion of the rectum. Anterior suspension of the mobilized rectum with the mesh addressed all three pathologies. No recurrence or complications occurred at two-year follow up. The patients ODS score decreased to 1/20.

scholarly journals Epilepsy surgery for low-grade epilepsy-associated neuroepithelial tumor of temporal lobe: a single-institution experience of 61 patients

2021 ◽  
Author(s):  
Zhe Zheng ◽  
Hongjie Jiang ◽  
Hemmings Wu ◽  
Yao Ding ◽  
Shuang Wang ◽  
...  
Keyword(s):  
Surgical Strategy ◽  
Seizure Outcome ◽  
Low Grade ◽  
Extended Resection ◽  
Single Institution ◽  
Presurgical Evaluation ◽  
Satisfactory Outcome ◽  
Electrocorticogram Ecog ◽  
Surgical Extent

Abstract Background Low-grade epilepsy-associated neuroepithelial tumor (LEAT) is highly responsive to surgery in general. The appropriate surgical strategy remains controversial in temporal LEAT. The aim of this study is to analyze the surgical seizure outcome of temporal LEAT, focusing on the aspects of surgical strategy. Methods Sixty-one patients from a single epilepsy center with temporal LEAT underwent surgery. The surgical strategy was according to the multidisciplinary presurgical evaluation. Electrocorticogram (ECoG)-assisted resection was utilized. Surgical extent including lesionectomy and extended resection was described in detail. Seizure outcome was classified as satisfactory (Engel class I) and unsatisfactory (Engel classes II–IV). Results After a median follow-up of 36.0 (30.0) months, 83.6% of patients achieved satisfactory outcome, including 72.1% with Engel class Ia. There was 39.3% (24/61) of patients with antiepileptic drug (AED) withdrawal. Use of ECoG (χ2 = 0.000, P > 0.1), preresection spike (χ2 = 0.000, P = 0.763), or spike residue (P = 0.545) was not correlated with the seizure outcome. For lateral temporal LEAT, outcome from lesionectomy was comparable to extended resection (χ2 = 0.499, P > 0.1). For mesial temporal LEAT, 94.7% (18/19) of patients who underwent additional hippocampectomy were satisfactory, whereas only 25% (1/4) of patients who underwent lesionectomy were satisfactory (P = 0.009). Conclusion Surgical treatment was highly effective for temporal LEAT. ECoG may not influence the seizure outcome. For lateral temporal LEAT, lesionectomy with or without cortectomy was sufficient in most patients. For mesial temporal LEAT, extended resection was recommended.

Sign in / Sign up

Export Citation Format

Share Document