Intersphincteric Exploration With Ligation of Intersphincteric Fistula Tract or Attempted Closure of Internal Opening for Acute Anorectal Abscesses.

Background: Acute anorectal abscesses of cryptoglandular origin are commonly managed by incision and drainage, which results in fistula development in up to 73% of cases, requiring subsequent definitive fistula surgery. However, given that fistula tracts may already be present at the initial presentation, primary closure of the tract as secondary prevention of fistula formation, using ligation of intersphincteric fistula tract, may be useful.

Objective: This study aims to examine the feasibility and outcomes of performing intersphincteric exploration with ligation of intersphincteric fistula tract or attempted closure of internal opening for acute anorectal abscesses.

Effects of preoperative endoanal ultrasound on functional outcome after anal fistula surgery.

Objective: Endoanal ultrasound (EAUS) is a recommended preoperative investigation for fistula-in-ano (FiA) which aims to provide the best chance of healing and preservation of continence function. This study aims are (1) to assess effect of EAUS on functional outcome and (2) to determine factors associated with clinical outcomes after FiA surgery.

Design: Retrospective analysis of subjects with cryptogenic FiA between January 2011 and December 2016, in a tertiary hospital, was performed by comparing EAUS and no-EAUS groups.

Ligation of Intersphincteric Fistula Tract for Fistula in Ano: Lessons Learned From a Decade of Experience.

Background: Ligation of intersphincteric fistula tract is a well-described sphincter-preserving technique for the management of fistula in ano. In 2007, we reported our early experience demonstrating a primary success rate of 94.4%.

Marsupialization for simple fistula in ano: a randomized controlled trial.

Background: Marsupialization of anal fistulotomy results in less raw-surface wound and may improve postoperative outcomes. The present study was designed to test the benefit of marsupialization for simple fistula in ano.

Material And Method: This was a randomized controlled study conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Internal sphincter myectomy for adult Hirschsprung's disease: a single institute experience.

Objective: Adult Hirschsprungs disease is a rare disease and frequently misdiagnosed as the long-standing refractory constipation. Almost all cases have short or ultra-short aganglionic segment of distal rectum. The clinical features are different from those in childhood when the diseased segment is long.

A comparison of early postoperative results between urgent closed hemorrhoidectomy for prolapsed thrombosed hemorrhoids and elective closed hemorrhoidectomy.

Objective: To compare the perioperative complications, analgesics requirement, and length of hospital stay between patients undergoing urgent closed hemorrhoidectomy for prolapsed thrombosed hemorrhoid and elective closed hemorrhoidectomy.

Research Design: Retrospective, comparative study.

Material And Method: All records of the patients who underwent urgent and elective hemorrhoidectomy between January 2000 and December 2005 were reviewed.

Sacrectomy for primary sacral tumors.

Purpose: En bloc resection with adequate margins has provided a chance for cure of primary sacral tumors. However, high sacral lesions are challenging because of the complexity of the surgical approach. The aims of this study were to describe a modification in technique and to evaluate the outcomes.

Multimedia article. Laparoscopic restorative proctocolectomy with small McBurney incision for ileal pouch construction without protective ileostomy.

Purpose: Restorative proctocolectomy is a standard treatment for colorectal diseases over decades. At present, this technique is frequently performed via minimal invasive approach. Most reported techniques of laparoscopic restorative proctocolectomy involved a Pfannenstiel incision for the major part of the operation to be performed openly; a double-stapled pouch anal anastomosis technique and protective ileostomy.

Outcome of familial adenomatous polyposis: a retrospective study.

Background: Familial adenomatous polyposis (FAP) is characterized by the presence of numerous colorectal adenomatous polyps that progress to colorectal cancer if left untreated. Following colorectal cancer, periampullary cancer and aggressive desmoid tumor are also the common causes of death. The purpose of the present study was to describe the clinical course of FAP patients.

New concept of ileocecal junction: intussusception of the terminal ileum into the cecum.

Aim: To prove that the terminal ileum is intussuscepted into the cecum creating the ileocecal junction, contrary to previous valvular concept which has been widely believed.

Methods: This study is based on gross and microscopic examinations of fresh specimens derived from colonic operations (right hemicolectomy or subtotal colectomy). Data compiled from observing and dissecting of specimens of seven patients are used to examine both gross and microscopic appearance of ileocecal junction.

Total anal sphincter saving technique for fistula-in-ano; the ligation of intersphincteric fistula tract.

Objective: To describe a new technique for fistula-in-ano surgery aimed at total sphincter preservation, and evaluate the preliminary results concerning non-healing and intact anal function.

Material And Method: A prospective observational study in eighteen fistula-in-ano patients treated by ligation of intersphincteric fistula tract (LIFT) technique, from January to June 2006.

Results: Fistula-in-ano in seventeen patients healed primarily (94.

Preoperative capecitabine with pelvic radiotherapy for locally advanced rectal cancer (phase I trial).

Objective: Phase I multicenter study defined the maximal tolerated dose (MTD), dose-limiting toxicity (DLT) and safety profile of capecitabine in combination with preoperative radiation for patients with locally advanced rectal cancer (LARC).

Material And Method: Patients were treated with oral capecitabine (700, 800, 900, 1000, 1100 and 1200 mg/m2 twice daily continuously) plus preoperative whole pelvic irradiation (45-46 Gy in 23-25 fractions over 5-6 weeks). Surgery was performed at the median of 42 days after chemoradiation treatment.

Closed vs ligasure hemorrhoidectomy: a prospective, randomized clinical trial.

Objective: To compare the operative time, postoperative complications, and analgesic requirement between closed hemorrhoidectomy and Ligasure hemorrhoidectomy.

Material And Method: The study was conducted in a prospectively randomized controlled fashion. Forty-seven patients with grade 3 or 4 hemorrhoids plus external component or skin tag were operated on by either hemorrhoidectomy with Ligasure (24 patients) or closed hemorrhoidectomy (23 patients).

Perineum push-up device to facilitate transabdominal suturing of the lower rectum.

Pressure on the perineum by the fist facilitates the placement of sutures into the rectal remnant, but put the assisting surgeon on an awkward and strenuous posture. The perineum push-up device to facilitate transabdominal suturing of the lower rectum was invented. The assisting surgeon can push up the perineum more comfortably with his abdominal wall or thigh.

Minimally invasive surgery training in soft cadaver (MIST-SC).

Objectives: The purpose of this study was to evaluate the surgical anatomy, tissue plane, organ consistency of soft cadaver and the possibility of minimally invasive surgery training in soft cadaver.

Setting: Surgical Training Center. Department of Anatomy and Department of Surgery Faculty of Medicine, Chulalongkorn University.

The new laparoscopic proctocolectomy training (in soft cadaver).

Objectives: The purpose of the present study was to evaluate the quality of preservation (tissue plane, named vessels identification, consistency of colon and rectum), quality of performing procedures, difficulties and problems and finally the satisfaction of surgeons in laparoscopic proctocolectomy in soft cadaver.

Setting: Colorectal Division, Department of Surgery and Surgical Training Center Department of Anatomy, Faculty of Medicine, Chulalongkorn University.

Design: Prospective descriptive study

Material And Method: 10 soft cadavers were scheduled for laparoscopic proctocolectomy.

Laparoscopic versus open surgery for rectosigmoid and rectal cancer.

Objectives: The aim of this study was to evaluate feasibility and safety of laparoscopic surgery for rectosigmoid cancer and rectal cancer.

Material And Method: Twenty four patients who underwent laparoscopic surgery for rectosigmoid cancer or rectal cancer were retrospectively evaluated. Results were compared with those of 25 patients who had open surgery at the same period.