Systematic review of internal hernia formation following laparoscopic left nephrectomy.

This is the first identifiable description where internal herniation following laparoscopic left nephrectomy necessitated gangrenous small intestinal resection; similar cases and prevention are discussed.

Endoscopic transanal rectal mucosal ablation in the surgical treatment of ulcerative colitis: preliminary results of a novel technique.

Purpose: We describe a new technique that endoscopically eradicates rectal stump mucosa after total colectomy for ulcerative colitis.

Methods: Seven patients (5 males; median age, 56 (range, 36-72) years) underwent attempted endoscopic transanal rectal mucosal ablation using the 28-French-gauge urologic resectoscope, either at the time of total colectomy and ileostomy for failed medical therapy (5 patients) or as an alternative to completion proctectomy (2 patients) with rectal stump discharge. All had declined restorative proctocolectomy.

Experimental model of fistula-in-ano.

Purpose: This study was designed to create and evaluate an experimental porcine model of fistula-in-ano.

Methods: Initial cadaveric dissection enabled refinement of the technique for fistula formation and histoanatomical study of the porcine anal canal. Subsequently, three surgically created fistulas were treated by seton drainage in each of eight male pigs (weight, 38-41 kg).

Pilot study: fibrin sealant in anal fistula model.

Purpose: The aim of this study was to investigate the failure of fibrin sealant treatment for fistula-in-ano in an experimental porcine model and to determine histologic changes associated with the sealant and setons.

Methods: Three surgically created fistulas were treated by seton drainage in each of eight male pigs. After 26 days, magnetic resonance imaging was performed and setons were removed.

Value of hydrogen peroxide enhancement of three-dimensional endoanal ultrasound in fistula-in-ano.

Purpose: The aim of this prospective study was to compare the accuracy of three-dimensional endoanal ultrasound with that of hydrogen peroxide enhanced three-dimensional endoanal ultrasound in diagnosing recurrent or complex fistula-in-ano.

Methods: Three-dimensional endoanal ultrasound reconstructions were performed before and after hydrogen peroxide enhancement in 19 patients with suspected recurrent or complex fistula-in-ano. Two experienced observers derived a consensus fistula classification after a blinded random review of the data sets.

Clinical examination, endosonography, and MR imaging in preoperative assessment of fistula in ano: comparison with outcome-based reference standard.

Purpose: To prospectively evaluate the relative accuracy of digital examination, anal endosonography, and magnetic resonance (MR) imaging for preoperative assessment of fistula in ano by comparison to an outcome-derived reference standard.

Materials And Methods: Ethical committee approval and informed consent were obtained. A total of 104 patients who were suspected of having fistula in ano underwent preoperative digital examination, 10-MHz anal endosonography, and body-coil MR imaging.

MRI of fistula in ano: inter- and intraobserver agreement and effects of directed education.

Objective: Preoperative MRI of fistula in ano is becoming more common. This prospective study aimed to determine if a significant difference occurred in interpretation between one expert and one novice observer and to assess inter- and intraobserver agreement after both observers underwent a period of directed education. SUBJECTS AND METHODS.

Efficacy of fibrin sealant in the management of complex anal fistula: a prospective trial.

Purpose: A prospective trial was conducted to establish long-term healing of complex idiopathic anorectal fistula, without extension, after fibrin glue treatment, with clinical assessment and magnetic resonance imaging to determine tract healing.

Methods: Twenty-two patients undergoing glue instillation after fistula curettage and irrigation were followed up for a median of 14 months. Clinical assessment, short tau inversion recovery sequence magnetic resonance imaging, and combined short tau inversion recovery and dynamic contrast-enhanced magnetic resonance imaging were performed at a median of three months postoperatively, and their ability to predict outcome in the presence of early skin healing was determined.

Diverticulitis.

Although diverticular disease is common in the Western world, few patients who develop diverticulitis require surgery. The use of appropriate broad-spectrum antibiotics in uncomplicated diverticulitis can be an effective treatment, avoiding the need for acute surgical intervention. In the event of surgery the choice of procedure is dictated by the degree of contamination and the expertise of the operating surgeon.