Smoking impairs rectal mucosal bloodflow--a pilot study: possible implications for transanal advancement flap repair.

Transanal advancement flap repair has been advocated as the treatment of choice for trans-sphincteric perianal fistulas, because it enables the healing of almost all fistulas without sphincter damage and consequent continence disturbance. After initial promising reports, recently less favorable results have been reported. It remains unclear why there is such a large variety in the reported healing rates.

Prevalence and risk factors for ischemia, leak, and stricture of esophageal anastomosis: gastric pull-up versus colon interposition.

Background: Reports of esophageal anastomotic complications often involve more gastric than colonic reconstructions and are incomplete because of fragmented followup by physicians unfamiliar with the surgical procedure.

Study Design: Three hundred ninety-three consecutive esophagectomy patients had prevalence and risk factors determined for graft ischemia and anastomotic leak; 363 of these patients followed for more than 1 month (median 15 months) had prevalence and risk factors determined for anastomotic stricture.

Results: Conduit ischemia occurred in 36 (9.

Impact of two different types of anal retractor on fecal continence after fistula repair: a prospective, randomized, clinical trial.

Purpose: This study was designed to compare two different types of anal retractors (Parks vs. Scott) with regard to their impact on fecal continence after fistula repair.

Methods: Between November 2000 and November 2001, 30 patients were randomized into two groups.