Experimental evaluation of a bovine pericardium-derived collagen matrix buttress in ileocolic and colon anastomoses.

Background: Anastomotic leakage is a major complication of colorectal surgery. The purpose of this study was to evaluate and compare stapled ileocolic and colon-colon anastomoses with or without a collagen buttress derived from bovine pericardium in the immediate postoperative period.

Methods: Various stapling devices were used to create ileocolic and colon-colon anastomoses in a canine model.

Bovine pericardium buttress reinforces colorectal anastomoses in a canine model.

Purpose: The consequences of an anastomotic leak or disruption can be devastating, particularly in the colorectal surgery population. The purpose of this study was to evaluate and compare colon anastomoses with or without a collagen matrix buttress derived from bovine pericardium.

Methods: A circular stapler was used to create colon-colon anastomoses in a canine model.

The utility of pudendal nerve terminal motor latencies in idiopathic incontinence.

Purpose: Pudendal nerve terminal motor latency testing has been used to test for pudendal neuropathy, but its value remains controversial. We sought to clarify the relationship of pudendal nerve terminal motor latency to sphincter pressure and level of continence in a cohort of patients with intact anal sphincters and normal pelvic floor anatomy.

Methods: We reviewed 1,404 consecutive patients who were evaluated at our pelvic floor laboratory for fecal incontinence.

Thermal imaging in the detection of bowel ischemia.

Purpose: The aim of this study was to introduce thermal imaging in the intraoperative detection of bowel ischemia by comparing thermal imaging with conventional techniques in detecting acutely ischemic bowel, using histologic evidence for intestinal necrosis as the standard.

Methods: A prospective study was performed using a porcine model. Laparotomy was performed on four pigs under general anesthesia.

Diaphragm-like strictures of the ileum associated with NSAID use: a rare complication.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed for many conditions including arthritis. A rare complication of their use is diaphragm-like strictures of the small and large intestines. A 65-year-old woman with a 12-year history of arthritis came to us with a 35-pound weight loss and anorexia.

Combination therapy for epidermoid carcinoma of the anal canal.

Purpose: This study was designed to assess results of chemoradiation therapy for epidermoid carcinoma of the anal canal.

Methods: A retrospective review of records of the prospective database revealed 35 patients who had been diagnosed with anal canal carcinoma and treated with chemoradiotherapy at Wilford Hall USAF Medical Center (tertiary referral hospital) from 1981 to 1991.

Results: Patients ranged in age from 35 to 80 (mean, 59) years, and 63 percent were women.

Laparoscopic-assisted full-thickness endoscopic polypectomy.

Purpose: To describe the procedure for endoscopically removing sessile colonic polyps with laparoscopic assistance.

Methods: Technique description and retrospective review of experience.

Results: The technique has been used to successfully remove polypoid colonic lesions in three patients.

Nonfunctioning parathyroid carcinoma.

Parathyroid carcinoma is a rare clinical entity accounting for only 4 per cent of all cases of parathyroid neoplasia. Nonfunctioning parathyroid carcinoma is even rarer. Previously, virtually all patients with these lesions were treated for a nonspecific neck mass.

Anorectal physiology testing. A survey of availability and use.

Survey forms were sent to all members of the Coloproctology Section of the Royal Society of Medicine and the American Society of Colon and Rectal Surgeons to obtain their opinions of the availability, actual use, and perceived helpfulness of different methods for the evaluation of the physiology of the colon and rectum. Responses revealed a similarity in age and practice patterns in both groups. Of the 19 methods surveyed, greater than 90 percent of respondents in both groups rely on three traditional methods of patient evaluation: patient history, digital examination, and sigmoidoscopy.