Colectomy for fulminant Clostridium difficile colitis: predictors of mortality.

The purpose of this study was to define clinical and radiographic variables associated with postoperative mortality after urgent colectomy for fulminant Clostridium difficile colitis. Data were obtained regarding patients undergoing colectomy for fulminant C. difficile colitis at two institutions (1997-2005).

Anastomotic sinuses after ileoanal pouch construction: incidence, management, and outcome.

Purpose: This study was designed to analyze the incidence, management, and outcome of pouch sinuses after ileal pouch-anal anastomosis at one institution.

Methods: We identified 282 ileal pouch-anal anastomosis patients between 1992 and 2002 who had a pouchogram before planned ileostomy closure. The management and outcome of patients with pouchograms revealing pouch sinuses were reviewed.

Occult perineal endometrioma diagnosed by endoanal ultrasound and treated by excision: a report of 3 cases.

Background: Isolated perineal endometrioma is a rare entity and often causes diagnostic uncertainty.

Cases: Three premenopausal women, none with a prior history of endometriosis, presented with vague perineal pain 3-6 months following obstetric delivery with episiotomy. The latency periods between the onset of symptoms and definitive diagnosis were 3 months, 18 months and 3 years despite multiple physician evaluations in the interim.

Laparoscopic colectomy for apparently benign colorectal neoplasia: A word of caution.

Purpose: Endoscopically unresectable apparently benign colorectal polyps are considered by some surgeons as ideal for their early laparoscopic colectomy experience. Our hypotheses were: (1) a substantial fraction of patients undergoing laparoscopic colectomy for apparently benign colorectal neoplasia will have adenocarcinoma on final pathology; and (2) in our practice, we perform an adequate laparoscopic oncological resection for apparently benign polyps as evidenced by margin status and nodal retrieval.

Methods: Data from a consecutive series of patients undergoing laparoscopic colectomy (on an intention-to-treat basis) for endoscopically unresectable neoplasms with benign preoperative histology were retrieved from a prospective database and supplemented by chart review.

Sexually transmitted proctitides.

Patients with sexually transmitted proctitides are increasingly presenting to doctors' offices. This may be secondary to increasing numbers of individuals participating in anal receptive intercourse and a rise in the incidence of sexually transmitted diseases. Although the sexually transmitted proctitides represent a small proportion of the overall number of cases of new proctitis, in certain populations the incidence of these diseases as causative agents is quite high, especially among men who have sex with men.

Laparoscopic rectal surgery: rectal cancer, pelvic pouch surgery, and rectal prolapse.

With the increasing popularity of minimally invasive approaches to surgery, laparoscopic techniques are being applied increasingly to more complex procedures. Surgeons who are interested in gaining skill and confidence with the techniques of rectal mobilization and resection initially should consider attempting procedures for benign disease. Patients who have rectal prolapse, who often have wide, accommodating pelvic anatomy, are the logical choice with whom to begin the laparoscopic rectal experience.

Oncologic outcomes of salvage surgery for epidermoid carcinoma of the anus initially managed with combined modality therapy.

Purpose: Primary chemoradiation failure for epidermoid carcinoma of the anus is treated by surgical resection. This study evaluates the outcome of salvage surgery at one institution.

Methods: All patients (n = 177) with a diagnosis of epidermoid carcinoma of the anus undergoing surgery since 1980 were reviewed.