Anal sphincter advancement flap for low transsphincteric anal fistula.

Laying open a transsphincteric anal fistula can be associated with risk of incontinence, especially in females. Therefore, an alternative option should be available to preserve the sphincter mechanism and cure the anal fistula. This article illustrates a new technique of using the distal part of the anal sphincter as an advancement flap to cover the internal opening and thereby effect a cure.

Clinical and quality-of-life outcomes after fertility-sparing laparoscopic surgery with bowel resection for severe endometriosis.

Study Objective: To describe the effect of fertility-sparing laparoscopic excision of endometriosis and bowel resection on clinical and quality-of-life outcomes.

Design: Prospective observational cohort study (Canadian Task Force classification II-2).

Setting: Australian tertiary referral center for the surgical treatment of endometriosis.

Transperineal repair of obstetric-related anovaginal fistula.

Background: To describe an operative technique for the repair of anovaginal fistulae secondary to obstetric injury and to assess its functional outcome and patient satisfaction.

Methods: An operative repair involving division of the anovaginal fistula, closure of rectal and vaginal walls, anterior levatoplasty and overlapping sphincteroplasty is described. Postoperative complications and recurrence were recorded.

Functional outcome and quality of life after ileal pouch-anal anastomosis in children and adults.

Background: In the past, children with ulcerative colitis were treated with a total colectomy, ileostomy and mucous fistula; ileal pouch-anal anastomosis was postponed until adulthood. The aim of the present study was to assess the functional outcome and quality of life after ileal pouch-anal anastomosis and determine whether it is justified to perform the operation in children when surgery is indicated.

Methods: A retrospective review of 38 medical records was carried out, of which there were 19 paediatric patients and 19 adult patients (control).

Cholecystectomy in patients with Crohn's ileitis.

Purpose: Gallstone disease is reported to be higher in patients with Crohn's disease than in the general population. This study was designed to determine the prevalence of cholecystectomy in patients with Crohn's ileitis, attempt to identify any associated risk factors, and determine whether it is justified to perform prophylactic cholecystectomy during ileocolic resection.

Methods: A total of 191 patients with Crohn's ileitis who were treated medically or who had an ileocolic resection were retrospective reviewed.

Short-term and long-term results of combined sclerotherapy and rubber band ligation of hemorrhoids and mucosal prolapse.

Purpose: Rubber band ligation is a common office procedure for symptomatic hemorrhoids. The aim of the study was to assess our short-term and long-term results of combined sclerotherapy and rubber band ligation in the management of hemorrhoids and incomplete mucosal prolapse.

Methods: Data on 6,739 patients who had previous combined sclerotherapy and rubber band ligation by the senior authors (GLN and PRD) were retrieved from the database dating between January 1976 and June 2000.

Anal fistula: Levovist-enhanced endoanal ultrasound: a pilot study.

Purpose: The aim of the study was to investigate the usefulness of the contrast agent Levovist in ultrasound assessment of anal fistula.

Methods: Fifteen patients (11 females, mean age 46) with a diagnosis of anal fistula were assessed by physical examination, conventional ultrasound, Levovist-enhanced ultrasound, and surgery. Levovist was injected a cannula into the fistula.

Small bowel obstruction: is routine colonoscopy necessary after resolution?

Background: Small bowel obstruction is common in clinical practice and is most often due to adhesions. The aim of this study was to determine the significance of colon cancer presenting as a small bowel obstruction at a single institution and to find out whether routine colonoscopy was necessary in patients who had spontaneous resolution of their small bowel obstruction.

Methods: A retrospective review of the medical records of patients presenting with small bowel obstruction from 1995 to 2000 at the Prince of Wales Hospital was performed.

Use of endoscopic titanium stapler in rectal anastomotic stricture.

A quick and effective technique is described here for the treatment of rectal anastomotic stricture. It consisted of cutting the stricture using the Ethicon 35-mm Endoscopic Titanium Stapler. A patient was treated here as a day-surgery case.