Background And Objectives: Wide pelvic tumors need urinary and fecal diversion. We set out to assess the efficacy of the double-barreled wet colostomy (DBWC) in patients undergoing simultaneous double diversion.
Material And Methods: We reviewed 56 consecutive patients submitted to surgery, divided into two groups: (1) total pelvic exenteration plus DBWC (n = 26); (2) DBWC without simultaneous pelvic resection (n = 30). Pelvic tumor recurrences accounted for most patients (n = 53), whereas the remaining three patients suffered from actinic pelvic complications.
Results: Surgical morbidity and mortality rates were 53.8% (14/26) and 11.5% (3/26) in Group 1, and 43.5% (13/30) and 3.3% (1/30) in Group 2, respectively. Only 2 patients out of 51 (3.9%) developed late postoperative urinary tract infection. Regression of the hydronephrosis was observed in 28 out of 33 assessable patients. Median survival in Groups 1 and 2 was 8.36 and 4.14 months, respectively. In the subgroup of patients submitted to curative surgery (n = 24), actuarial cancer-specific survival rate in 2 years was 58.78%.
Conclusion: DBWC is a safe and efficient alternative for simultaneous urinary and fecal diversion, with low morbidity and mortality rates, improvement of renal insufficiency, and low risk of postoperative urinary tract infection.
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http://dx.doi.org/10.1002/jso.20442 | DOI Listing |
Clin Transl Sci
January 2025
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Despite the widespread use of currently available serum phosphate management options, elevated serum phosphate is common in patients with end-stage kidney disease on dialysis. Characteristics of currently available phosphate binders that lead to poor patient experiences such as large drug volume size of required daily medication (e.g.
View Article and Find Full Text PDFJ Dairy Sci
January 2025
The Pennsylvania State University, University Park, PA 16802. Electronic address:
The objective of this experiment was to estimate the bioavailability (BA) of rumen-protected (RP) His, RPLys, and 2 RPMet products using 3 in vivo methods: area under the curve (AUC), plasma dose-response (PDR), and fecal free AA (FFAA) methods. We used 8 rumen-cannulated cows in a replicated 4 × 4 Latin square experiment with 16-d periods. Treatments were (1) abomasal infusion of water (control), (2) abomasal infusion of free His, Lys, and Met (FAA), (3) administration of RPHis + RPLys + RPMet1 (rumen-protected methionine protected with ethyl cellulose; RPAA1), and (4) administration of RPHis + RPLys + RPMet2 (rumen-protected methionine protected with a pH-sensitive polymer; RPAA2).
View Article and Find Full Text PDFBMJ Case Rep
December 2024
Yale University School of Medicine, New Haven, Connecticut, USA
Despite the widespread use of perirectal spacers to reduce radiation-induced rectal toxicity during prostate cancer treatment, postmarketing data reveal rare but significant complications. This case report details a severe complication of rectourethral fistula necessitating robotic pelvic exenteration with urinary and faecal diversion following perirectal spacer placement. Although SpaceOAR has been shown to reduce rectal radiation dose, the ensuing clinical benefit remains inconclusive in real-world data.
View Article and Find Full Text PDFBMJ Open
December 2024
School of Health Sciences, University of Southampton, Southampton, Hampshire, UK.
Introduction: Incontinence is commonly experienced by adults who receive care support in a residential facility or in their own home. These individuals are at risk of developing incontinence-associated dermatitis (IAD), which is caused by prolonged and repeated exposure of the skin to urine or faeces. An IAD manual was developed providing an evidence-based clinical algorithm and an e-learning training programme for the prevention and treatment of IAD.
View Article and Find Full Text PDFCureus
November 2024
Neurology, National Institute of Neurology and Neurosurgery "Dr. Manuel Velasco Suárez", Mexico City, MEX.
Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis stands as the most prevalent form of autoimmune encephalitis, primarily affecting young patients and exhibiting a higher incidence among females. Patients frequently present with psychiatric symptoms or cognitive impairments such as speech disturbances, decreased level of consciousness, autonomic dysfunction, as well as seizures, dyskinesias, and catatonia due to overactivation of extrasynaptic NMDA receptors. To date, there is no gold standard for the diagnosis of catatonia; however, a few rating scales exist to measure this phenomenon, with the Bush Francis Catatonia Rating Scale being the most commonly used due to its validity, reliability, and ease of application.
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