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Lactose free diet as therapeutic strategy in low anterior resection syndrome: a case series.
J Surg Case Rep
January 2025
Department of General Surgery, Royal Perth Hospital, 197 Wellington Street, Perth, Western Australia 6000, Australia.
Low anterior resection syndrome (LARS) is a challenging complication following sphincter-preserving rectal surgery, characterized by bowel dysfunctions such as urgency, frequency, and incontinence. This case series investigates the potential role of lactose intolerance in exacerbating LARS symptoms. Three patients who developed LARS after rectal resections showed persistent symptoms despite conventional management with bulking agents, physiotherapy, and loperamide.
View Article and Find Full Text PDFThe insane path of two cervical intervertebral implants: late migration, esophageal ingrowth, and rectal excretion: an exceptional case report.
J Spine Surg
December 2024
Spinal Surgery Team, Wirbelsäulenzentrum Ostschweiz AG, St. Gallen, Switzerland.
Background: The objective of this report is to present a case of two cervical spine artificial discs (Bryan Cervical Disk) that completely disappeared within 6 months as a result of a high-energy trauma more than 10 years after the initial surgery. Implant dislocation is a known complication in artificial cervical disc replacement. However, this report presents the case of an exceptional migration path with esophageal ingrowth and rectal excretion, not only for one artificial disc but for two at different times It highlights the need for long-term follow-up examinations after artificial cervical disc arthroplasty (ACDA).
View Article and Find Full Text PDFIatrogenic Proximal Urethro-Rectal Perforation During Foley Catheter Insertion.
Case Rep Surg
January 2025
Department of General Surgery, University of Balamand, Beirut, Lebanon.
Iatrogenic urethral-rectal perforation represents a rare but severe complication arising from medical interventions, notably highlighted in the context of Foley catheter insertion. This case report outlines the presentation, diagnosis, management, and outcomes of a 71-year-old male patient who experienced iatrogenic rectal perforation during the routine insertion of a Foley catheter, against the backdrop of several predisposing factors, such as atrial fibrillation, valvular disease, benign prostatic hyperplasia, urethral stenosis, and colorectal cancer with liver metastasis. The inadvertent creation of a rectourethral fistula during the procedure led to an urgent multidisciplinary approach involving surgery and postoperative management, including fecal and urine diversion and antibiotic therapy.
View Article and Find Full Text PDFEvidence-Based De-Escalation of Radiotherapy in Locally Advanced Rectal Cancer.
J Surg Oncol
January 2025
Division of Colo-Rectal and Peritoneal Surface Oncology, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
Advancements in cancer care have significantly extended the life expectancy of rectal cancer patients and the impact of treatment-related toxicity on long-term quality of life has become a crucial factor in determining the most suitable type of neoadjuvant therapy, particularly for patients who are likely to undergo surgery. While radiotherapy has traditionally been regarded as the cornerstone for achieving improved local control in rectal cancer, it is accompanied by a range of associated complications, including bowel and bladder dysfunction, gonadal ablation, and Low Anterior Resection Syndrome. De-escalation of treatment is undoubtedly beneficial for many patients, and this approach should be tailored to consider their expectations while prioritizing patient care in decision-making.
View Article and Find Full Text PDFPreservation of inferior mesenteric artery reduces short- and long-term defecatory dysfunction after laparoscopic colorectal resection for diverticular disease: An RCT.
Surg Endosc
January 2025
Department of Surgery, St. Andrea Hospital, Sapienza University of Rome, Rome, Italy.
Background: The quality of life after surgery for diverticular disease is mainly linked to the presence and severity of postoperative defecatory disorders. These symptoms are frequently related to the sigmoid and rectal denervation following the arterial ligation. The preservation of Inferior Mesenteric Artery performing colorectal resections seems to reduce denervation, which led to a better defecatory function.
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