For many decades the coloanal anastomosis was traditionally created as an end-to-end anastomosis. Despite successful surgical restoration of the intestinal passage after low rectal resection and total mesorectal excision (TME), physiological continence and evacuation function cannot be achieved in many cases using end-to-end anastomosis. Subsequent complaints, such as fecal incontinence and urge problems, evacuation difficulties and high stool frequency (so-called low anterior resection syndrome, LARS) are the result. The combination of symptoms after TME known as LARS is described in the literature in up to 60% of cases. The increased occurrence of the imperative urge to defecate, frequent bowel movements and problems with fecal incontinence motivated surgeons to look for alternative anastomosis techniques. Side-to-end anastomosis, coloplasty pouch and colonic J‑pouch have been shown in various studies to be superior to end-to-end anastomosis in terms of functional results. Current studies could show that the side-to-end anastomosis (even if this is not a pouch in the actual sense) and the two pouch techniques show comparable results in terms of functional outcome and the rate of anastomotic leakage. The alternative to coloanal anastomosis after TME is the abdominoperineal resection. Most, especially younger patients, prefer to try to maintain continence with the risk of the described functional problems. If the patients are well selected, TME can be carried out with the current techniques in such a way that continuity is maintained and a good defecation function is achieved for a large proportion of patients using the pouch-anal anastomosis or the side-to-end techniques.
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http://dx.doi.org/10.1007/s00104-022-01730-8 | DOI Listing |
Port J Card Thorac Vasc Surg
October 2024
Thoracic Surgery Department - Hospital de Santa Marta, Centro Hospitalar Universitário Lisboa Central, Portugal.
Kartagener syndrome (KS) is a rare congenital disorder, characterized by sinusitis, bronchiectasis and situs inversus. Lung transplantation is an effective treatment for end-stage lung failure, but dextrocardia and differences between hilar structures and pulmonary lobes require adjustments to conventional surgical technique. We present a case of a double-lung transplant without extracorporeal oxygenation in a 48-year-old male patient with KS.
View Article and Find Full Text PDFJ Reconstr Microsurg
January 2025
Division of Plastic and Reconstructive Surgery, University of Wisconsin, Madison, Wisconsin.
Background: High levels of precision, as well as controlled, efficient motions, are important components of microsurgical technique and success. An accurate and objective means of skill assessment is lacking in resident microsurgical education. Here we employ three-dimensional, real-time motion-tracking technology to analyze hand and instrument motion during microsurgical anastomoses.
View Article and Find Full Text PDFJPRAS Open
March 2025
Plastic and Reconstructive Surgery Department, Hospital Clinic of Barcelona, Barcelona, Spain.
Introduction: Different vessel diameters may challenge the completion of a high-quality anastomosis in microsurgery. In clinical practice, discrepancies in vessel size are commonly encountered. These variations can range from small to moderate, and microsurgeons typically employ established techniques, such as dilating the smaller vessel or creating an oblique cut in its wall, to address these differences.
View Article and Find Full Text PDFCureus
December 2024
Department of Urology, Basaksehir Cam Sakura City Hospital, Istanbul, TUR.
A penile fracture is typically a urological emergency resulting from blunt trauma to the penis, particularly during sexual activity, and it is rarely associated with urethral injury. A 52-year-old male patient presented to our emergency department with complaints of penile swelling and bruising following sexual intercourse. Assessment of the patient indicated the presence of both penile fracture and anterior urethral injury, and simultaneous repairs were performed.
View Article and Find Full Text PDFBMC Med Educ
January 2025
Department of Surgery, Saint-Louis Regional Hospital, Gaston Berger University, Road of Ngallelle, 234, Saint-Louis, Senegal.
Introduction: Video feedback, particularly with a head-mounted camera, has previously been described as a useful debriefing tool in well-funded health systems but has never been performed in a low-resource environment. The purpose of this randomized, intervention-controlled study is to evaluate the feasibility of using video feedback with a head-mounted camera during intestinal anastomosis simulation training in a low-resource setting.
Methodology: This study recruited 14 first-year surgery residents in Senegal, who were randomized into control and camera groups.
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