Direct comparison between Czerny-Lembert and circular-stapled anastomotic techniques in colorectal anastomosis: a similar pattern of healing for both.

There are scant experimental data directly comparing the healing of the circular-stapled (CS) anastomotic technique with the standard Czerny-Lembert two-layer hand-sewn (HS) anastomotic technique during the acute and chronic phases of healing. The purpose of this study, therefore, was to serially evaluate wound healing in CS and HS anastomoses in the normal porcine colorectum. Forty-two adult female mixed-breed pigs randomly underwent either HS or CS anastomosis at the sacral promontory.

Does a proximal colostomy affect colorectal anastomotic healing?

Fecal diversion has been implicated as an etiologic factor in anastomotic stenosis following colorectal surgery, particularly following the use of circular anastomotic stapling devices. However, experimental confirmation of the effects of fecal diversion on anastomotic healing is virtually nonexistent. The purpose of this study was to serially evaluate colorectal anastomotic healing with proximal colostomy (COL) and without it (CON; control) using two anastomotic techniques in a porcine model.

The bottom end. Handling of the perineal wound after abdominoperineal resection.

There are a number of options for handling the perineal wound following abdominoperineal resection, including open packing or primary closure with suction drainage. Open packing has not been widely accepted, fearing that it may delay perineal wound healing. The purpose of this paper, therefore, was to retrospectively evaluate, the experience at Ferguson Hospital with abdominoperineal resection from 1977 through 1986.

Selective microscopic examination of gallbladders, hernia sacs, and appendices.

The usefulness of many "routine" medical procedures is being challenged in the health care atmosphere of today. This study was undertaken to determine the utility of routine microscopic pathologic examination of three frequently submitted surgical specimens. Pathology reports of 39,568 consecutive specimens, 17,105 appendices, 14,654 hernia sacs, and 7,809 gallbladders, submitted over a 49-year period, were reviewed.

Intrarectal ultrasonography in rectal cancer staging and in the evaluation of pelvic disease. Clinical uses of intrarectal ultrasound.

Accurate preoperative staging of a rectal cancer patient may impact heavily on subsequent management. This study attempts to evaluate the accuracy of intrarectal ultrasonography (IRUS) in staging rectal cancers compared to clinical and pathologic examination. In addition the accuracy of IRUS was assessed in a group of patients with uncertain pelvic-perirectal disease after a negative physical examination.

A critical review of chemical lymph node clearance and staging of colon and rectal cancer at Ferguson Hospital, 1977 to 1982.

A unique opportunity to evaluate the method of chemical lymph node clearance for colorectal cancer exists at Ferguson Hospital. Lymph node clearance has been used at the institution since 1977, and this retrospective analysis was undertaken to ascertain its validity there. Furthermore, the node positive group was evaluated to ascertain if the current staging system (Turnbull, 1967) is prognostically accurate for the Dukes' C group.

Intramural pH: a quantitative measurement for predicting colorectal anastomotic healing.

Leakage and stenosis are serious complications of gastrointestinal anastomotic surgery that may, in part, be related to local ischemia. The ability to accurately quantitate the degree of gastrointestinal anastomotic ischemia remains a challenging clinical problem. The purpose of this study was to: 1) develop a model of colorectal anastomotic stenosis following local ischemia; 2) compare the accuracy of laser Doppler velocimetry and intramural colonic pH in quantitating critical levels of intestinal anastomotic ischemia; and 3) compare the anastomotic healing process using either a standard two-layer Czerny-Lembert handsewn or EEATM stapled anastomotic technique under ischemic conditions.

The use of anxiolytic and parasympathomimetic agents in the treatment of postoperative urinary retention following anorectal surgery. A prospective, randomized, double-blind study.

Approximately 30 percent of patients undergoing anorectal surgery will develop acute urinary retention. The cause of this complication is poorly understood. Anxiety, anal distention, bladder distention as a result of vigorous hydration during surgery, and reflex inhibition of the urinary bladder detrusor muscle secondary to pain have been postulated as contributing factors.

Colorectal anastomotic stenosis. Results of a survey of the ASCRS membership.

Anastomotic stenosis is a poorly understood and underexamined complication of gastrointestinal surgery, reportedly most frequent in the coloproctostomy. In order to better define this problem, a questionnaire was sent to members of the American Society of Colon and Rectal Surgeons regarding patients with gastrointestinal anastomotic stenosis. A total of 123 patients with intestinal anastomotic stenosis were analyzed.

Anorectal and colonic disease and the immunocompromised host.

The immunocompromised host is becoming increasingly ubiquitous in the authors' patient population. There are growing numbers of long-term transplant recipients, and combination chemotherapy is producing many long-term survivors. Of greatest concern is that the number of patients with human immunodeficiency virus (HIV) causing immunosuppression is increasing.

Intrarectal ultrasonography in the staging and management of rectal tumors.

Intrarectal ultrasonography (IRUS) was used in the preoperative staging of 17 patients with rectal neoplasms. Fourteen patients had biopsy proven adenocarcinoma, and three others had large villous adenomas. Comparisons were made between clinical examination, IRUS staging and subsequent histopathologic staging.

A comparison between intrarectal ultrasound and CT scanning in staging of experimental rectal tumors.

The purpose of this study was to compare the accuracy of preoperative staging of experimental rectal tumors by digital rectal exam, intrarectal ultrasound (IRUS), and CT scanning with pathologic exam. Rectal tumor masses were induced in 10 mongrel dogs by submucosal injection of 2-3 cc of Freund's complete adjuvant. One week later, the animals underwent digital rectal exam, IRUS, and pelvic CT scans.

An assessment of colostomy irrigation.

One hundred patients with permanent sigmoid colostomies were surveyed to determine their satisfaction and success with the "irrigation" technique of colostomy management. Most patients who irrigate their colostomies achieve continence. Odors and skin irritation are minimized.

Patient-controlled analgesia vs. conventional intramuscular analgesia following colon surgery.

Though patient-controlled analgesia (PCA) has been in use for over a decade, it has been popularized only recently. Conventional techniques of intermittent intramuscular (IM) administration of analgesia have fallen short of meeting the needs of patients following major abdominal surgery. This has prompted a search for methods to improve postoperative pain management.