The colonic J-pouch in colo-anal anastomosis.

Anastomosis of the colon to the anal canal is now an accepted technique in the surgical management of low and mid rectal cancers. Although significant postoperative bowel disturbance is often seen with straight colo-anal anastomosis, controversy exists over the benefit of adding a colonic pouch for low anastomoses. Several short and long-term studies have demonstrated the early functional superiority of pouch-anal over straight anastomosis.

The obstetric anesthetic management of cardiac syndrome X.

A 38 year old primiparous pregnant patient with a history of Cardiac Syndrome X presented in labour. An epidural was used for pain relief. Patient was hemodynamically stable through out the labour, which ended with a normal spontaneous vaginal delivery of a live female baby.

A reply.

Dr McHugh, K. and Dr Rosenfeld, K. (1999).

The pubofascial anchor sling procedure for recurrent genuine urinary stress incontinence.

Objective: To evaluate, in a preliminary study, the outcome of a modified pubovaginal sling operation with titanium bone anchors for recurrent genuine stress urinary incontinence (GSI) in women.

Patients And Methods: This prospective study included 13 consecutive women who underwent the modified sling procedure between September 1994 and August 1996. The subjective and objective cure of urinary stress incontinence, and the occurrence of postoperative osteitis pubis, were assessed.