3,208 results match your criteria: "Perineal Reconstruction"

Purpose: This study aimed to identify surgical site infection (SSI) risk factors after anal reconstruction surgery in patients with anorectal malformations (ARMs).

Methods: This retrospective analysis from January 2013 to December 2022, including all pediatric surgical facilities in Hokkaido, Japan, examined consecutive patients with ARMs, excluding cloacal cases, regarding perioperative and SSI factors during their initial anal reconstruction surgeries.

Results: This study involved 157 cases of major clinical groups and 7 cases of rare/regional variants, among whom 4% developed SSIs.

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Anal Sphincter Reconstruction Using the Posterior Sagittal Approach for Pediatric Perineal Trauma.

European J Pediatr Surg Rep

January 2024

Department of Surgery, Colorectal and Pelvic Reconstructive Surgery, Children's National Hospital, Washington, District of Columbia, United States.

Traumatic perineal injuries are rare but can result in significant morbidity, particularly when the anal sphincter is injured. The management of such injuries in the pediatric population is rarely noted in the literature. We aimed to describe reconstruction in such patients using lessons learned in reoperative anorectal malformation surgery.

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This article presents an innovative technique for perineal wound reconstruction following extralevator abdominoperineal excision (ELAPE) in rectal cancer surgery. The authors trace the evolution of surgical methods for rectal cancer treatment, from W.E.

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Objective: A prospective study was conducted to investigate the feasibility and effectiveness of three-dimensional printed guide plates assisted hip arthroscopy in the treatment of Cam-type femoroacetabular impingement (FAI).

Methods: The clinical data of 25 patients with Cam-type FAI who met the selection criteria between December 2016 and September 2022 were collected. There were 13 males and 12 females with an average age of 42 years (range, 19-66 years).

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Necrotising fasciitis (NF), commonly referred to as 'flesh-eating disease', is a rare but life-threatening infection. It rapidly affects subcutaneous tissue, leading to necrosis of the overlying skin. Though primarily seen in the abdomen, perineum and lower limbs, periorbital involvement is rare.

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Introduction: Perineal hernias, protrusions through the pelvic diaphragm, are a rare complication post-abdominoperineal resection. The shift to extralevator APR techniques could be linked to a potential increase in these hernias. This case series evaluates the surgical management of perineal hernias, focusing on the evolving role of robotic surgery.

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Background: Vesicourethral anastomosis stenosis (VUAS) is a well-known complication of prostate cancer treatments, observed in up to 26% of the cases after radical prostatectomy. Conservative management, with single or even repeated transurethral dilation or endoscopic incision of the stenosis, is successful in many cases, but up to 9% of patients are destined to fail after endoscopic treatment. In these cases, a revision of the vesicourethral anastomosis is necessary and can be realized with different surgical approaches.

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Perineal hernias occur rarely following abdominoperineal resections. No standardized surgical approach exists for treating PH. We herein present the case of a large, symptomatic PH that was repaired with a combined abdominal and perineal approach, with peritoneal flap reconstruction of the pelvic floor and placement of a biological mesh.

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Purpose: To create and validate an anterior urethral stricture disease (aUSD) staging system based on the previously validated Length (L), Urethral Segment (S), and Etiology (E, LSE) classification system.

Materials/methods: The Trauma and Urologic Reconstruction Network of Surgeons (TURNS) prospective database was used to create and validate the staging system. A novel Urethroplasty Triad Score (UTS) was created to aid in ranking the stagings into stricture severity based on 1) functional outcomes, 2) location of urethral meatus (e.

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The giant condyloma acuminatum, known as the Buschke-Löwenstein tumor (BLT), is an uncommon, slow-growing, cauliflower-like tumor located in the anogenital region. It has a high recurrence rate, is sexually transmitted, and is often linked with immunosuppression. This tumor is commonly associated with human papillomavirus (HPV) infection, making HPV one of the most prevalent sexually transmitted infections affecting the perineal and genital regions.

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Treatment of strictures of the male anterior urethra: Bulbar urethra.

Fr J Urol

November 2024

Department of Urology, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite cedex, France.

Background: Bulbar urethral strictures are the most frequently encountered. Their management is standardized and needs to be applied to improve results.

Methods: A comprehensive literature review was conducted from December 2020 to December 2023, combined with a summary of recommendations from the American, Canadian, European, and French urological associations.

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A radiologist's guide to the galaxy of complications post total pelvic exenteration for rectal cancers.

Clin Radiol

October 2024

Department of Radio-diagnosis, Tata Memorial Hospital, Parel, Mumbai, 400012, India; Homi Bhabha National Institute, Anushakti Nagar, Trombay, 400094, India.

Article Synopsis
  • - Total pelvic exenteration (TPE) is a complex surgical procedure that may be the sole curative option for patients with advanced rectal cancers, resulting in lifelong management of two permanent stomas.
  • - There is a knowledge gap among radiologists regarding the complications that can arise after TPE surgery, leading to potential misdiagnosis or overlooked symptoms that could have serious consequences.
  • - The article aims to enhance understanding of postoperative pelvic anatomy, highlight early and delayed complications, and provide guidance on imaging techniques to accurately diagnose issues related to TPE through illustrative case studies.
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Anorectal malformations.

Nat Rev Dis Primers

November 2024

Department of Paediatric Surgery, Helsinki University Central Hospital, Helsinki, Finland.

Article Synopsis
  • - Anorectal malformations (ARM) are rare congenital defects occurring in about 3.32 per 10,000 pregnancies, involving a range of issues from mild anal canal displacement to severe fusion of the anorectum, vagina, and urethra.
  • - The developmental basis of ARM stems from improper septation of the hindgut during early pregnancy, with most cases being non-syndromic and lacking clear genetic causes.
  • - Surgical correction, primarily through posterior sagittal anorectoplasty since 1982, is common, but there is a need for further improvements in surgery outcomes, prenatal detection, and understanding the psychosocial impacts on patients.
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Introduction: The treatment tactics of patients with recurrent urethral stricture requires an integrated approach. An increase in the treatment efficiency is possible not only through improvements in surgical technique, but also by influencing the pathogenetic mechanisms of the formation of urethral stricture and stimulating regeneration.

Aim: To evaluate the efficiency of reconstructive procedures using platelet-rich plasma in patients with recurrent urethral stricture.

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Background: Patients undergoing perineal defect reconstruction with the internal pudendal artery perforator (IPAP) flap traditionally face 5 days of postoperative bed rest (BR) to minimize surgical risks. However, prolonged BR can exacerbate postoperative physiologic changes such as increased fatigue, reduced body mass, and declining lung function, while also leading to complications such as pneumonia, delirium, deep vein thrombosis, and pressure injuries. This study assessed the effectiveness, feasibility, and safety of an adapted early mobilization (EM) program for these patients.

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Surgical treatment of hypospadias with lichen sclerosus: Long-term outcomes from a single center.

Andrology

November 2024

Department of Pediatric Surgery, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

Background: Hypospadias with lichen sclerosus (LS) poses surgical challenges due to lack of materials for urethral reconstruction and coverage and the limited number of reports on this clinical condition.

Objectives: To report surgical strategies and outcomes for primary and redo hypospadias patients with LS.

Materials And Methods: We conducted a retrospective observational descriptive study with 31 patients with primary/redo hypospadias and LS between 2013 and 2023.

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Management of Recurrent Anal Cancer.

Surg Oncol Clin N Am

January 2025

Department of Surgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. Electronic address:

Locoregional failure or recurrence after completion of chemoradiation for anal squamous cell carcinoma occurs in up to 27% of patients. Complete restaging with multimodality imaging should be performed to evaluate the extent of local disease and distant metastases. Extensive discussion in multidisciplinary tumor board and with necessary specialties is vital to assess possibility of R0 resection.

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Article Synopsis
  • * Researchers reviewed 114 TPE cases but focused on 94 patients, comparing those who had primary suture closure with those who received p-ALT flap reconstruction.
  • * Results indicated that the p-ALT flap group experienced significantly fewer severe pelvic abscesses and EPS-related readmissions compared to the primary closure group, suggesting it is a more effective reconstruction method.
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Introduction:  The perineal body preserving posterior sagittal anorectoplasty (PSARP) (PPP) is a novel modification of the original PSARP for female patients with rectovestibular fistulas designed to eliminate the risk of perineal body dehiscence. This study aims to examine the outcomes following PPP.

Methods:  A retrospective, single-institution study was performed examining female patients with rectovestibular fistula who underwent PPP between January /2020 and December 2023.

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Introduction: A urethro-rectal fistula is an abnormal communication between the urethra and the rectum. It is a rare entity. It is most often an iatrogenic lesion during prostate surgery.

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Evaluation of Comprehensive Documentation After Obstetric Anal Sphincter Injury.

Int Urogynecol J

November 2024

Urogynecology & Pelvic Reconstructive Surgery, Department of OB/GYN & Reproductive Sciences, UC San Diego, San Diego, CA, USA.

Introduction And Hypothesis: The incidence of obstetric anal sphincter injuries (OASI) has increased in recent years, which may be due to improved recognition and documentation. There is limited evidence regarding the effects of thorough documentation of obstetric anal sphincter injury repairs on postpartum clinical outcomes. Our objectives were to (1) compare the incidence of perineal wound complications between documentation groups, (2) compare other adverse events, and (3) to describe factors associated with adequate documentation.

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Essential Considerations for Radiologists in Diagnosing Hidradenitis Suppurativa.

Radiographics

November 2024

From the Department of Radiology, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (C.A.d.A., F.M.C.); Department of Radiology, Centro Universitário de Valença, Valença, Brazil (C.A.d.A.); Diagnósticos da América S/A, Rio de Janeiro, Brazil (C.A.d.A., P.H., F.M.C., J.P., P.A.M., H.W., C.C.M.D.C.); Department of Dermatology, Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil (M.L.); Department of Dermatology, Universidade Federal Fluminense, Niteroi, Brazil (F.B.L.); Bio Design Laboratory, Pontifícia Universidade Católica, Rio de Janeiro, Brazil (G.R., H.W., C.C.M.D.C.); Department of Radiology, Universidade Federal Fluminense, Niteroi, Brazil (C.C.M.D.C.); Department of Radiology, University Hospital Clementino Fraga Filho, R. Prof. Rodolpho Paulo Rocco, 255- Cidade Universitária, Rio de Janeiro, RJ 21941-617, Brazil (C.A.d.A.).

Article Synopsis
  • * Diagnosis is based on recognizing specific characteristics of the lesions and the chronic nature of the disease, without the need for definitive biological tests or biopsies.
  • * Treatment options depend on the disease's severity and can involve antibiotics, hormonal therapies, and surgery, with imaging techniques like high-frequency ultrasound being essential for accurate assessment and monitoring of the condition.
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