Quantitative contribution of prognosticators to oncologic outcome after rectal cancer resection.

Background: Prognostication is an important aspect of medical practice. It relies on statistical modeling testing the correlation of variables with the outcome of interest.

Objective: In contrast with the classic approach of predictive modeling, this study aimed to estimate the unique, individual, and relative contributions.

Completeness and registration bias in PROCARE, a Belgian multidisciplinary project on cancer of the rectum with participation on a voluntary basis.

Background: PROCARE, a Belgian multidisciplinary project on rectal cancer, started in 2006 with participation on a voluntary basis. Completeness and bias of registration in PROCARE were assessed.

Methods: Data from 6353 patients with rectal cancer were extracted from the population based Belgian Cancer Registry for the period 2006-2008.

Prosthesis-patient mismatch predicts structural valve degeneration in bioprosthetic heart valves.

Background: Prosthesis-patient mismatch (P-PtM) after aortic valve replacement results in disturbed valve performance associated with increased pressure gradients. However, it is unknown whether this can be related to future structural valve deterioration (SVD) of the bioprosthesis.

Methods And Results: In 564 patients (mean age, 74+/-5 years) receiving an aortic valve bioprosthesis, clinical follow-up (median, 6.

Yield of routine imaging after curative colorectal cancer treatment.

Background/aim: The use of imaging in the follow-up of patients after curative colorectal cancer resection is much debated. The American Society of Colon and Rectal Surgeons did not recommend routine imaging. This retrospective study assesses the yield of routine imaging to detect recurrent disease.

The effect of polyethylene glycol and butyrate on anastomotic healing in the rat colon.

Background: The use of mechanical bowel preparation is much debated.

Methods: We evaluated the effects of polyethylene glycol (PEG), with or without a single dose of 3.0 mmol butyrate (BUT), on the bursting pressure (BP) of an intact colon segment and a colon anastomosis in rats.

Prosthesis-patient mismatch is not clinically relevant in aortic valve replacement using the Carpentier-Edwards Perimount valve.

Background: Previous studies have shown that prosthesis-patient mismatch (PPM) results in higher early and late mortality after bioprosthetic aortic valve replacement. Careful selection of stented bioprostheses was recommended to avoid inadequate effective orifice area. We studied the incidence of PPM and its potential effects on clinical outcome in patients undergoing aortic valve replacement using the Carpentier-Edwards Perimount bioprosthesis.

Understanding participation in an asthma self-management program.

Study Objective: Asthma education programs improve asthma treatment results significantly. Low participation rate is a recurrent problem that impedes the efficiency of those programs. The purpose of this study was to investigate social cognitive determinants of the intention to participate in an asthma self-management program.

Success and failure after repair of rectovaginal fistula in Crohn's disease: analysis of prognostic factors.

Objective: To compare the healing rate after several types of surgical repair of rectovaginal fistula (RVF) in Crohn's disease, and to identify factors predicting a successful outcome.

Patients And Methods: A Medline review of the literature since 1980 and analysis of our results in 32 consecutive patients was done.

Results: All types of repair (rectal, vaginal, anocutaneous advancement flap, or perineoproctotomy with fistula closure) seem to be equally effective.

Factors affecting mortality in generalized postoperative peritonitis: multivariate analysis in 96 patients.

Mortality of generalized postoperative peritonitis remains high at 22% to 55%. The aim of the present study was to identify prognostic factors by means of univariate and multivariate analysis in a consecutive series of 96 patients. Mortality was 30%.

Rectal washout with cytotoxic solution can be extended to the whole colon.

Background: Rectal irrigation with a cytotoxic agent does not kill viable intraluminal cancer cells proximal to the primary tumour. To prevent implantation of these cells at the time of restorative proctectomy, the feasibility of retrograde whole-colon irrigation just before surgery was explored.

Methods: The cytotoxic efficacy of different combinations of povidone-iodine (PVPI) and Gastrografin was tested with the trypan blue exclusion test on a human colon carcinoma cell line (SW620) in vitro.

Endovascular repair of inflammatory abdominal aortic aneurysms with special reference to concomitant ureteric obstruction.

Objectives: To study the technical feasibility and results of endovascular treatment of inflammatory abdominal aortic aneurysms (AAA).

Design: Prospective study.

Material And Methods: Seven patients underwent endovascular repair of an inflammatory AAA.

Combined radiologic and manometric study of rectal filling sensation.

Purpose: Sensation is an essential aspect of fecal continence. We aimed to correlate manovolumetric and radiologic changes at successive levels of rectal filling sensation.

Methods: Combined anorectal manometry and proctography were performed in nine volunteers.

Cadaver fascia lata sling in the treatment of intrinsic sphincter weakness.

Eight older women with stress incontinence caused by intrinsic urethral weakness underwent sling surgery with allogenic fascia lata. The tolerance of the material was excellent. In 1 case a secondary release of the fixation on the pecten was necessary because of too much tension; in the other cases the evolution was uneventful and resulted in perfect continence lasting for at least 2 years of follow-up.

The pathology of complex fistula in ano.

Anal fistulae do not heal spontaneously without surgery. Knowledge of anorectal anatomy and function, and diligent examination frequently requiring anaesthesia are prerequisites for adequate assessment, classification and treatment of the pathology. Fistulography, endoanal ultrasound and MRI of the anorectum may have additional diagnostic value with therapeutic impact in complex and recurrent fistulae.

Extensive surgery on the trigone for complete ureteral duplication does not cause incontinence or voiding problems.

Objectives: To evaluate whether extensive trigonal surgery for duplicated kidneys is harmful for later bladder and urethral function.

Methods: Of 201 surgically treated children with kidney and ureteral duplication, 145 were followed up for at least 1 year. The mean follow-up was 5 years (range 1 to 15), and all patients were at least 7 years old at the date of their last follow-up visit.

The after-contraction: a true detrusor contraction or a late dyssynergic urethral sphincter contraction?

Objective: To evaluate the mechanism and significance of the after-contraction, recorded in bladder pressure by urodynamics, at the end of micturition.

Patients And Methods: The urodynamic recordings showing an after-contraction of the detrusor in 65 patients of all ages and with a variety of pathologies were re-examined. Special attention was directed to the anal or urethral sphincter needle electromyographic activity and to the monitored urethral pressure, to determine any relationships with the patterns of detrusor pressure.

Pouch-sacral fistula three years after restorative proctocolectomy for ulcerative colitis.

Fistula formation after restorative proctocolectomy poses a challenge to the surgeon and sometimes can lead to the excision of the pouch. A 21-year-old female patient developed an ileal J-pouch-sacral fistula with abscess and osteomyelitis of the sacrum, more than three years after the pouch construction for ulcerative colitis. Two months prior to this event, the patient had a single and transient episode of pouchitis.

Prevention of anastomotic tumour take by on-table colon washout with povidone-iodine. an experimental study in rats.

The presence of organic material in the intestinal lumen is reported to interfere with the efficacy of cancericidals when used in low concentrations to prevent anastomotic recurrence in colorectal cancer surgery. We aimed at investigating the efficacy of intra-operative whole-colon washout using povidone-iodine in an experimental model of anastomotic tumour growth. A large inoculum of highly 'tumorigenic' carcinoma cells was instilled in the colonic lumen of Fischer rats.

Local and systemic effects of intraoperative whole-colon washout with 5 per cent povidone-iodine.

Background: Segmental intraluminal instillation of several tumoricidal agents including povidone-iodine has been advocated to prevent anastomotic recurrence after colonic resection for colorectal cancer. The local and systemic effects of on-table whole-colon washout using 5 per cent povidone-iodine were assessed in patients undergoing elective surgery for colorectal cancer.

Methods: The local effect of 5 per cent povidone-iodine on the colonic mucosa and the effect of colonic mucosal damage by povidone-iodine on tumour take was first investigated in Fischer 344 rats.

The outcome of major biliary tract injury with leakage in laparoscopic cholecystectomy.

Background: Concern has been expressed regarding the increased rates of biliary tract injury (BTI) at laparoscopic cholecystectomy. The aim of the present investigation was to analyze the outcome of laparoscopic biliary tract injury with leakage.

Methods: Sixteen patients having major laparoscopic BTI with leakage were treated.