PURPOSE: This study was designed to evaluate the efficacy and outcome of the Starion and Ligasure vessel sealing systems for sutureless hemorrhoidectomy. METHODS: Sixty-four patients with Grades III and IV hemorrhoids were randomized into two groups: 1) Starion hemorrhoidectomy (32 patients), and 2) Ligasure hemorrhoidectomy (32 patients). The patient demographics, ...

PURPOSE: This study was a prospective evaluation of the long-term effects of hysterectomy on bowel function using self-reported outcome measures on symptoms of constipation, rectal emptying difficulties, and anal incontinence. METHODS: In this prospective cohort study, 120 consecutive patients undergoing hysterectomy for benign conditions answered a questionnaire on bowel habits ...

INTRODUCTION: Stapled techniques of coloanal anastomosis in anterior resection have gained widespread acceptance over hand anastomosis. We believe a modification of the 'triple staple technique' has ergonomic advantages over existing stapling methods and present our technique and experience here. METHODS: Fifty consecutive patients underwent anterior resection with a concomitant defunctioning ...

OBJECTIVE: This prospective study investigated the factors which might indicate anastomotic leakage after low anterior resection. METHOD: Thirty-three patients who underwent anterior resection for rectal carcinoma (n = 32) and severe dysplasia (n = 1), were monitored daily by serum C-reactive protein (CRP) and white blood cell count (WBC) estimations ...

OBJECTIVE: Sacral nerve stimulation (SNS) is an established treatment for faecal incontinence. We aimed to identify specific factors that could predict the outcome of temporary and permanent stimulation. METHOD: A cohort analysis was performed to identify potential predictive factors in 81 patients who underwent temporary SNS at a single institution ...

BACKGROUND AND AIM: Faecal incontinence is a devastating complaint. Even after conservative treatment, many patients still remain incontinent. Few patients have a sphincter defect suitable for repair. Other emerging surgical therapies like dynamic gracilis plasty, neuromodulation or artificial bowel sphincter, carry side effects and show only moderate improvement. Temperature-controlled radiofrequency ...

BACKGROUND: The author proposes a technique of finger fragmentation of internal anal sphincter fibers to relieve anal sphincter spasm in patients with chronic anal fissures. This prospective study evaluates the clinical and functional outcome in a group of patients with chronic anal fissures. MATERIALS AND METHODS: Forty-five patients suffering from ...

BACKGROUND: Anal incontinence is experienced by some patients with rectal cancer who received low anterior resection. This study was to examine the efficacy and adverse effects of the alpha-1 adrenergic agonist phenylephrine, which causes contraction of the internal anal sphincter and raises the resting pressure in these patients. PATIENTS AND ...

BACKGROUND/AIMS: Surgical management of anal fistulas is associated with considerable morbidity, mainly related to anal sphincter injury. However, treatment with fibrin glue is a safe and simple method associated with less discomfort and complications. A prospective trial was conducted at our institute to evaluate the use of fibrin glue (Tissucol, ...

PURPOSE: The procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy) has been introduced as an alternative to conventional hemorrhoidectomy. This is a systematic review on stapled hemorrhoidopexy of all randomized, controlled trials that have been published until August 2006. METHODS: All published, randomized, controlled trials comparing stapled hemorrhoidopexy to conventional hemorrhoidectomy ...

BACKGROUND: The aim of our study was to assess our early and long-term results after stapled haemorrhoidopexy for fourth-degree haemorrhoids. METHODS: Our study covers the time period from 1998 to 2002 and consists of 56 consecutive patients (33 men) with fourthdegree haemorrhoids who underwent stapled haemorrhoidopexy. RESULTS: During the postoperative ...

OBJECTIVE: We studied whether excision of residual external skin tags causes additional pain in patients undergoing a stapled anopexy for muco-anal prolapse. METHOD: Seventeen patients in whom skin tags had been excised were compared with 24 patients having no excision. The patients were selected from a prospective database of haemorrhoid ...

BACKGROUND: Pouchitis is the major long-term complication after ileal-pouch nal anastomosis for ulcerative colitis. Ten to 15% of patients develop a chronic pouchitis, either treatment responsive or treatment refractory. AIM: To evaluate the efficacy of oral budesonide in inducing remission and improving quality of life in patients with chronic refractory ...

BACKGROUND AND AIMS: Neoadjuvant chemoradiation (nCRT) followed by curative surgery has gained acceptance as the therapy of choice in locally advanced rectal cancer. This prospective study evaluates the effect of nCRT on postoperative anorectal function and continence. PATIENTS AND METHODS: Group A consisted of 12 patients (59.8 +/- 11.9 years, ...

The objective of this study was to document the complications, outcomes and causes of obstetric fistulas in East African women who underwent first-time surgical repair. Attention was also paid to social background and characteristics of the patients. Data were collected prospectively from patients operated on in the period from January ...

BACKGROUND: The present study evaluated outcomes of patients undergoing proximal diversion using either a loop ileostomy or loop colostomy following distal colorectal resection for malignant and non-malignant disease. METHODS: A literature search of the Medline, Ovid, Embase and Cochrane databases was performed to identify studies published between 1966 and 2006, ...

BACKGROUND: A cervical side-to-side stapled esophagogastric anastomosis appears to decrease morbidity compared with traditional hand-sewn techniques. We evaluated our experience with this novel technique in intrathoracic anastomoses and compared the outcome with circular-stapled or hand-sewn techniques. METHODS: All patients undergoing transthoracic esophagectomy from 1999 to 2005 for esophageal cancer with ...

Purpose Abdominal posterior rectopexy for rectal prolapse produces the lowest recurrence rates. However, 50% are troubled by severe postoperative constipation. Resection mitigates this dysfunction but involves the risks of an anastomosis. We aimed to evaluate functional results with laparoscopic anterior rectopexy, a novel technique designed to avoid rectal denervation and ...

OBJECTIVE: We have audited our 5 years experience of circumferential-stapled haemorrhoidopexy (PPH). METHOD: A prospectively collected electronic data base of our 5-year experience to September 2005 has been examined. RESULTS: A total of 357 consecutive patients (220 - 62% women, median age 46 years; range 28-92) with symptomatic third- and ...

BACKGROUND: The aim of the present study was to evaluate the influence of a younger age at the time of ileal pouch-anal anastomosis (IPAA) on functional outcome and quality of life in patients with familial adenomatous polyposis (FAP). METHOD: A total of 105 patients with FAP who had undergone IPAA ...

BACKGROUND: Total proctocolectomy and ileal pouch anal anastomosis (IPAA) is the preferred operation for patients with chronic ulcerative colitis (CUC) refractory to medical therapy. Infliximab (IFX), an antitumor necrosis factor-alpha antibody, has demonstrated efficacy in medical management of CUC. The aim of this study is to determine if IFX before ...

Analysis of the clinical course of patients with postirradiation rectovaginal fistula after fecal diversion. The studied group included 17 women with postirradiation rectovaginal fistula who underwent fecal diversion as a sole mode of treatment, between January 1987 and December 2002, in our department. All patients were subjected to radiotherapy due ...

Fournier's gangrene is a rare infection characterized with fast-progressing myonecrosis, that affect regions of perineum, genitalia and perianal area. This retrospective study presents authors' experiences and their principles in early diagnosis and treatment of Fournier's gangrene. The goal of this paper is to point out numerous diagnostically and therapeutic difficulties ...

BACKGROUND AND OBJECTIVES: Rectovaginal fistulas (RVF) in Crohn's disease continue to be a challenging problem. Several operations are often necessary to attain definitive healing of the disease process. There are no guidelines concerning optimal therapeutic approaches. Endoanal mobilization techniques such as the advancement flap technique were considered the therapy of ...

To assess the predictive value of wound amylase as an indicator for pharyngocutaneous fistula development following laryngectomy for cancer. We conducted a prospective observational study at a tertiary referral center of 102 consecutive laryngeal or hypopharyngeal cancer patients undergoing laryngectomy with or without pharyngectomy. Data were collated on potential predictors ...

PURPOSE: Although there is enthusiasm for nonoperative management of anal fissures, most trials have been of short duration (6-8 weeks) and long-term outcome is unknown. The purpose of this study was to assess long-term outcome in two cohorts of patients who had participated in a randomized, controlled trial to compare ...

PURPOSE: The natural history of sigmoid diverticulitis in terms of the virulence and management in young patients is an ongoing controversy. This retrospective study was designed to assess the severity and early management of acute diverticulitis according to age. METHODS: From 2000 to 2004, 284 patients were admitted for acute ...

In this retrospective study, our aim was to introduce an industrial synthetic material that can be used as a seton and then to present the results of complicated anal fistula cases treated with this different sort of seton. Between 1997 and 2005, 32 patients (aged 27-63 years) with a high ...

BACKGROUND: The impact of neoadjuvant treatment and their subsequent early complications in the treatment of rectal cancer has not been adequately assessed. The aim of this prospective study was to evaluate early postoperative morbidity and mortality among patients with rectal cancer treated with adjuvant radiotherapy and chemotherapy followed by surgery, ...

BACKGROUND & AIMS: The options for prevention of colorectal cancer in familial adenomatous polyposis are either a colectomy with ileorectal anastomosis (IRA) or a total proctocolectomy with ileal pouch-anal anastomosis (IPAA). Rectal cancer risk is eliminated by IPAA, but complication rate is higher than in IRA. Mutation analysis might predict ...

BACKGROUND/AIMS: We prospectively compared changes in function between colonic J-pouch and straight anastomoses from 1 to 5 years after low anterior resection for rectal cancer. METHODOLOGY: At 1, 3, and 5 years after surgery, functional outcome was compared between 48 patients with J-pouch reconstruction (J group) and 51 with straight ...

BACKGROUND: Long-term pouch function and physiological characteristics after ileal pouch-anal anastomosis (IPAA) are poorly described. The aim of this study was to undertake a prospective investigation of long-term pouch function and manovolumetric characteristics. METHODS: Forty-two patients with a median follow-up of 16 years after IPAA were included. Function was assessed ...

BACKGROUND: Ileal pouch-anal anastomosis (IPAA) is performed routinely for chronic ulcerative colitis. METHODS: Using data from a prospective database and annual standardized questionnaires, functional outcome, complications and quality of life (QoL) after IPAA were assessed. RESULTS: Some 1885 IPAA operations were performed for chronic ulcerative colitis over a 20-year period ...

OBJECTIVE: Controversy surrounds the optimal surgical management of the distal rectal remnant during colectomy for ulcerative colitis (UC) and the potential benefit from the placement of a rectal catheter for remnant drainage. This study reviews the clinical outcomes of patients who have undergone colectomy for UC with intra-peritoneal closure of ...

PURPOSE: Treatment of anal fistulas by use of adhesives is an attractive method because of its simplicity and it can be performed on an ambulatory basis. Furthermore, if the treatment is unsuccessful, adhesive use does not subsequently prevent the surgeon from utilizing alternative surgical techniques and/or products. BioGlue Surgical Adhesive ...

PURPOSE: Rectal instillation of 4 percent formalin solution has been described as a successful treatment for hemorrhagic radiation proctitis recalcitrant to medical treatment. We present our experience with a new method of treatment involving the topical application of 10 percent buffered formalin, which is well tolerated and suitable for office ...

Perianal eczema is a kind of inflammatory dermatosis on the perianal skin and mucosa. The aim of the study was to evaluate the clinical efficacy of the combined therapy of medicine and operation for the perianal eczema caused by the anal diseases such as hemorrhoids, fissures and fistulas. One hundred ...

Abstract. Background and aims: The main aim was to examine constipation and anal incontinence in patients before and after resection for external rectal prolapse. Material and mehods: Twenty patients had ligamentpreserving suture rectopexi and sigmoid resection (resection rectopexi) for external rectal prolapse by laparascopic (n=15) or open (n=5) technique during ...

BACKGROUND: Early surgical results of anterior sphincter repair for faecal incontinence can be good, but in the longer term are often disappointing. This study aimed to determine the short and long term outcomes from anterior sphincter repair and identify factors predictive of long term success. METHODS: Patients who underwent anterior ...

AIMS: This study was aimed to determine whether there was any relationship between consumption of chillies and postoperative symptoms after closed anal sphincterotomy in patients with chronic anal fissure. MATERIALS AND METHODS: Patients were randomly assigned to receive analgesics and fiber supplement alone (control patients) or consumption of 1.5 g ...

BACKGROUND: Grade III and IV anal sphincter ruptures after vaginal delivery are an increasing problem. We assessed the outcome of an overlap technique in primary repair. METHODS: In this retrospective observational study, from 2002 to 2004, 61 consecutive women with grade III and IV obstetric tears were included. Of the ...

OBJECTIVE: To evaluate the efficacy and costs of chemical (topical glyceryl trinitrate ointment) versus lateral internal sphincterotomy for the treatment of chronic anal fissure. Design: A quasi-experimental study. PLACE AND DURATION OF STUDY: This study was conducted at D.H.Q. /Allied Hospital, Faisalabad from November 2001 to October 2003. PATIENTS AND ...

This article shows a prospective study investigating bowel function after transanal rectal resection with internal and external sphincterectomy for low rectal cancer. Eight patients underwent standard low anterior resection with colonic J-pouch anal anastomosis (LARJ), and eight patients underwent transanal rectal resection with internal and external sphincter resection (IESR). Manometry, ...

OBJECTIVE: In prolapsed haemorrhoids, there is a permanent outward displacement of the mucosa of the anal canal, often involving the rectal mucosa. On this background, Longo set up a technique in 1998 to reduce haemorrhoidal prolapse, using a circular stapler. The aim of this study is to report our 7 ...

BACKGROUND: Anterior anal sphincter repair (ASR) is standard treatment for fecal incontinence resulting from an obstetrically damaged anal sphincter. Longterm results of repair have generally been shown to be poor. This review of single-unit series aimed to determine longterm outcomes of primary ASR for patients with fecal incontinence from obstetrically ...

BACKGROUND/AIMS: There are no reports about the relationship between soiling and other defecation states in patients with ulcerative colitis (UC) after ileal J pouch-anal anastomosis (IPAA). To assess the defecation states in patients with or without soiling at 5 years or more after IPAA for UC, we studied clinical findings ...

BACKGROUND AND AIMS: The main aim was to examine constipation and anal incontinence in patients before and after resection for external rectal prolapse. MATERIAL AND METHODS: Twenty patients had ligament preserving suture rectopexy and sigmoid resection (resection rectopexy) for external rectal prolapse by laparoscopic (n = 15) or open (n ...

INTRODUCTION: The Snodgrass technique and its modifications have become a preferred method for all varieties of hypospadias in the past decade. However, fistula is the most common complication of this technique. The aim of this study was to investigate the importance of the single and double flap to prevent fistula ...

AIM: The purse-string suture is the most important part of the procedure in stapled hemorrhoidopexy affecting resection of an ideal mucosal rectal ring. We designed a prospective, randomized study to evaluate the safety and clinical outcome of a 6-stitch purse-string suture compared with a more simple 3-stitch purse-string suture intended ...

PURPOSE: We developed several kinds of jejunal (J)-pouch reconstruction after a gastrectomy for gastric cancer. The aim of this study was to investigate the advantages of these methods. METHODS: As for the treatment of malignant gastric diseases at stage II or earlier, we employed the J-pouch reconstruction (Roux-en-Y method: JPRY, ...