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Biomedical subjects

B Ravo

Publications and source records attributed to B Ravo.

At least 37 records · Page 2Linked to original sources
PubMed1988

Preoperative and postoperative evaluation by manometric study of the anal sphincter after coloanal anastomosis for carcinoma.

The purpose of the present study was to pre- and postoperatively evaluate the anal sphincter after coloanal anastomosis in 20 patients with carcinoma of the rectum at 5.5 to 8 cm from the anal verge. The 20 patients matched age and sex with the controlled subjects. Of the 20 patients, 17 with normal preoperative manometric studies when compared with control subjects underwent a coloanal anastomosis as described by Castrini, and three patients with preoperative incontinence underwent abdominoperineal resection. Manometric studies preoperatively, and postoperatively at three and 12 months, indicated a statistically significant decrease in squeezing pressure, and rectal compliance at three months that almost normalized by 12 months. The rectal compliance correlated with the number of bowel movements per day at three months (four to five per day) and at 12 months (two to three per day). The rectoanal reflex and length of pressure zone have remained unchanged. Results seem to indicate that anal continence can be preserved after coloanal anastomosis.

Adult↗
PubMed1988

Modified technique of sphincteroplasty with the use of a specially prepared cannula.

A modified technique of sphincteroplasty with the use of a specially prepared cannula can exclude the pancreatic duct from the operative field by covering it with the posterior wall of the cannula. The use of the cannula can avoid some of the technical difficulties that may be encountered with operations involving the papilla of Vater. Our experience with 51 patients has been presented.

Adult↗
PubMed1988

Colorectal neurovasculature and anal sphincter.

The varied blood supply of the colon and rectum has been described. It may be stated that the efficiency of any surgeon's hand is primarily dependent on the knowledge that guides it. Significant anatomic facts are described herein. An important blood supply to the terminal ileum comes from the generally unknown ileal artery, which, when absent, creates a critical, poorly vascularized area and thus an inappropriate area for an anastomosis. This right colic artery may be absent in 2 per cent. It may arise in common with the middle colic trunk (52 per cent). The middle colic artery is absent in 3 per cent. It occurs as a separate branch in 44 per cent and may be derived from celiac artery rarely. The inferior mesenteric artery divides into the left colic, which ascends to the splenic flexure, and a descending branch that continues downward as the superior rectal artery. The left colic artery may not reach the splenic flexure. The marginal artery may be interrupted or weakly represented at the splenic flexure. Therefore, one should perform a ligation of the left colic vessel before its bifurcation if the splenic flexure is to be preserved. The superior rectal artery is the main blood supply of the rectum. Its branching on the rectum is varied, but it has a rich anastomosis with the other rectal arteries, namely, the middle rectal and inferior rectal arteries. Sudeck's point is not critical. The middle rectal artery varies in number and origin and is not essential provided the inferior rectal artery is intact. The anatomy of the anal canal is described. The rectum is for a short distance surrounded by the anal canal with the external sphincter. The internal sphincter is the end of circular muscle of the rectum. The external sphincter can be thought of as one continuous muscle divided by longitudinal bands into three main parts: subcutaneous, superficial, and deep. Below the pectinate line in the anal canal, the nerve supply, lymphatic drainage, blood supply, and epithelium are different from that in the rectum.

Anal Canal↗
PubMed1988

Diagnostic anorectal functional studies. Manometry, sphincter electromyography, and defecography.

Anorectal manometric and electromyographic studies assess anorectal and pelvic floor neuromuscular disorders and can help in the diagnosis and management of incontinence, prolapse, megarectum, and other functional anorectal disorders. These studies can assess preoperative and postoperative anorectal function and help in the differential diagnosis of anorectal disorders, and thus they assist the surgeon in carrying out rational therapy.

Anal Canal↗
PubMed1988

Colorectal anastomotic healing and intracolonic bypass procedure.

Intestinal anastomoses continue to be complicated by leakages even in the best of hands despite the development of new surgical techniques, suture materials, devices, and stapling instruments. One may explain such persistence of anastomotic leakage on the basis of the dynamic effect that multiple factors have on the healing of an anastomosis. Awareness of these factors and proper precautions by the surgeon can make a high-risk anastomosis less prone to leakage. The intracolonic bypass procedure is an alternative to a temporary colostomy. It does not prevent an anastomotic dehiscence but can prevent anastomotic leakage with its associated complications in those situations where dehiscence is most likely to occur.

Aged↗
PubMed1988

Splenic preservation with the use of a stapling instrument: a preliminary communication.

Observation, ligation of the splenic artery, repair of the spleen by simple suturing with or without the use of hemostatic agents, omentum, an absorbable net or ladder, and partial splenectomy have all been proposed as a means of preserving the injured spleen. A new technique of partial splenectomy with the use of a stapling instrument is presented. The instrument has been used with success experimentally in dogs and in two patients.

Accidents, Traffic↗
PubMed1987

Developmental retroperitoneal cysts of the pelvis. A review.

Retroperitoneal cysts have been classified into traumatic, infective, degenerative, neoplastic, and developmental, according to their origin. This paper focuses on the developmental variety of retroperitoneal pelvic cysts, particularly those of mesothelial, mesonephric, or paramesonephric origin. Their clinical presentations depend on their location; they may be mesenteric, parovarian, or vaginal. The pathogenesis and embryologic, diagnostic, and therapeutic aspects are reviewed and a case report is presented.

Cysts↗
PubMed1987

The treatment of perforated diverticulitis by one-stage intracolonic bypass procedure.

The one-stage intracolonic bypass procedure prevents gastrointestinal secretions and fecal content from coming in contact with an anastomotic site without interrupting the intraluminal continuity of the fecal flow from proximal to distal colon. This can be achieved by the intraluminal implantation of a soft, pliable tube above the anastomotic site. Previous clinical and experimental data have indicated that the intracolonic bypass procedure can protect an anastomosis in the presence of maximal colonic loading, gross dehiscences, or fecal peritonitis. This report presents 28 patients with perforated diverticulitis, all of whom were treated by one-stage intracolonic bypass procedures. Ten of the 28 patients had peritonitis, and 18 had pericolic abscesses. Results indicate no deaths and no anastomotic leakages. Three patients (10.7%) had a complicated postoperative course. One patient with fecal peritonitis had prolonged ileus and a pulmonary effusion, and one had a myocardial infarction. Both of these patients responded to medical therapy. Another patient had a wound infection. The hospital stay ranged from 10 to 18 postoperative days. All patients passed the tubes spontaneously 2 to 3 weeks after operation. The one-stage intracolonic bypass procedure can be recommended as a viable alternative to the two- or three-stage procedures commonly used for perforated diverticulitis.

Abscess↗
PubMed1987

The use of the myouterine flap in closure of defects of the bladder.

A new surgical technique to close bladder defects using well vascularized myouterine flap is described. The flap serves as a temporary scaffold while the bladder is being bridged by natural bladder regeneration. The advantage of this flap is that it is not a free flap, being well vascularized through its pedicle, enhancing optimal bladder regeneration. This technique may be a useful surgical alternative for repair of large bladder defects.

Female↗
PubMed1986

Mucosal destruction and regeneration of the colon by local hyperthermia. An experimental preliminary study.

An experimental model has been developed to produce colonic mucosal destruction followed by regeneration. The canine model consists of a defunctioned portion of the large intestine which has been subjected to water at a temperature of 125 degrees F for 7 hours. Colonic specimens were harvested at different periods of up to six weeks and studied macro- and microscopically. It has been shown that it is possible to achieve significant mucosal destruction and regeneration. Possible adaptation to clinical states is presented and discussed.

Absorption↗
PubMed1986

Perineal transanal colonic resection: an experimental study.

Experimental data have led to the conclusion that a transanal partial or subtotal colonic resection can safely be performed in the dog without entering the peritoneal cavity. The techniques of intussusception of the colon at the anus and resection of the colon at the perineum with modified use of the EEATM stapler are presented.

Anal Canal↗
PubMed1986

The fate of transposed immature muscle and its clinical application.

Transposition of muscles with their intact neurovascular bundles is a well-accepted procedure in the adult with a predictable outcome. The fate of transposed immature muscle, however, has not been studied. For this reason, muscles were transposed in three 6-week-old puppies and harvested when the puppies were 6 months old. The developing normal and transposed muscles were studied using serial biopsies, electromyography, and histochemical methods, and the growth in bulk was assessed by serial radiography and measurements of length, breadth, height, and weight of the muscles at death. As judged by these criteria, the transposed muscle developed normally. A patient with prune-belly syndrome, treated by muscle transpositions from thigh to abdomen with satisfactory results, is also described.

Aging↗
PubMed1986

Anastomosis of intracolonic bypass tube by the use of EEA stapler. An experimental study.

The intracolonic bypass is a procedure that prevents the gastrointestinal secretions and fecal contents from coming in contact with an anastomotic closure site without interrupting the intraluminal continuity of the fecal flow from proximal to distal colon. Experimental and clinical data have indicated that the intracolonic bypass can protect such an intestinal anastomosis in the presence of a maximal colonic loading, dehiscences and fecal peritonitis. An experimental technique of implanting an intracolonic bypass tube with the EEA stapler in the colon is described.

Animals↗
PubMed1985

Gangrene of male external genitalia in a patient with colorectal disease. Anatomic pathways of spread.

This is the report of a patient with gangrene of the skin and subcutaneous tissue of the scrotum and base of the penis secondary to diverticulitis of the sigmoid colon. Due to high mortality in such patients, the early, rapid, and radical debridement of all devitalized tissues and prompt recognition of the source of sepsis is of utmost importance. Computed tomography (CT) scanning facilitates delineating the extent of disease. Anatomy of the perineal body and pathways of spread are discussed.

Aged↗