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Biomedical subjects

B Salky

Publications and source records attributed to B Salky.

13 recordsLinked to original sources
PubMed1987

Familial polyposis coli. Results of mucosal proctectomy with ileoanal anastomosis.

The outcome of mucosal proctectomy with ileoanal anastomosis in patients with polyposis coli has not been well studied. A series of 25 patients with polyposis treated at the Mount Sinai Hospital over a period of ten years is reported. The mean age of the patients was 23 years. Early postoperative complications were present in seven patients and consisted of thrombophlebitis (three), pelvic sepsis (three), and retraction of the anastomosis (one). Intestinal obstruction requiring laparotomy occurred in another five patients. Twenty-three patients were followed for a mean of 47 months after closure of the ileostomy. Ninety-one percent are satisfied with the operative results. The mean number of bowel movements per 24 hours is 6.0. All patients are continent, but eight have occasional episodes of rectal seepage at night. Nearly 50 percent require some antidiarrheal medication. New adenomatous polyps have developed just above the dentate line in four patients. Patients with polyposis coli seem to have fewer serious complications requiring excision of the ileoanal anastomosis than patients with ulcerative colitis. They also should have lifelong surveillance of the entire gastrointestinal tract even after total colectomy with ileoanal anastomosis.

Adolescent↗
PubMed1983

Mucosal proctectomy without reservoir.

Mucosal proctectomy with endorectal pull-through allows the removal of all colonic mucosa with preservation of continence. This operation was performed in 19 patients with familial polyposis coli and ulcerative colitis. A temporary loop ileostomy was used to defunctionalize the anastomosis. Intestinal continuity was restored in 17 of the 19 patients. Mean duration of follow-up was 29 months. All patients are continent, and the mean number of bowel movements per 24 hours is 6. Follow-up barium studies revealed a gradual dilatation of the terminal ileum within the rectal cuff which accounts for the decrease in the number of bowel movements. This operation eliminates the risk of carcinoma without compromising sphincter function.

Adolescent↗
PubMed1983

Sexual dysfunction following proctocolectomy for benign disease of the colon and rectum.

Standard surgical therapy for the treatment of chronic ulcerative colitis is total extirpation of the colon and rectum. Since ulcerative colitis is primarily a disease of young adults affecting many people at the inception or height of their sexually active years, postoperative sexual dysfunction is an extremely disconcerting complication. Between July 1973 and May 1981, 291 proctectomies for benign disease of the colon and rectum were performed by the authors. This included 135 men and 156 women. Resection of the rectum was performed using an intrasphincteric technique with dissection kept extremely close to the wall of the rectosigmoid, rectum, and anus. Proctectomy was performed in this manner to prevent significant disruption of the nerves carrying stimuli to the genital organs. Of the 135 males undergoing a proctectomy, four (3%) had a permanent deficit in sexual function. Two men, aged 32 and 30, could sustain an erection but had retrograde ejaculation. Two patients, age 19 and 44, have remained impotent for 1 1/2 and two years, respectively. One hundred fifty-two of the 156 females are sexually active and only two (1.3%) have complained of any physical sexual dysfunction. Each had temporary dyspareunia lasting between nine months and one year after operation.

Adult↗
PubMed1982

Nonoperative conversion of tube gastrostomy to feeding jejunostomy.

Although esophageal reflux of gastrostomy feeds is an uncommon problem, severe pulmonary complications can arise. If implementation in an upright position and use of continuous infusion does not prevent reflux, an alternative method of providing adequate nutrition must be used. This nonoperative technique of converting a tube gastrostomy to a feeding jejunostomy is simple to perform, atraumatic and extremely useful.

Enteral Nutrition↗
PubMed1980

Toxic megacolon in ulcerative colitis complicated by pneumomediastinum: report of two cases.

We describe two cases of universal ulcerative colitis in which toxic megacolon was complicated by the unusual occurrence of air tracking retroperitoneally through the diaphragm and the mediastinum, without signs of free intraperitoneal air, and ultimately presenting as subcutaneous emphysema in the neck. Physicians should remain alert to this unusual presentation of air leakage from the colon in toxic ulcerative colitis, in order to appreciate the potential gravity of the situation.

Adolescent↗
PubMed1979

Splenectomy for Gaucher's disease.

The records of ten patients who underwent splenectomy for Gaucher's disease were reviewed. All patients had the adult type of the disease. The indications for splenectomy were hypersplenism and mechanical problems. The hematological picture returned to normal in all cases and has remained so throughout the follow-up period. The different forms Gaucher's disease and specific diagnostic tests are discussed. Even though splenectomy is indicated when hematological and mechanical problems exist, selective enzymatic replacement therapy seems to be the preferred future mode of treatment.

Adolescent↗