Search PubMed⌕ Search

Biomedical subjects

J Girona

Publications and source records attributed to J Girona.

50 records · Page 3Linked to original sources
PubMed1984

[Value of ileorectal anastomosis in the treatment of ulcerative colitis. Clinical and functional results in 16 patients].

Sixteen cases of ulcerative colitis (11 female, 5 male) of the colon, treated by colectomy and ileorectal anastomosis were examined. The average follow-up was 3.6 years. Recto-ileoscopy with histological examination at the follow-up time revealed inflammation of the rectal stump in 6 patients. No cancer or cellular dysplasia could be seen in the present biopsies. The average number of bowel movements during 24 hours was 5.6 (range 3 to 8). Evaluating the anorectal function was made by measuring the resting and squeeze anal canal pressures and by assessing the maximum volume tolerated during distention of a ballon in the rectum. The mean maximum tolerated volume was 178.3 +/- 59.9 ml; the maximum tolerated volumen was less than 150 ml in 5 of 12 patients. There was no significant difference in the maximum of the control group. The maximum resting pressure (100.6 +/- 24.4 cm H2O), (p less than 0.01) squeeze pressure (183.1 +/- 32 cm H2O), (p less than 0.05) and the length of the anal canal 3.07 +/- 1.02 cm (p less than 0.01) were in boths groups significant different. There were no deaths, and no clinical evidence of an anastomotic leak could be found.

Adult↗
PubMed1983

[New methods of treatment of perianal fistula in Crohn disease. Long-term results in 81 patients].

Surgical treatment of anal fistulas was carried out on 103 patients with Crohn's disease (49 men and 54 women). The patients were between 9 and 72 years of age with an average of 35 years. A new operative technique is briefly presented: the main fistulous tract is excised out of the sphincter (muscle), proceeding from a wide excision made around the external opening. Meticulous core is taken to limit the loss of muscle tissue. The resulting opening within the anal canal is closed transanally as well as externally, using two or three layers of sutures, partly to prevent contamination and partly to speed up healing. Secondary tracts are drained and be granulations removed with a sharp spoon. The follow-up of 81 patients over a period of 4.8 years uncovered fistula recurrence in 17 cases. Of these patients, 15 had a recurrence within the abdomen, necessitating hospitalization. A high recurrence rate of 26% occurred in those patients where the disease was already present in the rectum. By comparison the recurrence rate was only 14% when the disease was otherwise limited to the terminal ileum. Rectovaginal fistulas exhibited the highest recurrence rate of 27.2%. Manometric measurements in 22 patients exhibited a shortening of the anal canal from 2.52 +/- 0.42 cm over and against 2.83 +/- 0.64 cm. There was also a reduction of the maximum voluntary pressure of 165 +/- 35 cm H2O compared with 200 +/- 39 cm H2O (P less than 0.01). These patients were compared with patients with Crohn's disease without manifestation of perianal fistula. None of the patients operated on exhibited incontinence for a firm bowel movement.

Adolescent↗
PubMed1983

[Long-term follow-up of mechanical anastomoses in surgery of the large intestine. Prospective study of 683 patients].

The long-term results of colorectal and coloanal anastomoses using the EEA, SPTU and ILS circular staplers are reviewed. Anastomoses with these stapling devices were performed in 683 patients between September 1978 and April 1982. 91% of patients with rectal carcinoma underwent rectal resection and restoration of bowel continuity. All patients were operated on for the same way. We used a cancericidal rectal irrigation with 5.0% Sublimate (HgCl2) regularly in all patients with carcinoma. The inferior mesenteric artery is ligated and divided, preserving the arcade between the ascending and descending branch of the left colonic artery. The incidence of postoperative complications amounted to 17%. Intraoperative complications occurred in 12,7% (anastomotic leak 8%, difficult extraction 1,5%, bleeding 0,4%, instrument failure 2,8%). The incidence of dehiscence of anastomosis after low anterior resection (n = 422) was 15% and 3% after high anterior resection (n = 261). The clinical leakage in both groups was 4.2 and 2.3% respectively. Two of 23 patients died because of anastomotic leakage only .4 patients (1.3%) have been observed to develop a recurrent anastomotic tumour and 18 (5.8%) developed a recurrent pelvic tumour. To test the sphincter function after a very low colo-rectal anastomosis (3.5 to 5 cm from cutaneous-anal verge) 32 patients were examined by using manometric studies. There were no statistically differences between normal subjects and those patients in resting pressure, maximum squeeze pressure, and length of anal canal. A significantly lower rectal compliance and rectal capacity could be found.

Adult↗
PubMed1982

[Total colectomy, rectomucosectomy, and ileoanal anastomosis with the ileum reservoir in treatment of ulcerative colitis].

An operation avoiding a permanent ileostomy is described for patients with ulcerative colitis. The colon and upper half of the rectum are excised and the remaining inflamed mucosa is stripped from the rectal stump down to the dentate line of the anal canal. After excision of all diseased tissue, a reservoir is constructed from the terminal 40 cm of the small intestine. An ileoanal anastomosis via the peranal approach is then carried out. Six patients have been treated, five of whom were followed up for 2-21 months (mean 11 months). One patient died 3 weeks after the operation. The other five are currently well, with no disturbance of urinary or sexual function. The average frequency of evacuation is 5 times in 24 h. Three of these evacuate the reservoir spontaneously and one routinely uses a catheter. (One patient still has an ileostomy). Fecal continence is complete in all during the day and night.

Adolescent↗
PubMed1982

[The abdominoendorectal resection with peranal anastomosis in the treatment of radiation injuries of the rectum (author's transl)].

During the period 1974-1980 39 patients underwent operations at the Prosper Hospital in Recklinghausen for radiation injuries to the rectum or rectosigmoid. They comprised 22 patients with rectovaginal fistulas, 6 with ulcers, 3 suffering from severe hemorrhagic proctitis, 5 with rectal strictures, 1 with necrosis, and 2 with radiation ulcers and carcinoma. A sphincter-saving operative method of treating postirradiation damage of the rectum is presented. The technique involves the peranal anastomosis of healthy colon to the midanal canal using a sleeve anastomosis. Technical and functional results of resectional surgery for the rectal complications of radiation therapy are reported. Subjectively, total continence was present in 78%, only 1 patient was incontinent because of flatus and watery stools.

Adult↗
PubMed1982

[Experiences with the Soviet suture stapler SPTU in colon and and rectum surgery. Controlled study of 94 patients].

In a controlled study the practicability, tightness of the anastomosis and complications in the p.o. period were analyzed in a total 94 colon and rectum anastomoses by making use of the SPTU-model. 28% of the patients operated in this way were more than 70 years old, the average age came up to 63.3 years. The incidence of anastomotic leakage after low anterior resection was 24% and 5.5% after high anterior resection. 17 per cent of the patients suffered from complications during the postoperative period and 2 patients (2.1 per cent) came to death. The results of 36 high and 58 low anterior resections justify the further use of the SPTU auto-suture apparatus.

Adult↗
PubMed1982

[Experiences with intraoperative colonoscopy in patient protocols in 2,547 cases].

Technique and indications for intraoperative colonoscopy are reviewed. A total retrograde fiberoptic colonoscopy was performed on the unopened bowel at laparotomy in 1135 patients, and a partial colonoscopy (70 to 90 cm) in 1412 patients. Additional polyps were found in 24% of patients with carcinoma of the rectum and colon (n = 1023), in 26% of patients with diverticulitis (n = 112), and 8.3% of patients with proctological diseases (n = 1412). A second carcinoma was found in 3.1% of cases with colonic carcinoma, in 1.8% of cases with diverticulitis, and 0.35% of cases with proctological diseases.

Colonic Neoplasms↗
PubMed1981

[Comparative results of EEA and SPTU staplers used for colo-rectal anastomoses in 260 patients (author's transl)].

The EEA and SPTU circular suturing staplers were used for colorectal anastomoses in 260 (116 male, 144 female) patients undergoing high or low anterior resection. 59 patients were over 70 years old, the average age was 62.1 years. The occurrence of anastomotic leakage after low anterior resection was 11.7% and 4.1% after high anterior resection. EEA was used in 225 cases (11.1% leaks) and SPTU in 35 patients (17.1% leaks). 25 patients (9.6%) suffered a complication during the postoperative period and 8 (3%) of them died.

Adult↗
PubMedDate not supplied

[Results of valvuloplasties with balloon catheter in children. Follow-up using pulsed Doppler. Experience with our first cases].

Our series includes the first 19 consecutive patients with pulmonary valvar stenosis who underwent balloon valvuloplasty in our hospital. All of them have been evaluated by an echo-Doppler study at different follow-up times, and in 10 patients the study was also performed prior to the dilatation. The ages ranged between 0.4 and 10 years (mean 3.5 years; standard deviation [SD] 2.53 years). The prevalvuloplasty degree of pulmonic stenosis found at catheterization was quantified as severe in 8 cases (42.11%) with a right ventricular systolic pressure (RVSP) in excess of 90 mmHg, and moderate in 11 cases (57.89%) with an RVSP from 70 to 90 mmHg. Transvalvular gradients were registered between 38 and 110 mmHg (m: 69 mmHg and SD: 15 mmHg). According to catheterization data obtained at the time of valvuloplasty, the procedure was considered ineffective in 2 cases (10.52%), scarcely effective in four (21.05%), and successful in the remaining 13 cases (68.42%). Doppler follow-up was carried out between 1.6 and 31.9 months after valvuloplasty (mean 12.9 months and SD: 10 months). Residual stenoses were estimated by Doppler as mild in 13 cases (68.42%), moderate in four (21.05%) and severe in two (10.52%). Mild pulmonary regurgitation was detected in 10 patients (52%). The 13 patients with a satisfactory result had slight residual gradients at the valvular level that had not been modified with the course of time. Of the 4 cases with a poorly effective dilatation the gradients noted by Doppler increased in three of them, being valvular in all but one in whom the obstruction was catalogued as infundibular.(ABSTRACT TRUNCATED AT 250 WORDS)

Catheterization↗