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Biomedical subjects

M L Corman

Publications and source records attributed to M L Corman.

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

Long-term results of open and closed sphincterotomy for anal fissure.

Three hundred fifty patients who underwent open or closed lateral internal anal sphincterotomy for acute or chronic anal fissure between January 1981 and June 1985 were reviewed. Minimum follow-up was 14 months (mean, 37 months). No patient underwent an additional procedure at the time of sphincterotomy. Twenty-one failed to heal or developed a recurrence in the interval (6 percent). Five of these individuals were found subsequently to have Crohn's disease. Excluding these patients, the incidence of nonhealing was 4.6 percent. Eight patients (2.3 percent) developed postoperative infections requiring drainage, one half of which were associated with fistulas. Sixty patients (17 percent) complained of incontinence for flatus or feces. For two thirds, this was transient. There was no statistically significant difference in rate of healing or morbidity when comparing the open with the closed method.

Abscess↗
PubMed1988

Rectal prolapse. Surgical techniques.

The varied operative procedures available for the treatment of rectal prolapse can be confusing. Most of the maneuvers are relatively esoteric and can be performed successfully only by the few surgeons who have developed the specialized techniques. It is recommended, therefore, that the surgeon who is less experienced with rectal prolapse adopt one of the standard operations. A rectopexy or suspension procedure without resection can be performed safely with good results, low morbidity, and a low mortality rate. Anterior resection with or without sacral fixation, an operation familiar to most surgeons, also offers an excellent cure rate. The Thiersch-type approach should probably be reserved for those patients who cannot tolerate laparotomy. The material chosen should be one of the commercially available synthetic products; wire should not be used. The Silastic-impregnated Dacron prosthesis for this operation has some potential benefit, especially for the incontinent patient. Results of further studies are awaited.

Anal Canal↗
PubMed1986

Are we really operating on diverticulitis?

The results of elective surgery for diverticulitis in 100 consecutive patients were reviewed. Follow-up was possible in 82 individuals. Seventy-seven (94 percent) were improved. There was no inflammatory change apparent on histologic examination of the resected specimens in 24 percent of patients. These individuals were less likely to have favorable results. There are a number of preoperative factors which may predict the likelihood of a successful surgical outcome.

Adult↗
PubMed1985

Anal incontinence following obstetrical injury.

Insufficient attention has been given to the anatomical anomaly as a predisposing factor for obstetrical injury. The operative approach and results in 28 patients indicate that excellent function can be achieved by recognition of the deformity and by the appropriate repair.

Adult↗
PubMed1985

Rectal prolapse in children.

Rectal prolapse in children is an uncommon clinical entity in western countries. Treatment is generally supportive with surgery reserved for the intractable case. If operative intervention is advised, it should consist of one of several limited procedures that can be safely performed with low morbidity: anal encirclement, presacral packing, sclerosing injection, or linear rectal cauterization.

Child, Preschool↗
PubMed1982

Mortality, morbidity, and patterns of recurrence after abdominoperineal resection for cancer of the rectum.

Records of 230 patients who underwent abdominoperineal resection between 1963 and 1976 were reviewed. The median age of the patients was 62 years. The mortality rate was 1.7 per cent, and the morbidity rate was 61 per cent. One hundred eighty patients were followed for five to 13 years to identify patterns of recurrence. Ten-year survival for Dukes' A, B, and C lesions was 83 per cent, 57 per cent, and 31 per cent, respectively. Seventy-eight patients (43 per cent) had recurrent cancer; 10 per cent had local lesions, and 33 per cent had distant lesions. Dukes' B lesions had a greater latency for local recurrence than Dukes' C lesions. Dukes' A lesions with distant recurrence had a greater latency than Dukes' B or C lesions. Once recurrence was established, the survival rate was not significantly different, regardless of Dukes' stage or local or distant site. Radiation therapy for established local recurrence or chemotherapy for established distant recurrence did not seem to alter survival rates.

Adult↗
PubMed1982

Electrocoagulation of rectal cancer.

Electrocoagulation is an effective treatment modality for localized cancer of the distal rectum. Proper selection remains the key to successful treatment. Of potentially curable patients with cancer of the rectum followed up for a median of five years, 69 per cent had no evidence of cancer at the end of the study period. Gross tumor morphology defined two distinct groups with regard to outcome after electrocoagulation. Ninety-two per cent of patients with polypoid/exophytic tumors as compared to 33 per cent of patients with ulcerative lesions had successful treatment. Based on these results, the authors believe that lesions that are exophytic represent early cancers with a low incidence of nodal spread and, as such, can be treated by electrocoagulation with confidence. As a palliative measure, the the authors found electrocoagulation to yield equivocal results.

Adenocarcinoma↗
PubMed1981

Controlled clinical trial of three suture materials for abdominal wall closure after bowl operations.

One hundred sixty-one consecutive patients who underwent bowel procedures were randomly assigned a nonabsorbable multifilament suture material, a nonabsorbable monofilament suture material or a long-term absorbable suture material for abdominal closure. All patients had midline incisions; closure was by an interrupted single layer technique. Patients were evaluated 1 month, 6 months and 1 year after operation. No statistically significant difference was seen in the incidence of wound infection in these groups. By 1 year, six patients had incisional hernias, none in the long-term absorbable suture group. The absence of suture sinus formation and the failure to demonstrate an increased incidence of wound dehiscence or incisional hernia imply that long-term absorbable suture material may be the most appropriate choice after bowel operations.

Abdominal Muscles↗
PubMed1980

Long-term evaluation of rubber ring ligation in hemorrhoidal disease.

Records of 266 patients who had undergone rubber ring ligation for hemorrhoidal complaints from 1969 through 1976 were reviewed to evaluate the long-term results. The minimum follow-up period was 36 months, with a mean of 60 months. Of the patients, 80 per cent were improved, with 69 per cent totally free of all symptoms. A subsequent hemorrhoidectomy was required in 7.5 per cent. Results were similar when either bleeding or prolapse was the primary indication for treatment. Patients who had a single band applied fared as well as those with two or more ligations.

Adult↗
PubMed1980

Anal sphincter reconstruction.

Injury of the sphincter mechanism that is caused by trauma may be repaired if the operation is carried out without prolonged delay and if sufficient residual sphincter remains. Successful surgical reconstruction requires thorough preoperative evaluation, fastidious preoperative preparation, meticulous surgical technique, and vigorous postoperative management. When the operation is delayed or considerable tissue has been lost or if the patient is elderly and has a history of constipation or laxative abuse, direct repair is frequently unsuccessful.

Anal Canal↗