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PubMed1989

[The results of using necessarily low anterior resections for carcinoma of the lower half of the middle third of the rectum].

Compulsively low anterior resection of rectum was performed in patients with tumor localized in the lower half of the middle one third of the rectum (7-10 cm from the anorectal line) and vague vascular arcades in the left half of the colon or having very fat meso. The following technique was applied: The left half of the colon was mobilized, releasing it from the gastrocolic junction, and the rectum--to the anal sphincters; One-stage anastomosis with step-like course of the catgut was performed, threading it previously to the posterior and lateral parts of the anastomosis and on the anterior wall--to the rectal stump only; when the anastomosis was performed, the catgut was passed through the upper pelvic diaphragmatic fascia as well. The method was applied on 19 patients; the first six of them had prophylactic transversostomy performed. In none of the patients was insufficiency of the anastomosis or recurrence of the tumor observed.

Aged↗

PubMed1989

[Rectum prolapse: resection or abdominal rectopexy].

From January 1983 to December 1987 38 patients had an operation for rectum prolapse. Out of them 20 had anterior rectal resection, in 16 cases we performed a Ripstein-operation, in 1 case we had to do a Miles-procedure, in 1 case a Hartmann-procedure. The follow-up of the patients with anterior rectal resection showed significant increase of continence. There was no recurrence, no patient died from the operation. The Ripstein-procedure showed less effectiveness concerning the continence. In this group we found recurrences, no patient died due to the operation. There was no infection in the small pelvis. We now prefer the anterior resection for treatment of rectum prolapse. First of all we had no recurrence and we were able to increase the continence. This is reason enough to treat the rectum prolapse further on by anterior rectal resection.

Adult↗

PubMed1988

[Nd:YAG laser treatment of recurrent adenomas in the preserved rectum in patients with a ileo-rectal anastomosis in familial polyposis coli].

Eight patients with ileo-rectal anastomosis following a total colectomy for familial polyposis coli underwent Nd: YAG laser therapy to treat recurrent adenomas in the preserved rectum after the operation. The median follow-up period for these eight patients has been 4 years and 7 months. Of the eight patients, one underwent a mucosectomy of the preserved rectum and an ileo-anal pull-through five years after the first operation because of recurrent diffuse polyposis of the preserved rectum. In the remaining seven patients, Nd:YAG laser therapy was found to be effective in the abration of recurrent polyps.

Adenoma↗

PubMed1987

[The efficacy of temporary retention chemotherapy of the treatment of polyps in the remnant rectum of familial polyposis after total colectomy and ileorectostomy--a case report].

A case of familial polyposis is reported. The patient was a 24-year-old woman on whom total colectomy followed by ileorectostomy had been performed. However, there were multiple polyps remaining in the remnant rectum. For the treatment of these residual polyps, a new chemotherapeutic method known as Temporary Retention Chemotherapy (TRC), originally devised by us for the treatment of advanced gastric cancer, was applied. A balloon catheter was inserted and fixed into the rectum via the anus for the treatment of the rectal tumors. Through the catheter, high-dose 5-fluorouracil (5-FU) solution was injected into the rectum and retained there for one hour before being discarded. During the therapy, the patient was asked to change her position of recumbency at certain intervals, so that the 5-FU solution could act evenly on the lesions in question. This therapy was repeated twice a week, and followed by routine endoscopic studies. A total dose of 5,700 mg of 5-FU was necessary for obtaining a complete response of the remnant lesions. 6 months later, 4 polyps were found, and TRC was again applied, resulting in disappearance of the polyps again after the therapy. So far, no side-effect have been noted as a result of this therapy. She is currently still alive without any residual polyps, carcinoma or metastasis 6 years after the operation.

Adenomatous Polyposis Coli↗

PubMed1986

[Results of therapy of rectal cancer following anterior resection and abdominoperineal rectum amputation].

Since 1979, 174 patients with histopathologically proven adenocarcinoma of the rectum have undergone abdomino-perineal extirpation (Quenu) or anterior resection for cure. In 86% patients in Dukes stage B were undergone anterior resection and in 92.2% patients in Dukes stage C undergone extirpation. The recurrence rate was lower than 7%, 25% of them were local recurrences and 75% recurrence of the tumor in general. Anastomoic leak was not found after anterior resection. The three-years-survival rate was significantly higher in patients with adeno carcinoma of the rectum in the middle and upper part of the rectum. The three-years-survival rate was after anterior resection 87.6%. After abdominal extirpation, in most cases Dukes C, the three-years-survival time was 58.6%. For curative surgery a "curative" cancer resection involves resection of the cancer bearing rectal segment with its adjacent fat, blood vessels, nerves and lymph nodes. Specially in cases of mid rectal cancer involves resection of mesentery and utilizing high ligation of the inferior mesenteric artery and vein.

Abdomen↗

PubMed1986

[Single nonspecific ulcer of the rectum].

The authors report 4 cases with single, non-specific ulcer of rectum. The diagnosis, in all the cases, was made after endoscopic and histological studies. Single ulcer of rectum is for the first time reported in a pregnant woman, that necessitated the interruption of pregnancy. The ulcer could spontaneously be healed and be combined with an ulcer of duodenum. The patients with single ulcer of rectum should be under follow-up care and yearly controlled in the course of three years.

Adult↗

PubMed1985

Anterior resection of the rectum--a simplified stapling technique.

The use of a double stapling technique in anterior resection of the rectum eliminates the necessity for a rectal stump pursestring and removes the problem of tissue pouting on the spindle of the circular EEA stapler when a voluminous rectum is pulled onto it with the pursestring. We have used this technique in 20 patients with tumours in the middle and lower thirds of the rectum without complication. This technique may reduce contamination in the pelvis and certainly shortens operating time. Cost effectiveness of the technique should be evaluated in busy centres where the benefit would appear to be greatest.

Humans↗

PubMed1985

Actions of quinine on the rat isolated rectum.

The actions of quinine on the rat isolated rectum was studied. Quinine (2.5 X 10(-5) - 2.5 X 10(-4) M) initiated rhythmic phasic contractions (RPC) which were prevented by verapamil, lanthanum, indomethacin or Ca2+-withdrawal, but were unaffected by tetrodotoxin, L-propranolol, phentolamine, or atropine. Higher quinine concentrations (2.5 X 10(-4) - 10(-3) M) relaxed the rat rectum and inhibited the RPC induced by lower concentrations. Exposure to high Ca2+-Tyrode solution (6 Ca2+-Tyrode) increased the baseline tone of the muscle. Under this condition, quinine (2.5 X 10(-4) - 10(-3) M), but not lower concentrations relaxed the muscle. Quinine (2.5 X 10(-5) - 10(-3) M) concentration-dependently inhibited KCl and acetylcholine-induced contractions, but more readily blocked KCl than acetylcholine-induced responses; the inhibitory effect of quinine against KCl, but not acetylcholine, was largely reversed by increasing the Ca2+ concentration of the Tyrode solution. It is concluded that quinine-induced RPC occurred independently of adrenergic or cholinergic mechanisms, and are likely to be due to enhanced Ca2+ influx into the rectum, while the relaxation encountered with higher concentrations may be due to inhibition by quinine of transmembranal Ca2+ influx. Evidence was obtained that quinine may preferentially inhibit Ca2+ influx through a pathway linked to high K+ depolarisation.

Acetylcholine↗

PubMed1985

[Serous papillary cystadenoma of the rectum].

The authors describe a rare clinical observation: development of the serous papillary cystadenoma of the borderline malignancy in the rectum in a 53 year-old women. 20 years ago she was operated on and bilateral ovarian tumors were removed. The authors regard the tumor of the rectum to have arisen de novo. The hypothesis of local origin of the tumor is supported by the fact that no remnants of any tumor were found in the tissues adjacent to the rectum. The major part of the tumor was presented by the benign structures identical to the cellular composition of the normal fallopian tube mucosa. Poorly differentiated structures occupied small areas in the secondary papilla formed in the large cystic cavity. Possible mechanism of the development of this tumor are discussed.

Cystadenocarcinoma↗

PubMed1984

The effects on pelvic visceral function of anal sphincter ablating and anal sphincter preserving operations for cancer of the lower part of the rectum and for benign colo-rectal disease.

The effects on pelvic visceral function of radical operations for carcinoma of the lower part of the rectum and of operations for inflammatory bowel disease have been determined by studying bladder, sexual and rectal function. Denervation of the bladder was diagnosed in 15% of patients who had undergone sphincter-saving resection of the rectum for carcinoma and in 19% of patients who had undergone abdominoperineal excision of the rectum. In the remaining patients, temporary, less severe, degrees of impairment of bladder function were noted. Abnormalities of function were found on urodynamic testing of patients with denervation of the bladder which explained, in part, the propensity of such patients to develop incontinence of urine. Partial recovery of function was noted in the long term in patients with denervation of the bladder and evidence consistent with regeneration of autonomic nerves was obtained on histological examination of biopsies from the bladders of such patients. In patients who had undergone conventional proctectomy for inflammatory bowel disease, impairment of bladder and sexual function was observed. In contrast, no evidence of damage to pelvic autonomic nerves was found in patients who underwent selective mucosal proctectomy. Mucosal proctectomy and ileo-anal anastomosis in patients with ulcerative colitis did impair ano-rectal reflex function; nevertheless, most patients were continent. Patients in whom, in addition to mucosal proctectomy and ileo-anal anastomosis, a pelvic ileal reservoir had been constructed had better rectal function than patients who lacked such a reservoir.

Aged↗

PubMed1984

[Prognosis in radiation injuries of the bladder and rectum in patients with cancer of the cervix uteri].

The frequency and degree of severity of radiation injuries of the urinary bladder and rectum after combined treatment of 725 patients with cancer of the uterine body are analysed. A quantitative index was worked out permitting one to give an objective evaluation of the degree of early radiation reactions of the adjacent organs. The determination of the "radiation injuries prognosis index" (RIPI) makes it possible to forecast the occurrence and degree of severity of late radiation injuries of the urinary bladder and rectum. The evaluation of RIPI mean values in the patients' groups provides an opportunity to compare the damaging effect of different methods and regimens directly in the process of radiation therapy. The above method improves the potentialities of the forecasting of radiation injuries of the urinary bladder and rectum in patients with cancer of the uterine body.

Female↗

PubMedDate not supplied

Basal motility of dilated and non-dilated sigmoid colon and rectum in Chagas' disease.

The basal motility of the sigmoid colon and rectum was evaluated manometrically over 3 consecutive 10-minute periods in 29 control subjects, 14 chagasic patients without megacolon, and 32 chagasic patients with megacolon. The results indicated that the sigmoid colon of both chagasic groups had a lower motility index and lower wave frequency than that of the controls. Reduced wave frequency was observed in the rectum of patients with megacolon, out the rectum of the chagasic patients without megacolon showed manometric characteristics similar to those for the controls. The abnormalities observed were attributed to intramural denervation of the viscera under study. Waves of long duration were observed very frequently in megacolon, and were assumed to be caused by dilatation in itself and not by abnormal contraction of muscle fibers.

Adolescent↗

PubMed1983

[Rectum frame and positioning for abdominoperineal surgery].

The patient's positioning is of paramount importance in case of rectal surgery. It must allow any type of operation, planned or not (amputation, anterior resection, pulltrough) while providing good facilities for the two stages - abdominal and perineal - particularly in case of a two teams procedure. The ringed frame meets those requirements: it includes an oblique semi-circled frame, with hooks, and can be adjusted to the operating table through two steel stands. First used for the surgery of cancer of the rectum (894 cases operated), the position described has been adopted as well for low mechanical anastomosis in cases of colonic procedures, colpohystere it includes an oblique semi-circled frame, with hooks, and can be adjusted to the operating table through two steel stends. First used for the surgery of cancer of the rectum (894 cases operated), the position described has been adopted as well for low mechanical anastomosis in cases of colonic procedures, colpohystere it includes an oblique semi-circled frame, with hooks, and can be adjusted to the operating table through two steel stends. First used for the surgery of cancer of the rectum (894 cases operated), the position described has been adopted as well for low mechanical anastomosis in cases of colonic procedures, colpohysterectomies and total cystectomies.

Abdomen↗

PubMed1981

Acute and chronic benign ulcers of the rectum.

In managing 21 patients with benign ulcers of the rectum, there were seven patients with acute bleeding ulcers and two with acute rectal necrosis. Acute, bleeding ulcers of the rectum are associated with serious illness or injury, similar to those thought to cause stress ulcers of the stomach and duodenum. Rectal prolapse, complete or incomplete, is the condition most commonly associated with chronic, benign ulcers of the rectum. Repair of the rectal prolapse was successful treatment. Two patients had a tight muscular stenosis at the anorectal ring. This appeared to be a causative factor as complete healing occurred after myotomy.

Acute Disease↗

PubMed1980

[Dilemmas in surgery of the colon and rectum].

The introductory paper on the dilemmas in surgery of the colon and rectum provides the basic information on the pathology most frequently dealt with in this field. It reviews the present state of surgical tactics for solving these issues in Yugoslavia and in the world. Special stress is still to be placed on the carcinoma. The paper treats more extensively the vascular disorders, wish lately, have been on a constant increase outranking the hitherto more widely konown conditions, such as Crohn's disease, bleeding ulcerative colitis and familial and common polyposis of the rectum and sygmoid colon. Finally, the paper points to the sexual problem brought obout by the mutilative interventions, especially on the rectum and rectosygmoid colon, which is generally ignored and passed over without due attention.

Colon↗

PubMed1995

[Combined penetrating trauma of the rectum and urinary bladder].

Combined penetrating trauma of the rectum and urinary bladder is rare, and constitutes a diagnostic and therapeutic challenge. Most of the literature discusses trauma to either urinary bladder or rectum alone. The combination of penetrating trauma to both rectum and the urinary system is associated with high morbidity and mortality. There is controversy regarding the preferred approach to this type of combined trauma.

Adolescent↗

PubMedDate not supplied

[Influence of ano-perineal lesions on the outcome of the rectum in colonic and rectal Crohn disease].

Between 1960 and 1988, 83 patients (38 men, 43 women) underwent colectomy and ileorectal anastomosis (IRA) for severe colonic or rectal Crohn's disease. The mean age at IRA was 28.5 years. The mean interval from diagnosis was 4 years. There were two post-operative deaths. Among the 81 survivors 5 patients who had a covering ileostomy have never had their stomas closed and 24 patients required exclusion or excision of their IRA and rectum. (= 10 defunctioning IRA, 14 proctectomies with definitive ileostomy). The mean interval between IRA and the creation of a permanent ileostomy was 4.1 years. The mean interval between the onset of problems following IRA and permanent ileostomy was 2 years. 25 patients had perianal lesions prior to IRA. 5 of these patients had unhealed perianal disease at IRA and 7 required defunctioning ileostomy (28%). The need for rectal excision or exclusion following IRA was not related to the presence of perianal disease prior to IRA but functional results were worse. 33 patients developed perianal lesions following their IRA, among whom 19 required exclusion or excision of the rectum. Failure of IRA was then significantly higher amongst those who developed lesions following IRA. Rectal preservation after IRA may be proposed with success to patients with a healthy rectum or with minimal or moderate proctitis, even if there is perianal disease that could be safely treated before IRA. In this last setting the patient has to be informed of the risk of rectal preservation and the possible risk of requiring ulterior protectomy.

Adult↗

PubMedDate not supplied

Distribution and changes of glycosaminoglycans in neoplasias of rectum.

The content, composition and physicochemical characteristics of glycosaminoglycans in human rectum and rectum carcinoma were investigated by chemical analyses, enzymic treatments, chromatographic and electrophoretic techniques. The overall glycosaminoglycan content was increased about 2 fold in neoplastic tissues compared to nonneoplastic tissues. The absolute amounts of chondroitin sulfate, hyaluronic acid and dermatan sulfate significantly increased but the amounts of heparan sulfate decreased in neoplastic tissues compared with nonneoplastic tissues. In addition an increased fraction of keratan sulfate and undersulfated chondroitin was identified in neoplastic tissues. HPLC analysis of chondroitinase AC and ABC digests showed a marked increase in delta di-6S and delta di-OS disaccharides in tumor chondroitin sulfate, revealing significant alterations on the sulfation pattern. The results indicate that specific glycosaminoglycan alterations occur in human rectum carcinoma and suggest that proteoglycan metabolism is also altered in this carcinoma.

Aged↗