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At least 613 records · Page 34Linked to original sources
PubMed1984

Scanning electron microscopic studies of Trypanosoma cruzi in the rectum of its vector Triatoma infestans.

The cuticular surface of the rectum of Triatoma infestans and its colonization by a Trypanosoma cruzi strain originating from the same locality as the bugs were studied by scanning electron microscopy at different weeks post infectionem. On the basis of the cuticular folding, the rectum can be subdivided into five regions. The rectal gland has the finest structure and the region anterior to the anus the deepest folds. Try. cruzi always prefers to colonize the rectal gland, while the other regions are colonized in varying densities. Most of the flagellates are epimastigotes (long and short), except in the region at the entrance of the midgut, where trypomastigotes predominate.

Animals↗
PubMed1983

[Electrical and motor activity of the rectum following low anastomosis].

Electrical and motor activity of smooth muscle of the canine rectum was registered by transanal recording following low rectum anastomosis. The relaxation reflex of the anal canal had disappeared distal of the anastomosis in the first postoperative week, and electrical slow waves and pressure waves were desynchronized proximal and distal of the anastomosis. The resting pressure of the rectal wall had increased above preoperative values. After wound healing had accomplished the relaxation reflex and the synchronization of electrical and mechanical activity proximal and distal of the anastomosis did occur again. It is concluded that the rectal wall provides the pathways for the relaxation reflex of the anal canal. After wound healing has finished these pathways are restored across the anastomosis.

Action Potentials↗
PubMed1982

[Anterior resection of the rectum: comparison of the conservative suture technique and machine anastomosis (author's transl)].

Of a total of 3850 operations on the colon and rectum (1964--1980) 52 hand-made anastomoses after anterior rectum resection were performed from September 1979 to August 1980 (resection quota 47%) without intestinal fistula. These were compared with 52 anastomoses by machine (EEA). There was no extension of surgical indication by use of the machine. Complications like anastomotic insufficiency occurred in a similar range (hand: 4, machine: 3), but were easier to manage after machine suture. The number of other complications was comparable. Use of the machine gives advantages to the experienced surgeon, but it should only be used by those who are able to master the complex technique.

Aged↗
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↗
PubMed1987

Endocrine cells in the human colorectal mucosa: immunocytochemical observations on patients with prolapse or internal procidentia of the rectum.

We have examined the occurrence and distribution of endocrine cells storing serotonin and the regulatory peptides somatostatin, glicentin, peptide YY in rectal mucosa on 16 patients with prolapse or intussusception of the rectum. There were no significant differences compared with normal rectal mucosa. Our results do not support the assumption that these endocrine cells of the rectum are involved in the pathophysiology of rectal prolapse.

APUD Cells↗
PubMed1985

[Does synchronous abdominoperineal rectum excision have real advantages?].

From January 1st, 1974 through December, 31st, 1984 a total of 421 patients with cancer of the rectosigmoid was operated upon. 269 patients (63.8%) underwent operations in which continence was maintained. In 17 of the cases the rectum was removed and the sphincter muscle was left intact. In 86 cases (=20.4%) a combined abdominoperineal rectum excision was performed (42X metachronous and 44X synchronous) in one session. The operating time involved in the synchronous method is on the average 34 min shorter than in metachronous. The mortality was reduced from 19% to 9%.

Abdomen↗
PubMed1982

Alpha-thioglycerol sensitive excitatory oxytocin receptors in fowl rectum.

The selective antagonism of the excitatory responses of oxytocin by alpha-thioglycerol and its potentiation by Mg++ indicate the presence of specific oxytocin receptors in fowl rectum. In addition, the sensitivity of the rectum to very small doses of oxytocin suggests a possible facilitatory role of neurohypophyseal hormones in oviposition.

Animals↗
PubMed1993

Quantitative cultures of the mucosal-associated bacteria in the mechanically prepared colon and rectum.

Little is known about the mucosal microflora of the colon and rectum at the time of elective surgery. Our objective was to determine the concentrations of anaerobic and aerobic bacteria associated with the mucosa of the mechanically prepared large bowel. Ten patients were studied after a standard polyethylene glycol-electrolyte lavage preparation. No patient had taken antibiotics in the preceding four weeks. Sterile wire brushes passed through the colonoscope during advancement were used to culture the rectal, transverse colon, and cecal mucosa. Total anaerobic, aerobic, Gram-positive, and enteric bacterial counts were determined along with specific cultures for Bacteroides fragilis, Clostridium difficile, Escherichia coli, Pseudomonas aeruginosa, enterococcus, and staphylococcus species. The results showed that there was a significant increase (P < 0.01) in aerobes, anaerobes, enterics, Gram positives, B. fragilis, and E. coli mucosal counts with proximal progression. Aerobes showed a steady gradient, while anaerobes demonstrated an increase from the rectum to the transverse colon but no change between the transverse colon and cecum. We conclude that, in the prepared bowel, there is an increase in the mucosal bacterial counts in the more proximal portions of the bowel. The results may serve as a baseline for future studies on the mucosal-associated bacteria of the large intestine.

Adult↗
PubMed1991

Treatment of severe hemorrhage from a defunctionalized rectum with adrenaline chloride in ulcerative colitis.

Three patients suffering from ulcerative colitis, who had previously undergone a colectomy and temporary Brooke ileostomy and who were under treatment with methylprednisolone and 5-aminosalicylic acid per the rectum, were readmitted to the hospital, presenting with profuse rectal hemorrhage with six to nine blood losses per day. An adrenaline chloride solution washout of the rectum was given in an attempt to avoid surgery. In the two to six hours after treatment, hemorrhage was considerably reduced, the hemoglobin levels were stationary, and no further transfusions were necessary.

Colitis, Ulcerative↗
PubMed1995

Why do some patients experience poor functional results after anterior resection of the rectum for carcinoma?

PURPOSE: The aim of this study was to examine the dynamic inter-relationship of the anal sphincter, residual rectum, and neorectum after low anterior resection for rectal carcinoma. METHODS: Seventy-three patients underwent laboratory tests of anorectal function a median of ten (range 1-100) months after operation. All patients completed quality of life questionnaires and had the level of their anastomoses determined by rigid sigmoidoscopy. Forty-four patients (60 percent) had some form of disturbance of bowel function, which was classified as "poor" function if bowel frequency was four or more in 24 hours and if there was also either fecal leakage or urgency of defecation. Manometric data were analyzed using stepwise logistic regression analysis. RESULTS: Only two factors were found to be significantly and independently associated with poor bowel function, namely, the pressure recorded in the upper part of the anal sphincter in response to distention of the neorectum (15 (7-24) cm of water in patients with poor function vs. 29 (15-58) cm in patients with good function; P < 0.005) and the level of the anastomosis above the anal sphincteric high pressure zone (2.5 (2-3.5) cm in patients with poor function vs. 6 (4-12) cm in patients with good function; P < 0.005). CONCLUSION: Continence after anterior resection is related to an appropriate "sampling" response in the anal sphincter to activity within the neorectum. This in turn, is directly related to length of the residual rectum, which is, therefore, of crucial importance to function.

Aged↗
PubMed1999

Benefits of endorectal ultrasound for management of smooth-muscle tumor of the rectum: report of three cases.

Smooth-muscle tumor of the rectum is rare, and the therapeutic strategy is still controversial. Endorectal ultrasound was used to evaluate three patients with smooth-muscle tumor of the rectum. Endorectal ultrasound demonstrated a homogenous hypoechoic tumor without invasion to the perirectal tissue in two patients. The tumor was 5 cm in diameter in one patient and 4 cm in diameter in the other patient, and they were excised locally. Their histologic types were leiomyoma and leiomyosarcoma. The third patient had a recurrent leiomyosarcoma. Proctosigmoidoscopy found a linear lesion with ulcerated mucosa on the rectal wall. Endorectal ultrasound observed a hypoechoic solid tumor of 3.5 cm x 1 cm, which involved the mucosal, submucosal, and muscle layers of the rectal wall. Disruption of the first hypoechoic layer was identified. Abdominoperineal resection was performed. Endorectal ultrasound follow-up revealed no evidence of recurrence in any of these patients. Endorectal ultrasound can help to define the extent of disease and may be a useful adjunct in deciding about the appropriate surgical procedure in these diseases.

Adult↗
PubMed2000

Rectal compliance as a routine measurement: extreme volumes have direct clinical impact and normal volumes exclude rectum as a problem.

PURPOSE: The clinical impact of rectal compliance and sensitivity measurement is not clear. The aim of this study was to measure the rectal compliance in different patient groups compared with controls and to establish the clinical effect of rectal compliance. METHODS: Anorectal function tests were performed in 974 consecutive patients (284 men). Normal values were obtained from 24 controls. Rectal compliance measurement was performed by filling a latex rectal balloon with water at a rate of 60 ml per minute. Volume and intraballoon pressure were measured. Volume and pressure at three sensitivity thresholds were recorded for analysis: first sensation, urge, and maximal toleration. At maximal toleration, the rectal compliance (volume/pressure) was calculated. Proctoscopy, anal manometry, anal mucosal sensitivity, and anal endosonography were also performed as part of our anorectal function tests. RESULTS: No effect of age or gender was observed in either controls or patients. Patients with fecal incontinence had a higher volume at first sensation and a higher pressure at maximal toleration (P = 0.03), the presence of a sphincter defect or low or normal anal pressures made no difference. Patients with constipation had a larger volume at first sensation and urge (P < 0.0001 and P < 0.01). Patients with a rectocele had a larger volume at first sensation (P = 0.004). Patients with rectal prolapse did not differ from controls; after rectopexy, rectal compliance decreased (P < 0.0003). Patients with inflammatory bowel disease had a lower rectal compliance, most pronounced in active proctitis (P = 0.003). Patients with ileoanal pouches also had a lower compliance (P < 0.0001). In the 17 patients where a maximal toleration volume < 60 ml was found, 11 had complaints of fecal incontinence, and 6 had a stoma. In 31 patients a maximal toleration volume between 60 and 100 ml was found; 12 patients had complaints of fecal incontinence, and 6 had a stoma. Proctitis or pouchitis was the main cause for a small compliance. All 29 patients who had a maximal toleration volume > 500 ml had complaints of constipation. No correlation between rectal and anal mucosal sensitivity was found. CONCLUSION: Rectal compliance measurement with a latex balloon is easily feasible. In this series of 974 patients, some patient groups showed an abnormal rectal visceral sensitivity and compliance, but there was an overlap with controls. Rectal compliance measurement gave a good clinical impression about the contribution of the rectum to the anorectal problem. Patients with proctitis and pouchitis had the smallest rectal compliance. A maximal toleration volume < 60 ml always led to fecal incontinence, and stomas should be considered for such patients. A maximal toleration volume > 500 ml was only seen in constipated patients, and therapy should be given to prevent further damage to the pelvic floor. Values close to or within the normal range rule out the rectum as an important factor in the anorectal problem of the patient.

Adolescent↗
PubMed1998

Pelvic floor herniation after modified York-Mason approach to the rectum: report of a case.

The York-Mason approach to the rectum with resection of the coccyx provides an excellent exposure for the treatment of large villous adenomas and low-risk rectal cancers. Morbidity related to this operation primarily arises as local infection (septic pelvis, fistulation), chronic coccygeal pain, and fecal incontinence. This is the first report to describe a pelvic floor herniation two years after a York-Mason approach to the rectum.

Aged↗
PubMed1985

Anastomosis to the rectum. Operative experience.

Four hundred sixty-six consecutive procedures involving anastomosis to the rectum were performed between March 1969 and December 1982. Three hundred ninety-six (85 percent) were stapled anastomoses and 70 (15 percent) were hand-sutured anastomoses. The stapled anastomoses were constructed using the GIA or EEA instrument, some of the latter utilizing a pull-through technique. The hand-sutured anastomoses were constructed in the pelvic space, or externally as a staged pull-through procedure. A diverting stoma was constructed in all 14 staged pull-through procedures, in 47 of 56 (84 percent) conventional hand-sutured anastomoses, and in 38 of 396 (10 percent) stapled anastomoses. While the majority of very low anastomoses (0 to 5 cm from the dentate line) were stapled, 13 conventional hand-sutured anastomoses and all 14 of the staged pull-through procedures were constructed at this level. One patient (0.2 percent) died as the result of an anastomotic complication. Twelve patients (2.5 percent) had anastomotic complications requiring reoperation. The reoperation rate for stapled anastomoses was six of 396 (1.5 percent). For hand-sutured anastomoses, the reoperation rate was six of 70 (8.6 percent). The results show that, for anastomosis to the rectum, stapling instruments are at least as good as hand-suturing. Both stapling techniques and hand-suturing techniques provide the surgeon the capacity to construct safely very low anastomoses. A temporary, diverting stoma is required much less frequently with stapled than with hand-sutured anastomoses. The need for a permanent colostomy should be determined by the stage and level of disease, the systemic health of the patient, and the patient's anatomy, rather than by the selection of anastomotic technique.

Colostomy↗
PubMed1989

Method of creation of a smooth-muscle cuff at the site of the perineal colostomy after extirpation of the rectum.

The authors present a method of creation of a smooth-muscle cuff at the site of the perineal colostomy in 36 patients who have undergone extirpation for malignant neoplasms of the low ampulla recti. Creation of the smooth-muscle sphincter mechanism was performed during the process of removal of the rectum in 29 patients, whereas it was done two to eight years after extirpation of the rectum in seven patients. Inflammatory complications were observed in the perineal colostomy area during the early postoperative period in eight patients. These complications were accounted for by necrosis of the distal colon and transplanted muscle in two patients. There were no deaths. Satisfactory functional results were seen in 22 of 26 patients six months after surgery. Physiologic studies show that there is a functioning sphincter at the site of the perineal colostomy.

Adult↗
PubMed1983

Injuries of the retroperitoneal portions of the colon and rectum.

Experience with 66 penetrating injuries of the retroperitoneal colon and rectum is reviewed. These injuries usually affect the intraperitoneal anterior and the retroperitoneal posterior walls. The bare areas of the colon have to be inspected when only one intraperitoneal hole is found or whenever the wound is in the flank or back. There is an increasing tendency toward primary suture rather than exteriorization unless there are multiple severe intra-abdominal injuries, gross contamination, or poor general condition of the patient. Rectal injuries require careful repair, diverting colostomy, irrigation of the excluded rectum and presacral drainage. For suspected bowel injuries, antibiotics should be started preoperatively.

Anti-Bacterial Agents↗
PubMed1989

Morphology and rheology of the rectum in patients with chronic idiopathic constipation.

To evaluate whether there is a relationship between the viscoelastic properties of the rectum and its surface, barium enema and rectal accommodation studies were performed under standard conditions in 46 subjects (25 adults, 21 children) with chronic idiopathic constipation. In adults, a significant correlation was found between rectal surface at barium enema and the minimum radius of rectal distention with a balloon necessary to higher wall tension changes (r = 0.68; P less than 0.01). In both adults (r = 0.48; P less than 0.05) and children (r = 0.57; P less than 0.01), negative correlations were found between the surface of the rectum and its elasticity. It is concluded that rectal accommodation studies produce data comparable to those of radiologic examinations and may therefore be used repetitively, and without fear of radiation, as follow-up studies on constipated patients.

Adult↗