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At least 775 records · Page 43Linked to original sources
PubMed1961

Transitional cell cancer of the anus and rectum.

A study was made of all cases of transitional cell cancer of the anus or rectum in the records of the University of California Medical Center, San Francisco. None was listed until 1945, then an additional seven between 1954 and 1960. During the latter period there were 192 cases of adenocarcinoma of the rectum, six cases of squamous cell or epidermoid rectal cancer and 12 cases of squamous cell cancer of the anus.Distinctive and highly malignant anal and rectal epithelial tumors will occasionally arise at or near the anorectal junction from inconstant embryologic entodermal cloacal vestiges. These atypical nonkeratinizing lesions are very similar microscopically to transitional cell tumors found in the cloacogenic portions of the lower genitourinary tract. Review of the literature indicates that the prognosis of cloacogenic anal and rectal lesions appears to be relatively graver than that for the more common adenocarcinomas and keratinizing squamous cell epitheliomas. Early diagnosis and prompt, radical excision seem to offer the only hope for survival.

Adenocarcinoma↗
PubMed2004

[Total colectomy with simultaneous ileorectostomy in severe nonspecific ulcerative colitis complicated by constriction of the rectum].

Total colectomy with a one-stage ileorectostomy was fulfilled in 72 patients (67 children and 5 adult patients) with severe nonspecific ulcerative colitis by the method developed by the author. In 8 of the patients there was constriction of the rectum which required transanal finger bougieurage during the operation. None of the 72 patients had incompetence of the anastomosis. Follow-up observations during many years showed a rather high effect of the operation including the patients who had constriction of the rectum.

Adult↗
PubMed2004

[Sigma rectum pouch for urinary diversion].

OBJECTIVE: To investigate the clinical outcome of sigma rectum pouch as a continent form of urinary diversion. METHODS: The clinical data of 38 patients, 32 males and 7 females, aged 53.2 (42 - 68) with muscle-invading bladder carcinoma who underwent a Mainz pouch II procedure after radical cystectomy 1996 - 2001 were analyzed. The intestine was incised over a length of 20 - 24 cm with the junction of sigmoid colon and rectum as the midpoint so as to create a low-pressure reservoir for urine and side-to-side anastomosis was performed on the posterior borders of the rectosigmoid wall. Submucosal tunnel technique was employed in antireflux urethral implantation. The patients were followed up for 7 - 60 months with a mean of 30 months postoperatively. RESULTS: Continence has been achieved in all the 38 patients with a micturition frequency of 3 - 5 times during daytime and 0 - 3 times at night. The mean volume of pouch was 515.6 ml (400 - 650 ml). The basal intra-reservoir pressure was 8 - 23 cm H(2)O (mean 16.5 cm H(2)O, 1 cm H(2)O = 0.098 kPa), the highest peak pressure was 12 - 33 cm H(2)O (mean 21.3 cm H(2)O). CONCLUSION: A modified sigmoid rectal pouch procedure provides a reservoir with a higher capacity and lower pressure without a reflux to the upper urinary tract and descending colon with lower incidence of complication, it is also a better alternative diversion procedure that would be easily accepted by surgeons and patients.

Adult↗
PubMed2004

[Pelvic imaging modified by rectum predefecatory distension].

Computed tomography (CT) rectum imaging limited by anatomy, pathological process and CT own characteristics. The ways of image improving are: endorectal scanning, myorelaxatives, contrast substances. Rectum and anal canal has oval serrated profile without distension on CT and US scans. Purpose is to improve the CT and endorectal US scan role in pelvic structure changing disorders operating plan estimating.

Adult↗
PubMed1992

Synchronous squamous carcinoma of the anus and adenocarcinoma of the rectum.

Recent literature has reported several series of synchronous adenocarcinoma of the colon, but there has not been a reported case of synchronous squamous carcinoma of the anus and adenocarcinoma of the rectum. This article describes a patient with a large squamous carcinoma of the anus along with a large adenocarcinoma of the rectum, and also discusses a current review of the etiology and treatment of squamous carcinoma of the anus.

Adenocarcinoma↗
PubMed2004

[Recommendation of a new prostatic massage--an aside-bending and up-standing vs parallel and semi-squatting method to massage the prostate via the rectum].

OBJECTIVE: To recommend an improved method of prostate massage, which is safe, effective, simple and tolerable, and may increase the expressed prostatic secretin (EPS) success rate and promote the efficiency of the prostate massage. METHODS: Two methods are described in this paper, one being the aside-bending and up-standing vs parallel and semi-squatting method to massage the prostate via the rectum, and the other being the traditional massage method. A total of 261 chronic prostatitis (CP) patients were randomly divided into two groups, and treated separately with the new method and the traditional method. Then, the two methods were compared by EPS quantity and the patients' tolerability. RESULTS: The new method made it possible to collect larger quantity of EPS. The results of comparison showed that the new method was better received by the patients. CONCLUSION: The aside-bending and up-standing vs parallel and semi-squatting method to massage the prostate via the rectum may increase the EPS success rate of prostatic massage and hence help the clinical diagnosis and treatment of chronic prostatitis. This method is well worth recommending.

Adult↗
PubMedDate not supplied

[Rectum resection with colonic J reservoir and coloanal anastomosis for rectal cancer].

A low anterior resection of the rectum followed by a colo-rectal or a straight colo-anal anastomosis often leads to poor functional results (increased frequency and urgency of defecation) due to the loss of the reservoir function of the rectum. In order to improve the functional results the authors performed in 7 patients colo-anal anastomosis with a J shaped colonic pouch. In all the cases a temporary diverting loop ileostomy was performed. This ileostomy was closed 4-5 weeks after the first operation. There was no operative mortality. After stoma closure, the functional results were improved during the first week. A colo-anal anastomosis with a colonic reservoir appears to be an optimal solution comparing with a very low colorectal or a straight colon-anal anastomosis.

Aged↗
PubMed1992

[Retroperitoneal rectum perforation during barium enema].

The examination of rectum and colon with barium sulfate is a method which is increasingly replaced by the endoscopy; therefore, the routine of doing this examination is increasingly vanishing. This means that the risk of this method increases. We report a case and discuss the symptomatology as well as the management of a perforation of the rectum during an examination with barium sulfate.

Aged↗
PubMedDate not supplied

Colitis cystica profunda of the rectum: report of a case and review of the literature.

Colitis cystica profunda is a rare intestinal lesion. Because of its clinical expression (rectorrhagia, mucorrhea and abdominal pain) and the way it appears to current imaging techniques this disease presents features which can be associated with colon neoplasm. Its diagnosis has to be confirmed histologically, and its etiology remains unclear. The following is a case report of colitis cystica profunda recurring 20 years after a first episode in a white woman, who had had an anterior resection of the sigmoid colon and upper rectum to deal with a colitis cystica profunda-induced stenosis of the sigmoid colon and at 41 underwent the transanal removal of a polypoid lesion. A review of 20 cases in the literature showed that colitis cystica profunda has a predilection for the male and generally affects the medial and lower rectum and the sigmoid colon. The literature also confirmed the association with ulcerative rectocolitis, Crohn's disease and rectal prolapse. The type of treatment varies from surgical, medical, and endoscopic to no treatment at all.

Adult↗
PubMed1990

Operative and functional results of total mesorectal excision with ultra-low anterior resection in the management of carcinoma of the lower one-third of the rectum.

Eighty-one patients underwent anterior resection with curative (n = 57) or palliative (n = 24) intent for tumors below 7 centimeters from the anal verge. If a right angled clamp could be applied below the tumor at operation after full mobilization of the mesorectum and rectum, the procedure was performed in preference to abdominoperineal excision. The mean follow-up time was 4.8 years. Of the curative group, 26 had lesions within 5 centimeters of the anal verge. Thirty-one per cent were Dukes' A; 37 per cent, B, and 32 per cent, C lesions. The margin of distal clearance ranged from 2 to 35 millimeters. In five patients, squamous mucosa was observed in the distal doughnut. Serious postoperative complications occurred in 17 per cent of the curative series, one-half of which occurred within the first two years of the study period. In six patients, the temporary colostomy has not been closed. The incidence of local recurrence in the curative series was 3.5 per cent, and the over-all survival rate was 81 per cent at five years. Full continence was achieved within two years of closure of the colosomy in 85 per cent of the patients. In the palliative group, 11 of the 19 patients had temporary colostomies and 80 per cent were continent within six months of operation. The technique of total mesorectal excision and sphincter preservation by stapled coloanal anastomosis in the treatment of carcinomas of the lower one-third of the rectum may be an alternative to abdominoperineal excision. The final decision in such instances is made intraoperatively. The operative and functional results are satisfactory, but it is difficult to anticipate the patients who will not do well by preoperative criteria. Even in palliative procedures, low anterior resections provided satisfactory continence. Serious postoperative complications were more likely to occur if full mobilization of the splenic flexture was not routinely performed.

Adult↗
PubMed2006

Solitary rectal ulcer syndrome: characteristics, outcomes and predictive profiles for persistent bleeding per rectum.

INTRODUCTION: Solitary rectal ulcer syndrome (SRUS) is a rare disorder of defaecation and persistence of symptoms is common, particularly bleeding per rectum (BPR). This study assessed the clinical, endoscopical characteristics and predictive profiles for persistent BPR. METHODS: 28 patients (14 males) with biopsy-proven SRUS were identified from 1989 to 2003, and the clinical and endoscopical findings were retrospectively reviewed. RESULTS: At presentation, the mean age was 29.5 +/- 16.1 (range ten to 81) years. Common symptoms reported included BPR (86 percent), abdominal pain (36 percent), mucus per rectum (25 percent), straining at defaecation (25 percent), diarrhoea (14 percent) and constipation (14 percent). Digital manual evacuation was reported by 11 percent. 68 percent were anaemic and 57 percent required blood transfusion. Lesions were located anteriorly (38.5 percent), posteriorly (30.7 percent) and circumferentially (31.8 percent). The lesions were multiple (34 percent), ulcerative (64.3 percent) and polypoidal/nodular (32.1 percent). At a mean follow-up of 43.5 +/- 36 months, 64 percent (n=18) had multiple admissions (mean 3.1, range one to 12), mainly for transfusion (mean 7.4 units, range two to 27). There was no difference in clinical responses between patients with polypoidal/nodular or ulcerative lesions (p-value is 0.653). Follow-up endoscopies showed improvement (58 percent), progression (21 percent) and no change (21 percent) in the lesions. Four patients had surgery for concerns of neoplasms (n=2) and persistent BPR (n=2). BPR was persistent in 39 percent. Presence of abdominal pain (p-value is 0.008) and passage of abnormal stool (p-value is 0.002) were predictive of persistent BPR. CONCLUSION: SRUS occurs predominantly in young patients and despite being a benign condition, morbidity remains a problem. Patients' profiles are predictive of persistent BPR.

Adolescent↗
PubMed1991

Prognostic factors in management of traumatic perforation of colon and rectum.

A retrospective analysis was made of the prognostic factors and management of traumatic perforation of the colon and rectum in 80 patients during the period of 1980 to 1988 at Chang Gung Memorial Hospital. The total mortality was 11%. Morbidity was 18% among the survivors. The mortality was higher in patients with old age (50% for those over 60 years old), delayed operation (50% for a delay of more than 72 hours), poor nutrition (57%), shock condition before or during operation (50%), severe abdominal fecal contamination (35%) and associated abdominal injury. We conclude that the surgical procedures for traumatic perforation of colon and rectum performed depend upon the patient's condition. The prognostic factors in patients with traumatic perforation are patient's age, timing of operation, degree of abdominal fecal contamination, injury to other abdominal organs and general condition such as nutrition and shock.

Adolescent↗
PubMed1991

Retrocolic pelvic omentoplasty in abdominoperineal excision of the rectum.

A series of 53 patients underwent abdominoperineal excision of the rectum, 25 by the conventional method and 28 using retrocolic pelvic omentoplasty without drains. There were no differences in age, sex ratios, indications for surgery, stage of cancer and preoperative haemoglobin. There were no differences in the incidence of postoperative abdominal complications (wound dehiscence, obstruction and bleeding) between the two groups. However, patients undergoing omentoplasty without drainage stayed in hospital for a significantly shorter period (median of 16 days compared to 24 days) and benefited from far faster primary healing of the perineum (median of 20 days vs 133 days). It is concluded that retrocolic pelvic omentoplasty without drainage results in shortened postoperative hospital stay and promotes primary perineal healing after abdominoperineal excision of the rectum.

Abdomen↗
PubMed1991

[Rectum resection with colo-anal anastomosis. Results of continence with radical surgery].

The long-term clinical and functional results of coloanal anastomosis (CAA) in the management of low and midrectal cancer were analyzed and compared with an age matched group of patients with abdomino-perineal resection (APR). Between 1977 and 1990 85 patients underwent CAA following resection for carcinomas of the mid and low rectum (67 male and 18 female, mean age 57.3 years). In 62 patients the tumor was in the lower and in 23 patients in the middle third of the rectum. A hand-sewn anastomosis was performed in 20 patients, in the 65 most recent patients the anastomosis was performed using a circular stapling instrument. No patient died as a result of pelvic sepsis. Anastomotic leakage occurred in 7% (handsewn 20%, stapled 3%), anastomotic strictures in 2.4%. 9 months after CAA complete or near complete continence was achieved by 85% of the patients. One patient was totally incontinent. More than 3 years postoperatively (1977-1987) 57 patients with curative resection could be analyzed. 39% of the patients had Dukes' A, 31% Dukes' B and 30% Dukes' C lesions. After a mean (+/- SD) length of follow-up of 6.7 years (3-13.6 years) local recurrence cumulative rates were 11% after CAA and 17% after APR, distant recurrence rates were 33% and 34% respectively. According to Dukes' stage the cancer-related 5-years survival of patients after CAA was in Dukes' A stage 88%, in Dukes' B 56%, in Dukes' C 29% and after APR 100, 53, and 22% respectively (p greater than 0.05). From these results we conclude that intersphincteric resection with CAA is a safe and efficient alternative to APR in many distal rectal carcinomas.

Adult↗
PubMed1977

Excretion in insects: function of gut and rectum in concentrating and diluting the urine.

The diverse excretory systems of insects exhibit several features that appear unusual when comparisons are made with the mammalian kidney. Secretion by the Malpighian tubules of a fluid that is unlike the blood in composition, substitutes for glomerular filtration. Various reabsorptive functions, such as volume reduction, regulation of individual electrolytes, adjustment of osmotic concentration and pH regulation, which are associated with distinct renal segments in the mammalian kidney, all occur simultaneously in the rectum of terrestrial insects. Involvement of an extracellular molecular sieve in selective reabsorption is novel. As far as water transport is concerned, the rectal pads of the cockroach and locust appear to accomplish, across a single layer of cells, the same function as the countercurrent multiplier system of the mammalian kidney with its several epithelial layers. Direct absorption of water vapor in the rectum of some insects from atmospheres of low relative humidity, clearly involves quite different and unknown mechanisms. Finally, saline-water insect larvae produce hyperosmotic excreta by direct secretion of ions into the rectal lumen. They can adjust individual transport processes to form various secretions, which are appropriate to the natural waters of diverse chemical types in which these larvae thrive.

Amino Acids↗
PubMed1991

[Perineal clamping of the everted rectum in conservative coloproctectomy. Experimental and clinical results].

Technical alternatives in conservative proctocolectomy are presently investigated to improve the safety and the functional results of the operation. Abdominal transection of the rectum is not always satisfactory in this procedure. A new technique of stapled anastomosis is described: after full mobilization and eversion of the rectum, this latter is closed using a linear stapler and cut immediately above the anal canal via a perineal access; a 18 cm long J pouch is constructed and the anastomosis is stapled using the new premier EEA instrument through the staple line of the previously transected anorectal junction. This technique has been evaluated in dogs (N = 10): colo-anal anastomosis was easy, quick, and safe to perform. Clinical, radiological and gross results have confirmed the quality of these circular stapled anastomoses through an inverting linear suture of the anorectal junction. Clinical experience is actually based on 7 patients operated since January 1989 (proctocolitis: 3, polyposis: 4). The value of the technique was confirmed with ileostomy closure at 3 months for the 7 patients and good functional results. This method has several advantages: 1) to retain all of the anal canal, 2) to avoid prolonged anal dilatation, 3) to perform a rapid and safe stapled anastomosis.

Adult↗
PubMed1990

Ultrastructure of surface epithelial cells of the normal human rectum.

Luminal surface epithelial cells, excluding a few endocrine cells of the normal human rectum, were studied electron microscopically and 5 types of cells were recognized with special reference to some structure containing mucous substances. Principal-1 cells showing few tiny vesicles and Principal-2 cells containing some tiny vesicles seemed to belong to the absorptive cell group. Vesicle cells having numerous tiny vesicles, and Columnar mucous cells accompanied by numerous tiny vesicles and some round or oval mucous vacuoles, seemed to be labelled as of the secretory cell group. The common features of the epithelial columnar cells, except for the Goblet cell, were columnar shape, microvilli whose length and density had considerable variation, glycocalyceal bodies around the microvilli, and thick surface coat. Goblet cells were characterized by a goblet shape which was expanded by numerous mucous droplets. It is of special interest that 4 different types of columnar epithelial cells are recognized on the luminal surface of the normal human rectum, and that Vesicle cells and Columnar mucous cells are first observed on the luminal surface of the large intestine. Similar epithelial cells have only been reported in the crypt of the large intestine and not on the luminal surface.

Adult↗
PubMed1990

[Causes of complications of reconstructive operations in patients after resection of the rectum by the Hartmann method leaving a short stump. The ways of reducing the incidence of complications].

The article presents results of 25 restorative operations performed on patients who had endured resection of the rectum. Causes of the complications were established. A new method of restoration of the intestinal continuity after the Hartman operation has been developed in the clinic. The method developed was used in 25 operations. It had a positive effect not peculiar to other operations. It excluded incompetence of sutures of anastomosis with a short rectal stump and preserved the initial force of the constrictor of the rectum due to using the new principle of extra-sphincter descending of the mobilized intestine.

Anal Canal↗