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At least 937 records · Page 52Linked to original sources
PubMed1984

Ethnicity and cancer prevention in a tri-ethnic urban community.

A pilot study of knowledge and behavior regarding primary cancer prevention was conducted in a tri-ethnic urban community. Knowledge of smoking and dietary risk factors was substantial, but awareness of cancer safeguards involving reduced sun exposure and mouth and proctological examinations was low. One of five respondents had taken measures to prevent cancer, and these persons tended to rate their own risk higher than respondents who made no life-style changes. Self-motivated behavior change focused on avoidance of cancer-promoting food. Blacks differed from whites and Mexican-Americans in awareness of cancer cause and prevention, particularly regarding dietary factors and behavior modification. The findings have implications for the design of cancer control measures in multiethnic communities.

Adult↗
PubMed1984

[A case of allergic granulomatous prostatitis].

This is a case report of allergic granulomatous prostatitis and its systemic dissemination. A 45-year-old male visited our hospital with initial symptoms of dysuria, pollakiuria and fever on February 19, 1980. Thereafter, a painless abscess in his left cheek and hard swelling of his right parotid gland appeared. He was hospitalized on March 11 because of hearing difficulties and congestion in the conjunctiva. Physical examination revealed no abnormalities in the chest or abdomen, but a proctological examination showed stone-like hardness of the prostate gland which was the size of a hen's egg. Laboratory findings indicated peripheral eosinophilia and immunoglobulinemia. X-rays showed multiple coin lesions in the chest and multiple cystic changes in the spleen. Biopsies of the cheek lesion and prostate showed eosinophilic granulation accompanied by fibrinoid necrosis and vasculitis. When steroid administration was started, his symptoms and signs showed dramatic but temporary improvement. The allergic lesions then gradually progressed and resisted the steroid therapy. He died on March 13, 1982. In 1972, Towfighi et al. presented 31 cases of nonspecific granulomatous prostatitis with a comprehensive review of the literature. They stated that eosinophilic granulomatous prostatitis with both fibrinoid necrosis and vasculitis caused systemic disease with a poor prognosis. Since the pathological findings in our case showed eosinophilic granulation with fibrinoid necrosis and vasculitis, it was a very rare case of the systemic type of eosinophilic granulomatous prostatitis experienced by Towfighi et al.

Dexamethasone↗
PubMed1980

[Use of the laser scalpel in removing hemorroidal nodes].

The properties of laser scalpel (perfect homeostasis, aseptic coagulation surface, formation of dense coagulation crust) make it useful for proctological operations, and for ablation of hemorrhoids in particular. Operations were performed on 11 patients aged 33 to 62. No complications were noted. All the patients were followed in the postoperative period from 8 to 12 months. Recurrences, development of strictures or weakness of the anal constrictor were not noted.

Adult↗
PubMedDate not supplied

[Ano-rectal diseases observed at a venereal disease polyclinic].

The writers show how the polyclinic for venereal diseases at the Djkzigt hospital in Rotterdam is run. Their statistical study shows how they were struck by the large number of pederasts, and by the frequent occurrence of dermatological diseases amongst the various proctological lesions; e.g; acuminate condylomata.

Adolescent↗
PubMedDate not supplied

[Contribution of cryotherapy to phlebology].

Taking into account the results obtained by cryotherapy in proctology, the author has tried to apply this method in conjunction with microsclerosis in the treatment of telangiectasia. The results seem very encouraging on the whole, and could be considered an interesting contribution to the treatment of this obstinate and unattractive condition.

Cryosurgery↗
PubMed1978

[Early detection and results of therapy of malignant tumours of the rectum and sigmoid colon (author's transl)].

An analysis of statistical data indicates 0 growth of incidence and high percentage of advanced cases of rectum and colon cancer. The mean duration of preoperative history of rectum cancer comprises 8,9 months. The main causes of late diagnosis included the patients' unawareness of the symptoms of the lesion, and the defects of examinations performed in out-patient clinics. The efficacy of medical services rendered to this group of patients can be improved by extending the system of proctological services, establishing a practice of specialized out-patient examinations, screening procedures by proctologists, as well as developing modern diagnostic and operative measures for oncological lesions.

Humans↗
PubMed1981

[Ambulant coloscopy in colitis ulcerosa and colorectal cancer].

In the first year after establishing a gastroenterological center in a vineyard and industrial district with 220.000 inhabitants we examined 1.171 patients. In 36.53% we had diseases in the lower gastrointestinal tract excluding proctological disturbances. We could find out 37 cases of colitis ulcerosa and 42 colorectal cancers. Excluding two cancers in colon transversum and ascendens all the tumors were found by coloscopy. Previously 4 cases of colitis ulcerosa were identified by other methods, clinically or by rectoscopy. In 48.6% of the colitis ulcerosa the transfer was done by reason of blood in the feces. The melaena lingers between 1 month and 10 years. Other presumed diagnoses for transfer to our Institute were gastroenteritis, proctitis, hemorrhoids, fissure or ileitis terminalis Crohn. In some rare cases the supposed diagnosis was salmonellosis or mycosis of the intestinum. In colorectal cancers the main reason for special gastroenterological investigation was the addition of blood to stool, whether microscopically or visible. Abdominal pain or ileus were following in frequency. Clinical symptoms were to be reconstructed in 30.9% for six weeks, in 59% for six months and in 9.5% up to one year. Most of the colorectal tumors (85.7%) were localized distal from splenic colonflexur, mostly in the rectosigmoid and colon descendens (see figure 1). Ambulant coloscopy is a method for quickly and definitive clarification, if the practitioner will refer swiftly.

Ambulatory Care↗
PubMed1978

[The importance of hemorrhoids in gynecology and obstetrics (author's transl)].

Hemorrhoids are of enough importance in gynecology and obstetrics that the gynecologist should be well versed in proctologic diagnosis and treatment. In the gynecological office practice about 19% of the patients and in the antenatal practice about 46% of the patients have hemorrhoids which require treatment. Prior to treatment an exact examination with the exclusion of carcinoma of the rectum is important. The indications for different modes of treatment are discussed. Minor hemorrhoids require only general and conservative measures. Recurrent and severe hemorrhoid problems require specific treatment. The specific treatment should be as tolerable for the patient as possible, have few recurrences and be economic regarding time and money. These requirements are best fulfilled by aspiration rubberband ligature or the combination of this ligature with cryotherapy.

Cryosurgery↗
PubMedDate not supplied

[Treatment of peri-anal fistulas. A current problem].

This problem of the treatment of perianal fistulas is examined and current principles of correct, effective therapeutic conduct set out. The techniques available vary with the type of fistula and the school of proctology. The as yet controversial point revolves about the way and the extent of possible sphincteric section. 80 cases reported provide a basis for some practical considerations.

Humans↗
PubMed1995

Anismus and biofeedback: who benefits?

BACKGROUND: Biofeedback is the main treatment for dyschezia in patients with anismus, but retraining may fail because of the frequent association of pelvirectal disorders with anismus. We set out to identify indices of biofeedback failure in the treatment of anismus. PATIENTS AND METHODS: From May 1990 to May 1993, 27 patients (20 women and seven men; median age 46 years) with anismus in which dyschezia was not improved by laxative agents were enrolled in a biofeedback retraining programme. All patients underwent proctologic examination, anal manometry and defecography. Anismus was defined as an increase in anal pressure during attempted defecation in conjunction with an impairment of rectal emptying as assessed using an objective test (barium paste expulsion). Associated disorders were encountered frequently. These included abnormal perineal descent (22 cases), large rectocoele (12 cases), high-grade rectal prolapse (six cases), abnormally high anal canal pressures at rest (seven cases) and abnormal rectal response to inflation (20 cases). Anismus was the sole abnormality in 12 patients when perineal descent, low-grade prolapse and abnormal rectal sensations were not taken into account. RESULTS: Biofeedback retraining did not suppress dyschezia in 13 out of 27 patients. Neither associated disorders (rectocoele, rectal prolapse, abnormal perineal descent, anal pressure and abnormalities of rectal sensation) nor a relevant past history (hysterectomy, laxative abuse, use of antidepressive agents) were encountered more frequently in these 13 patients than in the other 14. The duration of symptoms before treatment was significantly longer in the group unresponsive to biofeedback retraining (81 +/- 61 compared with 33 +/- 34 months for the responsive group, P < 0.01), but the total duration of symptoms and the number of retraining sessions attended did not differ significantly between the two groups. CONCLUSIONS: (1) Extensive examination (defecography and manometry) before biofeedback retraining of anismus is not mandatory because the failure of retraining (48%) is not related to the presence of associated pelvirectal disorders. (2) A long past history of dyschezia seems to provide an index of the failure of biofeedback retraining.

Adult↗
PubMed1995

[Quality of life of post-colostomy patients].

The psychosomatic care of patients after surgical treatment must comprise the analysis of quality of life with colostomy. Five different parameters were assessed of 100 colostomy patients. Sixty-one percent of our patients had skin irritation problems. Twenty-eight patients applied regular irrigation. Seventy-two percent of these had daily motions, 20% had bidaily, the remaining 8% had irregular bowel movements. Seventeen percent of the nonirrigating patients observed very irritating fecal discharge around the stoma. Embarrassing noises concomittant with bowel movements were observed by 42% and 45% struggled with bad odors. Irrigating patients had hardly any of these problems. For 65% of the patients the idea of having a colostoma meant the greatest psychological burden before the operation. The stress situation culminated in the immediate postoperative period in 10%. Forty percent of those asked were seriously worried about the reaction of their social environment. In 65% a significant decrease of social relations could be observed. Sixteen percent reported an increased social activity after colostomy had been performed. Sixty percent admitted considering the option of suicide at least once. Thirty-five percent revealed to have any kind of sexual problems after colostomy. Eight of our 100 colostomy patients experienced serious adverse reactions from their family members. In eighty percent of the cases family members showed great sympathy although they acted naively. The quality of life of colostomy patients may be best taken care of by qualified stomatherapists, out-patient proctology departments and the ileo-colostomy movement (ILCO).

Adult↗
PubMed1995

[Ambulatory surgery in the hospital--analysis of a 1978-1994 patient sample].

In the outpatient department of the University hospital of the Technology University Dresden ambulatory surgery has been performed since 1965. The patients of 16 years were analyzed. From 1978 till VI/1994 we have carried out 13948 elective operations. The personal wish of a cooperative patient without risk factors and an orderly social surrounding are the prerequisites for carrying out outpatient operations. Applied anaesthetic techniques were: general anaesthesia 9.2%, spinal anaesthesia 7.1%, sacral anaesthesia 14.8%, nerveblock of the upper extremity 11.1 and infiltration anaesthesia 57.8%. On the day of operation 61 patients had to be admitted to the hospital because of intraoperative events, expansion of the operation and complications of anaesthesia. Between the first to eight postoperative day 23 patients were hospitalised due to bleeding and 1 patient due to a wound infection. After aseptic elective operations 33 patients (0.35%) and after proctology operations with primary wound closure 10% of the patients developed wound infections. The cooperation of the general practitioner must be ensured in the post-operative days. Outpatient operations lower the financial burden of the health insurance companies, medical care services can be reduced.

Adolescent↗
PubMed1995

[Endorectal advancement flap-plasty vs. transperineal closure in surgical treatment of rectovaginal fistulas. A prospective long-term study of 88 patients].

UNLABELLED: A prospective study was carried out on 88 patients with rectovaginal fistulae to evaluate the value of two sphincter-saving techniques: primary occlusion of the intraanal ostium and endorectal advancement flap (n = 37) or transperineal repair with levator interposition (n = 34). Causes were Crohn's disease 35, obstetric injury 31, proctological-gynecological operation 11, cryptoglandular 11. Perineal group: 11 patients underwent concomitant anterior sphincter plication. Crohn group (n = 35): endorectal advancement flap was performed in 8 patients only, and 10 with intra- or supraanal stenosis were treated by transperineal approach, 12 (34%) with extended perianal fistula complaints required primary proctectomy, and operative therapy was not possible in 5 with persistent rectal inflammation. No deaths occurred. Postoperatively 12 cases (17%) of suture leakage occurred (flap group (FG): 16.2%, transperineal group (TPG): 17.6%). Persistent or recurrent fistula occurred in 8 patients (11%), 5.4% FG, 17.6% TPG. Disturbance of continence was observed in one patient after endorectal approach. Postoperatively there were no significant changes in the resting anal pressure and maximum voluntary contraction pressure. A complete primary healing with no further recurrence (follow-up 3 months to 9.5 years) was noted in 78.4% FG and 64.7% TPG. One patient with postoperative incontinence after the endorectal flap, had undergone anterior levator plication with perineal body reconstruction. CONCLUSIONS: Endorectal advancement flap allows preservation of the sphincter and is an effective method for repair of rectovaginal fistulae. The endorectal advancement flap proved to result in a better primary healing rate with 85% than the mucosal advancement flap with 65%. Perineal procedures are indicated in selected patients with simultaneous sphincter plication and in Crohn's fistulae associated to intra- or supraanal stenosis.

Colostomy↗
PubMed1995

[AIDS and anorectal pathology].

Anorectal lesions are uncommon in patients infected by the HIV virus (13%, 1 female and 15 males in our personal series). Certain neoplastic lesions are specific and must suggest the possibility of AIDS: Kaposi sarcoma, non-Hodgkin's malignant lymphoma and, in young subjects, intra-epithelial dysplasias, carcinomas in situ or squamous cell of the anus. Other lesions encountered in proctology should also raise the suspicion of HIV infection: anorectal lesions of STD including florid papillomatosis, most frequently (25%) in its severe and recurrent form, extensive herpetic lesions refractory to the usual treatments, Cytomegalovirus ulcers. The clinical history, specifying sexual habits, a history of drug abuse and looking for the presence of chronic diarrhoea, and a complete clinical examination looking for lymphadenopathy are important elements to be considered in favour of the diagnosis. Apart from painful emergencies requiring an immediate surgical procedure, the therapeutic of the patient's general state, the stage of the disease and the expected benefit for the patient's comfort.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Multiple relaparotomies].

Under analysis was the material of the department of urgent and consultation medical aid (sanitary aviation) for the last 20 years. It was found that under conditions of surgical departments of central regional hospitals multiple relaparotomies made up 12.5% of all reoperations. It was shown that results of the multiple relaparotomies were dependent on urgent coming of a consultant and active surgical treatment on the spot. Reconstructive operations for intestinal fistulas must be performed under conditions of a specialized proctological department.

Abdomen, Acute↗
PubMed1994

[Transanal resection of the rectum].

A new method of an organ-preserving operation for the management of the initial forms of rectal carcinoma and benign tumors of the distal parts of the rectum has been elaborated and successfully used at the Scientific Research Institute of Proctology. It consists in transanal resection of the rectum with creation of a recto-anal anastomosis. Transanal resection of the rectum was performed on 34 patients. Sixteen patients had giant or recurrent villous tumours of the distal part of the rectum 6 of which had undergone malignant degeneration. In a group of 34 patients 14 had the initial forms of carcinoma of the inferoampular part of the rectum, 2 had a deep cystic colitis, and the other 2 patients were operated on for neurilemoma and teratoma. Recurrences were not revealed in patients with benign diseases in follow-up periods of 2 to 8 years. Recurrent carcinoma of the rectum in the region of the anastomosis was found in 2 patients in follow-up periods of 25 to 37 months. They underwent extirpation of the rectum. The new method enables stable recovery to be achieved and saves the patients from crippling abdomino-anal resections and extirpation of the rectum in the management of benign new growths and initial forms of carcinoma of the distal parts of this organ.

Adenoma, Villous↗
PubMed1994

[Orthograde intestinal lavage in the preparation for colonoscopy].

Thirty-eight proctological patients were prepared for colonoscopy by drinking 2l of aqueous solution of polyethylene glycol-4000 and electrolytes, so that additional purgatives, cleansing enemas, and waste-free diet are not needed. Control of hemodynamics, clinical and biochemical blood tests, and plasma electrolyte content revealed no significant changes in these parameters after preparation for the examination. Colonoscopy was conducted to a full measure in 94% of cases. This method was preferred rather than the use of purgatives and enemas by 82% of patients. Intestinal lavage with polyethylene glycol and electrolyte solution is a simple and effective method, it is convenient for the patient and does not cause marked side effects.

Administration, Oral↗
PubMed1994

[Muscle grafts in the reconstructive surgery of rectal sphincter].

Analysis of experimental (146 operations) and clinical (14 patients) material provides the grounds for recommending plastics with muscles on a mobile neurovascular pedicle to be included in the complex of surgical rehabilitation of patients with incompetence of the sphincter ani muscles. Optimization of the functional results of such operations holds much promise for the use of the method of muscular plastics on a mobile neurovascular pedicle in proctology.

Anus Diseases↗