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At least 1,081 records · Page 60Linked to original sources
PubMed2000

Radical cystectomy: minimizing operative blood loss with a "stapling technique".

We describe our experience with a surgical technique using the multiple fire Endo-GIA-30-3.5 stapler to control the vascular pedicles during radical cystectomy. This technique was performed in 16 radical cystectomies, including three pelvic anterior exenterations for female invasive bladder carcinoma, and compared with 23 cases treated with the conventional method. It was associated with a significant decrease in the intraoperative and postoperative blood loss and a shorter operative time.

Blood Loss, Surgical↗
PubMed2003

Clear cell adenocarcinoma in a female urethral diverticulum.

Primary urethral carcinoma is an uncommon diagnosis, and carcinomas arising from within a urethral diverticulum are rare. Because of the limited number of diagnosed cases, optimal treatment guidelines are not available. However, patients require an aggressive treatment approach to provide the best chance for cure.

Adenocarcinoma, Clear Cell↗
PubMed2000

Management of locally advanced rectal cancer.

The treatment of rectal cancer typically involves a multidisciplinary approach. A minority of patients will have tumors that are full thickness, involve adjacent structures, or have metastatic disease to regional lymph nodes. The combination of adjuvant therapy and surgical resection is the mainstay of treatment for locally advanced carcinoma of the rectum. This article will review the role of adjuvant chemotherapy and radiotherapy in patients with high risk tumors. The operative considerations in advanced rectal cancers will be reviewed. In particular, the role of mesorectal excision and exenterative surgery will be discussed.

Chemotherapy, Adjuvant↗
PubMed2003

How to treat the persistent perineal sinus after rectal excision.

As surgery for more advanced and complex pelvic malignancies continues to expand to include larger and more exenterative techniques, dealing with the resulting pelvic and perineal defect has become an increasingly frequent necessity. The goal is both to close the defect and to accomplish complete healing. Methodology for managing the perineal wound, which results after proctocolectomy for cancer and more recently, after exenterative resection of the rectum, sacrum, uterus, vagina, bladder and larger areas of soft tissue (i.e. perineum), varies between simple closure on one hand and creation of complex gluteal and rectus abdominus flaps on the other. We examined these methodologies in terms of indications, technical details, complications and outcomes. Finally, the newest techniques for eliminating persistent perineal sinus tracts are detailed.

Humans↗
PubMed2003

Simplified orthotopic ileocecal pouch (Mainz pouch) for bladder substitution.

OBJECTIVE: To report operative modifications that render construction of the orthotopic Mainz pouch more simple, namely formation of the pouch using absorbable staples and utilization of the ileocecal valve as an antireflux mechanism. PATIENTS AND METHODS: Between January 2001 and May 2002 out of 92 cystectomy cases, 21 patients (20 males and 1 female) underwent a simplified orthotopic Mainz pouch. The ureters were implanted via Wallace or Nesbit technique in the supravalvular portion of the ileocecal valve. The mean (range) age was 58 (43 - 74) years and the mean follow-up is 11.6 months (range 1 - 27). RESULTS: No staple-related complications were encountered. Four renal units (8.8 %) were dilated, one secondary to an impacted ureteral stone and three secondary to ureteral stenosis requiring reimplantation. At 6 months follow-up, 5 renal units showed reflux (11.1 %) but without any clinical symptoms. 86.5 % of patients void spontaneously without significant residual urine. Continence was achieved in 74 % of cases during day and in 74 % at night. CONCLUSION: The simplified Mainz pouch is a versatile form of continent urinary diversion. The use of absorbable staples has simplified the pouch creation and yields functional results which favorably compare with other pouch forms. The ileocecal valve serves as an anti-reflux-mechanism.

Adult↗
PubMed1993

Neovaginal procidentia.

Split-thickness skin grafts combined with an omental pedicle is a popular method of vaginal reconstruction. An unusual case of neovaginal prolapse presenting 3 months after construction is presented. Sacral colpopexy using autogenous fascial tissue allowed for both anatomical and functional correction of this neovagina.

Carcinoma, Squamous Cell↗
PubMed1999

The extended deep inferior epigastric flap: a case series.

The extended deep inferior epigastric flap is a reliable flap that has been found to be useful in covering difficult wounds in the lower torso, groin, perineum, and thigh regions. The author addresses the indications and outcomes in a series of 7 patients.

Aged↗