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At least 19 recordsLinked to original sources
PubMedDate not supplied

A new technique of laparoscopic surgery for rectal disease.

Laparoscopic rectal surgery is a technique that has to be done in a narrow space: the pelvis. If an immoderate operation is performed with a difficult view, for example in female where the field is disturbed by uterus, it is possible to produce organ trauma or an unexpected bleeding. Taking these problems in mind, we performed laparoscopic surgery in 44 cases of rectal disease with several techniques which we have invented. In these cases either the uterus or the rectum was retracted in the narrow space, and if an anterior resection was to be done, the tape was tied tightly around the rectum below the tumor to avoid touching the tumor and leaving adequate vascular irrigation to the remnant rectum. With the use of our techniques, we did not have female intestinal injury or unexpected bleeding. In addition laparoscopic anterior resection of rectum did not cause any intestinal injury, or unexpected bleeding or anastomotic leakage; also we did not have any local tumor recurrence. It is our belief that these techniques can decrease complications that traumatize the grasping intestine with intestinal forceps and prevent implantation in the anastomosis. This technical report validate that our technique modifications for rectal laparoscopic surgery are useful when a surgeon has to work in a narrow space.

Blood Loss, Surgical↗
PubMed1982

Alterations of creatine kinase isoenzymes in colon washings from patients with colonic and rectal diseases.

Mucus samples obtained from 61 patients with different types of colon and rectal disease were assayed for CK isoenzyme fractionation. Twelve additional patients without evidence of such diseases were used as reference subjects. The diseases surveyed were hemorrhoids, proctocolitis, polyps, and cancer of the colon and rectum. The CK BB fraction was predominant in the mucus of the reference subjects and in mild cases of hemorrhoids and polyps. With inflammation of degeneration of the colonic mucosa, the present CK BB decreased and the percent of CK MM increased. It is speculated that the increased CK MM possibly derives from increased permeability of degeneration of the colonic wall, permitting plasma CK MM to admix with the mucus. Mucin CK isoenzyme fractionation may be useful in assessing the pathogenesis of colonic and rectal diseases, as a marker to monitor the efficacy of the therapeutic regimen, and as a technique for monitoring conversion of a premalignant process into a malignant one.

Clinical Enzyme Tests↗
PubMed1999

[Analysis in pulmonary ventilatory function from 100 patients with ano-rectal diseases caused by deficiency of qi].

OBJECTIVE: To explore the pathogenesis of ano-rectal diseases caused by deficiency of Qi, which is correlated with obstruction of pulmonary ventilation. METHODS: The pulmonary ventilatory function was measured in 100 patients with the internal piles, the interno-external hemorrhoid and prolapse of rectum, the prolapse of anus was the principal symptom of them. RESULTS: Data from the 100 patients showed that 67% of them were diagnosed with the obstruction of pulmonary ventilation, the ratio was far less in the health control group. FEV 1.0 (mean +/- s) (2011.65 +/- 875) ml, MMF (1.84 +/- 1.24) L/s and PEF (2.34 +/- 1.51) L/s in male patients, (1551.54 +/- 514) ml, (1.57 +/- 0.62) L/s and (1.85 +/- 0.92) L/s in female patients, but those values were higher in the control than in the patients. The statistical analysis was performed and the difference was significant between patients and the control group (P < 0.01). CONCLUSION: The patients with ano-rectal diseases caused by deficiency of Qi accompanied with obstruction of pulmonary ventilation in different degree and varied sorts, it confirmed that the pathogenesis of ano-rectal diseases caused by deficiency of Qi is related with "sinking of pectoral Qi".

Adolescent↗
PubMed1982

Colonoscopic retroflexion in the evaluation of rectal disease.

Although previously described and advocated, rectal retroflexion has not been well studied as a diagnostic maneuver. We report 75 cases in which the maneuver was performed during colonoscopy or fibersigmoidoscopy. The technique was both easily performed by the examiner and well tolerated by patients. Rectal retroflexion increased diagnostic yield in six of 75 patients. It proved a useful adjunct to the standard forward-view of the rectum in the evaluation of internal hemorrhoids and in the detection of small perirectal polyps and rectal inflammatory bowel disease. Excluding patients with severe proctitis or a contracted rectal vault, rectal retroflexion is a valuable technique for the evaluation of suspected rectal disease.

Colonoscopy↗
PubMed1987

Coloanal anastomosis in the management of benign and malignant rectal disease.

The aim was to determine the efficacy, safety, and long-term clinical and functional results of coloanal anastomosis in patients with complicated benign and malignant rectal disease. Twenty-nine patients underwent coloanal or colopouch-anal anastomosis for either carcinoma of the rectum not technically amenable to conventional low anterior resection, severe radiation injury, large benign lower third tumors, or complications of previous operations. The mean age of the patients was 61 years and 82% were men. A diverting colostomy was constructed in 55% of the patients. The mean (+/- SEM) length of follow-up was 20 +/- 3 months. There was no operative mortality. Transient urinary retention, however, occurred in 40%, anastomotic stricture in 28%, and anastomotic leakage in 3.4%. Four patients (14%) could not have intestinal continuity restored and therefore were considered failures. The stool frequency for all remaining patients (N = 25) was 3 +/- 1 per day (mean +/- SEM) and did not vary with age, sex, or indication for operation. Complete continence was achieved by 84% of patients, but no patient was incapacitated by poor bowel function. In patients in whom a conventional colorectostomy is impractical or unwise, coloanal anastomosis is a safe and efficacious alternative operation that preserves anal continence.

Adenocarcinoma↗
PubMed1993

Medical malpractice involving colon and rectal disease: a 20-year review of United States civil court litigation.

To determine objectively the causes of malpractice litigation involving colon and rectal disease, a retrospective review was undertaken of all cases tried in the U.S. federal and state civil court system over a 21-year period from 1971 through 1991. Ninety-eight malpractice cases were identified from a computerized legal data base, involving 103 allegations of negligence. Allegations fell into five major categories: 1) failure to timely diagnose disease, principally colorectal cancer and appendicitis (n = 44/103; 43 percent); 2) iatrogenic colon injury (n = 25/103; 24 percent); 3) iatrogenic medical complications during diagnosis or treatment (n = 16/103; 15 percent); 4) sphincter injury with fecal incontinence, resulting from anorectal surgery or midline episiotomy (n = 10/103; 10 percent); and 5) lack of informed consent, especially regarding extent of procedures or risk of endoscopy (n = 8/103; 8 percent). These data may aid in design of risk prevention strategies related to the diagnosis and treatment of colorectal disease.

Anal Canal↗
PubMed1985

Histochemical demonstration of desialation and desulphation of normal and inflammatory bowel disease rectal mucus by faecal extracts.

Experiments were carried out to assess the susceptibility of normal and inflammatory bowel disease rectal mucus to desulphation and desialation by faecal extracts and by bacterial sialidase. The effects were assessed histochemically using a combined high iron diamine (HID) and alcian blue (AB) stain for sulphomucins and sialomucins. Rectal mucus in biopsies from controls (irritable bowel syndrome) and patients with ulcerative colitis or Crohn's disease was resistant to desialation by Clostridium perfringens sialidase, but susceptible to desialation and desulphation by bacteria-free extracts of normal faeces. Periodic acid-Schiff (PAS) staining of adjacent sections similarly treated showed retention of neutral mucus. One faecal extract selectively desulphated all 42 biopsies, causing the goblet cells to change from HID positive to AB positive, suggesting that most, or all HID positive cells also contain sialomucins. This alters the interpretation of previous histochemical studies. Faecal extracts from patients with active ulcerative colitis (n = 6) had desialating and desulphating effects similar to faecal extracts from normal subjects (n = 6). Ulcerative colitis (n = 21), Crohn's disease (n = 18), and control (irritable bowel syndrome) (n = 17) rectal biopsies all showed similar susceptibility to desulphation by a pooled normal faecal extract, but rectal biopsies from patients with Crohn's disease proved more resistant to desialation than control or ulcerative colitis biopsies (p less than 0.02). These studies imply that colonic mucus undergoes continual desulphation and desialation in vivo as a result of faecal enzyme activity that is probably mainly of bacterial origin. Altered susceptibility of colonic mucus to this may be important in the pathogenesis of colonic disease.

Adolescent↗