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  • 1
    Electronic Resource
    Electronic Resource
    Colostomy closure (1996)
    Springer
    Diseases of the colon & rectum 39 (1996), S. 605-609 
    Details
    ISSN: 1530-0358
    Keywords: Colostomy closure ; Hartmann's pouch ; Stoma ; Complications
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: We retrospectively reviewed the records from our past five years of experience with colostomy closure at a large multispecialty hospital to determine postoperative morbidity. RESULTS: From March 1988 to April 1993, 46 patients underwent colostomy closure. Patients ranged in age from 24 to 87 (mean, 41.8) years, and 25 (54 percent) were women. Stomas had been created during emergency operations in 40 patients (87 percent); most operations (54 percent) were for complications of acute diverticulitis. Of the 46 procedures, 40 (87 percent) were end colostomies, and 6 were loop colostomies. Stomas were closed at a range of 11 to 1,357 days after creation (mean, 207 days; median, 116 days). Twenty-six patients (57 percent) underwent colostomy closure alone, and the remainder underwent additional procedures ranging from appendectomy to hepatic lobectomy. Duration of operations ranged from 1 to 9.5 (mean, 4.2) hours, and estimated blood loss averaged 400 ml. Overall hospital stay for closure was 6 to 62 (mean, 11.5) days. Inpatient complications occurred in 15 percent of patients, including congestive heart failure (2 percent), cerebrovascular accident (4 percent), pneumonia (2 percent), enterocutaneous fistula (2 percent), and pulmonary embolus with death (2 percent). The most common longterm complication was midline wound hernia, which occurred in 10 percent of surviving patients. Overall, complications occurred in 24 percent.CONCLUSIONS: Colostomy closure is a major operation; however, with good surgical judgment and technique, associated morbidity and mortality can be minimized.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02056935
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  • 2
    Electronic Resource
    Electronic Resource
    Incidence of small-bowel obstruction and adhesiolysis after open colorectal and general surgery (1999)
    Springer
    Diseases of the colon & rectum 42 (1999), S. 241-248 
    Details
    ISSN: 1530-0358
    Keywords: Adhesions ; Complications ; Small-bowel obstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The study contained herein was undertaken to establish the incidence of small-bowel obstruction, adhesiolysis for obstruction, and additional abdominal surgery after open colorectal and general surgery. METHODS: A retrospective cohort study was performed using patient-specific Health Care Financing Administration data to evaluate a random 5 percent sample of all Medicare patients who underwent surgery in 1993. Of these, 18,912 patients had an index abdominal procedure. Two-year follow-up data documented outcomes of hospitalizations with obstruction, adhesiolysis for obstruction, and/or additional open colorectal or general surgery. RESULTS: Within two years of incision, excision, and anastomosis of intestine (International Classification of Diseases (ICD)-9 code 45), 14.3 percent of patients had obstructions, 2.6 percent required adhesiolysis for obstructions, and 12.9 percent underwent additional open colorectal or general surgery. After other operations of intestine (ICD code 46), 17 percent of patients had obstructions, 3.1 percent required adhesiolysis for obstructions, and 20.2 percent underwent additional open colorectal or general surgery. After operations of rectum, rectosigmoid, and perirectal tissue (ICD code 48), 15.3 percent of patients had obstructions, 5.1 percent required adhesiolysis for obstructions, and 16.4 percent underwent additional open colorectal or general surgery. After other operations on the abdominal region (ICD code 54), 12.4 percent of patients had obstructions, 2.3 percent required adhesiolysis for obstructions, and 8.8 percent underwent additional open colorectal or general surgery. CONCLUSIONS: In this retrospective study of Medicare patients, we learned that bowel obstruction, adhesiolysis for obstructions, and additional abdominal surgery occurred more often after abdominal surgery than was previously published.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02237135
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  • 3
    Electronic Resource
    Electronic Resource
    Seasonality, abundance, and microhabitat distribution of meiofauna from a Chickahominy River, Virginia tidal freshwater marsh (1995)
    Springer
    Hydrobiologia 310 (1995), S. 197-206 
    Details
    ISSN: 1573-5117
    Keywords: Meiobenthos ; tidal freshwater ; microtopography ; Chickahominy River
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract Meiofauna were sampled from intertidal pool and vegetative hummock microhabitats at a tidal freshwater marsh on the Chickahominy River, Virginia. Nematodes, ostracods, tardigrades, oligochaetes (Naididae), copepods (Harpacticoida and Cyclopoida), and the sabellid polychaete Manayunkia spp. were numerically dominant in monthly collections. Total meiofaunal densities ranged from 169 individuals 10 cm−2 (low marsh pools, April) to 13832 individuals 10 cm−2 (low marsh hummocks, September). Highest densities of total meiofauna were observed in August–September, coincident with recruitment of oligochaetes and Manyunkia spp. to low marsh hummocks. Nematodes were generally abundant in all seasons and represented 37% of total meiofauna collected. Nematode densities were significantly greater on hummocks (p=0.0001). Ostracods were significantly more abundant in pools, Greatest densities of ostracods were observed in May. Tardigrades were abundant November through March, and September. Significantly greater abundance of tardigrades was observed on hummocks. Harpacticoid copepods were abundant from December through April and cyclopoids were abundant from May through September (low marsh only). Intertidal freshwater meiofauna may represent an important, yet previously undescribed, trophic link in tidal freshwater wetlands; ostracods, copepods and other meiofauna are frequently consumed by young-of-the-year Cyprinodonts (Fundulus spp.) and other sub-adult nekton utilizing the surface of tidal freshwater wetlands as a nursery area.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00006831
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  • 4
    Electronic Resource
    Electronic Resource
    Composition and abundance of resident marsh-surface nekton: comparison between tidal freshwater and salt marshes in Virginia, USA (1997)
    Springer
    Hydrobiologia 362 (1997), S. 9-19 
    Details
    ISSN: 1573-5117
    Keywords: Nekton ; tidal freshwater marshes ; salt marshes ; Chickahominy River ; Fundulus heteroclitus ; Palaemonetespugio
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology
    Notes: Abstract Previous research on intertidal nekton communities has identifiedimportant determinants of community structure and distribution; however, fewstudies have compared nekton utilization of disparate marsh habitats. Inthis study, abundance and distribution patterns of resident nekton werecompared between tidal freshwater marsh and salt marsh surfaces varying inflooding depth and duration. Nekton were collected in pit traps installedalong elevational transects at four marshes in coastal Virginia (twofreshwater, two saline) from April through November 1992–1993. Thedominant fish collected at all sites was the mummichog Fundulusheteroclitus. The daggerblade grass shrimp Palaemonetes pugio was thedominant nekton species collected at salt marsh sites, and was seasonallyabundant on tidal freshwater marshes. A positive correlation betweenflooding depth and nekton abundance was observed on salt marshes; anopposite pattern was observed on tidal freshwater marshes. Tidal floodingregime influences the abundance of resident nekton, however, the effect maybe confounded by other environmental variables, including variation insurface topography and seasonal presence or absence of submerged aquaticvegetation (SAV) in adjacent subtidal areas. In mid-Atlantic tidalfreshwater wetlands, SAV provides a predation refuge and forage site forearly life stages of marsh-dependent nekton, and several species utilizethis environment extensively. Salt marshes in this region generally lackdense SAV in adjacent subtidal creeks. Consequently, between-sitedifferences in species and size-specific marsh surface utilization byresident nekton were observed. Larvae and juveniles represented 79%and 59% of total fish collected at tidal freshwater and salt marshsites, respectively. The resident nekton communities of tidal freshwater andsalt marsh surfaces are characterized by a few ubiquitous species with broadenvironmental tolerances.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1003105930199
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