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  • 1
    Electronic Resource
    Electronic Resource
    Colon trauma—Clinical staging for surgical decision making (1992)
    Springer
    Diseases of the colon & rectum 35 (1992), S. 986-990 
    Details
    ISSN: 1530-0358
    Keywords: Colon trauma ; Clinical staging ; Colon wounds
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A retrospective study is presented of 119 patients admitted to the Central Hospital of the Venezuelan Institute of Social Security, in Caracas, between 1982 and 1990, with the diagnosis of colon trauma. Several parameters including age, etiology, time elapsed between the accident or assault and hospital admission, preoperative and postoperative hemoglobin and diastolic blood pressure, associated lesions, procedure practiced, complication rate, and hospital mortality are reviewed. The second and third decades of life appear most often involved. Most patients reached the hospital within the first four hours of the accident or assault. Anemia, sustained diastolic hypotension, and number of organs involved in addition to the colon were important prognostic factors for complications. Apparently the surgical procedure, with simple suture or resection, mostly without “protective” colostomy, was not very relevant. Hospital mortality was 2.4 percent. A staging system based on clinical conditions for decision making in the operating room was used in an attempt to inject some objectivity into the surgical approach.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02253503
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Optimization of sphincter function after the ileoanal reservoir procedure (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 419-423 
    Details
    ISSN: 1530-0358
    Keywords: Kegel exercises ; Pelvic muscle exercises ; Ileoanal reservoir ; J-pouch ; Restorative proctocolectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Impairment of sphincter function in patients who undergo ileoanal reservoir is usually most severe immediately after ileostomy closure. Therefore, a prospective, randomized trial was undertaken to assess the potential value of preileostomy closure sphincter-strengthening exercises to improve early functional outcome. METHODS: Patients were randomized either to a control group (Group 1) or to undergo a five-week pelvic floor exercise program (Group 2). An incontinence score from 0 to 20 was used to clinically assess the functional results. Anorectal manometric assessment included: highpressure zone length, mean resting pressure, highest resting pressure, mean squeezing pressure, and highest squeezing pressure. The paired t-test was used to compare the functional results preoperatively and at the time of ileostomy closure. This time corresponded to the conclusion of the exercise program or the equivalent time period for the control group. RESULTS: Twenty-six patients who underwent double-stapled ileoanal reservoir between July 1991 and June 1992 were studied. They included 16 males and 10 females with a mean age of 38 (range, 17–69) years. When both evaluations were compared, the mean incontinence score decreased from 0.2 to 2.8 (Δ=2.6) in Group 1 and from 0.2 to 2.0 (Δ = 1.8) in Group 2 (P=0.07). None of the changes between the preoperative and postoperative clinical and physiologic evaluations were statistically significant (P〉0.05). CONCLUSION: Sphincter-strengthening exercises before ileostomy closure did not minimize the transient impairment of functional results.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02076184
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Ileal pouch-anal anastomosis: Is preoperative anal manometry predictive of postoperative functional outcome? (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 224-228 
    Details
    ISSN: 1530-0358
    Keywords: Ileal pouch-anal anastomosis ; Ileoanal reservoir ; Anal manometry ; Incontinence ; Anorectal physiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: The aim of this study was to determine the value of preoperative anal manometry in predicting postoperative continence. METHODS: Anal manometry was performed in 73 consecutive patients before ileal pouch-anal anastomosis (IPAA) surgery (m1), before loop ileostomy closure (m2), and at a follow-up of one (m3) and two (m4) years. Mean and maximum resting and squeezing pressures were documented at each occasion. One year after surgery, pressures were correlated (r)with an incontinence score. RESULTS: A significant (P 〈 0.05) decrease in mean resting pressures was observed after IPAA (m1=66 mmHg; m2=42.8 mmHg), followed by a significant (P 〈 0.05) improvement of mean resting pressure after loop ileostomy closure (m3 = 538 mmHg; m4 = 54.7 mmHg). Mean squeezing pressures did not change (P 〉 0.05) at any time during the study (m1 =114 mmHg; m2 = 102.9 mmHg; m3 = 103.4 mmHg; m4 = 95.8 mmHg). There was no correlation between preoperative mean resting pressure and postoperative (mI) incontinence score. CONCLUSION: Anal manometry showed a characteristic trend in internal anal sphincter injury after IPAA followed by recovery after ileostomy closure. However, it failed to prove helpful in the prediction of clinical outcome. Thus, although this study supports the continued use of manometry in a research setting, it challenges the value of routine manometry in a clinical context.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02048159
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Discrepancies in anal manometric pressure measurement—Important or inconsequential? (1994)
    Springer
    Diseases of the colon & rectum 37 (1994), S. 820-823 
    Details
    ISSN: 1530-0358
    Keywords: Anal manometry ; Anal sphincters ; Constipation ; Incontinence ; Anorectal physiology
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Maximum resting and squeeze pressures have been the most widely employed parameters for manometric assessment of the anal sphincters. However, a single maximum value may not always be the best assessment. METHODS: The aim of this study was to compare mean and maximum resting and mean and maximum squeeze pressures in a large sample population. All manometric pressure profiles were reviewed by a single individual blinded to the patient's age and diagnosis. RESULTS: Four hundred sixty-six patients with a measurable high-pressure zone were included in this study. The study population was comprised of 279 females and 186 males. A significant difference was found between mean (56.26 mmHg) and maximum (79.2 mmHg) resting pressures (P〈0.01) and also between mean (81.25 mmHg) and maximum (119.50 mmHg) squeeze pressures (P〈0.01). A significant difference (P〈0.01) was also observed when compared by length of the high-pressure zone. CONCLUSION: The measurement, documentation, and reporting of mean resting and mean squeeze pressures provide a better perspective of anal manometric results, since the two sets of values are significantly different (P〈0.01), regardless of the anal canal length. Therefore, these data support the standardized evaluation of both mean and maximum pressures in individual patients and in published series.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02050148
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Total mesorectal excision: A misnomer for a sound surgical approach (1998)
    Springer
    Diseases of the colon & rectum 41 (1998), S. 120-120 
    Details
    ISSN: 1530-0358
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02236909
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    Paper (German National Licenses)
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