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  • 11
    Electronic Resource
    Electronic Resource
    Continent perineal colostomy after abdominoperineal resection (1999)
    Springer
    Diseases of the colon & rectum 42 (1999), S. 626-630 
    Details
    ISSN: 1530-0358
    Keywords: Continent perineal colostomy ; Abdominoperineal resection
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: For patients with distal rectal or anal tumors, quality of life can be compromised after abdominoperineal resection and iliac colostomy. This study examines our experience with a continent perineal colostomy constructed from a colonic smooth-muscle cuff wrap. METHODS: Between 1987 and 1996, 63 patients with distal rectal or anal tumors (0–5 cm from the anal verge) underwent abdominoperineal resection and construction of a colonic smooth-muscle cuff at the site of the perineal colostomy. Postoperatively, all patients required colonic irrigations daily or every two days. The complications, continence at 6 and 12 months, and degree of satisfaction were prospectively evaluated using a standard questionnaire. RESULTS: Early complications included partial perineal dehiscence in 14 (22.5 percent) patients, pelvic abscess in 2 (3 percent) patients, and colostomy necrosis in 1 (1.6 percent) patient. Late complications were colostomy stricture in 7 (11.8 percent) patients, perineal sinus tract in 4 (6.7 percent) patients, and mucosal prolapse in 12 (20 percent) patients. Satisfactory continence (complete continence to stool and incontinence to gas) at 6 and 12 months was achieved in 30 (55.6 percent) and 27 (59 percent) patients, respectively. Patient satisfaction was noted in 85 percent. CONCLUSION: Continent perineal colostomy can serve as an alternative to conventional iliac colostomy. Most patients were satisfied. The modest complication rate can be minimized with patient selection.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02234140
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  • 12
    Electronic Resource
    Electronic Resource
    Coloanal anastomosis for distal third rectal cancer (1999)
    Springer
    Diseases of the colon & rectum 42 (1999), S. 1272-1275 
    Details
    ISSN: 1530-0358
    Keywords: Rectal cancer ; Coloanal anastomosis ; Survival ; Recurrence
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract PURPOSE: Jeopardizing cure and risking high local recurrence have served as arguments against sphincter-saving resection for patients with distal third rectal cancer. This prospective study examines and compares the local recurrence and survival rates in patients with distal third rectal cancer treated by either coloanal anastomosis or abdominoperineal resection. METHODS: Between 1977 and 1993, 174 patients underwent coloanal anastomoses and 38 patients underwent abdominoperineal resection. All tumors were located 4 to 7 cm from the anal verge. One hundred ninety-three patients (91 percent) underwent rectal excision with a curative intent. Mean follow-up was 66 months after sphincter-saving resection and 65 months after abdominoperineal resection. RESULTS: Mean anastomotic height from the anal verge was 2.3 cm after sphincter-saving resection. Overall local recurrence rate was 7.9 percent after sphincter-saving resection and 12.9 percent after abdominoperineal resection. The five-year actuarial survival rate was 78 percent after sphincter-saving resection and 74 percent after abdominoperineal resection. CONCLUSION: Local recurrence and survival are not compromised in patients with distal third rectal cancer when treated by sphincter-saving resection, provided that oncologic principles are not violated. Coloanal anastomosis can be performed with an acceptable morbidity.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02234212
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    Paper (German National Licenses)
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  • 13
    Electronic Resource
    Electronic Resource
    An unusual variant of popliteal artery entrapment (1995)
    Springer
    Annals of vascular surgery 9 (1995), S. 467-470 
    Details
    ISSN: 1615-5947
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A 43-year-old woman presented with incapacitating exertional pain in the right foot, ankle, and lower calf of 1 years' duration following a minor ankle sprain. Evaluation by several physicians had been inconclusive. Physical examination identified normal pedal pulses at rest but obliteration of pulses with active plantar flexion. Segmental pressures were normal at rest and duplex scanning showed occlusion of the popliteal artery with active plantar flexion. The findings were confirmed by arteriography despite a normal course of the popliteal artery. Magnetic resonance imaging (MRI) showed no muscular abnormality. At exploration entrapment was noted to be the result of compression by branches of the sural nerve and vein as they coursed medially inserting into the medial head of the gastrocnemius muscle. Division of the neurovascular bundle resulted in complete resolution of symptoms and arterial compression on duplex examination postoperatively. This case was unusual because of the patient's age, sex, and the pathologic findings that had not been previously reported. In this case MRI was not useful in demonstrating a muscular or neurovascular bundle abnormality, supporting the use of duplex scanning as the noninvasive diagnostic modality of choice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02143861
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    Paper (German National Licenses)
    Fulltext
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