Partial colectomy and coloanal anastomosis for idiopathic megarectum and megacolon

1992 ◽  
Vol 35 (2) ◽  
pp. 158-162 ◽  
Author(s):  
Giorgio Stabile ◽  
Michael A. Kamm ◽  
Robin K. S. Phillips ◽  
Peter R. Hawley ◽  
John E. Lennard-Jones
Keyword(s):  
Coloanal Anastomosis ◽  
Partial Colectomy ◽  
Idiopathic Megarectum

scholarly journals Short stump and high anastomosis pull-through (SHiP) procedure for delayed coloanal anastomosis with no protective stoma for low rectal cancer

2021 ◽  
Vol 73 (2) ◽  
pp. 495-502
Author(s):  
Francesco Bianco ◽  
Paola Incollingo ◽  
Armando Falato ◽  
Silvia De Franciscis ◽  
Andrea Belli ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Coloanal Anastomosis ◽  
Functional Results ◽  
Anal Margin ◽  
Perioperative Mortality ◽  
The Mean ◽  
Pull Through ◽  
Protective Stoma

AbstractDespite advances in coloanal anastomosis techniques, satisfactory procedures completed without complications remain lacking. We investigated the effectiveness of our recently developed ‘Short stump and High anastomosis Pull-through’ (SHiP) procedure for delayed coloanal anastomosis without a stoma. In this retrospective study, we analysed functional outcomes, morbidity, and mortality rates and local recurrence of 37 patients treated using SHiP procedure, out of the 282 patients affected by rectal cancer treated in our institution between 2012 and 2020. The inclusion criterion was that the rectal cancer be located within 4 cm from the anal margin. One patient died of local and pulmonary recurrence after 6 years, one developed lung and liver metastases after 2 years, and one experienced local recurrence 2.5 years after surgery. No major leak, retraction, or ischaemia of the colonic stump occurred; the perioperative mortality rate was zero. Five patients (13.51%) had early complications. Stenosis of the anastomosis, which occurred in nine patients (24.3%), was the only long-term complication; only three (8.1%) were symptomatic and were treated with endoscopic dilation. The mean Wexner scores at 24 and 36 months were 8.3 and 8.1 points, respectively. At the 36-month check-up, six patients (24%) had major LARS, ten (40%) had minor LARS, and nine (36%) had no LARS. The functional results in terms of LARS were similar to those previously reported after immediate coloanal anastomosis with protective stoma. The SHiP procedure resulted in a drastic reduction in major complications, and none of the patients had a stoma.

Facility of Origin Predicts Mortality After Colonic Perforation

2020 ◽  
pp. 000313482097162
Author(s):  
Samuel D. Butensky ◽  
Emma Gazzara ◽  
Gainosuke Sugiyama ◽  
Gene F. Coppa ◽  
Antonio Alfonso ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Chronic Care ◽  
Care Facility ◽  
Colonic Perforation ◽  
Risk Of Death ◽  
Increased Risk ◽  
Chronic Care Facility ◽  
Partial Colectomy ◽  
Emergent Surgery ◽  
Perforated Viscus

Introduction Colonic perforation often requires emergent intervention and carries high morbidity and mortality. The objective of this study was to determine whether nonclinical factors, such as transition of care from outpatient facilities to inpatient settings, are associated with increased risk of mortality in patients who underwent emergent surgical intervention for colonic perforation. Materials and Methods Using the 2006-2015 ACS National Surgical Quality Improvement Program database, we identified adult patients who underwent emergent partial colectomy with primary anastomosis ± protecting ostomy or partial colectomy with ostomy with intraoperative finding of wound class III or IV for a diagnosis of perforated viscus. The outcome of interest was 30-day postoperative mortality. Univariate and multivariate analyses using logistic regression were performed. Results 4705 patients met criteria, of which 841 (17.9%) died. Univariate analysis showed that patients who died after emergent surgery for perforated viscus were more likely to present from a chronic care facility (13.4% vs. 4.4%, P < .0001) and had longer time from admission to undergoing surgery (mean 4.1 vs. 2.0 days, P < .0001. Logistic regression demonstrated that septic shock vs. none (OR 3.60, P < .0001), sepsis vs. none (OR 1.57, P = .00045), transfer from chronic care facility vs. home (OR 1.87, P < .0001), and increased time from admission vs. operation (OR 1.01, P = .0055) were independently associated with increased risk of death. Discussion Transfer from a chronic care facility was independently associated with increased mortality in patients undergoing emergent surgery for perforated viscus.

scholarly journals Potential problems of partial resection for colitis-associated cancer in a patient with ulcerative colitis: case report

2021 ◽  
Vol 2021 (3) ◽  
Author(s):  
Yuki Horio ◽  
Motoi Uchino ◽  
Takako Kihara ◽  
Toshihiro Bando ◽  
Ryuichi Kuwahara ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Endoscopic Resection ◽  
Ileal Pouch ◽  
Standard Procedure ◽  
Partial Resection ◽  
Total Proctocolectomy ◽  
Potential Problems ◽  
Partial Colectomy ◽  
A Site ◽  
Anal Site

Abstract Total proctocolectomy and an ileal pouch-anal anastomosis are recommended as the standard procedure for ulcerative colitis (UC)-colitis-associated cancer (CAC). However, several studies have reported the partial colectomy and endoscopic resection of UC-CAC in recent years. We present a surgical case of UC-CAC that was detected at a site that had not been diagnosed preoperatively, and we report potential problems of partial colectomy and endoscopic resection through this case. Considerations of synchronous and metachronous cancer/dysplasia are important before partial resection is planned for CAC in UC. Moreover, it should be noted that endoscopic resection at the anal site can be a risk factor for pouch surgery failure due to fibrosis after resection.

scholarly journals Treatment of Rectal Cancer by Low Anterior Resection with Coloanal Anastomosis

1994 ◽  
Vol 219 (4) ◽  
pp. 365-373 ◽  
Author(s):  
Philip B. Paty ◽  
Warren E. Enker ◽  
Alfred M. Cohen ◽  
Gregory Y. Lauwers
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Coloanal Anastomosis

Vertical reduction rectoplasty: a new treatment for idiopathic megarectum

2000 ◽  
Vol 87 (9) ◽  
pp. 1203-1208 ◽  
Author(s):  
N. S. Williams ◽  
O. A. Fajobi ◽  
P. J. Lunniss ◽  
S. M. Scott ◽  
A. J. P. Eccersley ◽  
...  
Keyword(s):  
New Treatment ◽  
Idiopathic Megarectum

Low Colorectal and Coloanal Anastomosis

2001 ◽  
Vol 14 (01) ◽  
pp. 033-040 ◽  
Author(s):  
Asim Farid ◽  
David A. Margolin
Keyword(s):  
Coloanal Anastomosis
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