scholarly journals Fecal Incontinence after Posterior Sagittal Anorectoplasty for Anorectal Malformation: A Single-Center Study

Scientifica ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Manoochehr Ghorbanpoor ◽  
Behzad Dehvan ◽  
Siavash Rahimi ◽  
Azar Pirdehghan
Keyword(s):  
Fecal Incontinence ◽  
Anorectal Malformation ◽  
Fecal Continence ◽  
Posterior Sagittal Anorectoplasty ◽  
Medical Sciences ◽  
High Type ◽  
Single Center Study ◽  
The Status ◽  
The Difference

Background. Fecal incontinence is one of the worst functional complications of posterior sagittal anorectoplasty for treatment of anorectal malformation. Objectives. In this study, we aimed to identify the prevalence of fecal incontinence in patients with the diagnosis of high or low anorectal malformation who underwent three-stage posterior sagittal anorectoplasty surgery in our center. Patients and Methods. Children with the diagnosis of anorectal malformation who underwent posterior sagittal anorectoplasty at the Department of Pediatric Surgery of Besat Hospital, Hamadan University of Medical Sciences, Iran, from 2012 to 2016 were enrolled in the study. Parents or guardians were recruited and asked to fill the study questionnaire including the Templeton and Ditesheim Scoring System to assess the status of fecal continence of the patients. Results. Thirty-four patients including 10 (29.4%) males were enrolled in the study. High type of anorectal malformation was diagnosed in 23 (67.6%) patients. The overall mean scores of fecal continence were 4.57 ± 0.84 (range 1.5–5) after a mean follow-up time of 50.7 (range 22.5–69.8) months. Good fecal continence was observed in 91.3% of patients with low type compared to 72.8% of patients with high type of anorectal malformation; however, the difference was not significant (P=0.13). Conclusion. Posterior sagittal anorectoplasty surgery in patients with anorectal malformation may result in acceptable fecal continence.

Urological problems or fecal continence during long-term follow-up of patients with anorectal malformation

2010 ◽  
Vol 26 (7) ◽  
pp. 683-689 ◽  
Author(s):  
Emrah Senel ◽  
Fatih Akbiyik ◽  
Halil Atayurt ◽  
H. Tugrul Tiryaki
Keyword(s):  
Anorectal Malformation ◽  
Fecal Continence ◽  
Long Term Follow Up

Microscopic margins of resection in gastrointestinal stromal tumor (GIST): An analysis of 122 patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 10554-10554
Author(s):  
M. Di Battista ◽  
M. Saponara ◽  
M. A. Pantaleo ◽  
F. Catena ◽  
D. Santini ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Rank Test ◽  
R0 Resection ◽  
Strongly Correlated ◽  
R1 Resection ◽  
Complete Surgical Resection ◽  
The Status ◽  
The Difference ◽  
The Impact

10554 Background: The main treatment for localized GIST is complete surgical resection. The prognosis is strongly correlated with both tumor size and mitotic index. The aim of our study was to analyze retrospectively the outcome of patients affected by GIST related to microscopic margins of resection. Methods: The outcome of 122 patients surgically managed during the past 11 years, were evaluated. We analyzed the impact of R0 and R1 resection on DFS. Results: All patients but one, had a c-Kit positive GIST, 91% had primary disease without metastasis, 9% had metastasis. There were 46% high, 31% intermediate and 28% low risk GIST. The median age was 65 years (range 29–87). The most common sites of tumor origin were the stomach (54.9%) and the small bowel (36.9%). Sites of tumor metastasis were liver (18.2%), peritoneum (36.4%) or both (19.3%). R0 resection was achieved in 102 (83.6%) patients, while 16 pts (13.1%) had positive microscopic margins (R1). With a median follow up of 24 months (range 3–119), recurrence occurred in 34 (33.3%) R0 and in 9 (56.3%) R1 patients. The median DFS was 53.7 months and 35.6 months for the R0 and R1 group, respectively. The difference tested with univariate analysis using Long rank test, was not statistically significant (p= 0.228). Conclusions: In our series, the status of microscopic margins does not appear to be important for prediction of recurrence in patients affected by GIST. No significant financial relationships to disclose.

scholarly journals Anorectal malformation with long perineal fistula: one of a special type

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sen Li ◽  
Jun Wang
Keyword(s):  
Anorectal Malformation ◽  
Bowel Function ◽  
Anorectal Malformations ◽  
Contrast Enema ◽  
Posterior Sagittal Anorectoplasty ◽  
Function Score ◽  
Perineal Fistula ◽  
Definitive Surgery ◽  
Inhibitory Reflex

AbstractThe anorectal malformation with long perineal fistula is a rare anomaly in the spectrum of anorectal malformations. Aim of the study is to describe the series of patients with anorectal malformation with long perineal fistula and compare the outcome with patient with standard perineal fistula. From March 2012 to January 2019, 7 patients who suffered from anorectal malformation with long perineal fistula were retrospectively reviewed. Three were operated on primarily by our department, and 4 cases were re-operated after a perineal anoplasty repair performed elsewhere. Four were operated by laparoscopy assisted anorectoplasty, and 3 cases were repaired by posterior sagittal anorectoplasty. The follow-up outcomes were compared with 71 cases of normal perineal fistula (NPF) in the same period. 7 cases have been followed up for 0.5–4 years (M = 2.57 ± 1.26) after definitive surgery. Their bowel function score was lower than normal perineal fistula (SPF = 12, range: 5–18; NPF = 18.5, range: 18–20). Four cases underwent anorectomanometry. The incidence of rectoanal inhibitory reflex was lower in the special type group. (p = 0.14). Three cases of contrast enema using barium: 2 cases of colorectal dilatation and thickening changes, 1 case showed no obvious abnormalities. Anorectal perineal fistula should be examined by distal colostogram at preoperation. This should be altered in: When suspecting a case of anorectal malformation type long perineal fistula a preoperative contrast enema could give insight of the anatomy befor performing a anoplasty.

scholarly journals Magnetic Tracking and Electrocardiography-Guided Tip Confirmation System Versus Fluoroscopy for Placement of Peripherally Inserted Central Catheters: A Randomized, Noninferiority Comparison

2020 ◽  
Vol 43 (12) ◽  
pp. 1891-1897 ◽  
Author(s):  
V. Mack ◽  
D. Nißler ◽  
D. Kasikci ◽  
A. Malouhi ◽  
R. Aschenbach ◽  
...  
Keyword(s):  
Primary Objective ◽  
Magnetic Tracking ◽  
System Versus ◽  
Single Center Study ◽  
Resource Requirements ◽  
Catheter Tip ◽  
The Difference ◽  
Tip Position ◽  
Ancillary Benefit

Abstract Purpose To determine whether the use of a magnetic tracking and electrocardiography-guided catheter tip confirmation system (TCS) is safe and noninferior to fluoroscopy concerning positioning accuracy of a peripheral inserted central catheter (PICC). Methods In this prospective, randomized, single-center study, adult patients scheduled for PICC insertion were assigned 1:1 either to TCS or fluoroscopy. The primary objective was a noninferiority comparison of correct PICC tip position confirmed by X-ray obtained immediately after catheter insertion. Time needed for PICC insertion and insertion-related complications up to 14 days after the procedure were secondary outcomes to be assessed for superiority. Results A total of 210 patients (62.3 ± 14.4 years, 63.8% male) were included at a single German center between June 2016 and October 2017. Correct PICC tip position was achieved in 84 of 103 TCS (82.4%) and 103 of 104 fluoroscopy patients (99.0%). One-sided 95% lower confidence limit on the difference between proportions was −23.1%. Thus, noninferiority of TCS was not established (p > 0.99). Insertion of PICC took longer with TCS compared to fluoroscopy (8.4 ± 3.7 min vs. 5.0 ± 2.7 min, p < 0.001). Incidence of complications within a mean follow-up of 5.0 ± 2.3 days did not differ significantly between groups. Conclusion Noninferiority of TCS to fluoroscopy in the incidence of correct PICC tip position was not reached. Ancillary benefit of TCS over fluoroscopy including less radiation exposure and lower resource requirements may nonetheless justify the use of TCS. The study is registered with Clinical.Trials.gov (Identifier: NCT02929368).

scholarly journals Clinical and radiological postoperative evaluation of posterior sagittal anorectoplasty in patients with upper and intermediate anorectal malformations

1997 ◽  
Vol 115 (6) ◽  
pp. 1566-1569 ◽  
Author(s):  
José Luiz Martins ◽  
Henrique Manoel Lederman ◽  
José Pinus
Keyword(s):  
Surgical Technique ◽  
Fecal Incontinence ◽  
Anorectal Malformations ◽  
Fecal Continence ◽  
Radiological Evaluation ◽  
Posterior Sagittal Anorectoplasty ◽  
Postoperative Evaluation ◽  
Operative Evaluation

The PSARP is today the most-used surgical technique for correction of high and intermediary anorectal malformations.There is much controversy in the literature about the post-operative evaluation of these cases. We studied 27 cases of anorectal malformations from clinical and radiological aspects, in order to analyse: 1. Fecal continence 2.Relationship between post-operative fecal continence and the associated sacral anomalies 3.Relationship between the radiological evaluation by defecogram and fecal continence From the analysis of the cases, we concluded: 1. Fecal continence was achieved in 48.14% of the cases; partial continence in 25.92%; and fecal incontinence in 25.92% of the cases. 2.The presence of fecal incontinence was directly related to the associated sacral anomalies.

scholarly journals Fecal Incontinence after Posterior Sagittal Anorectoplasty – Follow up of 2 years

2003 ◽  
Vol 59 (3) ◽  
pp. 194-196 ◽  
Author(s):  
MM Harjai ◽  
Bipin Puri ◽  
PJ Vincent ◽  
BM Nagpal
Keyword(s):  
Fecal Incontinence ◽  
Posterior Sagittal Anorectoplasty

scholarly journals Anorectal Malformation: Paediatric Problem Presenting in Adult

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Rahulkumar N. Chavan ◽  
Bhargav Chikkala ◽  
Cinjini Das ◽  
Somak Biswas ◽  
Diptendra Kumar Sarkar ◽  
...  
Keyword(s):  
Case Report ◽  
Anorectal Malformation ◽  
Abdominal Distension ◽  
Definitive Treatment ◽  
Posterior Sagittal Anorectoplasty ◽  
Conventional Procedure ◽  
Satisfactory Outcome ◽  
Vestibular Fistula ◽  
Anal Transposition

This is a case report of 22-year-old girl admitted with abdominal distension, vomiting, and chronic constipation since birth. Abdomen was distended, and perineal examination revealed imperforate anus with vestibular fistula (ARM). So far worldwide very few cases have been reported about anorectal malformation presenting in adulthood, and thus extremely little data is available in the literature about an ideal management of anorectal malformation in adults. In our case in the treatment instead of conventional procedure of posterior sagittal anorectoplasty (PSARP) anal transposition was done and till two years after the definitive treatment during follow-up patient has been doing well with Kelly’s score of six. Our experience suggests that anal transposition provides satisfactory outcome in adults presenting late with anorectal malformation.

scholarly journals Rate of venous thromboembolism in a prospective all-comers cohort with COVID-19

2020 ◽  
Vol 50 (3) ◽  
pp. 558-566 ◽  
Author(s):  
Marina Rieder ◽  
Isabella Goller ◽  
Maren Jeserich ◽  
Niklas Baldus ◽  
Luisa Pollmeier ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Disease Severity ◽  
Maximum Level ◽  
Control Group ◽  
Control Groups ◽  
Course Of Disease ◽  
Clinical Complications ◽  
Single Center Study ◽  
The Difference

Abstract COVID-19 is associated with a variety of clinical complications including coagulopathy, which frequently results in venous thromboembolism (VTE). Retrospective analyses reported a markedly increased rate of VTEs in COVID-19. However, most recent studies on coagulopathy in COVID-19 were only focused on critically ill patients, and without suitable control groups. We aimed to evaluate the rate of VTEs in an all-comers cohort with suspected COVID-19 during a 30-days follow-up period. We also studied the level of D-dimers and their association with the course of disease. In our prospective single-center study (DRKS00021206, 03/30/2020), we analyzed 190 patients with suspected COVID-19 admitted to the emergency department between March and April 2020. Forty-nine patients were SARS-CoV-2 positive (25.8%). The 141 SARS-CoV-2-negative patients served as control group. After completion of a 30-days follow-up, VTE was diagnosed in 3 patients of the SARS-CoV-2-positive group (6.1%, amongst these 2 ICU cases) versus 5 patients in the SARS-CoV-2-negative group (3.5%), however the difference was not statistically significant (p = 0.427). 30-days mortality was similar in both groups (6.1% vs. 5%, p = 0.720). Disease severity correlated with the maximum level of D-dimers during follow-up in COVID-19. The rate of VTE was numerically higher in SARS-CoV-2 positive all-comers presenting with suspected COVID-19 as compared to well-matched controls suffering from similar symptoms. VTEs in the COVID-19 group predominantly occurred in ICU courses. The maximum level of D-dimers during follow-up was associated with disease severity in COVID-19, whereas the level of D-dimers at admission was not.

scholarly journals Anorectal Malformation with Rectovestibular Fistula and Vaginal Agenesis: Usage of Rectovestibular Fistula as a Neovagina Followed by PSARP with Preservation of the Anal Sphincter

2021 ◽  
Vol 09 (01) ◽  
pp. e51-e55
Author(s):  
Antonio Dessanti ◽  
Osnel Louisma ◽  
Gabriel Steve Pierre ◽  
Nguhien Thanh Liem
Keyword(s):  
Sigmoid Colon ◽  
Anal Sphincter ◽  
Surgical Approach ◽  
Anorectal Malformation ◽  
Good Option ◽  
Posterior Sagittal Anorectoplasty ◽  
Vaginal Agenesis ◽  
Rectovestibular Fistula

AbstractAnorectal malformation with rectovestibular fistula associated with vaginal agenesis is rare. We report on a child in whom this combination was diagnosed at the age of 1 year. After creation of a divided descending colostomy, we chose to leave the rectum-rectovestibular fistula to function as a neovagina, while the sigmoid colon was relocated via modified posterior sagittal anorectoplasty. The colostomy was closed 6 months after the main surgery. After a follow-up of 3 years, the patient is continent for stool and urine. The introitus of the neovagina appears wide and easy to explore. We conclude that our surgical approach may be a good option for these children.

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