Plastic and reconstructive surgeries of the anal canal

Nowa Medycyna ◽  
2018 ◽  
Vol 25 (2) ◽  
Author(s):  
Małgorzata Kołodziejczak ◽  
Przemysław Ciesielski ◽  
Piotr Diuwe
Keyword(s):  
Surgical Treatment ◽  
Anal Canal ◽  
Preoperative Imaging ◽  
Congenital Defects ◽  
Multidisciplinary Teams ◽  
Functional Diagnosis ◽  
Cosmetic Procedure ◽  
Sphincter Reconstruction ◽  
Anal Stricture ◽  
Anal Neoplasms

Anal canal plasty is used to treat anal deformities, congenital defects and cosmetic disfigurements. The range of surgeries includes simple aesthetic procedures, as well as extensive sphincter reconstruction and anal strictureplasty. Plasty of hypertrophied anodermal folds is the most common cosmetic procedure. Anal deformations requiring surgical treatment include those causing anal canal deformation of functional importance. Perinatal injuries are the most common cause of this type of sphincter damage. Other include postoperative keyhole deformities and a ”gaping anus”. Another group of deformities includes anal stricture (postoperative, due to chronic inflammation in this region, post-traumatic or induced by radiation therapy) and lesions associated with the treatment of anal neoplasms. Surgical treatment of congenital anal defects is often initiated already in early childhood and performed by multidisciplinary teams led by paediatric surgeons. In the later period of treatment, these patients may require proctological interventions due to anal stricture or anal sphincter dysfunction as a result of surgeries. Plastic and reconstructive surgeries of the anal canal are mostly complex procedures requiring experience and should be performed in reference centres. Appropriate patient qualification and preparation for surgical treatment seem to be essential. Preoperative imaging and functional diagnosis is of key importance.

scholarly journals Comparative characteristics of the results of surgical treatment of combined anorectal pathology using modern radiosurgical and high-frequency electrosurgical technologies

2021 ◽  
Vol 25 (4) ◽  
pp. 572-576
Author(s):  
V. V. Balytskyy
Keyword(s):  
Surgical Treatment ◽  
Anal Canal ◽  
Study Groups ◽  
Control Group ◽  
Minimal Impact ◽  
Rectal Diseases ◽  
Anal Stricture ◽  
Duration Of Surgery ◽  
Bonferroni Test ◽  
Anorectal Pathology

Annotation. Surgery of combined anal canal and rectal diseases requires an unconventional tactics and methods of treatment of these pathologies, which provide minimal impact on tissues, preventing postoperative complications. The purpose of the study was conduction a comparative evaluation of the results of surgical treatment of combined anorectal pathology using modern radiosurgery and electrosurgery technologies by analyzing the clinical course of the postoperative period and studying the depth of impact of these technological devices on the structure of operated tissues. The results of treatment of 635 patients with combined diseases of the anal canal and rectum, divided into four study groups, were analyzed. The control group consisted of 112 patients operated with a surgical scalpel. After surgery 30 patients from each study group underwent morphological investigation of rectal and anal tissues for measurement of the thickness of thermal impacts on them, which was performed using an eyepiece-micrometer scale. Statistical analysis of the obtained data was performed using IBM SPSS STATISTICS SUBSCRIPTIONAL TRIAL software. License number: L-CZAA-BHG85V. The following are used in the work: Kolmogorov-Smirnov test with Lilliefors and Shapiro-Wilk correction, Levene's criterion at p<0.05; applied one-way analysis of variance, Bonferroni test; used the Welch test and the Brown-Forsyth test, the Games-Howell test; used the Kruskal-Wallis test, the Mann-Whitney test. It is established that due to the minimal and shallow impact on the tissues during application of electrosurgery devices “KLS Martin”, “EFA” and “ERBE ICC 200”, as well as radiosurgery device “Surgitron”, there were no detected neither scar anal strictures in any of the four study groups nor scarring deformities of the pararectal areas, which contributed to the cosmetic nature of the combined operations and caused rapid rehabilitation of patients in the study groups. In the control group in 2 (1,8%) patients diagnosed the formation of scar anal stricture which required conservative (1 patient) and operative (1 patient) measures to eliminate them. Using of modern radiosurgical and electrosurgical technologies for the treatment of combined anal and rectal diseases reduces the duration of surgery, intraoperative blood loss, postoperative pain and prevents scar strictures of the anal canal.

scholarly journals Retrorectal Mucinous Adenocarcinoma Arising from a Tailgut Cyst: A Case Report

2021 ◽  
pp. 147-151
Author(s):  
Manon Baverez ◽  
Emilie Thibaudeau ◽  
Vincent Libois ◽  
Olivier Kerdraon ◽  
Hélène Senellart ◽  
...  
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Anal Canal ◽  
Malignant Transformation ◽  
Mucinous Adenocarcinoma ◽  
Tailgut Cyst ◽  
Local Invasion

We report the case of a 57-year-old woman who presented with local invasion of the anal canal by mucinous adenocarcinoma, the malignant transformation of a long-term preexisting retrorectal tailgut cyst. This progression is infrequent and justifies preemptive surgical treatment of retrorectal cysts.

scholarly journals Dr the efficacy of karpoor ghrith in the management of parikartika.

2020 ◽  
Vol 8 (05) ◽  
Author(s):  
Om Dhote
Keyword(s):  
Surgical Treatment ◽  
Anal Canal ◽  
Faecal Incontinence ◽  
Squamous Epithelium ◽  
Burning Sensation ◽  
Local Application ◽  
Ancient Text ◽  
Fissure In Ano ◽  
Longitudinal Ulcer ◽  
Stratified Squamous Epithelium

Fissure in Ano ( Parikartika) is a vertical tear or an elongated longitudinal ulcer in the long axis of stratified squamous epithelium of the lower anal canal. Ancient text couldn’t give a brief idea about this condition. Mainly it has been described as complication of Bastikarma and Atisar. It is so named in which sharp cutting pain is felt in the anus. For that Modern surgical treatment of choice is again has limitations such as faecal incontinence. Hence, karpoor Ghrita having effective Vranaropan & vedanashamak, tridoshaghna  property i.e. it relieves burning sensation quickly. So we modified a method of Local Application is conceived for this study.   

Surgical treatment of spontaneous spinal cerebrospinal fluid leaks

1998 ◽  
Vol 88 (2) ◽  
pp. 243-246 ◽  
Author(s):  
Wouter I. Schievink ◽  
Vittorio M. Morreale ◽  
John L. D. Atkinson ◽  
Fredric B. Meyer ◽  
David G. Piepgras ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Surgical Treatment ◽  
Intracranial Hypotension ◽  
Csf Leak ◽  
Preoperative Imaging ◽  
Content Type ◽  
Surgical Exploration ◽  
Fine Print ◽  
Csf Leaks

Object. Spontaneous spinal cerebrospinal fluid (CSF) leaks are an increasingly recognized cause of intracranial hypotension and may require neurosurgical intervention. In the present report the authors review their experience with the surgical management of spontaneous spinal CSF leaks. Methods. Between 1992 and 1997, 10 patients with spontaneous spinal CSF leaks and intracranial hypotension were treated surgically. The mean age of the seven women and three men was 42.3 years (range 22–61 years). Preoperative imaging showed a single meningeal diverticulum in two patients, a complex of diverticula in one patient, and a focal CSF leak alone in seven patients. Surgical exploration in these seven patients demonstrated meningeal diverticula in one patient; no clear source of CSF leakage could be identified in the remaining six patients. Treatment consisted of ligation of the diverticula or packing of the epidural space with muscle or Gelfoam. Multiple simultaneous spinal CSF leaks were identified in three patients. Conclusions. All patients experienced complete relief of their headaches postoperatively. There has been no recurrence of symptoms in any of the patients during a mean follow-up period of 19 months (range 3–58 months; 16 person-years of cumulative follow up). Complications consisted of transient intracranial hypertension in one patient and leg numbness in another patient. Although the disease is often self-limiting, surgical treatment has an important role in the management of spontaneous spinal CSF leaks. Surgery is effective in eliminating the headaches and the morbidity is generally low. Surgical exploration for a focal CSF leak, as demonstrated on radiographic studies, usually does not reveal a clear source of the leak. Some patients may have multiple simultaneous CSF leaks.

scholarly journals Contemporary surgical treatment of primary hyperparathyroidism without intraoperative parathyroid hormone measurement

2015 ◽  
Vol 97 (8) ◽  
pp. 603-607 ◽  
Author(s):  
OA Mownah ◽  
G Pafitanis ◽  
WM Drake ◽  
JN Crinnion
Keyword(s):  
Parathyroid Hormone ◽  
Surgical Treatment ◽  
Primary Hyperparathyroidism ◽  
Frozen Section ◽  
Lateral Approach ◽  
Preoperative Imaging ◽  
Surgical Cure ◽  
Focused Parathyroidectomy ◽  
Intraoperative Parathyroid Hormone ◽  
Iopth Measurement

Introduction Primary hyperparathyroidism (pHPT) is usually the result of a single adenoma that can often be accurately located preoperatively and excised by a focused operation. Intraoperative parathyroid hormone (IOPTH) measurement is used occasionally to detect additional abnormal glands. However, it remains controversial as to whether IOPTH monitoring is necessary. This study presents the results of a large series of focused parathyroidectomy without IOPTH measurement. Methods Data from 2003 to 2014 were collected on 180 consecutive patients who underwent surgical treatment for pHPT by a single surgeon. Preoperative ultrasonography and sestamibi imaging was performed routinely, with computed tomography (CT) and/or selective venous sampling in selected cases. The preferred procedure for single gland disease was a focused lateral approach guided by on-table surgeon performed ultrasonography. Frozen section was used selectively and surgical cure was defined as normocalcaemia at the six-month follow-up appointment. Results Focused surgery was undertaken in 146 patients (81%) and 97% of these cases had concordant results with two imaging modalities. In all cases, an abnormal gland was discovered at the predetermined site. Of the 146 patients, 132 underwent a focused lateral approach (11 of which were converted to a collar incision), 10 required a collar incision and 4 underwent a mini-sternotomy. At 6 months following surgery, 142 patients were normocalcaemic (97% primary cure rate). Three of the four treatment failures had subsequent surgery and are now biochemically cured. There were no complications or cases of persistent hypocalcaemia. Conclusions This study provides further evidence that in the presence of concordant preoperative imaging, IOPTH measurement can be safely omitted when performing focused parathyroidectomy for most cases of pHPT.

scholarly journals The Potential Role of Intraoperative Ultrasonography in the Surgical Treatment of Hilar Cholangiocarci noma

HPB Surgery ◽  
1996 ◽  
Vol 9 (2) ◽  
pp. 93-96 ◽  
Author(s):  
P. Watanapa ◽  
N. S. Hargrove ◽  
Y. Sirivatanauksorn
Keyword(s):  
Surgical Treatment ◽  
Hilar Cholangiocarcinoma ◽  
False Negative ◽  
Intraoperative Ultrasonography ◽  
Preoperative Imaging ◽  
Vascular Involvement ◽  
Surgical Specimen ◽  
Operative Exploration ◽  
The Mean

The role of intraoperative ultrasonography (IOU) in the surgical treatment of hilar cholangiocarcinoma was explored in twenty-two patients, 17 males and 5 females. The mean age was 55 years (range 36-78 years). Preoperative imaging studies included abdominal ultra-sonography and/or CT scan, and visceral angiography. Operations performed were segment III bypass in 18 patients, local resection of tumour in 2 and resection of tumour en bloc with left hepatectomy in 2. Interpretation of IOU in terms of vascular involvement by the tumour (as compared to angiography or operative findings) was correct in 21 patients; no vascular invasion in 20 and portal vein invasion in the remainder. One false negative result occurred in a patient whose IOU failed to show right hepatic artery encasement by the tumour. When compared to postoperative cholangiography or surgical specimen, IOU correctly demon-strated location and extent of the tumours in all but one patient who had incomplete tumour resection. IOU was also helpful in locating segment III duct for biliary bypass. The mean time used for IOU was 15.1 min (range 10-20 min.), and there was no procedure-related com-plication. When supplemented with operative exploration, IOU seems to be very useful in the assessment of the resectability of hilar cholangiocarcinoma.

Outpatient surgical treatment of cervical radiculopathy

1997 ◽  
Vol 87 (1) ◽  
pp. 41-43 ◽  
Author(s):  
Christopher R. Tomaras ◽  
J. Bob Blacklock ◽  
Warren D. Parker ◽  
Richard L. Harper
Keyword(s):  
Surgical Treatment ◽  
Cervical Radiculopathy ◽  
Preoperative Imaging ◽  
Anesthetic Techniques ◽  
Workers Compensation ◽  
General Anesthetic ◽  
Content Type ◽  
Good Outcome ◽  
Compensation Claims

✓ A series of 200 patients who underwent outpatient surgical treatment for cervical radiculopathy is presented. The patients were selected on the basis of their willingness to undergo surgery in the outpatient setting and the absence of serious underlying medical conditions. All operations were performed using general anesthetic techniques with limited posterior dissections. A laminoforaminotomy was performed at each affected level, which had been determined by preoperative imaging and clinical examination. After being observed for several hours, the patients were discharged if they met specific criteria. No patient required subsequent hospital admission in the immediate postoperative period. Follow-up review in 183 patients ranged from 3 to 43 months, with a mean of 19 months. In cases in which Workers' Compensation claims were not involved, 92.8% of patients reported an excellent or good outcome and returned to work or comparable duties at a mean of 2.9 weeks. In cases in which Workers' Compensation claims were involved, 77.8% of patients reported excellent or good outcome and returned to work at a mean of 7.6 weeks postoperatively. Two patients whose cases involved Workers' Compensation claims did not return to work. There were seven patients (3.8%) who had a poor outcome. Two of these patients underwent a second posterior procedure and reported a good outcome at the time of follow-up review. The results of this study show that outpatient surgical treatment of cervical radiculopathy can be safely provided in selected patients with outcomes similar to the inpatient surgical management of these individuals.

scholarly journals Ankyloblepharon Filiforme Adnatum with a bilateral cleft lip and palate

2018 ◽  
Vol 146 (7-8) ◽  
pp. 447-451
Author(s):  
Gordana Stankovic-Babic ◽  
Milena Vujanovic ◽  
Sonja Cekic
Keyword(s):  
Surgical Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Severe Form ◽  
Multidisciplinary Teams ◽  
Baby Girl ◽  
Rare Congenital Abnormality ◽  
Familial Clustering ◽  
Bilateral Cleft Lip ◽  
Dental Rehabilitation

Introduction. Ankyloblepharon filiforme adnatum (AFA) is a rare congenital abnormality of the eyelids that has been reported as an isolated anomaly, but may also be associated with other anomalies or as a part of well-defined syndromes. The aim of this work was to present a case of familial AFA associated with bilateral cleft lip and palate. Case outline. A full-term female newborn (40 weeks? GA, BM 3,700 g) had bilateral partially fused eyelids at birth, associated with a cleft lip and palate. The surgical treatment was performed five days after AFA was diagnosed. The baby?s mother also had AFA, without a cleft lip or palate. The baby girl has been followed up by a plastic surgeon, a specialist in orthodontics, as well as an ophthalmologist and a pediatrician. Conclusion. This case indicates familial clustering of AFA, whereby it assumes a more severe form in the following generation. A cleft lip and palate in our patient has required surgical treatment, oral and dental rehabilitation, as well as the need for more intensive care and regular follow-ups by multidisciplinary teams.

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