International journal of colorectal disease
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Int J Colorectal Dis · Jan 2008
Optimizing electrode implantation in sacral nerve stimulation--an anatomical cadaver study controlled by a laparoscopic camera.
Sacral nerve stimulation is the therapy of choice in patients with neurogenic faecal and urine incontinence, constipation and some pelvic pain syndromes. The aim of this study is to determine the best insertion angles of the electrode under laparoscopic visualization of the sacral nerves. ⋯ This study allows direct visualization during the placement of the needle and electrode, thus permitting accurate calculations of the best angle of approach during the surgical procedure in sacral nerve stimulation. These objective findings attempt to standardize this technique, which is often performed with the aid of intra-operative fluoroscopy but still leaving a lot to chance. These insertion angles should help to find more consistent and reproducible results and thus improved outcome in patients.
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Int J Colorectal Dis · Dec 2007
Clinical Trial"Fast-track" rehabilitation after colonic surgery in elderly patients--is it feasible?
The aim of the "fast-track" rehabilitation after elective colonic surgery is to lower the extent of general complications. Elderly patients may especially profit from this multi-modal peri-operative treatment including enforced early mobilisation and oral nutrition. ⋯ Using the "fast-track" rehabilitation programme on elderly patient is not only feasible but may also lower the number of general complications and the duration of the hospital stay.
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Int J Colorectal Dis · Dec 2007
A prolonged interval between deep intestinal ischemia and anastomotic construction does not impair wound strength in the rat.
Transient intestinal ischemia can reduce anastomotic strength, which poses an increased risk of complications. The objective of this study is to establish if a prolonged interval between profound ischemia and construction of an anastomosis affects anastomotic strength. ⋯ Extending the interval between transient deep intestinal ischemia and construction of an anastomosis does not impair wound strength.
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Int J Colorectal Dis · Dec 2007
C-reactive protein as early predictor for infectious postoperative complications in rectal surgery.
This study evaluated the role of the acute phase C-reactive protein (CRP) in the postoperative course of a large series of rectal resections on the basis of a prospective database. Main focus of this study was the early identification of complications. ⋯ Persistent CRP elevation and elevation of serum CRP above 140 mg/dl on PODs 3-4 are predictive of infectious postoperative complications and should prompt intense clinical search for an inflammatory process, especially for an anastomotic leak if pneumonia and wound infection are unlikely or excluded.