American journal of surgery
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Comparative Study
Stapled ileal pouch anal anastomoses are safer than handsewn anastomoses in patients with ulcerative colitis.
One of the theoretic advantages of using a stapled versus handsewn ileal pouch anal anastomosis (IPAA) in restorative proctocolectomy is a reduction in septic complications. We performed this study to compare the incidence of early septic complications in patients undergoing restorative proctocolectomy with stapled or handsewn IPAA. ⋯ The stapled technique for IPAA has fewer septic complications and results in fewer sepsis-related pouch excisions, in our hands, than the handsewn technique technique, for treating patients with ulcerative colitis.
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Occasionally, ipsilateral ischemia develops following the groin insertion of an intra-aortic balloon catheter. Various treatment options have evolved, and include replacing the catheter in the opposite groin, removing it completely, or performing a femorofemoral bypass to deliver blood flow below the catheter. Outlined in this paper is a simple method to restore blood flow to a threatened limb, during femoral artery exploration, in the presence of an intra-aortic balloon. This method is also appropriate for optimal positioning of the balloon catheter prior to femorofemoral bypass.
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Since the initial description of the radial arteriovenous (AV) shunt, hemodialysis has played a primary role in the survival of patients with chronic renal failure. However, it is not unusual to be confronted with patients on chronic hemodialysis who have exhausted all superficial venous access sites. ⋯ We have performed this technique with good success in 12 patients. Further experience and longer follow-up are needed.