Diseases of the colon and rectum
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En bloc resection with adequate margins has provided a chance for cure of primary sacral tumors. However, high sacral lesions are challenging because of the complexity of the surgical approach. The aims of this study were to describe a modification in technique and to evaluate the outcomes. ⋯ Sacrectomy for primary sacral tumors can be safely conducted, achieving tumor-free margins and acceptable functional and long-term outcomes.
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Bowel dysfunction is a problem in patients with spinal cord injury. The sacral anterior root stimulator has been used for neurogenic bladder and has been claimed to be useful for neurogenic bowel. The purposes of this study were to analyze the clinical response of bowel function to the sacral anterior root stimulator and to evaluate physiologic factors that could determine its efficacy. ⋯ The sacral anterior root stimulator improves bowel function, and patient satisfaction with this treatment is high. Further studies are needed to evaluate the characteristics of stimulation parameters to achieve better results.
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Comparative Study
An enhanced-recovery protocol improves outcome after colorectal resection already during the first year: a single-center experience in 168 consecutive patients.
This study was designed to investigate the clinical outcome and recovery before and immediately after implementation of the enhanced recovery after surgery enhanced recovery after surgery protocol in colonic and rectal resection. ⋯ Immediately after implementing enhanced recovery after surgery, recovery was improved and length of hospital stay was reduced. Notably, postoperative morbidity decreased only in patients undergoing colonic resection.
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Restorative proctocolectomy and ileal pouch-anal anastomosis is the current surgical treatment of choice for most patients with ulcerative colitis. Complications of the ileal pouch may necessitate additional operations to salvage the pouch. The aims of this study were to review the outcomes of reoperative restorative proctocolectomy and ileal pouch-anal anastomosis surgery and to define any predictors of successful pouch salvage surgery. ⋯ Ileal pouch-anal anastomosis salvage surgery can save a considerable number of patients from pouch excision and permanent ileostomy. Both local perineal and abdominal approaches yield acceptable results. The choice of procedure is based on the etiology and anatomy of the problem and the surgeon's preference and patient-related factors such as diagnosis.
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Single-incision laparoscopy is being performed for a wide variety of procedures. We describe our technique of single-incision laparoscopic right hemicolectomy for a colon mass. ⋯ Single-incision laparoscopic colectomy with an intracorporeal anastomosis can provide satisfactory oncologic resection.