Diseases of the colon and rectum
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Comparative Study
Thiopurine therapy is associated with postoperative intra-abdominal septic complications in abdominal surgery for Crohn's disease.
Thiopurines are important as maintenance therapy in Crohn's disease, but there have been concerns whether thiopurines increase the risk for anastomotic complications. The present study was performed to assess whether thiopurines alone, or together with other possible risk factors, are associated with postoperative intra-abdominal septic complications after abdominal surgery for Crohn's disease. ⋯ Thiopurine therapy is associated with postoperative intra-abdominal septic complications. The risk for intra-abdominal septic complications was related to the number of identified risk factors. This increased risk should be taken into consideration when planning surgery for Crohn's disease.
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Comparative Study
Can sensory and/or motor reactions during percutaneous nerve evaluation predict outcome of sacral nerve modulation?
A major advantage of sacral nerve modulation in the treatment of fecal incontinence is the ability to determine the likely treatment outcome before implantation by means of a percutaneous nerve evaluation and a test stimulation period. This study evaluated the predictive value of both sensory and motor responses during percutaneous nerve evaluation for determining the outcome of subchronic test stimulation and permanent stimulation. ⋯ Positive motor responses during percutaneous nerve evaluation are highly predictive of a successful outcome of subchronic test stimulation and permanent sacral nerve modulation. Sensory responses also have the same predictive value. For this reason, percutaneous nerve evaluation preferably should be performed in awake patients under local anesthesia to avoid missing those who may benefit from permanent stimulation but who do not have a motor response during the procedure.
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Comparative Study
The impact of cirrhosis and portal hypertension on mortality following colorectal surgery: a nationwide, population-based study.
Population-based data on outcomes associated with colorectal procedures in cirrhotic patients are sparse. We sought to assess the impact of liver cirrhosis and portal hypertension on mortality following colorectal surgery. ⋯ Patients with liver cirrhosis, in particular, those with portal hypertension, have increased in-hospital mortality and morbidity following colorectal surgery. Strategies are needed to optimize preoperative risk.