Diseases of the colon and rectum
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Comparative Study
The value of specialization--is there an outcome difference in the management of fistulas complicating diverticulitis.
The value of specialization has frequently been challenged by many health care institutions and providers. This review was conducted to determine whether there were any outcome differences in the management of fistulas complicating diverticulitis. ⋯ We conclude that specialization in colon and rectal surgery contributed to an improved outcome, with a lower rate of diverting procedures, a shorter hospital stay, and a lower rate of complications.
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Multicenter Study Clinical Trial
Short-term sacral nerve stimulation for functional anorectal and urinary disturbances: results in 40 patients: evaluation of a new option for anorectal functional disorders.
There are several options in the treatment of fecal incontinence; it is often difficult to choose the most appropriate, adequate treatment. The consolidated experience gained in the urologic field suggests that sacral nerve stimulation may be a further option in the choice of treatment. The aim of our study was to evaluate the preliminary results of the peripheral nerve evaluation test obtained in a multicenter collaborative study on patients with defecatory and urinary disturbances. ⋯ In functional bowel disorders short-term sacral nerve stimulation seems to be a useful diagnostic tool to assess patients for a minor invasive therapy alternative to conventional surgical procedure.
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Clinical Trial
New, simple, ultrasound-guided infiltration of the pudendal nerve: ultrasonographic technique.
Anesthetic infiltration of the pudendal nerve at the ischial spine can relieve perineal pain in cases of compression or distention. The aim of our study was to look for a real-time, visually controlled infiltration technique using ultrasound. ⋯ In almost one-half of the cases a direct ultrasound-guided infiltration of the pudendal nerve is possible. In the remaining cases the nerve can be detected and blocked indirectly, using the ischial spine or the internal pudendal artery as a landmark.
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We report the topographic relationship of the pudendal nerve to the accompanying pudendal vessels and the ischial spine and provide the basics for an ultrasonographic depiction of these structures. ⋯ The knowledge of the close spatial relationship between the pudendal nerve and the internal pudendal artery is important for any infiltration technique and even surgical release. It demands real-time, visually controlled infiltration techniques, such as with ultrasound.