Diseases of the colon and rectum
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Electrophysiologic evaluation has been suggested as a means of identifying prognostic factors for patients with fecal incontinence who undergo anal sphincter repair. The purpose of this study was to evaluate the results of anal sphincter repair in patients with documented pudendal neuropathy and to determine the usefulness of electrophysiologic studies for prognostication of sphincteroplasty. ⋯ Anterior anal sphincteroplasty in patients with unilateral or bilateral prolonged pudendal nerve terminal motor latency can provide significant improvement in continence with minimum morbidity. Therefore, correction of the anatomic sphincter defect should still be considered, even in patients with documented pudendal neuropathy.
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Biography Historical Article
All's Well That Ends Well: Shakespeare's treatment of anal fistula.
Textual and contextual evidence suggests that the French king's fistula, a central plot device in Shakespeare's play All's Well That Ends Well, is a fistula-in-ano. Anal fistula was known to the lay public in Shakespeare's time. In addition, Shakespeare may have known of the anal fistula treatise of John Arderne, an ancestor on Shakespeare's mother's side. ⋯ It is also understandable when one looks at what wounds in different locations mean in European legend. In this light, it is not surprising that subsequent expurgations treat Boccaccio's and Shakespeare's fistulas differently, censoring only Shakespeare's. This reading has implications for the staging of All's Well That Ends Well, and for our view of the place of anal fistulas in cultural history.
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The aim of this study was to demonstrate the advantages of rhombic excision and Limberg flap closure in the treatment of pilonidal sinus disease. ⋯ Because other treatment methods carry a significant failure rate, this technique is an effective alternative in the treatment of pilonidal sinus disease.
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Meta Analysis
Effect of perioperative blood transfusions on recurrence of colorectal cancer: meta-analysis stratified on risk factors.
This study was undertaken to evaluate the influence of perioperative blood transfusions on colorectal cancer recurrence. ⋯ A consistently detrimental association was discovered between the use of perioperative blood transfusion and colorectal cancer recurrence. Further studies are needed to confirm that blood transfusion has a causal association.
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5-Fluorouracil is the most effective chemotherapeutic agent in the management of patients with systemic colorectal cancer. Studies in recent years discussed the gradually increasing benefits of 5-fluorouracil within adjuvant chemotherapy protocols after complete surgical resections. However, many studies also have demonstrated that 5-fluorouracil impairs wound-healing on colonic anastomoses. ⋯ Our study showed a positive effect of Iloprost on the healing of colon anastomosis and, more importantly, if wound-healing is impaired by a chemotherapeutic agent, Iloprost counteracts and reverses the effect. [Key words: 5-Fluorouracil; Healing of colon anastomoses; Iloprost