Hepato Gastroenterol
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Hepato Gastroenterol · Sep 2008
Randomized Controlled TrialDefunctioning loop ileostomy with low anterior resection for distal rectal cancer: should we make an ileostomy as a routine procedure? A prospective randomized study.
Anastomotic leakage is a major problem in colorectal surgery particularly in low rectal cancer. The defunctioning loop ileostomy was introduced as a technique to create a manageable stoma that would divert the fecal stream from a more distal anastomosis in order to reduce the consequences of any anastomotic leakage. Therefore, the use of a defunctioning stoma has been suggested, but limited data exist to clearly determine the necessity of routine diversion. This study was designed to evaluate early morbidity, mortality and hospital stay in patients undergoing lower rectal cancer surgery concerned with or without loop ileostomy. ⋯ The use of defunctioning loop ileostomy in all patients undergoing lower rectal surgery with stapler anastomosis is beneficial and safe. Defunctioning loop ileostomy use has resulted in no anastomotic leak rate and considerable low morbidity. So according to our study, we strongly recommend defunctioning loop ileostomy as a routine procedure in patients undergoing lower rectal cancer surgery.
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Hepato Gastroenterol · Sep 2008
Incidence of gastric cancer in the remnant stomach after proximal gastrectomy.
Gastric cancer in the remnant stomach after proximal gastrectomy has not been studied in detail. The aim of this study was to clarify the incidence of this type of cancer. ⋯ The incidence of proximal gastrectomy after proximal gastrectomy is not high, and the risk in males is especially low. However, proximal gastrectomy may develop over 10 years after surgery, and long-term follow-up is essential.
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Hepato Gastroenterol · Sep 2008
Early conversion from oral morphine to transdermal fentanyl in patients with cancer pain.
The aim of this study is to prove that an early conversion from oral morphine to transdermal fentanyl is an effective and safe treatment modality for patients with cancer pain. ⋯ Early conversion from oral morphine to transdermal fentanyl helped to effectively relieve cancer pain while improving the effects of morphine induced nausea.
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The aim of this study was to retrospectively review all children who presented with intussusception over a 24-year period. ⋯ Idiopathic intussusception commonly presenting as an ileocolic type constituted the majority of the cases in the present study, occurring in 96 patients (89.7%). The clinical features were classical, vomiting being the most common. The average interval between the onset of symptoms and presentation to the hospital was 46 hours and barium enema reduction was successful in 20 out of 48 cases in which it was attempted. Surgical intervention was required in 86 cases (81%); of which manual reduction was successful in 59 cases, resection was required in 22 cases and 5 patients required an additional Ladd procedure for associated malrotation.