Abstract:
BACKGROUND:Perineal wound complications are frequently observed after abdominoperineal resection (APR) for rectal cancer, especially in preoperatively irradiated patients. This is the first study to investigate whether local application of gentamicin-impregnated collagen fleece reduces deep perineal wound infection after APR for rectal cancer following short-term radiotherapy. METHODS:Between 2003 and 2007, a consecutive series of 40 patients underwent an APR for rectal cancer after short-course radiotherapy in our hospital. Of these patients, 19 received supplementary application of three reabsorbable gentamicin-impregnated collagen fleece sponges into the sacral cavity before closure of the perineum (group A), and 21 patients underwent primary closure of the perineal wound and served as a control group (group B). All patients received sacral drainage. A superficial perineal wound infection was defined as cellulitis with no evidence of deep tissue infection. A deep perineal wound infection was defined as skin and subcutaneous tissue breakdown with infection extending deep into the subcutaneous tissue or a wound abscess. RESULTS:The two groups were comparable regarding age, sex, tumour stage and level of the tumour. No postoperative mortality was observed in either group. Primary wound healing occurred in 16 patients (84%) in the gentamicin group and 9 patients (43%%) in the control group (p=0.01). The incidences of superficial perineal wound complications were 11% (two patients) in group A who received local application of gentamicin and 29% (six patients) in group B (p=0.15). Six patients (29%) in group B developed a deep infection or wound abscess, resulting in full dehiscence of the wound and sacral cavity. This devastating complication occurred in only one patient (5%) in group A (p=0.05). In most patients deep perineal wound infection was treated with vacuum therapy or drainage. The mean hospital stay of the gentamicin group was 15 days and of the control group 25 days (p=0.04). CONCLUSIONS:Based on the results of this study, we recommend local application of gentamicin in the sacral cavity in patients who undergo abdominoperineal resection after shortterm radiotherapy.
journal_name
Tech Coloproctoljournal_title
Techniques in coloproctologyauthors
de Bruin AF,Gosselink MP,Wijffels NA,Coene PP,van der Harst Edoi
10.1007/s10151-008-0440-8subject
Has Abstractpub_date
2008-12-01 00:00:00pages
303-7issue
4eissn
1123-6337issn
1128-045Xjournal_volume
12pub_type
杂志文章abstract:BACKGROUND:Representatives from the Italian centers experienced in sacral neuromodulation (SNM) for the treatment of bowel dysfunction met in order to define the current clinical practice in Italy and to produce a consensus statement regarding indications for this therapy and patient management. METHODS:Fifty Italian ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1002-2
更新日期:2014-01-01 00:00:00
abstract::Split transverse colostomy is a novel method of defunctioning the distal colon. Herein, we describe the method of this procedure and present early interim results showing that this procedure is safe, relatively complication free and feasible for many pathologies affecting the colon and pelvis, especially in alleviatio...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-006-0253-6
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Various sequelae which might lead to reintervention have been described after stapled rectal mucosectomy for hemorrhoids. One potential treatment modality for persistent complaints after stapled hemorrhoidopexy (SHP) or stapling for rectocele is the so-called agraffectomy (removal of the retained staples). T...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-011-0704-6
更新日期:2011-09-01 00:00:00
abstract::Colorectal cancer (CRC) is the leading cause of cancer-related mortality in western countries. Adjuvant treatment does not seem to be highly effective and recurrent or metastatic disease occurs in half of the new cases within one year of diagnosis and median survival does not exceed 18 months. CRC represents an optima...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-004-0170-5
更新日期:2004-12-01 00:00:00
abstract:BACKGROUND:Oncologic outcomes after complete mesocolic excision (CME) in colon cancer are under investigation. The aim of our study was to compare CME and conventional colectomy (CC) in terms of pathological and oncological outcomes for right colon cancer and to evaluate the impact of lymph node metastasis around the v...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02378-4
更新日期:2021-01-05 00:00:00
abstract:BACKGROUND:Early detection of colorectal anastomotic leakage (AL) may lead to better outcome. AL may be preceded by change in local metabolism and local ischaemia. Microdialysis of the peritoneal cavity is able to measure these changes in real-time and is minimally invasive. The aim of this prospective cohort study was...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1020-0
更新日期:2014-01-01 00:00:00
abstract::Turnbull and Cutait described abdominoperineal pull-through followed by delayed coloanal anastomosis (DCA) in 1961. DCA could reduce anastomotic leaks, pelvic morbidity and use of stomas. Strong evidence about its clinical benefits is still lacking. This systematic review examined the clinical outcomes of DCA for the ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-014-1132-1
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The proposed difficulty scoring system (DSS) may aid in preoperative planning for laparoscopic total mesorectal excision (L-TME) for rectal cancer. METHODS:Fifty-three patients [28 males; 59.0 (31.0-88.0) years of age] treated for rectal cancer at our institution from 2/2011-5/2018 were identified. "Difficu...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02285-8
更新日期:2020-11-01 00:00:00
abstract::Retained rectal foreign body is not an uncommon condition, but reliable epidemiological data are not available. The diagnosis and management can present a significant challenge due to delayed presentation and the reluctance of the patients to provide details of the incident. The aim of the clinical evaluation is to id...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-012-0899-1
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate patient factors that affect the progression of anal dysplasia in human immunodeficiency virus (HIV)-positive individuals. METHODS:A retrospective cohort study of HIV-positive adults with human papilloma virus related anal lesions was performed from 2012 to 2017. ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-019-01951-w
更新日期:2019-04-01 00:00:00
abstract::Colorectal cancer remains a leading cause of cancer death in the UK. With the advent of screening programmes and developing techniques designed to treat and stage colorectal neoplasia, there is increasing pressure on the colonoscopist to keep up to date with the latest practices in this area. This review looks at the ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-007-0319-0
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to systematically analyse the clinical trials on the effectiveness of transanal haemorrhoidal de-arterialisation (THD) and stapled haemorrhoidopexy (SH) in the management of haemorrhoidal disease (HD). METHODS:Clinical trials on the effectiveness of THD and SH in the management of ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s10151-011-0796-z
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Previous studies of the outcome after perineal stapled prolapse resection (PSPR) have included a limited number of patients with a short follow-up and high recurrence rates. The present study was designed to assess the initial results, complications, recurrence rate, and outcomes up to 4 years after PSPR, as...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-016-1557-9
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Chronic non-healing wounds are a major problem after closed incision pilonidal surgery. Freshly collected autologous adipose tissue injected into perianal fistulas in patients with Crohn's disease seems to promote healing. We investigated this technique in patients with non-healing wounds after cleft-lift su...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02276-9
更新日期:2020-12-01 00:00:00
abstract::Advancements in the medical treatment of Crohn's disease have reduced the need for surgery. The indications for surgery include the failure of medical management, especially the persistence or worsening of symptoms in spite of proper treatment and complications of the disease process. These complications include intes...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0728-y
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:Various predictors of perioperative risk for patients with rectal cancer undergoing radical resection have been well described, but no simple scoring system for surgeons to estimate this risk currently exists. The objective of this study was to develop a system for more accurate preoperative evaluations of c...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1076-x
更新日期:2014-05-01 00:00:00
abstract::Guidelines for the treatment of anal fissure have been published in the USA and UK but differ. Many centers follow guidelines based on local experience. In December 2005, we met with the aim of developing an evidence-based treatment algorithm for anal fissure, applicable to both primary and secondary care. This algori...
journal_title:Techniques in coloproctology
pub_type: 共识发展会议,杂志文章
doi:10.1007/s10151-006-0276-z
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Management of anal fistula (AF) remains challenging with many controversies. The purpose of this study was to explore current surgical practice in the management of AF with a focus on technical variations among surgeons. METHODS:An online survey was conducted by inviting all surgeons and physicians on the m...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-019-02051-5
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:In theory, perioperative detection of lymph nodes with the injection of isosulfan blue dye should provide lymph road mapping (LRM) able to direct the resection. However, there is no supporting evidence for this theory in cases of colon cancer. We reanalysed all operative reports using the sentinel lymph node...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-010-0603-2
更新日期:2010-09-01 00:00:00
abstract::After radical resection of rectal carcinoma, the circumferential resection margin (CRM) on the non-peritonealized surface of the resected specimen is of critical importance. Histopathological examination of resected specimens must include careful assessment of the CRM. There is a need to distinguish between CRM-positi...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-005-0226-1
更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:In the United States, colorectal cancer (CRC) screening and surveillance is recommended until age 75. However, rates of surgery for CRC are greatest in the elderly, questioning current guidelines. Tumor sidedness is an emerging prognostic marker that may help guide screening and treatment decisions, with spe...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02329-z
更新日期:2020-08-27 00:00:00
abstract::Germline mutations in BRCA1 and BRCA2 genes predispose to hereditary breast cancer, whereas carriers of mutations in any of the mismatch repair genes (MMR; hMLH1, hMSH2, hMSH6, hPMS2) are highly susceptible to Lynch syndrome. In the present study, we describe a woman affected by unilateral breast cancer at the age of ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1030-y
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:The aim of our study was to assess perineal wound healing in patients with Crohn's disease (CD) who undergo proctectomy or proctocolectomy with end ileostomy and to evaluate the influence of various factors including types of perineal dissection on eventual wound healing. METHODS:Data for patients with CD w...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-017-1695-8
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:Studies have shown differences in postoperative outcomes between two minimally invasive extraction methods for colorectal lesions-natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery (CLS). The aim of this study was to discover the major differences in NOSES and CLS to re...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-020-02330-6
更新日期:2020-08-26 00:00:00
abstract:BACKGROUND:Pouchitis after total rectocolectomy is among the most common complications of patients with ulcerative colitis (UC). However, its frequency is quite rare in patients with familial adenomatous polyposis (FAP). We evaluated the inflammatory and pro-apoptotic activity in endoscopically normal mucosa of the ile...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-008-0395-9
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:The aim of this study is to underscore the incidence of synchronous polyps in patients with colorectal cancer and to emphasise the importance of their perioperative detection and management. PATIENTS AND METHODS:Three hundred and seven patients underwent a potentially curative resection for colorectal cance...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0117-x
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Colonic resection according to the procedure by Hartmann is considered a fast and safe surgical intervention, which has been used for years, in particular, in emergency situations. METHODS:Using data of a prospective multicentre study on the operative treatment of colorectal carcinoma over the time period f...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10151-004-0164-3
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Technical factors affect oncologic outcomes in rectal cancer surgery. The anatomy of the bony pelvis can affect technical aspects of surgery, but is seldom considered preoperatively. We performed a morphometric analysis of the bony pelvis in patients having rectal cancer resection to assess its effect on sur...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02273-y
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Ligation of the intersphincteric tract (LIFT), a novel sphincter-saving technique, has been recently described with promising results. Literature data are still scant. In this prospective observational study, we present our experience with this technique. METHODS:Between October 2010 and April 2011, 18 pati...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0779-0
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Anastomotic leak after rectal surgery is reported in 9% (range 3-28%) of patients. The aim of our study was to evaluate the effectiveness of endosponge therapy for anastomotic. Endpoints were the rate of restored continuity and the functional bowel outcome after anastomotic leakage. METHODS:This was a multi...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10151-019-02007-9
更新日期:2019-06-01 00:00:00