All issues
Predecessor
Volume 60, Issue 6
Displaying 1-6 of 6 articles from this issue
- |<
- <
- 1
- >
- >|
Original Articles
-
M. Kunimoto, T. Abe, Y. Hachiro, T. Tsuruma2007 Volume 60 Issue 6 Pages 327-332
Published: 2007
Released on J-STAGE: October 31, 2008
JOURNAL FREE ACCESSALTA injection is a promising sclerosing therapy for internal hemorrhoids. This therapy has become the most frequent choice for treating patients with internal hemorrhoids at Kunimoto Hospital since April 23, 2005, obtaining good results overall in 700 cases. However, symptomatic rectal ulcer after this therapy occurred in three patients. One case of the three was a severe ulcer grossly recognized as Ul-3. These patients were cured by conservative therapy for a few months, and no defecation disorders were observed afterward. From the results, we found that there is a possibility of rectal ulcers occurring after sclerosing therapy of internal hemorrhoids with ALTA. After applying ALTA, regular observation of the patient, adequate explanation to the patient, and proper conservative medical treatment are essential.View full abstractDownload PDF (877K) -
H. Horie, Y. Miyakura, H. Satoh, T. Hamada, H. Kumano, K. Koinuma, K. ...2007 Volume 60 Issue 6 Pages 333-337
Published: 2007
Released on J-STAGE: October 31, 2008
JOURNAL FREE ACCESSPurpose : A prospective study was conducted to compare the outcome between stapled anastomosis (a functional end-to-end) and hand-sewn anastomosis for the closure of loop ileostomy.
Patients and Methods : Patients undergoing ileostomy closure were sequentially divided into a stapled group (n=10) and a hand-sewn group (n=10). Functional end-to-end anastomosis was performed by an inexperienced surgeon in the stapled group, whereas layer-to-layer anastomosis was performed by an experienced surgeon in the hand-sewn group.
Results : Mean career (years) of the surgeon was shorter in the stapled group than in the hand-sewn group (3±1 v.s. 7±3 (p<0.05)). Mean operating time (minutes) was shorter in the stapled group than in the hand-sewn group (96±21 v.s. 127±26 (p<0.05)). Anastomotic leakage and bowel obstruction were not observed in both groups. Superficial surgical site infection occurred in 1 (10%) of the stapled group and in 4 (40%) of the hand-sewn group. Mean postoperative hospital stay (days) was 10±3 in the stapled group and 11±1 in the hand-sewn group. The cost (yen) of equipment used for stapled closure and hand-sewn closure was 32,000 and 24,827, respectively.
Conclusion : Stapled closure was less time-consuming than hand-sewn closure even by inexperienced surgeons, with low complication rate and acceptable extra cost. Stapled closure using the functional end-to-end technique could be a standard procedure for the closure of loop ileostomy.View full abstractDownload PDF (1038K)
Clinical Studies
-
K. Yamamoto, [in Japanese], H. Furukawa, M. Fukunaga, H. Takemoto, R. ...2007 Volume 60 Issue 6 Pages 338-341
Published: 2007
Released on J-STAGE: October 31, 2008
JOURNAL FREE ACCESSObjective
To evaluate in the clinical setting a new method of haemorrhoidectomy utilizing the Vessel Sealing System (VSS), an electrothermal device which seals tissue by coagulating collagen and elastin within vessel walls.
Methods
A total of 136 patients, 73 men and 63 women, aged 58.6±14.8 (mean±SD) years underwent hemorrhoidectomy using the VSS method between January 17, 2002 and October 1, 2004. There were three patients who required dialysis, one patient who suffered from chronic lymphocytic leukemia and one patient who suffered from myelodysplastic syndrome. The benefits of the VSS method are compared to those of traditional techniques in terms of the number of excisions, operating time, intraoperative blood loss, days in hospital, and the incidence of complications.
RESULTS
Mean operating time was 16.6±10.1 minutes and operative blood loss was minimal in all cases. The mean hospital stay was 5.5±1.7 days. The mean number of excisions was 2.7±0.9. Postoperative bleeding occurred in seven cases (5.1%) and three of these (2.2%) required surgery. Stenosis occurred in one patient. Although the incidence of postoperative bleeding proved slightly higher than in traditional methods in the first set of cases we dealt with, it was later reduced by adding reinforcing sutures to the sealed area even for the patients with complications. There were no instances of recurrence.
CONCLUSION
The VSS method is safe even for patients with complications by adding reinforcing sutures and it may be the most useful method of hemorrhoidectomy.View full abstractDownload PDF (435K) -
Y. Bamba, M. Itabashi, T. Hirosawa, S. Ogawa, E. Noguchi, K. Takemoto, ...2007 Volume 60 Issue 6 Pages 342-346
Published: 2007
Released on J-STAGE: October 31, 2008
JOURNAL FREE ACCESSPurpose : We studied the clinical characteristics of cases of ulcerative colitis (UC) with perioperative complications of deep venous thrombosis (DVT) and pulmonary embolism (PE).
Methods : Of 103 operative patients with UC in our department treated between 1998 and 2005, 7 (6.8%) had DVT or PE perioperatively. Clinical findings were compared with those of cases without DVT and PE. In addition, appropriate treatment measures were considered.
Results : The 7 patients with perioperative DVT or PE consisted of 3 (43%) men and 4 (57%) women, with a mean body mass index of 18.9kg/m2 (range, 15.2∼21.7). The 7 cases included 6 of DVT (86%) and 1 of PE (14%). Preoperative clinical diagnosis of DVT was made in 4 patients (67%), and postoperative DVT occurred in 1 patient (14%). A retrospective diagnosis of DVT was made in 1 patient (14%). All patients were heparinised perioperatively and a filter was inserted into the inferior vena cava in 4 cases (67%). Those with PE were also heparinised. In all cases with DVT or PE, no new main thrombosis occurred after heparinisation and the symptoms of thrombosis disappeared.
Conclusions : Early diagnosis is necessary in DVT and PE, and heparinisation and filter insertion are useful perioperatively.View full abstractDownload PDF (544K)
Case Report
-
G. Nakayama, Y. Kodera, M. Koike, Y. Shibata, M. Nogaki, A. Nakao2007 Volume 60 Issue 6 Pages 347-353
Published: 2007
Released on J-STAGE: October 31, 2008
JOURNAL FREE ACCESSWe present a case of liposarcoma that evolved from the ischiorectal space with a daughter lesion, treated successfully by abdominoperineal excision of the tumor with the rectum and coccyx followed by adjuvant radiotherapy. A 37-year-old man was admitted to our hospital because of a perianal tumor. Pelvic CT scans and magnetic resonance imaging scans revealed a large multilobular tumor on the left side of the ischiorectal space, accompanied with the daughter lesion on the right side. Percutaneous fine needle aspiration biopsy specimens were taken from the main tumor, with a subsequent diagnosis of myxoid liposarcoma. Abdominoperineal excision of the tumor with the rectum and coccyx was performed. The tumors were yellowish-white and elastic soft, measuring 12×9×6cm and 5×5×4cm in size. Histopathological examination of the tumor revealed myxoid type liposarcoma. Postoperative radiation was added as an adjuvant therapy. The patient is currently disease-free at one year following surgery. Radical excision with adjuvant radiotherapy could be an option for locally advanced liposarcoma in the ischiorectal space.View full abstractDownload PDF (1095K)
How I do it
-
H. Morita, Y. Kikawa, N. Koyama2007 Volume 60 Issue 6 Pages 354-358
Published: 2007
Released on J-STAGE: October 31, 2008
JOURNAL FREE ACCESSPartial rectal resection combined with the Thiersch method was performed for completely prolapsed rectum in two women of advanced age. The procedure was carried out following the trans anal approach. The rectum was completely cut off at 5 cm from the anus and the mesorectum was subsequently and carefully separated from the invaginated rectal wall. A segment about twice the length of the rectum that was prolapsed from the anus was resected from the proximal colon. Finally, auto-suture™ was employed for the anastomosis and the Thiersch method was done. In view of its low surgical risk, this technique was considered an excellent method for patients of advanced age.View full abstractDownload PDF (425K)
- |<
- <
- 1
- >
- >|