Diseases of the colon and rectum
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This study was designed to analyze the impact of anastomotic leak and intra-abdominal abscess on cancer recurrence and survival in patients who underwent resection for colorectal cancer. ⋯ Anastomotic leak and intra-abdominal abscess were not associated with worsened 5-year survival or recurrence in patients who underwent resection for colon cancer. However, these complications were associated with increased overall and cancer-specific mortality and increased overall and local recurrence in patients who underwent resection for rectal cancer.
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Randomized Controlled Trial
The effect of glyceryl trinitrate ointment on posthemorrhoidectomy pain and wound healing: results of a randomized, double-blind, placebo-controlled study.
Spasm of the internal sphincter may be a source of anal pain and delayed healing after hemorrhoidectomy. This study assessed whether glyceryl trinitrate (GTN) ointment reduces pain and promotes wound healing after hemorrhoidectomy. ⋯ Compared with placebo, perianal application of 0.2 percent GTN ointment significantly decreases postoperative pain after hemorrhoidectomy and reduces analgesic requirements in the immediate postoperative period. GTN ointment also achieves more rapid healing of wounds.
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The elderly constitute an increasing portion of the world's population. Our study assessed morbidity, mortality, and outcome in octogenarians who have undergone lower intestinal operations, and compared outcome between subsequent decades. ⋯ Elective surgery in the elderly is safe. Emergency surgery is accompanied by significant morbidity and mortality.
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Comparative Study
Treatment of transsphincteric anal fistulas by endorectal advancement flap or collagen fistula plug: a comparative study.
In this study we compared the outcomes of patients with complex cryptoglandular fistulas treated by endorectal advancement flap or anal fistula plug. ⋯ The current study indicates that the endorectal advancement flap provides a higher success rate than the anal fistula plug. Randomized trials are needed to further elucidate the efficacy and potential functional benefit of the anal fistula plug in the treatment of complex anal fistulas.
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The goal of this study was to determine the unplanned hospital readmission rate following ileal pouch-anal anastomosis, prior to loop ileostomy closure. ⋯ Hospital readmission after ileal pouch-anal anastomosis is common. We plan to institute a more intensive follow-up in an effort to prevent readmission of selected high-risk patients who might be effectively managed as outpatients.