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Query: UMLS:C0042961 (volvulus)
 4,305 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The double stapling technique for rectal reconstruction after resection involves closing the lower rectal segment with a linear stapler and performing the anastomosis using a circular stapler across the linear staple row. The purpose of this report is to review the results of double stapling, present our experience, and draw conclusions from the material available. We have utilized the double stapling technique in 80 patients for primary anastomoses and in 11 patients for secondary anastomoses following Hartmann procedures. Twenty-one anastomoses were at or near the dentate line. Fifty-six patients had rectal carcinoma, 29 patients had diverticulitis, 3 patients had carcinoma of the ovary, and 1 patient each had traumatic rectal perforation, volvulus, or rectal prolapse. Complications in the total 91 patients included 3 anastomotic leaks (3.3%), 1 postoperative hemoperitoneum (1.1%), and 3 strictures (3.3%). No anastomosis was protected by diverting colostomy. There were no operative deaths. Of 43 patients with cancer available for follow-up, 4 patients have developed local recurrence. The technique has been modified for ileoanal anastomosis during abdominal restorative proctocolectomy for ulcerative colitis and familial polyposis and early results are favorable. The double stapling technique provides a safe method for rectal reconstruction at or near the dentate line and offers the following advantages over other stapler techniques: (1) It eliminates the frustrating distal pursestring; (2) The rectal segment is not opened, minimizing contamination; and (3) It avoids gathering the sometimes generous circumference of the rectum on a pursestring thus allowing a more precise distal donut.
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PMID:Results of the double stapling procedure in pelvic surgery. 146 21

Ileal J-pouch rectal anastomosis is a commonly performed procedure for patients who have undergone subtotal colectomy for ulcerative colitis or familial adenomatous polyposis without rectal involvement. We herein report the case of a patient with ileal pouch volvulus that developed 15 years after subtotal colectomy for ulcerative colitis. A 62-year-old female visited our emergency room with complaints of abdominal pain and nausea that had persisted for 12 h. Abdominal radiography and contrast-enhanced computed tomography detected segmental distention of the small intestine around the staples. We diagnosed volvulus of the ileal pouch-rectal anastomosis and performed emergency laparotomy. We released the volvulus and performed pouchpexy. The patient was discharged on postoperative day 10, and recurrence of the volvulus has not been observed for 5 months since the procedure was performed. Our study indicates that an early diagnosis and intervention are needed to avoid serious complications, such as pouch necrosis and perforation, in such cases.
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PMID:Volvulus of an ileal pouch-rectal anastomosis after subtotal colectomy for ulcerative colitis: report of a case. 2404 65

Ileal pouch-anal anastomosis is currently accepted as the standard method to restore continence after total proctocolectomy for medically refractory ulcerative colitis and familial adenomatous polyposis. Ileal pouches offer improved quality of life and high patient satisfaction; however, there are many pouch-related complications due to the original disease process and change in anatomy. This is a review article of the common and some rare surgical complications after J pouches, which can be subdivided into the septic and nonseptic categories. Septic-related complications include anastomotic leak, abscess, and fistulas, whereas common nonseptic-related complications include small bowel obstruction, strictures, Crohn's disease, pouchitis, and cuffitis. Rare nonseptic complications to be discussed are prolapse, volvulus, and neoplasia.
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PMID:Ileal j pouch complications and surgical solutions: a review. 2498 86