Postoperative biliary stricture is a relatively rare but serious complication of biliary surgery. Although Rouxen-Y hepaticojejunostomy or choledochojejunostomy are well-established and fundamental therapeutic approaches, their postoperative morbidity and mortality rates have been reported to be up to 33% and 13%, respectively. Recent studies suggest that percutaneous transhepatic intervention is an effective and less invasive therapeutic modality compared with traditional surgical treatment. Compared with fluoroscopic intervention, percutaneous with cholangioscopy may be more useful in biliary strictures, as it can provide visual information regarding the stricture site. We recently experienced two cases complete membranous occlusion of the bilioenteric anastomosis and successfully treated both patients using percutaneous transhepatic cholangioscopy.
Choledochostomy ; Cholestasis ; Constriction, Pathologic ; Humans ; Postoperative Complications

We performed original and modified technique of Mays' glanuloplasty in 6 and 12 cases respectively. The results were as follows: 1. 6 cases of mild from of hypospadias (2 cases of coronal, 4 cases of dist. penile) and 12 cases of severe form of hypospadias (5 cases of prox. penile, 6 cases of penoscrotal, 1 case of perineal) on pre-chordectomy but all cases became severe from of hypospadias (2 cases of prox. penile, 15 cases of penoscrotal, 1 case of perineal) on post-chordectomy. 2. The postoperative complications were 3 cases (50.0%) (1 case of meatal stenosis, 2 cases of meatal necrosis) in original technique of Mays' glanuloplasty and 2 cases of meatal stenosis (16.7%) in modified technique of Mays' glanuloplasty.
Constriction, Pathologic ; Female ; Hypospadias* ; Male ; Postoperative Complications

Complications of ureteroneocystostomy are relatively rare. Nevertheless, it would be desirable to use and operative approach that would prevent all complications. Based on our experiences with ureteroneocystostomy during the last 5.6 years, the causes, the operative methods and results were discussed. The results were as follows 1. Ureteroneocystostomy was performed in cases of primary reflux( 7 ureters), megaureter (6), ectopic ureter(5), posterior urethral valve(4) and ureterocele(3) as congenital causes. Acquired causes were iatrogenic ( 7 ureters) , tuberculosis(6), bladder ca(3) and traumatic ureteral injury(2) And causes of remained three ureters couldn`t be seeked. 2. Thirty nine of forty six ureters was performed with the method of submucosal tunnel and 7 with end to side. Among them 11 ureters with diffuse ureteral stricture were combined with the method of Vesico-psoas hitch. 3. Thirty five of thirty eight ureters was successfully corrected. Postoperative complications were contracted VUR in 2 cases, ipsilateral VUR, obstruction and unimproved renal function in each one case.
Constriction, Pathologic ; Postoperative Complications ; Ureter ; Urinary Bladder

PURPOSE: We performed this study to evaluate the alterations in renal function for patients with ileal conduit and ileal orthotopic neobladder MATERIALS AND METHODS: From January 1999 to June 2004, 48 patients who had undergone radical cystectomy with urinary diversion were included in our study. The patients were divided into two groups according to the types of urinary diversion. One group consisted of 29 patients with ileal conduit and the other group consisted of 19 patients with ileal W neobladder. The mean age of the ileal conduit group and the ileal W neobladder group were 65.6+/-9.9 years and 60.8+/-8.3 years, respectively. The preoperative and postoperative blood urea nitrogen/creatinine (BUN/Cr) levels, postoperative complications and postoperative GFR, as measured by (99m)Tc-DTPA scans, were compared between the two groups. RESULTS: For the postoperative complications, stricture at the ureterovesical anastomosis site occurred in 1.7% (1/58 renal units) of the ileal conduit group and in 10.5% (4/38 renal units) of the ileal W neobladder group. Acute pyelonephritis occurred in 5.2% (3/58 renal units) of the ileal conduit group and in 5.3% (2/38 renal units) of the ileal W neobladder group. The pre- and postoperative serum BUN/Cr levels were 20.8/1.3 and 24.8/1.6, respectively, in the ileal conduit group, and 17.2/1.1 and 18.8/1.2, respectively, in the ileal W neobladder group. There were no statistical significant differences between the pre- and postoperative changes of the serum BUN/Cr levels for both groups. The GFR, as measured by (99m)Tc-DTPA scans, were 77.6 and 78.7ml/ min/1.73m2 in the ileal conduit group and the ileal W neobladder group, respectively. There were no statistical significant differences between the two groups. CONCLUSIONS: There were no significant differences in renal function between the ileal conduit and ileal W neobladder.
Constriction, Pathologic ; Cystectomy ; Humans ; Postoperative Complications ; Pyelonephritis ; Urea ; Urinary Diversion*

PURPOSE: The surgical treatment of anal stenosis includes internal sphincterotomy, rotaton flap and advancement flap according to the stenosis degree, recently, Christensen performed house shaped advancement flap and reported fair results. We compared and analyzed the surgical methods and results in patients with moderate and severe anal stenosis who underwent house shaped advancement flap and C-anoplasty. METHODS: We have performed this study with 6 cases using the house shaped advancement flap and 6 cases using the C-anoplasty. The out come was assessed by clinical characteristics, surgical method, operation time, duration of hospitalization, healing time, postoperative complications, results. RESULTS: The average operation time was 38 min in those house shaped advancement flap cases and 63 min in C-anoplasty cases. The average time of hospitalization was 6 days and 9 days, respectively, and the average time of healing was 28 days and 46 days, respectively. In those house advancement flap cases, surgery could be done in 2 directions at the same time in 4 cases and 3 directions in 2 cases; as for those C-anoplasty cases, surgery could be done in 1 direction in 4 cases and 2 directions in 1 case. Two complications were observed in C-anoplasty, one flap infection and one flap necrosis, and in house shaped advancement flap, no complication was observed. CONCLUSIONS: House shaped advancement flap have several advantages compared to the C-anoplasty, and since house shaped advancement flap could be performed in 2 to 3 directions or even 4 directions at the same time, the anus could sufficiently expanded in severe anal stenosis patients. The house shaped advancement flap might be one of the good method in treating anal stenosis.
Anal Canal ; Constriction, Pathologic* ; Hospitalization ; Humans ; Necrosis ; Postoperative Complications

Laparoscopic colorectal operation is one of the most reliable procedures and widely used in the treatment of gastrointestinal tumor. Its advantages, including minimed invasiveness and rapid postoperative recovery have been widely accepted, but the complications are still chanllenging for surgeons. Intraoperative complications mainly include vascular injury, bowel injury and ureteral damage. Postoperative complications include anastomotic leak, bleeding and stenosis. Understanding of anatomy and precise operation are critical to prevent complications. Diagnosis of postoperative complications in time and proper treatment can achieve maximal improvement of outcomes.
Anastomotic Leak ; Colorectal Surgery ; Constriction, Pathologic ; Humans ; Intraoperative Complications ; Laparoscopy ; Postoperative Complications

Constriction, Pathologic ; Coronary Angiography ; Coronary Stenosis ; complications ; Coronary Vessels ; Humans ; Syphilis, Cardiovascular ; complications

Central lung cancer is a common disease in clinic which usually occurs above the segmental bronchus. It is commonly accompanied by bronchial stenosis or obstruction, which can easily lead to atelectasis. Accurately distinguishing lung cancer from atelectasis is important for tumor staging, delineating the radiotherapy target area, and evaluating treatment efficacy. This article reviews domestic and foreign literatures on how to define the boundary between central lung cancer and atelectasis based on multimodal images, aiming to summarize the experiences and propose the prospects.
Humans ; Lung Neoplasms/diagnostic imaging* ; Pulmonary Atelectasis/complications* ; Bronchi ; Constriction, Pathologic/complications* ; Multimodal Imaging

PURPOSE: The use of barium enemas to confirm the anastomotic integrity prior to ileostomy closure is still controversial. The purpose of the study was to determine the utility of routine contrast enema prior to ileostomy closure and its impact on patient management in patients with a low pelvic anastomosis. METHODS: One hundred forty-five patients had a temporary loop ileostomy constructed to protect a low colorectal or coloanal anastomosis following low anterior resection for rectal cancer. All patients were evaluated by physical examination, proctoscopy, and barium enema prior to ileostomy closure. RESULTS: The median time from ileostomy creation to closure was 8 months. Five (3.5%) of the 144 patients were found to have clinically relevant strictures at the colorectal anastomosis on routine barium enema. One patient (0.7%) showed anastomotic leak on their barium enema. Overall, 141 patients (97.9%) had an uncomplicated postoperative course. Postoperative complication occurred in three patients (2.1%). None of them showed abnormal barium enema finding, which suggested that routine contrast enema examination did not predict postoperative complication. CONCLUSION: Routine barium enema evaluation of low pelvic anastomoses before loop ileostomy closure did not provide any additional information for postoperative colorectal anastomotic complication.
Anastomotic Leak ; Barium ; Constriction, Pathologic ; Enema ; Humans ; Ileostomy ; Physical Examination ; Postoperative Complications ; Proctoscopy ; Rectal Neoplasms

OBJECTIVES: To compare the late complications after operations for rectal cancers with and without preoperative chemoradiation. METHODS: From January 2003 to December 2005, 55 patients underwent operation after preoperative chemoradiation for adenocarcinoma of the rectum. All of them received the full scheduled dose of radiation with concurrent chemotherapy. The interval between preoperative chemoradiation and surgery was 4-6 weeks. 47 patients who had tumors below 8 cm from the anal verge were enrolled into the study group (CRT group). During same period, we selected 153 patients who had adenocarcinoma of the rectum below 8cm from the anal verge, underwent surgery alone without postoperative radiotherapy non-CRT group). We compared the early and the late postoperative complications between the CRT group and the non-CRT group. RESULTS: Of the late complications, the incidence of anastomotic stricture was significantly higher in the CRT group (P = 0.018). The incidence of anal stricture was higher in the CRT group (P = 0.164). In the CRT group, 3 cases (17.6%) had failed to preserve the anal function due to moderate or severe anal stricture. Of the 3 cases, protective ileostomy was persistent in 2 cases, colostomy was performed in one case. Otherwise, the late complications of the CRT group were intestinal obstruction in 2 cases (4.3%), lymph edema in 2 cases (4.3%). CONCLUSION: In CRT group, failure of anal function preservation due to anastomotic stricture or anal stricture was more common and serious than non-CRT group. We emphasize the need for careful management for postoperative anal stricture after preoperative chemoradiation.
Adenocarcinoma ; Colostomy ; Constriction, Pathologic ; Edema ; Humans ; Ileostomy ; Incidence ; Intestinal Obstruction ; Postoperative Complications ; Rectal Neoplasms ; Rectum