1.A propos 11 operations with ileum-cecum anastomosis and ileum-cecum intubation
Journal of Medical and Pharmaceutical Information 2003;1():34-37
From Feb. 1993 to Nov. 1996 at Viet Duc Hospital, 4 cases of ileum-cecum annatomosis and 7 cases of ileum-cecum intubation were performed. In 4 cases of annatomosis 3 had good result, 1 case had post operative peritonitis at the 8th day later due to anatomotic dehiscence, the two ends were exposed out of abdomen and the operation was repeated 1 month later. Right colon was cut and an end-end anastomosis was carried out, good result attained. The 7 cases of ileum-cecum intubation had good results
Ileum
;
Cecum
;
Peritonitis
;
surgery
;
Therapeutics
2.Application and evaluation of pouch configuration in rectal surgery.
Chinese Journal of Gastrointestinal Surgery 2014;17(5):431-434
Colonic pouch can improve fecal continence after low anterior resection in the short-term, but its superiority would disappear in the long-term (2 years after surgery), since fecal continence improves gradually with time in the non-pouch group. Furthermore, the incidence of incomplete defecation increases gradually with time, and a lot of patients would have difficulty in defecation and require long-term use of suppositories and enemas. Pouch enforcement will result in prolonged operation time and increased treatment cost. Therefore, the value of colonic pouch in low rectal anastomosis is being questioned, and its application diminishes gradually. For patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) after total colectomy, ileal pouch anal anastomosis (IPAA) can reduce fecal frequency and improve patients' quality of life in both short-term and long-term, by increasing the volume of the neo-rectum and altering intestinal motility. For these reasons, IPAA is the first surgical choice for UC and FAP.
Anal Canal
;
surgery
;
Anastomosis, Surgical
;
methods
;
Humans
;
Ileum
;
surgery
;
Rectum
;
surgery
3.Exploration of surgical procedures in the treatment of type 2 diabetes mellitus in China.
Hui LIANG ; Wei GUAN ; Huan LIU ; Qing CAO ; Yi MIAO
Chinese Journal of Gastrointestinal Surgery 2014;17(7):644-647
The median body mass index(BMI) of patients with type 2 diabetes mellitus(T2DM) in China is only 24 kg/m(2) and diabetic diet in China is different from that in the Western countries. Currently there are no sufficient weight loss surgery data and guidance in China. Therefore, aside from the internationally recognized surgical procedures, Chinese surgeons have been trying to find other suitable procedures for T2DM. In 2011, operations for treatment of T2DM recommended by the International Diabetes Federation(IDF) are as follow: gastric bypass surgery(GBP), sleeve gastrectomy(SG), bile pancreatic surgery(BPD), duodenal inversion technique(DS) and the adjustable gastric band surgery(AGB). At present, the main exploratory surgery procedures in China include: sleeve gastrectomy and duodenal-jejual bypass, duodenal-jejual bypass, sleeve gastrectomy and jejual-ileal bypass, sleeve gastrectomy and ileal interposition, ileal interposition, jejunal-ileal bypass, gastric folding technique, gastric folding and banding, and other weight loss surgery under endoscopy. Each operation has different characteristics, but the optimal surgery for patients with T2DM still needs long term follow-up and large sample of multi-center clinical research. We believe that under the scientific standardization, surgeons in China will develop the most suitable procedures for patients with T2DM.
Bariatric Surgery
;
Body Mass Index
;
China
;
Diabetes Mellitus, Type 2
;
surgery
;
Gastrectomy
;
Humans
;
Ileum
;
Weight Loss
4.Treatment of ulcerative colitis by total colectomy ileal pouch-anal anastomosis.
Chinese Journal of Gastrointestinal Surgery 2012;15(12):1221-1223
Ulcerative colitis (UC) is a relapsing and remitting disease characterised by chronic mucosal and submucosal inflammation of the colon and rectum. Treatment may vary depending upon the extent and severity of inflammation. Broadly speaking medical treatments can induce and maintain remission. Approximately 25% of patients with UC ultimately require colectomy for ineffective medical treatment or complications. Ileal pouch-anal anastomosis(IPAA) has become the standard of care for patients with ulcerative colitis who ultimately require colectomy.Improvement in pouch technique may decrease the perioperative complication rate and postoperative stool frequency. Laparoscopic IP AA can lessen surgical trauma,abdominal adhesion and intestinal obstruction. Timing of surgery, appropriate surgical technique , and prevention of postoperative complications are the keys to successful treatment of UC.
Anal Canal
;
surgery
;
Anastomosis, Surgical
;
Colectomy
;
Colitis, Ulcerative
;
surgery
;
Humans
;
Ileum
;
surgery
;
Intestinal Obstruction
;
Laparoscopy
;
Postoperative Complications
;
Recurrence
5.Changes of N2O Concentration in the Intestinal Lumen and Bowel Distension During General Endotracheal Anesthesia.
Jang Hoon PARK ; Sang Kyi LEE ; Jong Hoon KIM ; He Sun SONG
Korean Journal of Anesthesiology 1995;29(3):368-372
During the course of anesthetic administration, appreciate volume of nitrous oxide can move into closed gas spaces. The use of nitrous oxide during abdominal surgery may cause distension of the intestine and make difficulty in operating procedure. We studied 29 patients undergoing elective colorectal surgery and they were classified into two groups -N2O group and Air group, N2O group was administered with air-oxygen-enflurane before peritoneal opening and administered with N2O- oxygen-enflurane after peritoneal opening. Air group was administered with air-oxygen-enflurane throughout the surgery. We measured N2O concentration in the terminal ileum, the degree of distension in the small and large intestine during anesthesia, and the time of postoperative flatulence and feces passage. The N2O concentration in the intestine increased throughout the time course in N2O group. The distension score of the small and large bowel had a tendency to increase in N2O group. There were no significant differences between the two groups in postoperative bowel motility. These results suggest that a long-term N2O administration in patients undergoing colorectal surgery may interfere surgical conditions of the intestine because of the bowel distension.
Anesthesia*
;
Colorectal Surgery
;
Feces
;
Flatulence
;
Humans
;
Ileum
;
Intestine, Large
;
Intestines
;
Nitrous Oxide
6.Reinforcing the continent mechanism of continent cutaneous diversions by wrapped rectus abdominis muscle flap: a preliminary experimental study.
Xin-ru ZHANG ; Yue-min XU ; Chao FENG ; Jian-jun YU ; Lu-jie SONG ; Xiao-fang FEI
Chinese Medical Journal 2009;122(9):1087-1091
BACKGROUNDContinent cutaneous diversion (CCD) has been widely used in almost any lower urinary reconstruction. We have been continually trying to modify this procedure because of the high complications rate, especially as they relate to the efferent tube. In this study, we reported a modified procedure with a tapered ileum wrapped by the rectus abdominalis flap (RAMF) and assessed the feasibility of this new technique to achieve urinary continence.
METHODSA procedure in which two ileal segments were tapered and connected to a U-shaped reservoir was performed in ten dogs. A RAMF with its blood supply was wrapped around one of the tapered ileum. In control groups, the tapered ileum was brought to the abdominal skin. Urodynamic studies were conducted In the 1st, 3rd and 6th months post-operatively. The data of maximum inner pressure (MIP) and functional pressure length (FPL) in every group at each phase were recorded. Retrograde radiograms of the efferent limbs were performed before sacrifice.
RESULTSMIP in the study group was significantly higher than that in the control group at each phase (P < 0.05). However, no significant differences in MIP or FPL were found in the study group between an empty and full reservoir. In the control group, MIP increased (P < 0.05) and FPL decreased significantly (P < 0.05) compared with an empty and full reservoir. Retrograde radiograms confirmed that efferent limbs were positioned straigh beneath the abdominal wall. Histological examination of the study group demonstrated a layer of striated muscle around the outside surface of the ileum.
CONCLUSIONThe continent mechanism of tapered ileum can be enhanced by extra support from wrapped RAMF.
Animals ; Dogs ; Female ; Ileum ; surgery ; Male ; Urinary Diversion ; methods ; Urinary Reservoirs, Continent ; Urodynamics
7.Re-optimized technology of protective ileostomy with no need of reversal.
Bu-jun GE ; Qi HUANG ; Quan-ning CHEN ; Zhong-yan LIU ; Hai-bo ZHAO
Chinese Journal of Gastrointestinal Surgery 2013;16(10):981-984
OBJECTIVETo explore the clinical application of aoptimizedtechniquebased onpreviouslyreported protecting stoma with no need forreversal.
METHODSThetechniquealso used "the assembly of drainage device" to performprotecting ileostomy. The original method includes enterotomy at the terminal ileum to placedrainage device, which was optimized as follows: two intestinal pursestring with 0.5 cm distance were placed 5 cm away from the ileocecal valve. Transverse enterotomy was performed in the anti-mesenteric side. The assembly was placed at the root of the appendix between two pursestring, and then the intestine purse suture was tighten. Ligation of the small intestine anastomosis between the anastomosis ring at both ends was carried out, and theanastomosis ring was deployed. From the root of the appendix in the cecum wall, the assembly was embedded about 2 cm and pulled out of abdominal cavitythough the Trocar hole.
RESULTSSeventeen cases of ultra-low rectal cancer completed protecting stoma, including 11 cases through ileocecal protective stoma. All the anastomosis healed well. Defecation drainage tube was removed 3-5 weeks after anastomosis ring degradation. Drainage nozzle healed after 3 to 5 days, and no complications occurred.
CONCLUSIONThe optimized ileocecal protective ileostomy has the following advantages: (1)wound healing time is significantly shorter. (2)secondary intestinal fistula can be prevented. (3)no need to fix ileum and less chance of subsequent volvulus, intestinal obstruction.
Anastomosis, Surgical ; Defecation ; Drainage ; Humans ; Ileostomy ; methods ; Ileum ; surgery ; Intestinal Fistula ; Rectal Neoplasms ; Surgical Stomas
8.Urodynamic study of enhanced continent mechanism using tapered ileum as continent urinary reservoir.
Yuemin XU ; Yong QIAO ; Zhong CHEN ; Xinru ZHANG ; Rong CHEN ; Yinglong SA ; Jiong ZHANG ; Tao LI ; Denglong WU
Chinese Medical Journal 2002;115(11):1653-1656
OBJECTIVETo investigate the effect of extramural support from the pouch and abdominal wall to enhance the continent mechanism of tapered ileum.
METHODSA total of 24 patients underwent a procedure in which an ileal segment was tapered into an efferent tube, of which a part was placed between the back surface of the rectus muscle and the ileal pouch wall. The internal orifice of the tapered ileum was anastomosed to the ileal pouch and its external orifice was anastomosed to the umbilicus. A urodynamic study of the efferent tubes and pouch was done 1.5 to 3 months and 6 to 24 months postoperatively.
RESULTSOne patient died of heart disease 55 days postoperatively, while 22 of the remaining 23 were completely continent day and night. At 1.5 to 3 months, the urodynamic study of the efferent tubes demonstrated that the maximum closure pressure with a full pouch was 46 - 124 cmH(2)O (91.26 +/- 15.71 cmH(2)O) and with an empty pouch was 34 - 84 cmH(2)O (67 +/- 10.60 cmH(2)O). The difference in mean maximum closure pressure in the full and empty pouches was statistically significant (t = -11.78 and P = 0.00001). At 6 to 24 months, a second urodynamic study was performed on 18 cases, demonstrating a reservoir capacity of 420 to 750 ml (481.67 +/- 78.83 ml). Reservoir pressure was 6 to 9 cmH(2)O (7.17 +/- 1.17 cmH(2)O) when the pouch was filled to 50 ml, and 16 to 35 cmH(2)O (24.12 +/- 5.61 cmH(2)O) when it was filled to maximum capacity. There was no contractive wave during the filling in any patient. Maximum closure pressure in the efferent tube was 80 to 194 cm H(2)O (98.89 +/- 26.34 cmH(2)O) when the pouch was filled with saline, and 64 to 128 cmH(2)O (74.78 +/- 14.54 cmH(2)O) when the pouch was empty. The difference in mean maximum closure pressure in the full and empty pouches was statistically significant (t = -7.58 and P = 0.00003).
CONCLUSIONSThis study indicates that the continent mechanism of tapered ileum may be greatly enhanced by extramural support from the abdominal and pouch walls.
Adult ; Aged ; Female ; Humans ; Ileum ; surgery ; Male ; Middle Aged ; Urinary Diversion ; methods ; Urinary Reservoirs, Continent ; Urodynamics
9.Vesico-ileosigmoidal Fistula Caused by Diverticulitis: Report of a Case and Literature Review in Japan.
Hidefumi NISHIMORI ; Koichi HIRATA ; Rika FUKUI ; Mayumi SASAKI ; Takahiro YASOSHIMA ; Futoshi NAKAJIMA ; Fumitake HATA ; Kenji KOBAYASHI
Journal of Korean Medical Science 2003;18(3):433-436
Enterovesical fistula is a relatively uncommon complication of colorectal and pelvic malignancies, diverticulitis, inflammatory bowel disease, radiotherapy, and trauma in Asian countries. A case of vesico-ileosigmoidal fistula and a literature review of this disease in Japan are presented. A 70-yr-old male was referred with complaints of urinary pain and pneumaturia. On admission, urinary tract infection and pneumaturia were presented. A barium enema demonstrated multiple diverticulum in his sigmoid colon and the passage of contrast medium into the bladder and ileum. Under the diagnosis of vesico-ileosigmoidal fistula due to suspected diverticulitis of the sigmoid colon, sigmoidectomy and partial resection of the ileum with partial cystectomy were performed. The histopathology revealed diverticulosis of the sigmoid colon with diverticulitis and development of a vesico-ileosigmoidal fistula. No malignant findings were observed. Until the year 2000, a total of 173 cases of vesico-sigmoidal fistula caused by diverticulitis had been reported in Japan. Pneumaturia and fecaluria are the most common types, presenting symptoms in 63% of the cases. Computed tomography, with a sensitivity of 40% to 100%, is the most commonly used diagnostic study. For patients with vesico-sigmoidal fistula, resection of the diseased sigmoid colon and partial cystectomy with primary anastomosis are the safest and most acceptable procedures, leading to the best results.
Aged
;
Anastomosis, Surgical
;
Bladder Fistula/*etiology/*pathology/surgery
;
Colon, Sigmoid/pathology
;
Cystectomy
;
Diverticulitis/*complications/*pathology/surgery
;
Human
;
Ileum/pathology
;
Male
10.Giant chylous cyst and ileal duplication in a young adult.
Yue YU ; Jin-Sheng WU ; Zhong-Wei KE
Singapore medical journal 2014;55(5):e77-81
Alimentary tract duplications are rare congenital anomalies that usually present in childhood and occasionally in adults. They are most common in the ileum, but can occur anywhere along the alimentary tract from the mouth to the anus. We report a 24-year-old woman who presented with a giant chylous ileum cyst duplication. To our knowledge, there is only one other report of a patient with a giant chylous cyst in the literature.
Abdominal Pain
;
Adult
;
Cysts
;
diagnosis
;
pathology
;
surgery
;
Female
;
Humans
;
Ileum
;
surgery
;
Magnetic Resonance Imaging
;
Tomography, X-Ray Computed