No abstract available.

No abstract available.
Rectal Fistula*

No abstract available.
Rectal Fistula*

Adhesives ; Burns ; Calcium Chloride ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen ; Factor XIII ; Fibrin Tissue Adhesive ; Fibrin ; Fibrinogen ; Follow-Up Studies ; Gingiva ; Hemorrhage ; Humans ; Mouth ; Nose ; Polymers ; Skin Transplantation ; Skin ; Surgery, Oral ; Sutures ; Thrombin ; Tissue Donors ; Transplants ; Wound Healing

No abstract available.
Humans ; Infant, Newborn ; Infant, Premature* ; Nephroma, Mesoblastic* ; Ultrasonography, Prenatal*

No abstract available.
Colon* ; Polyps*

No abstract available.
Lymphoma*

Rectovagianl fistula(RVF) is a congenital or acquired communication between the two epithelial-lined surface of the rectum and the vagina. We present our experience with 62 patients with RVF. There were various etiologies and repair methods of rectovaginal fistula. The purpose of this study was to retospectively review the clinical course of the patients we treated and to evaluate the efficacy of various treatment options. The mean age was 40.5 yr, The type of RVF was classified to one of two(simple and complex), according to their location, size and etiology. RVF was developed most commonly after radiotherapy due to cervical cancer(n=17), then after pelvic surgery due to malignancy(n=16), obstetric trauma after episiotomy at delivery(n=7), congenital malformation(n=4), inflammatory bowel disease(n=1), Bechet's disease(n=1), infections such as perianal fistula or abscess(n=2), direct invasion of carcinoma(n=3), after chemotherapy(n=1), and idiopathic(n=6). Three cases of them associated with rectovesicovaginal fistula. Surgical therapeutic option was divided to local repair, abdominal approach and tissue transposition by the type of RVF. Most simple RVFs were repaired with local approach through the vagina or rectum. Most complex RVFs were repaired through abdominal approach or tissue transposition. With an average follow up of 20 months, the treatment results were as follows: completely healed(n=36, 58.1%), persistent symptom(n=6, 9.7%), recurrence after repair(n=5, 8.1%), loss of search or death(n=15, 24.1%). Therefore we assist that the management of RVF depends on size, location, and cause. anal sphincter function and overall health status of the patient. Careful preoperative assessment of the fistula, surrounding tissues, and anal sphincter and exclusion of associated disease are essential. With through evaluation, thoughtful consideration of treatment options, and meticulous operative technique, patient can be assured of an optimal outcome.
Anal Canal ; Episiotomy ; Female ; Fistula ; Follow-Up Studies ; Humans ; Radiotherapy ; Rectovaginal Fistula* ; Rectum ; Recurrence ; Vagina

Infectious complications such as wound infection and intra-abdominal abscess are rarely fatal, but perplexing to both patients and surgeons, and still remain asserious problem after appendectomy in about 5% of the patients. To be helpful to reduce post-appendectomy complications, authors retrospectively analyzed 229 cases of appendectomy performed during the period of one year, from January 1 through December 31, 1995, to find out contributing factors to the post-appendectomy infectious complications such as wound infection or intra-abdominal abscess. The results were as follows. 1) Infectious complications are more common in patients with four or more days of symptom. 2) Infectious complications are more common in patients with complicated appendicitis such as gangrenous or perforated appendicitis. 3) Preoperative antibiotics are helpful to prevent infectious complications in cases of complicated appendicitis. 4) There is no difference in the incidence of infectious complications between the immediate operations and overnight delayed operations in patients who were admitted in the late evening or at night. 5) There is no difference in the incidence of infectious complications between operators: staff surgeons who exclusively operated on patients with complicated appendicitis and residents(with or without supervision of staff surgeons) who mostly operated on patients with simple appendicitis. This means technical superiority has its role in preventing infectious complications. Early diagnosis and operation before the gangrenous change or perforation are warranted. Preoperative antibiotics are effective in cases of complicated appendicitis, but not in cases of simple appendicitis. But the lack of objective criteria to decide complicated appendicitis before the operation remains problem, and prospective study to solve this problem is needed. Technical perfectness is required to protect the wound and to remove the appendix without contamination. Preventive measures are also important to prevent the infectious complications in cases of inevitably contaminated wounds or inta-abdominal spaces.
Abdominal Abscess ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis ; Appendix ; Early Diagnosis ; Humans ; Incidence ; Organization and Administration ; Retrospective Studies ; Wound Infection ; Wounds and Injuries

Conventional hemorrhoidectomy is still the main stairway to the treatment of the third or the fourth degree hemorrhoids. Among the various methods of hemorrhoidectomy, open hemonhoidectomy is claimed to decrease postoperative pain and wound infection, but to have disadvantage of long period of wound healing. Semi-closed hemorrhoidectomy has the advantage of rapid wound healing without increased risk of wound infection, but more painful postoperative course than open hemorrhoidectomy is suggested. To assess this conventional concept, two hundreds of patients were randomly allocated to either an open hemorrhoidectomy(Group 4, Operated by modified Goligher method, n=100) or a semi-closed hemorrhoidectomy(Group B, Operated by modified Nesselrod method, n=100), and postoperative results were analyzed. In group 4, the average time for disappearance of wound edema was 4.9days, average time for disappearance of wound pain was 9.0days, average time for painless defecation was 14.1 days, average time for complete wound healing was 28.4days. The main complications were overgranulation, skin tag, anal discharge and pruritus. The overgranulation requires curettage, the skin tags were resected under local anesthesia. Anal discharge and pruritus were spontaneously disappeared after the healing of the wound. In group B, the average time for disappearance of wound edema was 6.1 days, average time for disappearance of wound pain was 6.3days, average time for painless defecation was 9.2days, average time for complete wound healing was 20.7days. The main complications were skin tags, more prevalent than group 4, requiring resection under local anesthesia. No infectious complications were noted in both groups. Consequently, the old concept that open hemorrhoidectomy has advantage of less painful postoperative course than semiclosed hemorrhoidectomy cannot be accepted. Semi-closed hemorrhoidectomy offers more rapid loss of pain and more rapid healing of the wound than open hemorrhoidectomy, without increased risk of infectious complications. In conclusion, semi-closed hemorrhoidectomy is superior method to open hemorrhoidectomy in third or fourth degree hemorrhoids.
Anesthesia, Local ; Curettage ; Defecation ; Edema ; Hemorrhoidectomy* ; Hemorrhoids ; Humans ; Pain, Postoperative ; Pruritus ; Skin ; Wound Healing ; Wound Infection ; Wounds and Injuries