1.Ileocolonic Transposition Esophagogastric Bypass as an Antireflux Treatment for Corrosive Esophageal Injury.
Yuda HANDAYA ; Mukhamad SUNARDI
Annals of Coloproctology 2017;33(4):150-155
Because most surgeons perform an esophagectomy and colonic transposition as the main reconstruction method for patients with esophageal stenosis caused by swallowing corrosive materials, we report 2 cases in which ileocolonic transposition was used to treat such patients. Both patients displayed stenosis in the middle third of the esophagus. Their chief complaint was dysphagia. Ileocolonic transposition using vascularization of the Drummond and ileal arteries was followed by a prepared ileocolic graft by ligating ileocolic vessels. We performed an ileocolonic transposition esophagogastric bypass without an esophagectomy. All surgeries resulted in minimal intraoperative bleeding. Patients experienced no leakage, postoperative fistulas, dysphagia, or postoperative reflux. Three weeks after surgery, 1 patient experienced reversible hoarseness caused by extensive laryngeal-nerve manipulation. Cumulatively, ileocolonic transposition with cervical anastomosis for the treatment of patients with esophageal stenosis caused by corrosive esophageal injury can be considered to be an antireflux treatment because the ileocaecal sphincter is maintained.
Arteries
;
Colon
;
Constriction, Pathologic
;
Deglutition
;
Deglutition Disorders
;
Esophageal Stenosis
;
Esophagectomy
;
Esophagus
;
Fistula
;
Hemorrhage
;
Hoarseness
;
Humans
;
Methods
;
Surgeons
;
Transplants
2.Bilateral Rotational S Flap Technique for Preventing Restenosis in Patients With Severe Circular Anal Stenosis: A Review of 2 Cases
Yuda HANDAYA ; Mukhamad SUNARDI
Annals of Coloproctology 2019;35(4):221-224
Anal stenosis is a late hemorrhoidectomy complication. Sphincterotomy and various anoplasty techniques are used for treatment severe anal stenosis, such as the C flap, House flap, U flap, and rotational S flap, but no procedure is ideal for every patient. We review 2 cases of severe circular anal stenosis. Their complaints included narrow caliber of the stool and feeling unsatisfied defecation. Excision of scar tissue using the circular technique was followed by reconstruction using the bilateral rotational S flap procedure. At the 1-year follow-up, the patient had complaints about neither defecation nor pain, and no longer needed laxative agents. In conclusion, the bilateral rotational S flap technique should be considered as a viable treatment because it can also prevent the occurrence of restenosis, especially given the consideration of adequate blood supply.
Cicatrix
;
Constipation
;
Constriction, Pathologic
;
Defecation
;
Follow-Up Studies
;
Hemorrhoidectomy
;
Humans
3.A novel wound healing accelerator: Effect of vitreous gel of cow eyeball on a chronic wound model
Akhmad Makhmudi ; Yohanes Widodo Wirohadidjojo ; Enrico Gahara ; Hafni Zuchra Noor ; Mukhamad Sunardi ; Noor Afif Mahmudah ; Alvin Santoso Kalim ; Gunadi
The Medical Journal of Malaysia 2020;75(6):698-704
ss of wound healing after administration ofmitomycin-C, which inhibits granulation tissue formationand collagen synthesis, resulting in chronic wounds. Thevitreous gel of cow eyeballs contains a high level ofhyaluronic acid, which has a role in inflammation,granulation, re-epithelialization, and remodelling. This studyaims to understand the effect of 1% povidone iodine andvitreous gel of cow eyeballs on wound healing afteradministration of mitomycin-C.Methods: This was an invivostudy with quasi-experimentalmethods on 32 Wistar mice. Full-thickness wounds weremade and then treated with mitomicyn-C. The mice weredivided into 4 groups: a control group with NaCl 0.9%vitreous gel of cow eyeball (VGCE), 1% povidone-iodine, anda combination of VGCE and 1% povidone-iodine groups.Macroscopic and microscopic observations of the processof wound healing were performed on days 3, 7, and 14.Results: Vitreous gel administration produced significantwound healing rates within the first three days, andhistological analysis revealed an increased number offibroblasts and polymorphonuclear cells. However, thepovidone iodine group and the combination group withvitreous gel did not produce significant results.Conclusion: The single administration of VGCE canaccelerate the wound healing process, increase the numberof fibroblasts, and reduce inflammation in a chronic woundmodel.