1.Successful Staged Repair of an Anomalous Origin of the Right Pulmonary Artery from the Ascending Aorta.
Toshihiro Funatsu ; Hidefumi Kishimoto ; Hiroaki Kawata ; Takuya Miura ; Takayoshi Ueno ; Shigemitsu Iwai ; Masamichi Ono ; Tomoko Kita ; Toru Nakajima ; Takeshi Nakada
Japanese Journal of Cardiovascular Surgery 2000;29(1):25-28
We report a successful staged repair of anomalous origin of right pulmonary artery from the ascending aorta in a neonate. A two-day-old girl, who suffered from severe circulatory failure, was admitted. In spite of all medical treatment, acidosis and systemic hypotension developed. Right pulmonary artery banding was performed in an emergency procedure, resulting in immediate elevation of systemic blood pressure. Definitive operation was subsequently performed on the 48th day after birth. The right pulmonary artery, which was de-banded and divided from aorta, was anastomosed directly to the pulmonary trunk in a side-to-end manner. The postoperative course was uneventful and the pulmonary artery pressure was within the normal range.
2.Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure
Taro TANABE ; Emi YAMAGUCHI ; Takuya NAKADA ; Risa NISHIO ; Kinya OKAMOTO ; Tetsuo YAMANA
Annals of Coloproctology 2022;38(4):314-318
Purpose:
Risk factors for recurrence of rectal prolapse after surgery remain unclear. Delorme’s procedure is often selected for relatively small-sized rectal prolapse, but there are few reports discussing the association between prolapsed rectum length and prolapse recurrence after Delorme’s procedure. We hypothesized that patients with longer rectal prolapses are at a higher risk of recurrence after Delorme’s procedure.
Methods:
The study population comprised patients with rectal prolapse who underwent Delorme’s procedure between January 2014 and December 2019 at Tokyo Yamate Medical Center. We extracted data on patient age, sex, body mass index, previous history of anal surgery, previous history of surgery for rectal prolapse, and length of prolapse, to identify risk factors for prolapse recurrence.
Results:
Altogether, 96 patients were eligible for analysis. The median length of the prolapsed rectum was 3.0 cm (range, 1.0–6.6 cm). Twenty-four patients (25.0%) experienced recurrence after Delorme’s procedure after a median of 7.5 months (interquartile range, 3.2–20.9 months). Multivariate analysis revealed that longer prolapsed rectum length increased the risk of recurrence after Delorme’s procedure (hazard ratio, 6.28; 95% confidence interval, 1.83–21.50; P<0.001).
Conclusion
The length of the prolapsed rectum should be measured before Delorme’s procedure for rectal prolapse, because length is associated with a risk of recurrence after the surgery.