Jurnalul de Chirurgie

Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter
ISSN: 1584 - 9341 Vol.10 Nr.3 - Iulie-Septembrie 2014 | miercuri, 20 ianuarie 2021
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
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| Romana

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THE PLACE OF MECHANIC SUTURES IN MEDIUM AND LOW RECTAL CANCER
C. Oprescu (1), M. Beuran (1), AE. Nicolau (1), I. Negoi (1), M.D. Venter (1), S. Morteanu (1),
Anca Monica Oprescu-Macovei (2)
(1) Clinica de Chirurgie, Spitalul Clinic de Urgenta Bucuresti
Universitatea de Medicina si Farmacie „Carol Davila”, Bucuresti, Romania
(2) Clinica de Gastroenterologie, Spitalul Clinic de Urgenta Bucuresti
Jurnalul de chirurgie (Iaşi). 2013; 9(1): 29-34.
Full text: Format PDF (Română/Romanian)

Abstract:

BACKGROUND: For medium and low rectal cancer the most common surgical procedures are: low anterior resection with mechanical or manual colorectal anastomosis and transanal rectosigmiod resection with abdominoendoanal intubation. METHODS: We have conducted an observational, retrospective single-center study on a number of consecutive patients operated between January 1st and June 31st, 2011 for malign pathology of the middle and low rectum in The Clinical Emergency Hospital Bucuresti. We included patients with medium and low rectal cancer who had been previously treated by radiotherapy. We practiced rectal resection with mechanical colorectal anastomosis or abdominoendoanal intubation with anal mucous membrane removal. We assessed a number of parameters in relation to surgical procedure, such as: anastomosis dehiscence (AD), anastomotic stenosis (AS), the number of defecations in 24 hours, nocturnal incontinence, delayed bowel movement, flatulence continence, postoperative complications, local tumour recurrence and mortality. RESULTS: The study comprises 53 patients divided into 2 groups: the 1st group, included 19 patients treated by rectal resection with abdominoendoanal intubation and anal mucous membrane removal, and the 2nd group, included 34 patients treated by rectal resection with mechanical colorectal anastomosis. AD was found in 5.26% (1/19) in group 1, respectively 20.5% (7/34) in group nr 2. At 6 months follow-up, one patient from the 1st group experienced AS (5.26%), as for the 2nd group, AS was present in 5 patients (14.7%); at 12 months after the procedure the number of patients with AS increased to 3 in group 1 (15.78%) and to 6 in group 2 (17.64%) respectively. After 12 months, the nocturnal incontinence evaluated between 11.00 pm and 06.00 am: 3 patients from group 1 had 1 night evacuation daily, in all days of the week; 1 patient from group 2 presented 2 night evacuations on week. After 12 months postoperative: 11 patients, (57.89%) from group 1 had complete continence and also 29 patients (85.29%) from group 2. Patients from group 1: 36.36% (4/11) needed evacuation clysters’ and also 10.34% (3/29) for the group 2. In the case of group 1 mortality was 5.26% (1/19) and for group 2 was 8.82% (3/34). CONCLUSIONS: The intestinal transit disorders are quite frequent after colonal anastomosis.”Achilles heel” of mechanical anastomosis is represented by postanastomotical stenosis.

HOW TO CITE: Oprescu C?, Beuran M, Nicolau AE, Negoi I, Venter MD, Morteanu S, Oprescu-Macovei AM. [The place of mechanic sutures in medium and low rectal cancer]. Jurnalul de chirurgie (Iasi). 2013; 9(1): 29-34.
DOI: 10.7438/1584-9341-9-1-4.

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Jurnalul de chirurgie [Journal of Surgery] by Editorial Board, Department of Surgery University of Medicine and Pharmacy Iasi, E. Tarcoveanu, R. Moldovanu is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
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