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E Max

Publications and source records attributed to E Max.

16 recordsLinked to original sources
PubMed1999

Single-layer continuous colon and rectal anastomosis using monofilament absorbable suture (Maxon): study of 500 cases.

PURPOSE: The study purpose was to evaluate the results of continuous, single-layer colon and rectal anastomoses using a monofilament absorbable suture material (Maxon). METHODS: Four hundred ninety-two consecutive patients undergoing five hundred colon and rectal anastomoses with the above technique were evaluated for outcome, including anastomotic leakage, stricture, and other complications, by means of chart review. RESULTS: Three patients (0.6 percent) died after surgery and 7 (1.4 percent) developed clinical evidence of anastomotic leakage. Twenty-four percent developed some postoperative complications, most of which were minor. CONCLUSIONS: Continuous, single-layer colorectal anastomosis using monofilament absorbable suture can be performed safely, quickly, and with a favorable cost ratio. Handsewn anastomoses should still be part of the armamentarium of the well-trained surgeon.

Absorbable Implants↗
PubMed1994

Ambulatory surgical hemorrhoidectomy--a solution to postoperative urinary retention?

PURPOSE: The most frequent complication of surgical hemorrhoidectomy is urinary retention. This study evaluates the incidence of urinary retention in a series of patients undergoing surgical hemorrhoidectomy in an ambulatory setting. METHODS: The records of all patients undergoing anorectal surgical operative procedures during the calendar year 1990 were reviewed, with particular emphasis on urinary retention and other postoperative complications. RESULTS: Of 201 patients undergoing full surgical hemorrhoidectomy by Colon and Rectal Clinic, 91 percent had operations performed on an ambulatory basis (discharge less than four hours following surgery). Of these 190 patients, only 1 (0.53 percent) required urinary catheterization during the postoperative period. CONCLUSIONS: The ambulatory setting, when combined with careful patient education and perioperative fluid restriction, allows surgical hemorrhoidectomy to be performed with a very low incidence of urinary retention to the benefit of both patient and surgeon.

Adult↗
PubMed1992

Heterotopic bone formation in rectal carcinoma. Case report and literature review.

A case of heterotopic bone formation in a primary rectal adenocarcinoma was recently observed in a 54-year-old woman. This unusual finding was present both in the diagnostic biopsy and in the subsequently resected bowel. Pertinent gross and microscopic features are presented. This report represents the twelfth case in the literature of heterotopic bone formation in a primary rectal adenocarcinoma and the first such finding in a colonic biopsy from one of these malignancies. The average age of these patients was 56 years (range 32-72) and the male-to-female ratio was 5:7. The rectum is the most common site of ossification in the gastrointestinal tract. The exact mechanism of heterotopic ossification is unknown, but it is probably the result of metaplasia of fibroblasts. Adenocarcinoma has been associated with 12 of the 16 reported cases of rectal glandular tumors with heterotopic bone.

Adenocarcinoma↗
PubMed1992

Local excision of carcinoma of the rectum for cure.

During the past 10 years, we have treated 63 patients with invasive adenocarcinoma of the rectum by full-thickness local excision. Rigid criteria were employed in patient selection. None of the tumors was pedunculated or in situ carcinoma. Of the 63 lesions, 53 were confined to the bowel wall and constitute the basis for this report. Thirty-five lesions penetrated only the submucosa and 18 invaded the muscularis propria. Twenty-four patients underwent full-dose postoperative radiotherapy with minimal complications. Follow-up ranged from 12 to 130 months, with a median of 44 months. Four tumors recurred locally (8%). Of these, two patients apparently have been salvaged by reexcision. One patient died 32 months after abdominoperineal resection of brain metastases (without local tumor). One patient who did not receive close follow-up died of local recurrence. Seven have died of unrelated causes. The 5-year corrected disease-free survival is 90%. Local excision combined with radiotherapy for selected rectal cancers yields a high rate of cure with minimal morbidity and is now our preferred mode of treatment for all patients whose tumors meet our rigid criteria.

Adenocarcinoma↗
PubMed1991

Results of 1,000 single-layer continuous polypropylene intestinal anastomoses.

Between 1979 and 1988, we created intestinal anastomoses in 1,000 patients using a single-layer, continuous suturing technique and a polypropylene suture. The technique is easily learned, flexible in its application, and incurs less cost than most other techniques. The anastomoses involved all levels of the colon and the upper (intraperitoneal and extraperitoneal) rectum. All patients were followed for a minimum of 1 year. The clinically suspected anastomotic leak rate was 1%. Other morbidity included would complications (2%), obstruction of the small intestine (2%), anastomotic stricture (1%), and death (1%). No death was due to anastomotic complications. These rates of complications are comparable with, and in many instances lower than, those reported with other techniques of intestinal anastomosis.

Adolescent↗
PubMed1989

Productivity loss due to deformity from leprosy in India.

The productivity loss in India due to deformity from leprosy was assessed in a random sample of 550 leprosy patients from a rural and an urban area in the state of Tamil Nadu. Logistic and log-linear regression analyses on these leprosy patients showed that elimination of deformity would: a) raise the probability of gainful employment from 42.2% to 77.6%; b) increase annual earnings per patient gainfully employed from Rs 2948 to Rs 6469; and c) raise overall earnings for all patients from Rs 1259 to Rs 5023 per year. The earnings of 550 control subjects (adult family members of the leprosy patients) were consistent with these predictions. Extrapolation to all of India's estimated 645,000 leprosy patients with deformity suggests that elimination of deformity would raise productivity by +130 million per year. The authors conclude that the development and evaluation of programs to eliminate deformity from leprosy deserve high priority.

Disability Evaluation↗
PubMed1988

The single-layer continuous polypropylene colon anastomosis. A prospective assessment using water-soluble contrast enemas.

Fifty consecutive unselected patients with anastomoses to the left side of the colon were studied. Each patient had an anastomosis constructed with a single layer of continuous 4-0 polypropylene. On the seventh postoperative day, or sooner, a water-soluble contrast enema was obtained to evaluate the integrity of the anastomosis. Two patients developed radiographic and clinical evidence of anastomotic leakage, and one patient developed a late pelvic abscess and colocutaneous fistula. The documented leak rate of 6 percent attests to the safety of this method of colonic anastomosis.

Adult↗
PubMed1987

Metabolic changes during the defunctionalized stage after ileal pouch-anal anastomosis.

Metabolic changes between the preoperative period and the defunctionalized stage after ileal pouch-anal anastomosis were investigated in 21 patients. Aspects studied included weight change, renal function, liver function, lipid metabolism, and two hematologic parameters. Of 21 patients, 19 lost weight. Cholesterol levels decreased from 183 +/- 30 IU/1 to 122 +/- 48 IU/1 (P less than .0001). Triglyceride levels rose from 95 +/- 29 IU/1 to 190 +/- 86 IU/1 (P less than .01). Significant elevations were seen in values of four liver function tests: SGOT, SGPT, lactic dehydrogenase, and alkaline phosphatase (P less than .05). Blood urea nitrogen levels increased from 11.1 +/- 4.7 mg/100 ml to 21.8 +/- 24.8 mg/100 ml (P less than .05). Serum creatinine levels rose from 0.97 +/- .18 mg/100 ml to 1.5 +/- 1.2 mg/100 ml (P less than .05). Uric acid levels increased from 5.6 +/- 1.8 mg/100 ml to 7.5 +/- 2.3 mg/100 ml (P less than .001). Hemoglobin values did not change significantly. Platelet counts rose from 304,000 +/- 79,000 to 447,800 +/- 189,000 (P less than .05). Identification of these systematic alterations in metabolic parameters during the defunctionalized stage can aid the physician in management of these patients.

Adenomatous Polyposis Coli↗
PubMed1984

Single-layer polypropylene colorectal anastomosis. Experience with 100 cases.

The technique of single-layer continuous polypropylene colorectal anastomosis is described. The authors' experience with their initial 100 cases is analyzed in detail. No clinical leaks or anastomotic strictures were noted in a two-year follow-up period. The technique is safe, easily learned, rapidly performed, and it does not add significantly to the cost of medical care. The authors' total experience with this anastomosis now exceeds 350 cases.

Adolescent↗
PubMed1981

Single-layer continuous colorectal anastomosis.

Since the first successful resection of a colonic neoplasm was carried out in 1823, many attempts have been made to find the ideal technique for bowel anastomosis, in respect both of the surgical technique employed and the suture material used. We have finally adopted a single layer anastomosis with a continuous polypropylene suture. To out knowledge, no series of such anastomoses has so far been reported, and we now review our technique, first described by Allen in 1979, and our very satisfactory experiences following our adoption of it for virtually all colorectal anastomoses above the peritoneal reflection.

Adolescent↗