Biomedical subjects
Publications and source records attributed to G Maskow.
The authors describe the surgical technique and results of knot sutures in 129 patients. The principle of this operation can be compared with sclerotization. It is a relatively sparing method which can be used also in ambulatory treatment. There were no serious complications, relapses were observed in three patients.
The authors elaborated a method of rectoanal perfusion manometry as part of the objective examination of the functional state of continence structures. They describe in detail the examination method and manometric equipment. In a group of 10 volunteers, 8 incontinent patients and 23 subjects after operations causing improved continence they draw attention to the great sensitivity and specificity of the examination as well as to the correlation of manometric results with results of Holschneider's evaluation by a point system. This method should be used in departments concerned with rectoanal surgery.
Retrospective analyses were made of 171 of 200 patients on whom operations had been performed for anorectal abscesses and fistulas, between 1981 and 1985. For abscess exposure and deroofing, we tried to perform simultaneous fistulotomy, with no recurrence being recorded from 37 patients treated that way. The major courses of anorectal fistulas proved to be predictible in most cases. Surgical approach and postoperative management are described in some detail. Clinical records were evaluated together with a questionnaire, with particular reference being made to the type of fistula, susceptibility to recurrence, faecal continence as well as length of hospitalisation and certified absence from work.
Reported in this paper is the use of staplers in gastro-intestinal surgery. Three soviet-made types of staplers, UO 40/60, NShKA, and SPTU (comparable to TA 30/55/90, GIA, and EEA) were used on the upper part of the gastro-intestinal tract in 237 cases and in colorectal surgery on 66 patients. The UO stapler worked well, when used for closure of uncomplicated duodenal stumps, though no absolute indication can be claimed for such application. The SPTU type, on the other hand, proved to be an ideal solution in cases of oesophago-jejunostomy with intrathoracic localisation of the anastomosis. Another, nearly absolute indication for the use of the SPTU can be claimed for anterior rectum resection (especially in male patients) with narrow pelvis and tense pelvic floor.
A case of endometriosis of the large intestine is reported in a 41 years old woman. The endometrioma involved the Bauhin-valve, the distal ileum and the right adnexa. The symptoms and signs were thought of a caecal carcinoma causing a mechanical ileus. The morphologic aspects and the management of the diagnostic and therapeutic procedure are discussed with respect to the endometriosis of the intestine.
43 patients suffering from anal incontinence underwent surgical correction. The late results up to 14 years after surgery are described. Continence was evaluated by inquiries and by manometric readings of the recto-anal stress profile. Prevailing surgical procedures were reconstruction of the anal sphincter (n = 23) and pedicled transplantation of the M. gracilis (n = 10). Both methods yielded satisfactory late results.
Complex radiologic examination comprises tomography and fistulography as well as arteriography and phlebography. This programme can be extended by intraarterial perfusion scintigraphy, 133Xe-muscle clearance as well as quantified bone scintigraphy using 99m-TC-diphonate.
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