PubMed Health⌕ Search

Biomedical subjects

J H Kuijpers

Publications and source records attributed to J H Kuijpers.

At least 19 recordsLinked to original sources
PubMed1992

Postoperative and long-term results of ileal pouch-anal anastomosis for ulcerative colitis and familial polyposis coli.

The immediate postoperative and long-term functional results of 51 ulcerative colitis patients and 21 familial polyposis patients who underwent ileal J-pouch-anal anastomosis were compared in this study. The incidence of postoperative complications requiring reoperation was not statistically different in both groups. The mean daily stool frequency was significantly higher in colitis patients. Pouchitis occurred in 44% of colitis patients but not in polyposis patients (P < 0.005). Symptoms of pouchitis included bloody diarrhea, urgency, abdominal pain, weight loss, fever, and arthritis. Six colitis patients required pouch excision because of intractable pouchitis. The overall pouch excision rate was 22% in ulcerative colitis patients and 5% in familial polyposis patients. Patient satisfaction was good in 46% of ulcerative colitis patients and 76% of polyposis patients (P < 0.05). Our data demonstrate that the long-term outcome of ileal pouch-anal anastomosis is more favorable in polyposis patients than in colitis patients. Pouchitis is a major long-term complication occurring exclusively in colitis patients.

Adenomatous Polyposis Coli↗
PubMed1991

Functional constipation: results of application of the colorectal laboratory.

Constipation and defaecation may be considered as the last taboo. The inability of defaecate or to achieve this only by digital evacuation has never been a popular topic among patients and doctors. Application of tests from the colorectal laboratory has made it possible to study the function of the different parts of the colon and the mechanism of continence. Two types of constipation can be distinguished: I slow transit, which is probably a systemic disease, and 2 functional colonic outlet obstruction due to abnormal pelvic floor function during defaecation straining, which is likely to be a behavioural disorder. Since 30 per cent of the patients with constipation have a normal total colonic transit time, constipation is not merely related to a low frequency of defaecation, but should be defined as a difficult and painful rectal evacuation which may even be impossible over several days.

Anal Canal↗
PubMed1991

Non-surgical treatment for constipation in adults: the place of biofeedback.

The treatment of slow-transit constipation consists of dietary measures combined with a regime of laxatives and enemas. Surgery should only be considered when intractable constipation persists despite these measures. Results, however, are moderate. Functional outlet obstruction, the spastic pelvic floor syndrome, is caused by an abnormal use of a normal pelvic floor muscle. Procedures aiming at weakening pelvic floor function give no long-term good results and may lead to faecal incontinence. Biofeedback treatment, relearning normal muscle function by monitoring pelvic floor EMG and simulating defaecation, gives excellent results.

Anal Canal↗
PubMed1990

Obstetric fecal incontinence. Role of pelvic floor denervation and results of delayed sphincter repair.

During the last five years, 37 patients with fecal incontinence because of childbirth have been investigated. Ages varied from 22 to 62 years and duration of symptoms from 0.3 to 26 years. Anal manometry was performed in all patients and electromyography was performed in 24 patients. Thirty patients underwent delayed sphincter repair. In all patients, a dehiscence was found anteriorly, bridged by scar tissue. Continence was restored in 25 patients (83 percent). Electromyography was performed postoperatively in patients who remained incontinent and who demonstrated severe denervation. All these patients had undergone previous sphincter repair. In seven patients, there were no signs of obstetric injury. Electromyography demonstrated severe denervation, but sphincter mapping did not demonstrate muscle discontinuity. Continence improved in four patients within one year as a result of reinnervation demonstrated by electromyography. The authors conclude that fecal incontinence after childbirth may be due to either obstetric rupture or denervation. Both disorders may coexist. Delayed sphincter repair gives excellent results provided that denervation is not present. Preoperative assessment with electromyography is mandatory.

Adult↗
PubMed1989

Treatment of complete rectal prolapse with foreign material.

The results of treatment of complete rectal prolapse with Teflon mesh repair are described in 64 patients. Adequate fixation by posterior rectopexy was reached in all patients. In 23 per cent of the patients postoperative constipation was noticed that could adequately be managed with laxatives in most instances. After a mean follow-up of 30 months, none of the patients had complete recurrences. Four patients had new complaints of prolapse. These complaints were two times based on haemorrhoids, two other patients had a small mucosal prolapse. Modified Teflon mesh repair is recommended as a safe method to manage rectal prolapse with a high rate of success.

Adolescent↗
PubMed1988

Toward a selection of the most appropriate procedure in the treatment of complete rectal prolapse.

Defecographic evaluation was performed in 30 patients with rectal prolapse to assess the effect of posterior rectopexy on rectal function and to arrive at a selection of the best procedure. Preoperative defecography revealed rectal intussusception in all patients. Postoperative control studies showed adequate rectal fixation to the anterior sacral surface. Intussusception no longer occurred. Rectal stenosis due to the surgical procedure was absent. The described technique of posterior rectopexy eliminates the prolapse mechanism without creating new disorders and is therefore a rational procedure. Advocation of new procedures should also be based on results of colorectal tests that assess the effect of the procedures on rectal function.

Adult↗