The studies included in this review do not allow firm conclusions as to the question of whether the quality of life of people after anterior resection is superior to that of people after abdominoperineal excision. The included studies challenged the assumption that anterior resection patients fare better.Larger, better designed and executed prospective studies are needed to answer this question.
The studies included in this review do not allow firm conclusions as to the question of whether the quality of life of people after anterior resection is superior to that of people after abdominoperineal excision/Hartmann's operation. The included studies challenges the assumption that anterior resection patients fare better. Larger, better designed and executed prospective studies are needed to answer this question.
Aim Ileal pouch-anal anastomosis is a procedure offered to patients with ulcerative colitis who opt for restoration of bowel continuity. The aim of this study was to determine the risk of pouch failure and ascertain the risk factors associated with failure.
MethodThe study included 1991 patients with ulcerative colitis who underwent ileal pouch-anal anastomosis in Denmark in the period 1980-2013. Pouch failure was defined as excision of the pouch or presence of an unreversed stoma within 1 year after its creation. We used Cox proportional hazards regression to explore the association between pouch failure and age, gender, synchronous colectomy, primary faecal diversion, annual hospital volume (very low, 1-5 cases per year; low, 6-10; intermediate 11-20; high > 20), calendar year, laparoscopy and primary sclerosing cholangitis.Results Over a median 11.4 years, 295 failures occurred, corresponding to 5-, 10-and 20-year cumulative risks of 9.1%, 12.1% and 18.2%, respectively. The risk of failure was higher for women [adjusted hazard ratio (aHR) 1.39, 95% CI 1.10-1.75]. Primary nondiversion (aHR 1.63, 95% CI 1.11-2.41) and a low hospital volume (aHR, very low volume vs high volume 2.30, 95% CI 1.26-4.20) were also associated with a higher risk of failure. The risk of failure was not associated with calendar year, primary sclerosing cholangitis, synchronous colectomy or laparoscopy.Conclusion In a cohort of patients from Denmark (where pouch surgery is centralized) with ulcerative colitis and ileal pouch-anal anastomosis, women had a higher risk of pouch failure. Of modifiable factors, low hospital volume and non-diversion were associated with a higher risk of pouch failure.
Objective
To evaluate whether patients performing clean intermittent self‐catheterization (CISC) for a short period preferred a prelubricated, hydrophilic, disposable polyvinyl chloride (PVC) catheter or a non‐hydrophilic PVC catheter which could be used several times and that had to be lubricated by the patient.
Patients and methods
In a prospective cross‐over study, 32 patients used each type of catheter for 3 weeks. After each 3‐week period, the patients completed a questionnaire to assess comfort and preference, and urine specimens were obtained for culture.
Results
There was no significant difference between the groups in the frequency of CISC, discomfort when used, opinion on handling the catheters, preference toward one of the catheters, or of infection.
Conclusion
Non‐hydrophilic PVC catheters may be used safely and with no discomfort to the patient. In addition it may be possible for the healthcare system to save money, as the non‐hydrophilic PVC catheters are much cheaper.
Dome carcinoma may be more under-recognised than rare. The reporting of variants of colorectal carcinoma, displaying histological features suggestive of dome carcinoma, is encouraged in order to obtain more exact knowledge on its putative clinical significance.
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