Stapled hemorrhoidectomy is a safe and effective option in treating irreducible prolapsed piles. It is more expensive but less painful, with less time needed off work. Nonetheless, long-term results are still awaited.
Ingested FB perforation in the adult population is most commonly secondary to unconscious accidental ingestion and is frequently caused by dietary FBs especially fish bones. A preoperative history of FB ingestion is thus rarely obtained, although wearing dentures is a common risk factor. FB perforations of the stomach, duodenum, and large intestine tend to present with a longer, more innocuous clinical picture than perforations in the jejunum or ileum.
Laparoscopically assisted rectal resection is associated with a higher rate of male sexual dysfunction, but not bladder dysfunction, compared with the open approach. This has implications, particularly for sexually active males with bulky or low rectal cancers, when deciding the best operative approach.
A diverting stoma does not reduce postoperative anastomotic leak rate. Rather, it reduces the otherwise catastrophic effects of an anastomotic leak such as fecal peritonitis and septicemia. An ileostomy carries certain morbidity and also adds to the cost of the entire operation. Therefore, it should not be performed routinely. Instead, it should be performed selectively in patients with poorly prepared bowels, coupled with a distal limb washout, and in patients with significant comorbidities who can ill afford the complications of a leak.
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