INTERSPHINCTERIC PROCTECTOMY PDF

Although described several times since , intersphincteric proctectomy is a technique used by very few surgeons in the United States. Accurate and safe rectal mobilization is easily accomplished by dissection within the intersphincteric plane, resulting in minimal damage to the pelvic floor and pelvic nerves and a much smaller perineal wound. The records of 58 patients who underwent rectal excision were examined. Proctectomy was performed in a conventional fashion for 30 patients and an intersphincteric proctectomy was performed for 28 patients. Of the 30 conventional procedures, 20 were for ulcerative colitis and 10 were for Crohn's disease. There were four residual deep sinus tracts.

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Although described several times since , intersphincteric proctectomy is a technique used by very few surgeons in the United States. Accurate and safe rectal mobilization is easily accomplished by dissection within the intersphincteric plane, resulting in minimal damage to the pelvic floor and pelvic nerves and a much smaller perineal wound.

The records of 58 patients who underwent rectal excision were examined. Proctectomy was performed in a conventional fashion for 30 patients and an intersphincteric proctectomy was performed for 28 patients.

Of the 30 conventional procedures, 20 were for ulcerative colitis and 10 were for Crohn's disease. There were four residual deep sinus tracts. Of the 15 men, three developed impotence, one permanently. Of the 28 patients who underwent intersphincteric proctectomy, 17 had ulcerative colitis, eight had Crohn's disease, two had incapacitating proctitis, and one had cancer of the midrectum.

There were no residual deep sinus tracts. Of the 15 men, one developed impotence that resolved after 1 year. Only one patient complained of persistent anal discomfort. The morbidity rate from intersphincteric proctectomy is low and we recommend more widespread use of this technique. This site needs JavaScript to work properly. Please enable it to take advantage of the complete set of features!

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Send even when there aren't any new results. Optional text in email:. Save Cancel. Create a file for external citation management software Create file Cancel. Cite Favorites. Similar articles Perineal wound morbidity following proctectomy for inflammatory bowel disease IBD. Adam, Shorthouse. Adam, et al. Colorectal Dis. PMID: Cleft closure for the treatment of unhealed perineal sinus. Branagan G, et al. Transanal endoscopic microsurgery: a new technique for completion proctectomy.

Liyanage C, et al. Ann Urol Paris. PMID: Review. Gambiez L, et al. Ann Chir. Show more similar articles See all similar articles. Cited by 9 articles Intersphincteric proctectomy for rectal mucocele in a Crohn's patient with anal stenosis. A case report and review of literature. Draeger TB, et al.

Int J Surg Case Rep. Epub Feb 3. Healing of the perineal wound after proctectomy in Crohn's disease patients: only preoperative perineal sepsis predicts poor outcome. Li W, et al. Tech Coloproctol. Epub Oct Transanal minimally invasive surgery for total mesorectal excision TAMIS-TME : a stepwise description of the surgical technique with video demonstration. Atallah S, et al.

Epub Feb 2. Management of nonhealing perineal wounds. Genua JC, et al. Clin Colon Rectal Surg. Persistent perineal sinus: incidence, pathogenesis, risk factors, and management. Lohsiriwat V. Surg Today. Epub Mar Show more "Cited by" articles See all "Cited by" articles.

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Functional and oncologic results after intersphincteric proctectomy?

Correspondence Address : Dr. Background: The role of intersphincteric proctectomy in low rectal cancer remains controversial. Objective: To compare the perioperative and oncologic outcomes of intersphincteric proctectomy to proctectomy with stapled coloanal anastomosis. Design: A retrospective case-matched review. Setting: A tertiary colorectal surgery unit. Patients and Methods: All intersphincteric proctectomy cases conducted by one surgeon over a 7-year period were matched for gender, race, age, and comorbidities with patients who underwent proctectomy with stapled coloanal anastomosis. Main Outcome Measures: Operative time, blood loss, postoperative complications, length of stay, margin status, lymph node harvest, and local recurrence rate.

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Intersphincteric Proctectomy

Anthony de Buck van Overstraeten, Albert M. Background: Perianal Crohn's disease CD represents a more aggressive phenotype of inflammatory bowel disease and often coincides with proctocolitis. This study aims to assess the outcome of patients undergoing proctectomy with end-colostomy. Methods: A retrospective outcome analysis of 10 consecutive patients who underwent intersphincteric proctectomy with end-colostomy between February and May was performed. All patients suffered from refractory distal and perianal CD. The proximal colon was normal at endoscopy. All data were extracted from a prospectively maintained database.

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