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Register a new userIleal Pouch - Anal Anastomosis (IPAA) Study of 15 Cases
مفاغرة الجيب الدقاقي على الشرج: خبرة 15 حالة
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Added by
Damascus University ورقة بحثية
Publication date
2009
fields
Medicine
and research's language is
العربية
Authors
عبد الغني الشلبي( باحث )
Created by
Shamra Editor
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تقييم المعالجة الجذرية لآفات كولونية تترافق باحتمال خباثة مرتفع (داء البوليبات العائلي و التهاب الكولون القرحي) من خلال استئصال الكولون التام و تصنيع الجيب الدقاقي و مفاغرته على الشرج (IPAA) بحيث يتم المحافظة على السبيل الهضمي دون الضرورة لتحويل محتويات الأمعاء عبر جدار البطن.
Evaluation of radical surgical treatment of colonic lesions which have the potential for malignant transformation, namely familial adenomatous polyposis (FAP) and ulcerative colitis (UC), by performing total proctocolectomy with ileal pouch-anal anastomoses (IPAA). This technique helps preserving the continuity of the gastrointestinal tract without the need for external enteral diversion.
Artificial intelligence review:
Research summary
يهدف هذا البحث إلى تقييم العلاج الجراحي الجذري للآفات الكولونية التي تحمل احتمالاً عالياً للتحول الخبيث، مثل داء البوليبات العائلي والتهاب الكولون القرحي، من خلال استئصال الكولون التام وتصنيع الجيب الدقاقي ومفاغرته على الشرج (IPAA). شملت الدراسة 15 مريضاً خضعوا لهذه العملية في مستشفى الأسد الجامعي بين عامي 1998 و2004. كانت النتائج إيجابية بشكل عام، حيث لم تُشاهد أي حالة فشل جيب أو جيب غير وظيفي. بلغ متوسط عدد مرات التغوط 6 مرات نهاراً ومرة واحدة ليلاً، وكان الاستمساك النهاري والليلي تاماً في 80% و69% من المرضى على التوالي. شملت المضاعفات الحوضية الخراجات والتسريب من الخزان والتضيق الشرجي والتهاب الخزان، وكانت هناك حالة وفاة واحدة بسبب صمة رئوية. توصلت الدراسة إلى أن استئصال الكولون التام مع تصنيع جيب دقاقي ومفاغرته على الشرج يحافظ على وظيفة المعصرة الشرجية مع مضاعفات قليلة وتوصي بإجراء هذا النمط من الجراحة عند وجود الاستطبابات المحددة.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مفيدة في تسليط الضوء على فعالية وسلامة عملية مفاغرة الجيب الدقاقي على الشرج (IPAA) في علاج داء البوليبات العائلي والتهاب الكولون القرحي. ومع ذلك، هناك بعض النقاط التي يمكن تحسينها. أولاً، حجم العينة صغير نسبياً (15 مريضاً فقط)، مما قد يؤثر على تعميم النتائج. ثانياً، لم يتم التطرق بشكل كافٍ إلى المتابعة طويلة الأمد للمرضى بعد الجراحة، وهو جانب مهم لتقييم النتائج الوظيفية والجودة الحياتية على المدى الطويل. أخيراً، كان من الأفضل تضمين مجموعة مقارنة (مثل المرضى الذين خضعوا لطرق علاجية أخرى) لتعزيز قوة النتائج.
Questions related to the research
-
ما هو الهدف الرئيسي من الدراسة؟
الهدف الرئيسي من الدراسة هو تقييم العلاج الجراحي الجذري للآفات الكولونية التي تحمل احتمالاً عالياً للتحول الخبيث، مثل داء البوليبات العائلي والتهاب الكولون القرحي، من خلال استئصال الكولون التام وتصنيع الجيب الدقاقي ومفاغرته على الشرج (IPAA).
-
ما هي المضاعفات الأكثر شيوعاً التي تم رصدها في الدراسة؟
شملت المضاعفات الأكثر شيوعاً الخراجات الحوضية، التسريب من الخزان، التضيق الشرجي، التهاب الخزان، التهاب الجلد حول فغر الدقاق، التهاب الجلد حول الشرج، انسداد الأمعاء، عسرة التبول العابرة، وعدوى الجرح.
-
ما هو معدل الاستمساك النهاري والليلي بين المرضى بعد الجراحة؟
كان معدل الاستمساك النهاري تاماً في 80% من المرضى، بينما كان الاستمساك الليلي تاماً في 69% من المرضى.
-
هل كانت هناك أي حالات فشل جيب أو جيب غير وظيفي في الدراسة؟
لم تُشاهد أي حالة فشل جيب أو جيب غير وظيفي في الدراسة.
References used
Kelly KA. Anal sphincter-saving operations for chronic ulcerative colitis. Am J Surg. 1992; 163: 5-11
Setti-Carraro P, Ritchie JK, Wilkinson KH, et al. The first 10-years experience of restorative proctocolectomy for ulcerative colitis. Gut. 1994; 35: 1070-1075
Parc YR, Moslein G, Dozois RR, et al. Familial adenomatous polyposis: results after ileal pouch-anal anastomosis in teenagers. Dis Colon Rectum. 2000 Jul;43(7):893-8
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have been used with different success rates , including curett
age, trichloroacetic acid , and
cryotherapy .
All treatment modalities are associated with substantial pain, tissue destruction, and
frequent recurrence.
There are other modalities that can be applied by parents and less side effects , such as using
tretinoin and KOH .
In our study , we compare between KOH which dissolves keratin and penetrate deeply the
skin , and tretinoin which damages the viral protein – lipid membrane
Objective : To compare the efficacy and side effects of KOH 15% solution with tretinoin
0.05% cream for treatment of molluscum contagiosum .
Material and methods : Total 52 patients with molluscum contagiosum were enrolled in this
study, from 2013 to 2014 , from Dermatology Department of Al Assad University outpatients,
Lattakia .We have designed a questionnaire include personal factors In addition to the tables to
compare all of KOH (15%) solution and teritnoian (0.05%) cream in terms of effectiveness in the
treatment and side effects.
Results : Mail : female ratio was (1.48 : 1) , age onset was higher at first decade (67.3%).
The most common involved site was the trunk ( 42.3 %) .
Both of the study treatment regimens have advantage over other treatment options as they
are locally applicable , less traumatic and painful .
Because of these characteristics , they can be easily applicable for the treatment of
Molluscum Contagiosum .
During the treatment period , using KOH (15%) showed cure rate ( 75%) after two weeks of
treatment , while using tretinoin (0.05%) showed cure rate (20.8%) after two weeks, and most of
the patients need four weeks and even more
Conclusion : The result of both KOH and tretinoin showed good response , well tolerated by
children but between the two , KOH showed fast recovery and most lesions were resolved before 4
week . The side effects could be minimized if applied as stated above . On the other hand , tretinoin
showed delayed response and even some of lesion extended beyond 4 week but the side effect were
less , and hence can be used in recurrent cases.
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from (Promega, Madison, USA) according to manufacturer’s instructions
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Weinberg equilibrium predictions.
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Conclusion: Our Data may be a useful forensic tool which can be applied for identification purposes also in the Syria population.
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This study aimed to assess the rate
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The study was conducted on 1680 children. The sample was divided into four main groups, depending on the grade of severity of the dental caries. The analysis of data showed that the prevalence of dental caries was 67.1±1.92% and the DMFT value was 2.35. The study also showed that mother feeding, the factor of dental care and socioeconomical factors are important in all groups
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Conclusion: Surgery affords excellent long-term resolution of symptoms. Early diagnosis and surgery are imperative to reduce the long-termsequels.
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