A generally accepted explanation for the etiology of anorectal abscess and fistula-in-ano is that the abscess results from obstruction of an anal gland and the fistula is due to chronic infection and epithelialization of the abscess drainage tract. Anorectal abscesses are defined by the anatomic space in which they develop and are more common in the perianal and ischiorectal spaces and less common in the intersphincteric, supralevator,and submucosal locations.

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Diverting ileostomy in colorectal surgery: when is it necessary?

“The role of fecal diversion using a loop ileostomy in patients undergoing rectal resection and anastomosis is controversial. There has been conflicting evidence on the perceived benefit vs. the morbidity of a defunctioning stoma. This is a review of the relevant surgical literature evaluating the risks, benefits, and costs of constructing a diverting ileostomy in current colorectal surgical practice”

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Diverting Ostomy: For Whom, When, What, Where, and Why

“Fecal diversion is an important tool in the surgical armamentarium. There is much controversy regarding which clinical scenarios warrant diversion. Some of the most common applications for the use of a diverting stoma include construction of diverting ileostomy or colostomy, ostomy for low colorectal/coloanal anastomosis, inflammatory bowel disease, diverticular disease, and obstructing colorectal cancer with the conclusion that diverting loop ileostomy is preferred to loop colostomy” (Plasencia)

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The Landmark Series: Pancreatic Neuroendocrine Tumors

“Pancreatic neuroendocrine tumors (PNETs) comprise a heterogeneous group of neoplasms arising from pancreatic islet cells that remain relatively rare but are increasing in incidence worldwide. While significant advances have been made in recent years with regard to systemic therapies for patients with advanced disease, surgical resection remains the standard of care for most patients with localized tumors. Although formal pancreatectomy with regional lymphadenectomy is the standard approach for most PNETs, pancreas-preserving approaches without formal lymphadenectomy are acceptable for smaller tumors at low risk for lymph node metastases.”

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Management of Iatrogenic Cervical Esophageal Perforations

“Esophageal perforations are difficult to diagnose and have a high mortality rate. The existing studies on esophageal perforations address treatment by anatomic location and by cause, but few focus specifically on iCEPs. The management of iCEPs is controversial. There is a need for additional prospective studies comparing treatment options for iCEPs to establish a gold standard treatment and to assess for the expanding role of endoscopic interventions.” (Chen)

(Chen)
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Salvage rate of infected prosthetic mesh

“Mesh properties and position within the abdominal wall are the primary determinants in the ability to salvage mesh in the event of PMI. Mesh placed in an intraperitoneal position is rarely salvageable. Similarly, microporous, multifilament, and composite mesh constructs required complete mesh removal in most cases. However, macroporous, monofilament PP mesh in an extraperitoneal position can be salvaged in 72.2% of cases, positively impacting both the need for reoperation for mesh removal and subsequent hernia
recurrence.” (Warren)

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