• Title/Summary/Keyword: Rectosigmoid

Search Result 38, Processing Time 0.022 seconds

Is Rectosigmoid Vaginoplasty Still Useful?

  • Kim, Seok-Kwun;Park, Ji-Woen;Lim, Kwang-Ryeol;Lee, Keun-Cheol
    • Archives of Plastic Surgery
    • /
    • v.44 no.1
    • /
    • pp.48-52
    • /
    • 2017
  • Background The ideal vaginoplasty must be successful functionally as well as have a natural appearance, and also must retain its functionality and appearance over the long term. Conventional vaginoplasty techniques have functional limitations and are associated with recurrent complications, but rectosigmoid vaginoplasty is known to have a high satisfaction rate due to its functional similarity with the vagina. We conducted the present study to assess the usability of rectosigmoid vaginoplasty over the course of long-term follow-up. Methods From March 1992 to February 2014, 84 patients were treated with rectosigmoid vaginoplasty; 44 had gender identity disorder, 29 had vaginal agenesis, 8 had female pseudohermaphroditism, and 3 had gynecologic malignancies after radical pelvic surgery. This retrospective study was based on a review of the patients' records, clinical examinations, complications, and questionnaires about appearance, function, and sexual intercourse. Results All patients who underwent rectosigmoid vaginoplasty were discharged within 2 weeks without surgical flap loss. The early complications were partial flap necrosis, difficulty in defecation, mucous hypersecretion, and postoperative ileus. The late complications were vaginal introitus contracture, vaginal prolapse, and difficulty in urination. The mean length and diameter of the neovagina 3.4 years after rectosigmoid vaginoplasty were 13.2 cm and 3.8 cm, respectively. On questionnaires about satisfaction, 70% of patients reported excellent satisfaction, 11% good, 12% fair, and 7% poor. Conclusions Rectosigmoid vaginoplasty is useful, safe, and well-accepted operative method with good functional and cosmetic results, such as natural lubrication and adequate vaginal length and width obtained without requiring the use of a dilator.

Laparoscopic-Assisted Transanal Endorectal Pull-Through for Segmental Dilatation of Rectosigmoid Colon in a Child (소아에서 발생한 직장구불결장의 분절확장에 대한 Laparoscopic-Assisted Transanal Endorectal Pull-Through 술식)

  • Park, Ji Young;Park, Jinyoung
    • Advances in pediatric surgery
    • /
    • v.19 no.2
    • /
    • pp.156-161
    • /
    • 2013
  • Congenital segmental dilatation of the colon is a very rare entity of unknown etiology, characterized by a localized dilatation of a bowel segment of the colon of variable length and an abrupt transition between the normal and dilated intestine. It can affect any part of the colon, with the rectosigmoid colon being the most commonly affected site. The clinical and radiological features may resemble that of Hirschsprung disease, but differ in that the normal ganglion cells are found in the dilated and normal segment of the colon. We performed laparoscopic-assisted transanal endorectal pull-through for segmental dilatation of rectosigmoid colon in an 8-year-old boy with chronic constipation since the age of 5 months.

Morphologic change of rectosigmoid colon using belly board and distended bladder protocol

  • Cho, Yeona;Chang, Jee Suk;Kim, Mi Sun;Lee, Jaehwan;Byun, Hwakyung;Kim, Nalee;Park, Sang Joon;Keum, Ki Chnag;Koom, Woong Sub
    • Radiation Oncology Journal
    • /
    • v.33 no.2
    • /
    • pp.134-141
    • /
    • 2015
  • Purpose: This study investigates morphologic change of the rectosigmoid colon using a belly board in prone position and distended bladder in patients with rectal cancer. We evaluate the possibility of excluding the proximal margin of anastomosis from the radiation field by straightening the rectosigmoid colon. Materials and Methods: Nineteen patients who received preoperative radiotherapy between 2006 and 2009 underwent simulation in a prone position (group A). These patients were compared to 19 patients treated using a belly board in prone position and a distended bladder protocol (group B). Rectosigmoid colon in the pelvic cavity was delineated on planning computed tomography (CT) images. A total dose of 45 Gy was planned for the whole pelvic field with superior margin of the sacral promontory. The volume and redundancy of rectosigmoid colon was assessed. Results: Patients in group B had straighter rectosigmoid colons than those in group A (no redundancy; group A vs. group B, 10% vs. 42%; p = 0.03). The volume of rectosigmoid colon in the radiation field was significantly larger in group A (56.7 vs. 49.1 mL; p = 0.009). In dose volume histogram analysis, the mean irradiated volume was lower in patients in group B (V45 27.2 vs. 18.2 mL; p = 0.004). In Pearson correlation coefficient analysis, the in-field volume of rectosigmoid colon was significantly correlated with the bladder volume (R = 0.86, p = 0.003). Conclusion: Use of a belly board and distended bladder protocol could contribute to exclusion of the proximal margin of anastomosis from the radiation field.

The Effects of Acupuncture(ST36. LI4) on the Colonic Transit Time in Chronic Constipation Patients

  • Lee Un Jung;Kim Dong Woung
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.17 no.1
    • /
    • pp.251-257
    • /
    • 2003
  • Background and Purpose : We were to investigate whether simple and electric acupuncture can affect the colonic transit time in both normal persons and chronic constipation patients. Methods: Twenty one volunteers were divided into two groups; first, normal control group(N=12) who had normal defecation habits, second, chronic constipation group(N=13). Before acupuncture, colonic transit time was checked using radio-opaque markers. Then simple acupuncture was done at four acupoints(both ST36, LI4) and maintained for 15 minutes during 4 days. Electric acupuncture was done using same methods except for applying 2Hz electrical stimulation. Result : In the normal group, after simple acupuncture, each transit time in the total, right, left was not changed statistic significance compared to pre-acupuncture(P>0.05), but which of rectosigmoid colon shortened statistic significance(P<0.05). After Electric acupuncture, transit time of right colon was shortened(P<0.05), and extended(P>0.05) in rectosigmoid colon compared to pre-acupuncture and simple acupuncture. In constipation group, after simple acupuncture, only rectosigmoid colonic transit time shortened statistic significance compared to pre-acupuncture(P<0.05). After electric acupuncture, also the transit time of rectosigmoid colon was shortened statistic significance compared to pre-acupuncture(P<0.05), but not to simple acupuncture(P>0.05). Conclusion : In normal persons without constipation, acupuncture affect the colonic transit time differently to the methods of it. In chronic constipation group, simple and electric acupuncture only reduces the rectosigmoid colonic transit time statistically significant(P<0.05).

Vaginal Reconstruction with Laparoscopic-perineal Rectosigmoid Colpopoiesis in Mayer-Rokitansky-Kuster-Hauser Syndrome: A Case Report (Mayer-Rokitansky-Kuster-Hauser 증후군 환자에서 회음부 복강경하 직결장질성형술을 이용한 질의 재건: 증례보고)

  • Bae, Sung-Gun;Lee, Sang-Yun;Cho, Byung-Chae;Choi, Kyu-Seok
    • Archives of Plastic Surgery
    • /
    • v.38 no.3
    • /
    • pp.333-337
    • /
    • 2011
  • Purpose: Various operations have been proposed to compensate for congenital absence of the vagina using ileal or colonic interposition. These methods involve laparotomy, which shows postoperative complications such as long scar and delayed recovery. One case of neovagina reconstruction with laparoscopic rectosigmoid colpopoiesis in Mayer-Rokitansky-Kuster-Hauser syndrome is presented to avoid laparotomic complications. Methods: Laparoscopic surgery was performed in a 27-year-old MRKH syndrome patient. After a cruciate incision, blunt dissection through two-finger wide space was created between the bladder and the rectum. A 14-cm rectosigmoid segment vascularized by a branch of sigmoid artery was isolated by laparoscopy. The distal end was sutured with vaginal vestibule mucosa. A continuity of intestine was restored by circular end-to-end proximate curved intraluminal stapler CDH29$^{(R)}$ through perineal opening. Results: Total operation time was 4 hr 15 min. Normal walking and ingestion were possible within 3 days and 4 days after surgery. The hospital stay was 7 days and the patient was followed up for 6 months. The neovaginal introitus was wide enough for inserting two fingers, and there has been no narrowing of the neovagina on palpation as confirmed by vaginogram. The patient had functional self-lubricating neovagina without excessive mucous production or the need for routine dilation or unnoticeable scar. Conclusion: The successful result of this laparoscopic vaginal reconstruction technique with rectosigmoid segment suggests that this technique can be considered for the option of vaginal reconstruction in girls with the MRKH syndrome.

Diffuse Cavernous Hemangioma of the Rectosigmoid Colon - a Case Report - (범발성 해면상 S-결장 및 직장 혈관종 -1 예 보고-)

  • Park, Yong-Geun;Chung, Jae-Hee;Song, Young-Tack
    • Advances in pediatric surgery
    • /
    • v.9 no.2
    • /
    • pp.121-124
    • /
    • 2003
  • Diffuse cavernous hemangioma of the rectosigmoid is a rare lesion usually presented in children and young adult, often with life threatening hemorrhage. The clinical diagnosis is difficult and often delayed because of lack of awareness of the clinical features. We report a case of diffuse cavernous hemangioma of the rectosigmoid in a 12 year old boy who had undergone suture ligation under the impression of hemorrhoid at his age 3. Sphincter saving coloanal pull through procedure were applied as the surgical treatment. Sclerotherapy was needed with recurrent rectal bleeding 6 months after the pull through operation. The patient is well at 12 months follow-up.

  • PDF

Effect of an Aqueous Extract of Poncirus trifoliate (L.) Raf. in Stroke Patient with Constipation (뇌졸중환자의 변비에서 지실 열수 추출물의 효과)

  • Moon, Hyo Jeong;Lee, Su Kyung;Noh, Se Eung;Joo, Min Cheol
    • Journal of Korean Medicine Rehabilitation
    • /
    • v.26 no.2
    • /
    • pp.97-103
    • /
    • 2016
  • Objectives To evaluate the effects and safety of the aqueous extract of the dried, immature fruit of Poncirus trifoliate (L.) Raf. (Rutaceae) (PF) in stroke patients with constipation. Methods A total of 22 patients were recruited. Patients were interviewed about the clinical informations, constipation score and Bristol stool form scale at twice, before intake PF and after intake PF 2 weeks. The total and segmental colon transit time (CTT) were measured by using radio-opaque markers (Kolomark$^{(R)}$). The degree of stool retention was evaluated by the plain abdominal radiography and was scored by Leech score. Results Before intake PF, constipation scores ranged from 3 to 12, average $6.54{\pm}2.87$ and Bristol stool form scale ranged from 1 to 6, average $3.86{\pm}1.21$. CTTs were $9.05{\pm}6.89hours$, $14.29{\pm}10.68hours$, $12.11{\pm}7.19hours$ and $35.40{\pm}19.5hours$ in the right, left, rectosigmoid and total colon, respectively. Stool retention score was $2.45{\pm}0.61$, $2.3{\pm}0.86$, $1.9{\pm}0.85$, $6.65{\pm}1.56$ in the right, left, rectosigmoid and total colon, respectively. After 2 weeks, constipation scores ranged from 2 to 8, average $4.28{\pm}2.05$ and Bristol stool form scale ranged from 1 to 6, average $4.17{\pm}1.04$. CTTs were $7.41{\pm}8.86hours$, $11.12{\pm}9.12 hours$, $8.83{\pm}8.75hours$ and $27.3{\pm}20.2$ hours in the right, left, rectosigmoid and total colon, respectively. Stool retention score was $1.9{\pm}0.64$, $2.2{\pm}0.69$, $1.4{\pm}0.88$, $5.5{\pm}1.39$ in the right, left, rectosigmoid and total colon, respectively. There were statistically significant difference in the total and rectosigmoid colon CTT and constipation score, Stool retention score in right and rectosigmoid colon (p<0.05) after PF therapy. Conclusions These results suggest potential for PF therapy in stroke patient with constipation.

A case report of inoperable rectosigmoid colon cancer treated with standardized Allergen-removed Rhus verniciflua Stokes Extract (수술이 힘든 고령의 직장-S상결장암 환자에 대한 알러젠 제거 옻나무 추출물 위주의 한방치료 1례)

  • Kwon, Eun-Mi;Jeong, Yee-Hong;Kim, Kyung-Suk;Jung, Hyun-Sik;Cheon, Seong-Ha;Eo, Wan-Kyu;Choi, Won-Cheol;Lee, Sang-Hun
    • Journal of Korean Traditional Oncology
    • /
    • v.15 no.1
    • /
    • pp.63-69
    • /
    • 2010
  • We report a case of an 85-year old man with an adenocarcinoma of the rectosigmoid colon (clinical stage II). Though tumor was resectable, the patient was considered to be inoperable because of old age and comorbidities such as asthma, diabetes and old myocardial infarction. He wanted to receive alternative care, so he was exclusively treated with standardized Allegern-removed Rhus verniciflua Stokes (aRVS) extract and other herbal medicine such as BOJUNGIKGI-TANG GAMIBANG. During 18 months, he has shown good performance status without transfusion. This report suggests that herbal treatment including standardized aRVS for rectosigmoid colon cancer could be an alternative treatment option when it is unabled to be treated by surgical resection.

  • PDF

Supernumerary ovary on recto-sigmoid colon with associated endometriosis

  • Lim, Chul Kwon;Kim, Hee Jin;Pack, Joon Sook;Ha, Joong Gyu;Yang, Yun Seok;Lee, Hye Kyung;Kim, Seung Hyun
    • Obstetrics & gynecology science
    • /
    • v.61 no.6
    • /
    • pp.702-706
    • /
    • 2018
  • A supernumerary ovary is a rare gynecological anomaly, and is usually excised due to its malignant transformation potential. We report a case of a supernumerary ovary and endometriosis situated on the anterior rectosigmoid colon. When laparoscopy was conducted, a firm, 5-cm mass was discovered on the anterior rectosigmoid colon along with normal ovaries. In this case, the discovery of a supernumerary ovary implied the presence of endometriosis. It is unusual for endometriosis and a supernumerary ovary to exist simultaneously.

Herbal Medicine Therapeutic Attempt for Diarrhea Induced by Carcinoid Symptoms of Rectosigmoid Neuroendocrine Tumor with Liver Metastasis Patient : a Case Report (간전이가 있는 직장구불결장의 신경내분비 종양 환자의 카르시노이드 증후에 의해 발생한 설사에 대한 한약 치료 시도 : 증례 보고)

  • Jeon, Hyung Joon;Kim, Jong Min;Cho, Chong Kwan;Lee, Yeon Weol;Yoo, Hwa Seung
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.29 no.1
    • /
    • pp.72-78
    • /
    • 2015
  • This study aims to report a case of rectosigmoid neuroendocrine tumor patient with liver metastasis whose outstanding carcinoid symptom was mucosal diarrhea for more than 10 times a day. Three different herbal decoctions were administered orally for the treatment of diarrhea which was among carcinoid symptoms from diffuse metastatic liver lesion. The herbal decoctions given were modified Lijung-tang, modified Sambaek-tang and modified Jeokseokjiuyeoryang-tang. The administration period was 5, 14 and 9 days respectively. Frequency of patient's mucosal diarrhea had increased consistently during hospitalization. It had almost doubled compared to pre-hospitalization up to 27 times/24 hrs. But during the period of modified Sambaek-tang administration, frequency of diarrhea was maintained between 9 to 15 times/24hrs. There was no difference of liver tumors between Nov 16th 2013 and Dec 9th 2013 in computed tomography images. Three conventional established herbal prescriptions administered in this case didn't show any favorable effect on improving mucosal diarrhea induced by carcinoid symptoms of a rectosigmoid neuroendocrine tumor with liver metastasis. Even if modified Sambaek-tang showed partial effect on frequency of diarrhea, we concluded that it was not sufficient to be a therapeutic method of the diarrhea as carcinoid symptom. Furthermore, it is necessary to conduct additional studies about the diarrhea of neuroendocrine tumor with liver metastasis.