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THE CILNICAL AND BACTERIOLOGICAL PROFILE OF ANO-RECTAL ABSCESS IN BASRAH; A PROSPECTIVE STUDY.

Authors: Mahmoud S Al-Haroon --- Safwan A Taha
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 1 Pages: 36-41
Publisher: Basrah University جامعة البصرة

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Abstract

Introduction norectal abscess is one of the common surgical problems of the anorectal region1-4. It is a suppurative process of the anal canal that originates from infection of an obstructed anal gland5,6. Once infection gains access to the intersphincteric space, it has easy access to the adjacent perirectal spaces7. Men are affected more than women with 3rd and 4th decades of life as the peak age of incidence7,8. In a descending order of frequency; perianal, ischiorectal, sub-mucosal and supralevator are abscess types according to anatomical location7-12. The bacterial profile of an abscess, which is usually a mixed infection involving aerobic and anaerobic microorganisms, is considered as a prognostic factor for recurrent abscess and fistula formation1,5, 7,10,13,14. Diagnosis is made on basis of history and anorectal examination and is usually easy except in case of deep abscess9,15. All cases require urgent incision and drainage4,16.

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ROUX-EN-Y ESOPHAGOJEJUNOSTOMY AFTER TOTAL GASTRECTOMY FOR GASTRIC MALIGNANCY …51

Authors: HASHIM S KHAYAT --- SAFWAN A TAHA
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2006 Volume: 12 Issue: 2 Pages: 51-56
Publisher: Basrah University جامعة البصرة

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Abstract

ROUX-EN-Y ESOPHAGOJEJUNOSTOMY AFTER TOTAL GASTRECTOMY FOR GASTRICMALIGNANCY.Hashim S Khayat# & Safwan A Taha**CABS. Professor, Dept. of Surgery, University of Basrah, College of Medicine; #FRCS Ed. Consultant Surgeon and Chairman, Basrah General Hospital, Basrah; IRAQ.AbstractOut of 62 patients who underwent total gastrectomy for gastric malignancy, 40 patients had roux-en-y esophagojejunostomy. Their age ranged from 32 to 70 years. Seventeen patients were less than 60 years old and 27 were older. There were 23 males and 17 females. Operations were done through thoraco-abdominal incisions in 28 patients and upper midline incisions in 12. The anastomoses, on the other hand, were hand sewn in 34 patients and stapled in the other 6. The procedure included splenectomy in 37 patients, distal pancreatectomy in 6 and transverse colectomy in 2 patients. Postoperative complications included chest infection (8 patients), wound infection (7 patients) and anastomotic leak (1 patient). Eleven patients died postoperatively, the leading cause being pulmonary embolism, respiratory failure and over-whelming sepsis. Out of our surviving patients, 4 (10%) are still alive 5 years or more after surgery and are enjoying good health. Our results are well within the international figures although we think that the outlook could have improved had we gained access to certain facilities like hyperalimentation, chest physiotherapy units and measures that could prevent deep venous thrombosis. Roux-en-y esophagojejunostomy is a safe method to restore the continuity of the alimentary tract after gastrectomy. It requires less time than “pouch-forming” procedures, has less incidence of anastomotic leakage, produces acceptable morbidity and mortality, gives good nutritional value and does not require the special expertise needed to perform the “pouch-forming” procedures.

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