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Debra Archer - One of the best experts on this subject based on the ideXlab platform.

Omer Onbas - One of the best experts on this subject based on the ideXlab platform.

  • An Algorithm for the Management of Sigmoid Colon Volvulus and the Safety of Primary Resection: Experience with 827 Cases
    Diseases of the Colon & Rectum, 2007
    Co-Authors: Durkaya Oren, Sabri Selcuk Atamanalp, Bulent Aydinli, Mahmut Basoglu, M. İlhan Yildirgan, K. Yalçın Polat, Omer Onbas
    Abstract:

    Purpose This study was designed to review the outcomes of emergent treatment of sigmoid Colon Volvulus. Methods The records of 827 patients were reviewed retrospectively. Results The mean age was 57.9 years (range, 10 weeks to 98 years), and 688 patients (83.2 percent) were male. Nonoperative reduction was applied in 575 patients (barium enema in 13, rigid sigmoidoscopy in 351, and flexible sigmoidoscopy in 211, with rectal tube placement in all patients). The results were as follows: success of 78.1 percent, mortality of 0.9 percent, complication of 3 percent, and early recurrence of 3.3 percent. Surgical treatment was performed on 393 patients (detorsion in 46, mesosigmoidopexy in 56, exteriorization in 4, resection with Hartmann’s procedure in 146, resection with Mikulicz procedure in 14, resection with primary anastomosis in 51, tube cecostomy and Colonic cleansing with resection in 75, and laparotomy in 1). The results were as follows: mortality of 15.8 percent, complication of 37.2 percent, early recurrence of 0.8 percent, and late recurrence of 6.7 percent. Conclusions Nonoperative reduction is the initial treatment of sigmoid Colon Volvulus, and flexible sigmoidoscopy with rectal tube placement can be used successfully. Patients in whom bowel gangrene or peritonitis is present or nonoperative treatment is unsuccessful need emergency surgery. In surgical treatment, resection and primary anastomosis is the first choice, and it can be performed with acceptable mortality and morbidity rates if the patient is stable and a tension-free anastomosis is possible. Nondefinitive procedures have high recurrence rates; thus, definitive surgical techniques must be preferred.

  • an algorithm for the management of sigmoid Colon Volvulus and the safety of primary resection experience with 827 cases
    Diseases of The Colon & Rectum, 2007
    Co-Authors: Durkaya Oren, Sabri Selcuk Atamanalp, Bulent Aydinli, Ilhan M Yildirgan, Mahmut Basoglu, Yalcin K Polat, Omer Onbas
    Abstract:

    This study was designed to review the outcomes of emergent treatment of sigmoid Colon Volvulus. The records of 827 patients were reviewed retrospectively. The mean age was 57.9 years (range, 10 weeks to 98 years), and 688 patients (83.2 percent) were male. Nonoperative reduction was applied in 575 patients (barium enema in 13, rigid sigmoidoscopy in 351, and flexible sigmoidoscopy in 211, with rectal tube placement in all patients). The results were as follows: success of 78.1 percent, mortality of 0.9 percent, complication of 3 percent, and early recurrence of 3.3 percent. Surgical treatment was performed on 393 patients (detorsion in 46, mesosigmoidopexy in 56, exteriorization in 4, resection with Hartmann’s procedure in 146, resection with Mikulicz procedure in 14, resection with primary anastomosis in 51, tube cecostomy and Colonic cleansing with resection in 75, and laparotomy in 1). The results were as follows: mortality of 15.8 percent, complication of 37.2 percent, early recurrence of 0.8 percent, and late recurrence of 6.7 percent. Nonoperative reduction is the initial treatment of sigmoid Colon Volvulus, and flexible sigmoidoscopy with rectal tube placement can be used successfully. Patients in whom bowel gangrene or peritonitis is present or nonoperative treatment is unsuccessful need emergency surgery. In surgical treatment, resection and primary anastomosis is the first choice, and it can be performed with acceptable mortality and morbidity rates if the patient is stable and a tension-free anastomosis is possible. Nondefinitive procedures have high recurrence rates; thus, definitive surgical techniques must be preferred.

Faith E. Hughes - One of the best experts on this subject based on the ideXlab platform.

  • comparison of histomorphometric characteristics of dorsal Colon and pelvic flexure biopsy specimens obtained from horses with large Colon Volvulus that underwent resection
    American Journal of Veterinary Research, 2020
    Co-Authors: Liara M. Gonzalez, Faith E. Hughes, Anthony T. Blikslager, True W Baker, Callie A. Fogle
    Abstract:

    OBJECTIVE To determine the degree of histomorphometric damage in dorsal Colon and pelvic flexure biopsy specimens (DCBSs and PFBSs, respectively) obtained from horses with large Colon Volvulus (LCV...

  • Prognostic value of Colonic and peripheral venous lactate measurements in horses with large Colon Volvulus.
    Veterinary surgery : VS, 2020
    Co-Authors: Kindra. E. Orr, Faith E. Hughes, Donnie E. Slone, Timothy M. Lynch, Carol K. Clark, Callie A. Fogle, W. True Baker, Liara M. Gonzalez
    Abstract:

    OBJECTIVE To determine the prognostic value of (1) Colonic venous lactate or peripheral lactate values obtained before and after manual correction of a large Colon Volvulus and (2) a combination of variables including pelvic flexure biopsy. STUDY DESIGN Prospective clinical study. ANIMALS Forty adult horses in which large Colon Volvulus was diagnosed intraoperatively. METHODS Colonic venous, peripheral venous, and arterial blood samples were collected to measure lactate values before and after manual correction. Mucosal biopsy samples were obtained in cases that underwent enterotomy or Colonic resection and anastomosis. Interstitium to crypt (I:C) ratio and hemorrhage scores were measured. Optimal cutoff values were determined by receiver operator curve analysis, and associations between variables and short-term outcome were determined by univariable regression. Short-term survival was defined as horses being discharged from the hospital. P ≤ .05 was considered significant. RESULTS No association was found between Colonic venous lactate values before (P = .011) or after (P = .201) manual correction of large Colon Volvulus and determination of short-term outcome. Peripheral venous lactate at admission ≥3.2 mmol/L and after manual correction ≥5 mmol/L, arterial lactate postmanual correction ≥3.53 mmol/L, and histomorphometric measurements of mucosal hemorrhage ≥3 and I:C ratio > 1 were associated with poor short-term outcome. CONCLUSION Peripheral lactate values, histomorphometric measures of I:C ratio, and hemorrhage score provided prognostic information that could help guide recommendations made to owners. CLINICAL SIGNIFICANCE Peripheral lactate values after manual correction provide important intraoperative diagnostic information to assist in predicting case outcome in the operative and immediately postoperative period.

  • Protein biomarker of cell proliferation determines survival to discharge in cases of equine large Colon Volvulus.
    Equine veterinary journal, 2017
    Co-Authors: C. R. Kucera, Faith E. Hughes, Anthony T. Blikslager, Lauren W. Stranahan, Liara M. Gonzalez
    Abstract:

    SummaryBackground Progenitor cells play critical roles in epithelial repair following ischaemic injury. Protein biomarkers have been used to identify intestinal progenitor cell subpopulations. This study aims to determine if a critical number of intestinal progenitor cells can predict tissue viability and survival to discharge of large Colon Volvulus (LCV) cases. Objectives The objectives were to 1) identify intestinal progenitor cell subpopulations using biomarkers: proliferating cell nuclear antigen (PCNA), sex determining region Y box 9 (SOX9), phospho-histone H3 (PHH3) and Ki-67, 2) define cut-off values for critical numbers of positive cells and 3) determine if survival to discharge is associated with cut-off values. Study design Retrospective cohort study. Methods Adult horses admitted to the Farm and Equine Veterinary Medical Center at NC State's Veterinary Hospital and Peterson and Smith Equine Hospital between 2006 and 2016 that underwent an exploratory coeliotomy with a diagnosis of LCV of ≥360 degrees, had pelvic flexure biopsy and that recovered from general anaesthesia were selected for inclusion in the study. Immunohistochemical analyses were performed and positive cells were counted. Optimal cut-off values were determined using receiver operator curves. A Fisher's exact test was used to associate cut-off values with survival to discharge. Results In this study, 23 cases of LCV ≥360° were included. Of 23 horses, 13 (57%) survived to discharge. A cut-off value of

  • Operative factors associated with short-term outcome in horses with large Colon Volvulus: 47 cases from 2006 to 2013
    Equine veterinary journal, 2014
    Co-Authors: Liara M. Gonzalez, Faith E. Hughes, Callie A. Fogle, W. T. Baker, J. M. Law, Alison A. Motsinger-reif, Anthony T. Blikslager
    Abstract:

    Summary Reasons for performing study There is an important need for objective parameters that accurately predict the outcome of horses with large Colon Volvulus. Objectives To evaluate the predictive value of a series of histomorphometric parameters on short-term outcome, as well as the impact of Colonic resection on horses with large Colon Volvulus. Study design Retrospective cohort study. Methods Adult horses admitted to the Equine and Farm Animal Veterinary Center at North Carolina State University, Peterson and Smith and Chino Valley Equine Hospitals between 2006 and 2013 that underwent an exploratory coeliotomy, diagnosed with large Colon Volvulus of ≥360 degrees, where a pelvic flexure biopsy was obtained, and that recovered from general anaesthesia, were selected for inclusion in the study. Logistic regression was used to determine associations between signalment, histomorphometric measurements of interstitium-to-crypt ratio, degree of haemorrhage, percentage loss of luminal and glandular epithelium, as well as Colonic resection with short-term outcome (discharge from the hospital). Results Pelvic flexure biopsies from 47 horses with large Colon Volvulus were evaluated. Factors that were significantly associated with short-term outcome on univariate logistic regression were Thoroughbred breed (P = 0.04), interstitium-to-crypt ratio >1 (P = 0.02) and haemorrhage score ≥3 (P = 0.005). Resection (P = 0.92) was not found to be associated significantly with short-term outcome. No combined factors increased the likelihood of death in forward stepwise logistic regression modelling. A digitally quantified measurement of haemorrhage area strengthened the association of haemorrhage with nonsurvival in cases of large Colon Volvulus. Conclusions Histomorphometric measurements of interstitium-to-crypt ratio and degree of haemorrhage predict short-term outcome in cases of large Colon Volvulus. Resection was not associated with short-term outcome in horses selected for this study. Accurate quantification of mucosal haemorrhage at the time of surgery may improve veterinary surgeons’ prognostic capabilities in horses with large Colon Volvulus.

  • survival and complications after large Colon resection and end to end anastomosis for strangulating large Colon Volvulus in seventy three horses
    Veterinary Surgery, 2008
    Co-Authors: Christina M. Ellis, Faith E. Hughes, Donnie E. Slone, Timothy M. Lynch, Carol K. Clark
    Abstract:

    Objective— To report complications and survival after large Colon resection and end-to-end anastomosis in horses with strangulating large Colon Volvulus. Study Design— Retrospective case series. Animals— Horses (n=73) with strangulating large Colon Volvulus. Methods— Records (January 1995 to December 2005) of horses that had large Colon resection and anastomosis for strangulating large Colon Volvulus were reviewed for complications. Follow-up data were obtained by telephone questionnaire at least 1 year postoperatively. Cox proportional hazards model was used for multivariate association with survival time. Variables included admission date, age, temperature, heart rate, packed cell volume, total plasma protein concentration, white blood cell count, breed, and sex. Significance was set at P<.05. Results— The most common postoperative complication was diarrhea. None of the 9 variables of interest were significant for survival. Short-term survival rate (to discharge) was 74%. Overall survival rates at 1, 2, and 3 years postoperatively were 67.8%, 66.0%, and 63.5%, respectively. Four horses died of colic in the first year after surgery. All horses surviving long-term (>1 year) returned to their intended use (37 brood mares, 2 racehorses, and 1 show horse) with no chronic problems related to the surgical procedure. Conclusion— None of the variables examined were associated with survival. Outcomes were similar to other large studies of surgical colic in the horse. Self-limiting diarrhea is common after large Colon resection and the prognosis for survival after hospital discharge is favorable. Clinical Relevance— Horses that survive the early postoperative period and are discharged after large Colon resection and anastomosis have a good chance for long-term survival with minimal negative impact on quality of life and use.

Herand Abcarian - One of the best experts on this subject based on the ideXlab platform.

J. M. Suthers - One of the best experts on this subject based on the ideXlab platform.