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Shaotao Tang - One of the best experts on this subject based on the ideXlab platform.

  • transumbilical Enterostomy for hirschsprung s disease with a two stage laparoscopy assisted pull through procedure
    World Journal of Gastroenterology, 2019
    Co-Authors: Xiaopan Chang, Xi Zhang, Shuiqing Chi, Guoqing Cao, Dehua Yang, Shaotao Tang
    Abstract:

    Background A one-stage laparoscopic operation has recently been considered a favorable option for the management of patients with Hirschsprung's disease (HD) due to its superior cosmetic results. One-stage transanal endorectal pull-through for the treatment of rectosigmoid HD has been widely used in newborns without complications. However, Enterostomy is required in some HD cases for enterocolitis and dilated colon. Our transumbilical Enterostomy (TUE) and two-stage laparoscopy-assisted anorectoplasty were effective and achieved a similar cosmetic effect to one-stage laparoscopy on the abdominal wall in patients with anorectal malformation, but the effect in patients with HD is unclear. Aim To evaluate the safety, efficacy and cosmetic results of TUE in two-stage laparoscopy-assisted pull-through for HD. Methods From June 2013 to June 2018, 53 patients (40 boys, 13 girls; mean age at Enterostomy: 5.5 ± 2.2 mo) who underwent Enterostomy and two-stage laparoscopy-assisted pull-through for HD with stoma closure were reviewed at our institution. Two Enterostomy approaches were used: TUE in 24 patients, and conventional abdominal Enterostomy (CAE) in 29 patients. Eleven patients with rectosigmoid HD had severe preoperative enterocolitis or a dilated colon. 26 patients had long-segment HD, and 16 patients had total colonic aganglionosis (TCA). The patients with left-sided HD underwent the two-stage laparoscopic Soave procedure, and the patients with right-sided HD and TCA underwent the laparoscopic Duhamel procedure. Demographics, Enterostomy operative time, complications and cosmetic results were respectively evaluated. Results There were no differences between the groups with respect to gender, age at Enterostomy, weight and clinical type (P > 0.05). No conversion to open technique was required. Two patients experienced episodes of stomal mucosal prolapse in the TUE group and 1 patient in the CAE group (8.33% vs 3.45%, P > 0.05). No parastomal hernia was observed in either of the two groups. Wound infection at the stoma was seen in 1 case in the TUE group, and 2 cases in the CAE group (4.17% vs 6.90%, P > 0.05). No obstruction was noted in any of the patients in the TUE group, whereas obstruction was found in 1 patient in the CAE group. Enterocolitis was observed in 3 and 5 patients in the TUE and CAE group, respectively (12.50% vs 17.24%, P > 0.05). There was no significant difference between the TUE group and CAE group in terms of the incidence of soiling and constipation (P > 0.05). The cosmetic result using the scar score in the TUE group was better than that in the CAE group (6.83 ± 0.96 vs 13.32 ± 1.57, P Conclusion TUE is a safe and feasible method for the treatment of HD, and the staged Enterostomy and two-stage laparoscopy-assisted pull-through achieved a similar cosmetic effect to the one-stage laparoscopic procedure.

  • Transumbilical Enterostomy for Hirschsprung's disease with a two-stage laparoscopy-assisted pull-through procedure.
    World journal of gastroenterology, 2019
    Co-Authors: Xiaopan Chang, Xi Zhang, Shuiqing Chi, Guoqing Cao, Dehua Yang, Shaotao Tang
    Abstract:

    A one-stage laparoscopic operation has recently been considered a favorable option for the management of patients with Hirschsprung's disease (HD) due to its superior cosmetic results. One-stage transanal endorectal pull-through for the treatment of rectosigmoid HD has been widely used in newborns without complications. However, Enterostomy is required in some HD cases for enterocolitis and dilated colon. Our transumbilical Enterostomy (TUE) and two-stage laparoscopy-assisted anorectoplasty were effective and achieved a similar cosmetic effect to one-stage laparoscopy on the abdominal wall in patients with anorectal malformation, but the effect in patients with HD is unclear. To evaluate the safety, efficacy and cosmetic results of TUE in two-stage laparoscopy-assisted pull-through for HD. From June 2013 to June 2018, 53 patients (40 boys, 13 girls; mean age at Enterostomy: 5.5 ± 2.2 mo) who underwent Enterostomy and two-stage laparoscopy-assisted pull-through for HD with stoma closure were reviewed at our institution. Two Enterostomy approaches were used: TUE in 24 patients, and conventional abdominal Enterostomy (CAE) in 29 patients. Eleven patients with rectosigmoid HD had severe preoperative enterocolitis or a dilated colon. 26 patients had long-segment HD, and 16 patients had total colonic aganglionosis (TCA). The patients with left-sided HD underwent the two-stage laparoscopic Soave procedure, and the patients with right-sided HD and TCA underwent the laparoscopic Duhamel procedure. Demographics, Enterostomy operative time, complications and cosmetic results were respectively evaluated. There were no differences between the groups with respect to gender, age at Enterostomy, weight and clinical type (P > 0.05). No conversion to open technique was required. Two patients experienced episodes of stomal mucosal prolapse in the TUE group and 1 patient in the CAE group (8.33% vs 3.45%, P > 0.05). No parastomal hernia was observed in either of the two groups. Wound infection at the stoma was seen in 1 case in the TUE group, and 2 cases in the CAE group (4.17% vs 6.90%, P > 0.05). No obstruction was noted in any of the patients in the TUE group, whereas obstruction was found in 1 patient in the CAE group. Enterocolitis was observed in 3 and 5 patients in the TUE and CAE group, respectively (12.50% vs 17.24%, P > 0.05). There was no significant difference between the TUE group and CAE group in terms of the incidence of soiling and constipation (P > 0.05). The cosmetic result using the scar score in the TUE group was better than that in the CAE group (6.83 ± 0.96 vs 13.32 ± 1.57, P < 0.05). TUE is a safe and feasible method for the treatment of HD, and the staged Enterostomy and two-stage laparoscopy-assisted pull-through achieved a similar cosmetic effect to the one-stage laparoscopic procedure. ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.

Chien-wei Chen - One of the best experts on this subject based on the ideXlab platform.

  • short bowel syndrome caused by laparoscopic loop Enterostomy of the jejunum in an adult with undiagnosed intestinal malrotation a case report
    Medicine, 2018
    Co-Authors: Yin-chen Hsu, Li-sheng Hsu, Wen-shih Huang, Jun-cheng Weng, Chien-wei Chen
    Abstract:

    Rationale Failure to recognize intestinal malrotation in adults can cause complications during surgeries, especially those with a limited operative field. We report a case of short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. Patient concerns A 72-year-old man underwent a laparoscopic right hemicolectomy and ileocolostomy because of complicated diverticulitis. Six days after the surgery, he received laparoscopic exploration because of anastomotic leak, and a laparoscopic loop ileostomy was also performed as a protective diversion stoma. One month after surgery, he complained of severe diarrhea from the Enterostomy after food and water intake. An upper gastrointestinal and small bowel series revealed that the duodenojejunal junction (DJJ) did not cross the midline and there was a short distance between the DJJ and the Enterostomy in the right lower quadrant. Diagnoses Short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. Interventions Total parental nutrition was used and the loop Enterostomy was closed 3 months after the initial surgery. Outcomes The patient was discharged uneventfully 2 weeks after the loop Enterostomy. Lessons Intestinal malrotation in adults is often encountered during routine radiological examinations. However, it may cause complications during surgery if ignored. Radiologists should keep in mind that complications may occur if a complete presurgical evaluation of intestinal malrotation is not performed, and surgeons should take caution when performing surgeries, especially those with a limited operative field.

  • Short bowel syndrome caused by laparoscopic loop Enterostomy of the jejunum in an adult with undiagnosed intestinal malrotation: A case report.
    Medicine, 2018
    Co-Authors: Yin-chen Hsu, Li-sheng Hsu, Wen-shih Huang, Jun-cheng Weng, Chien-wei Chen
    Abstract:

    Failure to recognize intestinal malrotation in adults can cause complications during surgeries, especially those with a limited operative field. We report a case of short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. A 72-year-old man underwent a laparoscopic right hemicolectomy and ileocolostomy because of complicated diverticulitis. Six days after the surgery, he received laparoscopic exploration because of anastomotic leak, and a laparoscopic loop ileostomy was also performed as a protective diversion stoma. One month after surgery, he complained of severe diarrhea from the Enterostomy after food and water intake. An upper gastrointestinal and small bowel series revealed that the duodenojejunal junction (DJJ) did not cross the midline and there was a short distance between the DJJ and the Enterostomy in the right lower quadrant. Short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. Total parental nutrition was used and the loop Enterostomy was closed 3 months after the initial surgery. The patient was discharged uneventfully 2 weeks after the loop Enterostomy. Intestinal malrotation in adults is often encountered during routine radiological examinations. However, it may cause complications during surgery if ignored. Radiologists should keep in mind that complications may occur if a complete presurgical evaluation of intestinal malrotation is not performed, and surgeons should take caution when performing surgeries, especially those with a limited operative field.

Yin-chen Hsu - One of the best experts on this subject based on the ideXlab platform.

  • short bowel syndrome caused by laparoscopic loop Enterostomy of the jejunum in an adult with undiagnosed intestinal malrotation a case report
    Medicine, 2018
    Co-Authors: Yin-chen Hsu, Li-sheng Hsu, Wen-shih Huang, Jun-cheng Weng, Chien-wei Chen
    Abstract:

    Rationale Failure to recognize intestinal malrotation in adults can cause complications during surgeries, especially those with a limited operative field. We report a case of short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. Patient concerns A 72-year-old man underwent a laparoscopic right hemicolectomy and ileocolostomy because of complicated diverticulitis. Six days after the surgery, he received laparoscopic exploration because of anastomotic leak, and a laparoscopic loop ileostomy was also performed as a protective diversion stoma. One month after surgery, he complained of severe diarrhea from the Enterostomy after food and water intake. An upper gastrointestinal and small bowel series revealed that the duodenojejunal junction (DJJ) did not cross the midline and there was a short distance between the DJJ and the Enterostomy in the right lower quadrant. Diagnoses Short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. Interventions Total parental nutrition was used and the loop Enterostomy was closed 3 months after the initial surgery. Outcomes The patient was discharged uneventfully 2 weeks after the loop Enterostomy. Lessons Intestinal malrotation in adults is often encountered during routine radiological examinations. However, it may cause complications during surgery if ignored. Radiologists should keep in mind that complications may occur if a complete presurgical evaluation of intestinal malrotation is not performed, and surgeons should take caution when performing surgeries, especially those with a limited operative field.

  • Short bowel syndrome caused by laparoscopic loop Enterostomy of the jejunum in an adult with undiagnosed intestinal malrotation: A case report.
    Medicine, 2018
    Co-Authors: Yin-chen Hsu, Li-sheng Hsu, Wen-shih Huang, Jun-cheng Weng, Chien-wei Chen
    Abstract:

    Failure to recognize intestinal malrotation in adults can cause complications during surgeries, especially those with a limited operative field. We report a case of short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. A 72-year-old man underwent a laparoscopic right hemicolectomy and ileocolostomy because of complicated diverticulitis. Six days after the surgery, he received laparoscopic exploration because of anastomotic leak, and a laparoscopic loop ileostomy was also performed as a protective diversion stoma. One month after surgery, he complained of severe diarrhea from the Enterostomy after food and water intake. An upper gastrointestinal and small bowel series revealed that the duodenojejunal junction (DJJ) did not cross the midline and there was a short distance between the DJJ and the Enterostomy in the right lower quadrant. Short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. Total parental nutrition was used and the loop Enterostomy was closed 3 months after the initial surgery. The patient was discharged uneventfully 2 weeks after the loop Enterostomy. Intestinal malrotation in adults is often encountered during routine radiological examinations. However, it may cause complications during surgery if ignored. Radiologists should keep in mind that complications may occur if a complete presurgical evaluation of intestinal malrotation is not performed, and surgeons should take caution when performing surgeries, especially those with a limited operative field.

Li-sheng Hsu - One of the best experts on this subject based on the ideXlab platform.

  • short bowel syndrome caused by laparoscopic loop Enterostomy of the jejunum in an adult with undiagnosed intestinal malrotation a case report
    Medicine, 2018
    Co-Authors: Yin-chen Hsu, Li-sheng Hsu, Wen-shih Huang, Jun-cheng Weng, Chien-wei Chen
    Abstract:

    Rationale Failure to recognize intestinal malrotation in adults can cause complications during surgeries, especially those with a limited operative field. We report a case of short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. Patient concerns A 72-year-old man underwent a laparoscopic right hemicolectomy and ileocolostomy because of complicated diverticulitis. Six days after the surgery, he received laparoscopic exploration because of anastomotic leak, and a laparoscopic loop ileostomy was also performed as a protective diversion stoma. One month after surgery, he complained of severe diarrhea from the Enterostomy after food and water intake. An upper gastrointestinal and small bowel series revealed that the duodenojejunal junction (DJJ) did not cross the midline and there was a short distance between the DJJ and the Enterostomy in the right lower quadrant. Diagnoses Short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. Interventions Total parental nutrition was used and the loop Enterostomy was closed 3 months after the initial surgery. Outcomes The patient was discharged uneventfully 2 weeks after the loop Enterostomy. Lessons Intestinal malrotation in adults is often encountered during routine radiological examinations. However, it may cause complications during surgery if ignored. Radiologists should keep in mind that complications may occur if a complete presurgical evaluation of intestinal malrotation is not performed, and surgeons should take caution when performing surgeries, especially those with a limited operative field.

  • Short bowel syndrome caused by laparoscopic loop Enterostomy of the jejunum in an adult with undiagnosed intestinal malrotation: A case report.
    Medicine, 2018
    Co-Authors: Yin-chen Hsu, Li-sheng Hsu, Wen-shih Huang, Jun-cheng Weng, Chien-wei Chen
    Abstract:

    Failure to recognize intestinal malrotation in adults can cause complications during surgeries, especially those with a limited operative field. We report a case of short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. A 72-year-old man underwent a laparoscopic right hemicolectomy and ileocolostomy because of complicated diverticulitis. Six days after the surgery, he received laparoscopic exploration because of anastomotic leak, and a laparoscopic loop ileostomy was also performed as a protective diversion stoma. One month after surgery, he complained of severe diarrhea from the Enterostomy after food and water intake. An upper gastrointestinal and small bowel series revealed that the duodenojejunal junction (DJJ) did not cross the midline and there was a short distance between the DJJ and the Enterostomy in the right lower quadrant. Short bowel syndrome caused by mistaken creation of a loop Enterostomy in the jejunum due to undiagnosed intestinal malrotation. Total parental nutrition was used and the loop Enterostomy was closed 3 months after the initial surgery. The patient was discharged uneventfully 2 weeks after the loop Enterostomy. Intestinal malrotation in adults is often encountered during routine radiological examinations. However, it may cause complications during surgery if ignored. Radiologists should keep in mind that complications may occur if a complete presurgical evaluation of intestinal malrotation is not performed, and surgeons should take caution when performing surgeries, especially those with a limited operative field.

J.n. Friedman - One of the best experts on this subject based on the ideXlab platform.

  • Enterostomy tube placement in children with spinal muscular atrophy type 1
    The Journal of Pediatrics, 2006
    Co-Authors: S. Mahant, N. Taback, J. Vajsar, P.g. Chait, J.n. Friedman
    Abstract:

    Objective To determine the major complication rate in the first 30 days after Enterostomy tube insertion in infants with spinal muscular atrophy (SMA) type 1. Study design A retrospective case review of all children with SMA type 1 who had a gastrostomy or gastrojejunostomy tube placed by the image-guided technique at the Hospital for Sick Children from 1994–2004. Major complications were classified as peritonitis, aspiration pneumonia, respiratory failure, nonelective admission to the pediatric intensive care unit, and death. Results Twelve children were identified as having SMA type 1 with an Enterostomy tube insertion. The median age at tube insertion was 6.1 months (range 2.2 to 15.8 months). Major complications in the first 30 days after the procedure included aspiration pneumonia (5/12 patients [41.6%]), respiratory failure requiring admission to the pediatric intensive care unit (4/12 [33%]), and death (2/12 [16.7%]). Children with development of aspiration pneumonia were significantly older at time of tube insertion (P Conclusions Major complications including death are seen in children with SMA type 1 in the first 30 days after Enterostomy tube insertion.

  • Enterostomy tube placement in children with spinal muscular atrophy type 1
    The Journal of pediatrics, 2006
    Co-Authors: S. Mahant, N. Taback, J. Vajsar, P.g. Chait, J.n. Friedman
    Abstract:

    To determine the major complication rate in the first 30 days after Enterostomy tube insertion in infants with spinal muscular atrophy (SMA) type 1. A retrospective case review of all children with SMA type 1 who had a gastrostomy or gastrojejunostomy tube placed by the image-guided technique at the Hospital for Sick Children from 1994-2004. Major complications were classified as peritonitis, aspiration pneumonia, respiratory failure, nonelective admission to the pediatric intensive care unit, and death. Twelve children were identified as having SMA type 1 with an Enterostomy tube insertion. The median age at tube insertion was 6.1 months (range 2.2 to 15.8 months). Major complications in the first 30 days after the procedure included aspiration pneumonia (5/12 patients [41.6%]), respiratory failure requiring admission to the pediatric intensive care unit (4/12 [33%]), and death (2/12 [16.7%]). Children with development of aspiration pneumonia were significantly older at time of tube insertion (P < .05) than those with no aspiration. Major complications including death are seen in children with SMA type 1 in the first 30 days after Enterostomy tube insertion.