The Experts below are selected from a list of 1722 Experts worldwide ranked by ideXlab platform
Chu-an Cheng - One of the best experts on this subject based on the ideXlab platform.
-
Medialization laryngoplasty with strap Muscle Transposition for vocal fold atrophy with or without sulcus vocalis.
The Laryngoscope, 2004Co-Authors: Shang-shyue Tsai, Jeng-fen Chiu, Chu-an ChengAbstract:Objective: Vocal fold atrophy with or without sulcus vocalis may result in a spindle-shaped glottal incompetence (SGI). Because of varying drawbacks with all existing materials (e.g., Silastic block, Teflon, fat, etc.) used for medialization or augmentation of the atrophic vocal folds, there is a need to supplant these materials with a more stable, autologous tissue to correct the SGI. Study Design: Thirty-two patients with vocal fold atrophy underwent medialization laryngoplasty with strap Muscle Transposition. Methods: Under local or general anesthesia, the thyroid lamina on the more affected side was vertically incised 5 mm off the midline. The inner perichondrium was carefully elevated from the overlying thyroid ala. Care was taken not to enter the laryngeal lumen. After dividing the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally. To accommodate the Muscle flap more easily, the caudal edge of the lamina was trimmed using a small burr. A bipedicled strap Muscle flap was then transposed into the space between the lamina and the paraglottic soft tissue. The thyroid cartilages were carefully sutured back in place. All patients underwent pre- and postoperative voice evaluations including laryngostroboscopy, perceptual assessment, and acoustic and aerodynamic analyses. Patients who had been followed up for more than 3 months were enrolled in this study. Results: A total of 27 of the 32 patients with complete pre- and postoperative voice function measurements were included in the analysis. Vocal improvement was demonstrated in 26 of these 27 (96%) patients. No dyspnea or other major complications were noted in any patients. Conclusion: The results indicate that medialization laryngoplasty with strap Muscle Transposition is a prosthesis-free, safe, and effective technique for correcting SGI caused by vocal fold atrophy.
-
A new paramedian approach to arytenoid adduction and strap Muscle Transposition for vocal fold medialization.
Laryngoscope, 2002Co-Authors: Chih-ying Su, Jeng-fen Chiu, Chu-an ChengAbstract:Objective To develop a prosthesis-free medialization laryngoplasty for the treatment of glottal incompetence. Study Design Twenty-two consecutive patients with glottal incompetence underwent vocal fold medialization using a new paramedian approach to arytenoid adduction and/or strap Muscle Transposition. Methods Under local anesthesia, the thyroid lamina on the involved side was parasagittally separated 5 mm off the midline. The inner perichondrium was carefully freed from the overlying thyroid cartilage. After dividing the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally, the inner perichondrium was opened, and the lateral cricoarytenoid Muscle identified. Tracing the Muscle fibers posterosuperiorly, the muscular process of the arytenoid was identified. A 2-0 or 3-0 Prolene suture was placed through the muscular process and tied to the cricoid cartilage at the origin of the lateral cricoarytenoid Muscle. A bipedicled strap Muscle flap was then transposed into the space between the lamina and the inner perichondrium and the thyroid cartilages sutured back into place. Pre- and postoperative voice evaluations measured mean fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, and maximal phonation time, as well as assessments of voice quality. Results Vocal improvement was obtained in 95% (21 of 22) of patients. There was a significant improvement (P
-
a new paramedian approach to arytenoid adduction and strap Muscle Transposition for vocal fold medialization
Laryngoscope, 2002Co-Authors: Chunchung Lui, Jeng-fen Chiu, Hsinching Lin, Chu-an ChengAbstract:Objective To develop a prosthesis-free medialization laryngoplasty for the treatment of glottal incompetence. Study Design Twenty-two consecutive patients with glottal incompetence underwent vocal fold medialization using a new paramedian approach to arytenoid adduction and/or strap Muscle Transposition. Methods Under local anesthesia, the thyroid lamina on the involved side was parasagittally separated 5 mm off the midline. The inner perichondrium was carefully freed from the overlying thyroid cartilage. After dividing the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally, the inner perichondrium was opened, and the lateral cricoarytenoid Muscle identified. Tracing the Muscle fibers posterosuperiorly, the muscular process of the arytenoid was identified. A 2-0 or 3-0 Prolene suture was placed through the muscular process and tied to the cricoid cartilage at the origin of the lateral cricoarytenoid Muscle. A bipedicled strap Muscle flap was then transposed into the space between the lamina and the inner perichondrium and the thyroid cartilages sutured back into place. Pre- and postoperative voice evaluations measured mean fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, and maximal phonation time, as well as assessments of voice quality. Results Vocal improvement was obtained in 95% (21 of 22) of patients. There was a significant improvement (P <.05) in all parameters except shimmer. No major complications were noted in any patient, except for dyspnea in one patient resulting from arytenoid overrotation. Conclusion The results suggest that a paramedian approach to arytenoid adduction combined with strap Muscle Transposition is a safe and effective method for treating glottal incompetence, particularly in patients with unilateral paralytic dysphonia.
Osnat Zmora - One of the best experts on this subject based on the ideXlab platform.
-
gracilis Muscle Transposition for fistulas between the rectum and urethra or vagina
Diseases of The Colon & Rectum, 2006Co-Authors: Osnat Zmora, Hagit Tulchinsky, G. Goldman, Joseph M. Klausner, Micha RabauAbstract:PURPOSE: This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing rectovaginal and rectourethral fistulas. METHODS: Data were retrieved from a retrospective chart review of patients who underwent gracilis Muscle Transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. RESULTS: Six females and three males, aged 30 to 64 years, underwent gracilis Muscle Transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1-66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. CONCLUSIONS: Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
-
recto vaginal urethral fistula repair with gracilis Muscle Transposition
Acta Chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, G. GoldmanAbstract:This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing rectovaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. Results: Six females and four males underwent gracilis Muscle Transposition from 1999 to 2006. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.
-
Recto-vaginal/urethral fistula: repair with gracilis Muscle Transposition.
Acta chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, Eyal Gur, G. GoldmanAbstract:UNLABELLED This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing recto-vaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. RESULTS Six females and four males underwent gracilis Muscle Transposition from 1999 to 2006. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
-
recto vaginal urethral fistula repair with gracilis Muscle Transposition
Acta Chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, Eyal Gur, G. GoldmanAbstract:UNLABELLED This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing recto-vaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. RESULTS Six females and four males underwent gracilis Muscle Transposition from 1999 to 2006. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
-
Gracilis Muscle Transposition for fistulas between the rectum and urethra or vagina.
Diseases of the Colon & Rectum, 2006Co-Authors: Osnat Zmora, Hagit Tulchinsky, G. Goldman, Joseph M. Klausner, Eyal Gur, Micha RabauAbstract:This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing rectovaginal and rectourethral fistulas. Data were retrieved from a retrospective chart review of patients who underwent gracilis Muscle Transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. Six females and three males, aged 30 to 64 years, underwent gracilis Muscle Transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1–66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
Micha Rabau - One of the best experts on this subject based on the ideXlab platform.
-
gracilis Muscle Transposition for fistulas between the rectum and urethra or vagina
Diseases of The Colon & Rectum, 2006Co-Authors: Osnat Zmora, Hagit Tulchinsky, G. Goldman, Joseph M. Klausner, Micha RabauAbstract:PURPOSE: This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing rectovaginal and rectourethral fistulas. METHODS: Data were retrieved from a retrospective chart review of patients who underwent gracilis Muscle Transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. RESULTS: Six females and three males, aged 30 to 64 years, underwent gracilis Muscle Transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1-66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. CONCLUSIONS: Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
-
recto vaginal urethral fistula repair with gracilis Muscle Transposition
Acta Chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, G. GoldmanAbstract:This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing rectovaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. Results: Six females and four males underwent gracilis Muscle Transposition from 1999 to 2006. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.
-
Recto-vaginal/urethral fistula: repair with gracilis Muscle Transposition.
Acta chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, Eyal Gur, G. GoldmanAbstract:UNLABELLED This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing recto-vaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. RESULTS Six females and four males underwent gracilis Muscle Transposition from 1999 to 2006. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
-
recto vaginal urethral fistula repair with gracilis Muscle Transposition
Acta Chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, Eyal Gur, G. GoldmanAbstract:UNLABELLED This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing recto-vaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. RESULTS Six females and four males underwent gracilis Muscle Transposition from 1999 to 2006. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
-
Gracilis Muscle Transposition for fistulas between the rectum and urethra or vagina.
Diseases of the Colon & Rectum, 2006Co-Authors: Osnat Zmora, Hagit Tulchinsky, G. Goldman, Joseph M. Klausner, Eyal Gur, Micha RabauAbstract:This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing rectovaginal and rectourethral fistulas. Data were retrieved from a retrospective chart review of patients who underwent gracilis Muscle Transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. Six females and three males, aged 30 to 64 years, underwent gracilis Muscle Transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1–66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
Jeng-fen Chiu - One of the best experts on this subject based on the ideXlab platform.
-
Bipedicled Strap Muscle Transposition for Vocal Fold Deficit after Laser Cordectomy in Early Glottic Cancer Patients
The Laryngoscope, 2005Co-Authors: Hui-ching Chuang, Shang-shyue Tsai, Jeng-fen ChiuAbstract:Objective: In treating early glottic carcinomas, the outcomes of endoscopic laser cordectomy have been proven to be valuable in local control, survival, and vocal function preservation. In some extended cases, however, laser cordectomy may leave patients with poor vocal function because of vocal fold deficit. This work assesses the vocal outcome of medialization laryngoplasty with bipedicled strap Muscle Transposition for vocal fold deficit resulting from laser cordectomy in early glottic cancer patients. Study Design: A prospective clinical series. Methods: Thirteen early glottic cancer patients who had vocal fold deficit caused by previous laser cordectomy underwent medialization laryngoplasty with bipedicled strap Muscle Transposition. The thyroid lamina on the cordectomy side was paramedially separated. The inner perichondrium was circumspectly raised from the overlying thyroid cartilage. After separating the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally. A bipedicled strap Muscle flap was then transposed into the area between the lamina and the paraglottic soft tissue. The thyroid cartilages were carefully sutured back in position. All patients received pre- and postoperative voice assessments comprising laryngostroboscopy and vocal function studies. Results: Vocal enhancement was present in 92% (12/13) of patients after medialization laryngoplasty with strap Muscle Transposition. The glottal closure and maximal phonation time were noticeably improved by surgery. No dyspnea or other significant complications were observed in any patients. Conclusion: The outcomes show that bipedicled strap Muscle Transposition is a prosthesis-free, safe, and valuable laryngoplastic technique for correcting glottal incompetence caused by endoscopic laser cordectomy in early glottic cancer patients.
-
Medialization laryngoplasty with strap Muscle Transposition for vocal fold atrophy with or without sulcus vocalis.
The Laryngoscope, 2004Co-Authors: Shang-shyue Tsai, Jeng-fen Chiu, Chu-an ChengAbstract:Objective: Vocal fold atrophy with or without sulcus vocalis may result in a spindle-shaped glottal incompetence (SGI). Because of varying drawbacks with all existing materials (e.g., Silastic block, Teflon, fat, etc.) used for medialization or augmentation of the atrophic vocal folds, there is a need to supplant these materials with a more stable, autologous tissue to correct the SGI. Study Design: Thirty-two patients with vocal fold atrophy underwent medialization laryngoplasty with strap Muscle Transposition. Methods: Under local or general anesthesia, the thyroid lamina on the more affected side was vertically incised 5 mm off the midline. The inner perichondrium was carefully elevated from the overlying thyroid ala. Care was taken not to enter the laryngeal lumen. After dividing the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally. To accommodate the Muscle flap more easily, the caudal edge of the lamina was trimmed using a small burr. A bipedicled strap Muscle flap was then transposed into the space between the lamina and the paraglottic soft tissue. The thyroid cartilages were carefully sutured back in place. All patients underwent pre- and postoperative voice evaluations including laryngostroboscopy, perceptual assessment, and acoustic and aerodynamic analyses. Patients who had been followed up for more than 3 months were enrolled in this study. Results: A total of 27 of the 32 patients with complete pre- and postoperative voice function measurements were included in the analysis. Vocal improvement was demonstrated in 26 of these 27 (96%) patients. No dyspnea or other major complications were noted in any patients. Conclusion: The results indicate that medialization laryngoplasty with strap Muscle Transposition is a prosthesis-free, safe, and effective technique for correcting SGI caused by vocal fold atrophy.
-
A new paramedian approach to arytenoid adduction and strap Muscle Transposition for vocal fold medialization.
Laryngoscope, 2002Co-Authors: Chih-ying Su, Jeng-fen Chiu, Chu-an ChengAbstract:Objective To develop a prosthesis-free medialization laryngoplasty for the treatment of glottal incompetence. Study Design Twenty-two consecutive patients with glottal incompetence underwent vocal fold medialization using a new paramedian approach to arytenoid adduction and/or strap Muscle Transposition. Methods Under local anesthesia, the thyroid lamina on the involved side was parasagittally separated 5 mm off the midline. The inner perichondrium was carefully freed from the overlying thyroid cartilage. After dividing the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally, the inner perichondrium was opened, and the lateral cricoarytenoid Muscle identified. Tracing the Muscle fibers posterosuperiorly, the muscular process of the arytenoid was identified. A 2-0 or 3-0 Prolene suture was placed through the muscular process and tied to the cricoid cartilage at the origin of the lateral cricoarytenoid Muscle. A bipedicled strap Muscle flap was then transposed into the space between the lamina and the inner perichondrium and the thyroid cartilages sutured back into place. Pre- and postoperative voice evaluations measured mean fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, and maximal phonation time, as well as assessments of voice quality. Results Vocal improvement was obtained in 95% (21 of 22) of patients. There was a significant improvement (P
-
a new paramedian approach to arytenoid adduction and strap Muscle Transposition for vocal fold medialization
Laryngoscope, 2002Co-Authors: Chunchung Lui, Jeng-fen Chiu, Hsinching Lin, Chu-an ChengAbstract:Objective To develop a prosthesis-free medialization laryngoplasty for the treatment of glottal incompetence. Study Design Twenty-two consecutive patients with glottal incompetence underwent vocal fold medialization using a new paramedian approach to arytenoid adduction and/or strap Muscle Transposition. Methods Under local anesthesia, the thyroid lamina on the involved side was parasagittally separated 5 mm off the midline. The inner perichondrium was carefully freed from the overlying thyroid cartilage. After dividing the thyrohyoid and cricothyroid membranes, the lamina was retracted laterally, the inner perichondrium was opened, and the lateral cricoarytenoid Muscle identified. Tracing the Muscle fibers posterosuperiorly, the muscular process of the arytenoid was identified. A 2-0 or 3-0 Prolene suture was placed through the muscular process and tied to the cricoid cartilage at the origin of the lateral cricoarytenoid Muscle. A bipedicled strap Muscle flap was then transposed into the space between the lamina and the inner perichondrium and the thyroid cartilages sutured back into place. Pre- and postoperative voice evaluations measured mean fundamental frequency, jitter, shimmer, noise-to-harmonic ratio, and maximal phonation time, as well as assessments of voice quality. Results Vocal improvement was obtained in 95% (21 of 22) of patients. There was a significant improvement (P <.05) in all parameters except shimmer. No major complications were noted in any patient, except for dyspnea in one patient resulting from arytenoid overrotation. Conclusion The results suggest that a paramedian approach to arytenoid adduction combined with strap Muscle Transposition is a safe and effective method for treating glottal incompetence, particularly in patients with unilateral paralytic dysphonia.
G. Goldman - One of the best experts on this subject based on the ideXlab platform.
-
gracilis Muscle Transposition for fistulas between the rectum and urethra or vagina
Diseases of The Colon & Rectum, 2006Co-Authors: Osnat Zmora, Hagit Tulchinsky, G. Goldman, Joseph M. Klausner, Micha RabauAbstract:PURPOSE: This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing rectovaginal and rectourethral fistulas. METHODS: Data were retrieved from a retrospective chart review of patients who underwent gracilis Muscle Transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. RESULTS: Six females and three males, aged 30 to 64 years, underwent gracilis Muscle Transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1-66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. CONCLUSIONS: Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
-
recto vaginal urethral fistula repair with gracilis Muscle Transposition
Acta Chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, G. GoldmanAbstract:This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing rectovaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. Results: Six females and four males underwent gracilis Muscle Transposition from 1999 to 2006. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn’s disease and previous radiation are associated with poor prognosis.
-
Recto-vaginal/urethral fistula: repair with gracilis Muscle Transposition.
Acta chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, Eyal Gur, G. GoldmanAbstract:UNLABELLED This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing recto-vaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. RESULTS Six females and four males underwent gracilis Muscle Transposition from 1999 to 2006. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
-
recto vaginal urethral fistula repair with gracilis Muscle Transposition
Acta Chirurgica Iugoslavica, 2006Co-Authors: Micha Rabau, Osnat Zmora, Hagit Tulchinsky, Eyal Gur, G. GoldmanAbstract:UNLABELLED This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing recto-vaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure. RESULTS Six females and four males underwent gracilis Muscle Transposition from 1999 to 2006. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina and the rectum, especially after failed perineal or trans-anal repair. It is associated with low morbidity and good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
-
Gracilis Muscle Transposition for fistulas between the rectum and urethra or vagina.
Diseases of the Colon & Rectum, 2006Co-Authors: Osnat Zmora, Hagit Tulchinsky, G. Goldman, Joseph M. Klausner, Eyal Gur, Micha RabauAbstract:This study was designed to assess the efficacy of gracilis Muscle Transposition in repairing rectovaginal and rectourethral fistulas. Data were retrieved from a retrospective chart review of patients who underwent gracilis Muscle Transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Follow-up data were gathered from outpatient clinic visits. Success was defined as a healed fistula after stoma closure. Six females and three males, aged 30 to 64 years, underwent gracilis Muscle Transpositions from 1999 to 2005. One pouch-vaginal, three rectourethral, and five rectovaginal fistulas were repaired. The etiologies were Crohn's disease (n = 2), iatrogenic injury to the rectum during radical prostatectomy (n = 2), previous pelvic irradiation for rectal cancer (n = 2) or for cervical cancer (n = 1), recurrent perianal abscesses with fistulas (n = 1), and obstetric tear (n = 1). Seven patients underwent previous medical and surgical repair attempts. There were no intraoperative complications. Postoperative complications included perineal wound infection (n = 1) and at the colostomy closure (n = 2). There were no long-term sequelae. At a median follow-up period of 14 (range, 1–66) months since stoma closure, the fistula healed in seven patients. One patient refused ileostomy closure. One patient with severe Crohn's proctitis has a persistent rectovaginal fistula. Gracilis Muscle Transposition is a viable option for repairing fistulas between the urethra, vagina, and the rectum, especially after failed perineal or transanal repairs. It is associated with low morbidity and a good success rate. Underlying Crohn's disease and previous radiation are associated with poor prognosis.
