References: Laxative
AJR Am J Roentgenol. 2001 Oct;177(4):823-7.
MR colonography without colonic cleansing: a new strategy to improve patient acceptance.
Lauenstein T, Holtmann G, Schoenfelder D, Bosk S, Ruehm SG, Debatin JF.
Department of Diagnostic Radiology, University Hospital Essen, Hufelandstr. 55, D-45122 Essen, Germany.
OBJECTIVE: MR colonography permits accurate detection of colonic polyps larger than 8 mm. Patient acceptance remains limited because of the need for bowel cleansing. The aim of this study was to develop and assess a strategy obviating colonic cleansing by performing MR colonography in conjunction with fecal tagging based on the oral administration of barium. SUBJECTS AND METHODS: Six healthy volunteers and six patients with suspected colorectal tumors, undergoing conventional colonoscopy within 1 week of MR imaging, were included in this study. For fecal tagging, 200 mL of a barium-containing contrast agent was ingested with each of four principal meals preceding the examination. For MR colonography, the colon was filled with a barium and water mixture while gadobenate dimeglumine (0.2 mmol/kg) was injected IV. RESULTS: The combination of fecal tagging and colonic filling with barium resulted in a homogeneously low signal throughout the colonic lumen in all 12 subjects. IV injection of gadolinium caused avid enhancement of the colonic wall. Similarly, lesions arising from the colonic wall enhanced avidly. In the six evaluated patients, MR colonography correctly identified two colonic carcinomas in two patients and one polyp in each of another two patients. CONCLUSION: Fecal tagging obviates bowel cleansing and should, therefore, enhance patient acceptance for MR colonoscopy. Barium used as the tagging agent is promising because it is inexpensive, commercially available, and characterized by an excellent safety profile.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11566681&dopt=Abstract constipation laxative colon cleansing
Zhonghua Zhong Liu Za Zhi. 2001 Jul;23(4):338-40.
[Surgical management for colon cancer complicated with acute obstruction]
[Article in Chinese]
Wan D, Chen G, Liu H.
Department of Abdominal Surgery, Tumor Hospital, Sun Yat-sen University of Medical Sciences, Guangzhou 510060, China.
OBJECTIVE: To evaluate the feasibility of tumor resection and stage-I anastomosis for colon cancer complicated with acute obstruction. METHODS: Seventeen colon cancer patients complicated with acute obstruction admitted from 1994-1998 into our hospital, together with 1,872 cases collected from 40 reports published in the same interval in China, a total of 1,889 cases were analyzed as to the results of their surgical management. RESULTS: In the whole group, there was an incidence of 3.1% anastomotic leak, 6.6% wound infection and 1.1% pulmonary infection. Ninety-three patients died of operation with an operation mortality of 4.9%. Postoperative 5-year survival rate was 26.0%-48.0% in patients with stage-I operation. It was 20.0%-38.0% in staged operation. CONCLUSION: Tumor resection with stage-I anastomosis for colon cancer complicated with acute obstruction is acceptable giving relatively satisfactory results. Technique, bowel cleansing during the operation, rational use of antibiotics and adherence to proper indications are crucial for stage-I operation.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11783122&dopt=Abstract constipation laxative colon cleansing
Tech Coloproctol. 2001 Apr;5(1):27-32.
Reconstructive perineoplasty in the management of non-healing wounds after anorectal surgery.
Bernardi C, Pescatori M.
Plastic Surgery, Nuova Villa Claudia, Via Flaminia Nuova 280, I-00191 Rome, Italy.
Non-healing wounds (NHW) following anorectal surgery cause great distress to the patient and may be followed by a retracting scar causing anal deformity and incontinence. The management of NHW is controversial. The aim of this study was to review our experience with reconstructive perineoplasty in the treatment of such condition. From January 1992 to June 2000, we treated 12 patients affected by NHW (4 men and 8 women, mean age 47 years), not responding to conservative treatment. None had Crohn's disease or HIV infection. Pre- and postoperative anal manometry and ultrasound were carried out in 8 patients. All had microspinal anesthesia, mechanical preparation of the intestine, and perineal wound cleansing. Reconstructive perineoplasty was performed by means of local flaps (i. e. cutaneous, fasciocutaneous, myocutaneous). Median follow-up was 13 months (range, 1 to 70). Postoperative complications were as follows: 5 perineal suture dehiscences (1 total, 4 partial), the flap being resutured in one case under local anesthesia; one patient required dilatations for mild anal stricture. No case of gross fecal incontinence, retracting scar or perineal ulcer was observed. Among those patients who had disordered anal continence prior to surgery, all but one improved continence score following perineoplasty from 2.8+/-2.2 to 1.8+/-1.2 (mean +/- sdm, not significant). Following reconstructive perineoplasty, no significant change was observed in functional and morphologic patterns of the anal sphincters either at manometry or by ultrasound. Reconstructive perineoplasty resulted in a good functional and clinical outcome in most cases and, therefore, may be considered an effective procedure in the management of NHW.
Laxative online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11793257&dopt=Abstract constipation laxative colon cleansing [PubMed - indexed for MEDLINE
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