This paper retrospectively analyzes the complicated rectovaginal fistula in 2 cases after the successful treatment. Through literatures collected, with the difficulties and contradictions of the treatment of complicat...This paper retrospectively analyzes the complicated rectovaginal fistula in 2 cases after the successful treatment. Through literatures collected, with the difficulties and contradictions of the treatment of complicated rectovaginal fistula as the starting point, the currently used hanging line method, the advantage and deficiency of surgical treatment in recent years, and the change of treatment method were reviewed. We wish to explore which current treatments could be a better choice.展开更多
Management of the complex anal fistula represents a perennial challenge to surgeons.Conventional approaches often upset the balance between recurrence prevention and continence preservation with their high failure rat...Management of the complex anal fistula represents a perennial challenge to surgeons.Conventional approaches often upset the balance between recurrence prevention and continence preservation with their high failure rates and significant associated morbidity.The emergence of minimally invasive treatment in recent years,however,offers a promising paradigm shift.Regenerative solutions like autologous stem cell therapy or fistula plugs with extracellular and synthetic matrices represent new frontiers in anal fistula treatment,harnessing physiological regenerative capacities and avoiding the traditional postoperative burden of open wounds,drains,or setons in situ.Together with novel techniques like fistula laser closure,video-assisted fistula treatment,or over-the-scope clip burgeoning over the last decade,these state-of-the-art approaches have been touted for their total sphincter-sparing nature,preserving functional outcomes and quality of life.Despite gaining much scientific and clinical momentum,do these newer modalities live up to their promise?This review aims to critically appraise the latest evidence surrounding minimally invasive approaches,providing up-todate insights into the constantly evolving landscape of anal fistula management.Further long-term and comparative studies will nevertheless be needed to supplement the significantly heterogenous,retrospective analyses consolidated.展开更多
AIM: To clarify the usefulness of a new method for performing a pancreaticojejunostomy by using a fast-absorbable suture material irradiated polyglactin 910, and a temporary stent tube for a narrow pancreatic duct wit...AIM: To clarify the usefulness of a new method for performing a pancreaticojejunostomy by using a fast-absorbable suture material irradiated polyglactin 910, and a temporary stent tube for a narrow pancreatic duct with a soft pancreatic texture.METHODS: Among 63 consecutive patients with soft pancreas undergoing a pancreaticoduodenectomy from 2003 to 2006, 35 patients were treated with a new reconstructive method. Briefly, after the pancreatic transaction, a stent tube was inserted into the lumen of the pancreatic duct and ligated with it by a fast-absorbable suture. Another tip of the stent tube was introduced into the intestinal lumen at the jejunal limb, where a purse-string suture was made by another fast-absorbable suture to roughly fix the tube. The pancreaticojejunostomy was completed by ligating two fast-absorbable sutures to approximate the ductal end and the jejunal mucosa, and by adding a rough anastomosis between the pancreatic parenchyma and the seromuscular layer of the jejunum. The initial surgical results with this method were retrospectively compared with those of the 28 patients treated with conventional duct-to-mucosa anastomosis.RESULTS: The incidences of postoperative morbidity including pancreatic fistula were comparable between the two groups (new; 3%-17% vs conventional; 7%-14% according to the definitions). There was no mortality and re-admission. Late complications were also rarely seen.CONCLUSION: A pancreaticojejunostomy using an irradiated polyglactin 910 suture material and a temporary stent is easy to perform and is feasible even in cases with a narrow pancreatic duct and a normal soft pancreas.展开更多
With the change of people’s lifestyle and diet,the incidence of anorectal diseases is increasing year by year.Anal fistula is a common anorectal disease.Because it cannot heal by itself,surgery has become the main tr...With the change of people’s lifestyle and diet,the incidence of anorectal diseases is increasing year by year.Anal fistula is a common anorectal disease.Because it cannot heal by itself,surgery has become the main treatment method.Due to the particularity of wound location and physiological structure,the wound is easily contaminated by bacteria,so dressing change after surgery plays a decisive role in wound healing.Modern western medicine and traditional Chinese medicine have different dressing changing methods respectively.In this paper,we reviewed commonly used dressing changing methods of traditional Chinese and western medicine after anal fistula surgery.展开更多
BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ...BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.展开更多
Objective:To compare the efficacy of anal adenectomy with virtual hanging wire and anal fistulotomy in the treatment of low anal fistula in infants and children.Methods:60 children with low anal fistula who were admit...Objective:To compare the efficacy of anal adenectomy with virtual hanging wire and anal fistulotomy in the treatment of low anal fistula in infants and children.Methods:60 children with low anal fistula who were admitted to our hospital from October 2021 to March 2022 and met the inclusion criteria were randomly divided into two groups of 30 cases each;the treatment group was treated with anal adenectomy and virtual hanging wire surgery,and the control group was treated with anal fistula resection.The clinical efficacy after treatment was compared.Results:The total effective rate of both groups was 96.67%and the difference between the two groups was not statistically significant(P>0.05).The postoperative pain score of the treatment group was lower than that of the control group(P<0.05).The length of hospitalization and healing time of the treatment group was lower than that of the control group(P<0.05).The anal function of the patients in both groups was normal,and there was no adverse reaction.Conclusion:Anal gland excision and virtual hanging surgery for the treatment of low anal fistula in infants and children have the advantages of mild pain,reduced length of hospitalization,short healing time,and better patient experience as compared to anal fistula excision.展开更多
Dear Editor,I am responding to Zou and Li's,The missing perilymph sign on MRI indicates a perilymphatic fistula:A case report Zou J,Li H.Journal of Otology,2025, 20(1):1-4.https://doi.org/10.26599/JOTO.2025.954000...Dear Editor,I am responding to Zou and Li's,The missing perilymph sign on MRI indicates a perilymphatic fistula:A case report Zou J,Li H.Journal of Otology,2025, 20(1):1-4.https://doi.org/10.26599/JOTO.2025.9540001 proposing the"missing perilymph"sign on MRI as a novel radiological indicator of perilymphatic fistula(PLF).This study adds to the growing body of work seeking objective,non-invasive diagnostic methods for PLF,a condition that has long eluded definitive radiological confirmation.The avoidance of gadolinium contrast in the imaging technique is an additional strength,given increasing awareness of gadoliniumassociated risks (Starekova et al.,2024).展开更多
文摘This paper retrospectively analyzes the complicated rectovaginal fistula in 2 cases after the successful treatment. Through literatures collected, with the difficulties and contradictions of the treatment of complicated rectovaginal fistula as the starting point, the currently used hanging line method, the advantage and deficiency of surgical treatment in recent years, and the change of treatment method were reviewed. We wish to explore which current treatments could be a better choice.
文摘Management of the complex anal fistula represents a perennial challenge to surgeons.Conventional approaches often upset the balance between recurrence prevention and continence preservation with their high failure rates and significant associated morbidity.The emergence of minimally invasive treatment in recent years,however,offers a promising paradigm shift.Regenerative solutions like autologous stem cell therapy or fistula plugs with extracellular and synthetic matrices represent new frontiers in anal fistula treatment,harnessing physiological regenerative capacities and avoiding the traditional postoperative burden of open wounds,drains,or setons in situ.Together with novel techniques like fistula laser closure,video-assisted fistula treatment,or over-the-scope clip burgeoning over the last decade,these state-of-the-art approaches have been touted for their total sphincter-sparing nature,preserving functional outcomes and quality of life.Despite gaining much scientific and clinical momentum,do these newer modalities live up to their promise?This review aims to critically appraise the latest evidence surrounding minimally invasive approaches,providing up-todate insights into the constantly evolving landscape of anal fistula management.Further long-term and comparative studies will nevertheless be needed to supplement the significantly heterogenous,retrospective analyses consolidated.
文摘AIM: To clarify the usefulness of a new method for performing a pancreaticojejunostomy by using a fast-absorbable suture material irradiated polyglactin 910, and a temporary stent tube for a narrow pancreatic duct with a soft pancreatic texture.METHODS: Among 63 consecutive patients with soft pancreas undergoing a pancreaticoduodenectomy from 2003 to 2006, 35 patients were treated with a new reconstructive method. Briefly, after the pancreatic transaction, a stent tube was inserted into the lumen of the pancreatic duct and ligated with it by a fast-absorbable suture. Another tip of the stent tube was introduced into the intestinal lumen at the jejunal limb, where a purse-string suture was made by another fast-absorbable suture to roughly fix the tube. The pancreaticojejunostomy was completed by ligating two fast-absorbable sutures to approximate the ductal end and the jejunal mucosa, and by adding a rough anastomosis between the pancreatic parenchyma and the seromuscular layer of the jejunum. The initial surgical results with this method were retrospectively compared with those of the 28 patients treated with conventional duct-to-mucosa anastomosis.RESULTS: The incidences of postoperative morbidity including pancreatic fistula were comparable between the two groups (new; 3%-17% vs conventional; 7%-14% according to the definitions). There was no mortality and re-admission. Late complications were also rarely seen.CONCLUSION: A pancreaticojejunostomy using an irradiated polyglactin 910 suture material and a temporary stent is easy to perform and is feasible even in cases with a narrow pancreatic duct and a normal soft pancreas.
基金Shaanxi Provincial Key Research and Development Program(Project number:2021SF-351)。
文摘With the change of people’s lifestyle and diet,the incidence of anorectal diseases is increasing year by year.Anal fistula is a common anorectal disease.Because it cannot heal by itself,surgery has become the main treatment method.Due to the particularity of wound location and physiological structure,the wound is easily contaminated by bacteria,so dressing change after surgery plays a decisive role in wound healing.Modern western medicine and traditional Chinese medicine have different dressing changing methods respectively.In this paper,we reviewed commonly used dressing changing methods of traditional Chinese and western medicine after anal fistula surgery.
文摘BACKGROUND At present,there is no unified and effective treatment for extreme corrosive esophageal stenosis(CES)with esophagotracheal fistula(ETF).This case had extreme and severe esophageal stenosis(ES)and ETF after ingesting an enzyme-based chemical detergent,resulting in a serious pulmonary infection and severe malnutrition.Upper gastrointestinal imaging showed that he had an ETF,and endoscopy showed that he had extreme and severe esophageal stricture.This case was complex and difficult to treat.According to the domestic and foreign lite-rature,there is no universal treatment that is low-risk.CASE SUMMARY A patient came to our hospital with extreme ES,an ETF,and severe malnutrition complicated with pulmonary tuberculosis 1 mo after the consumption of an enzy-me-based detergent.The ES was serious,and the endoscope was unable to pass through the esophagus.We treated him by endoscopic incision method(EIM),esophageal stent placement(ESP),and endoscopic balloon dilation(EBD)by using the bronchoscope and gastroscope.This treatment not only closed the ETF,but also expanded the esophagus,with minimal trauma,greatly reducing the pain of the patient.According to the literature,there are no similar reported cases.CONCLUSION We report,for the first time,a patient with extreme CES complicated with ETF,where the endoscope could not be passed through his esophagus but he could be examined by bronchoscopy and treated by EIM,ESP,and EBD.
基金Xi’an Municipal Bureau of Science and Technology,No.21YXYJ0060。
文摘Objective:To compare the efficacy of anal adenectomy with virtual hanging wire and anal fistulotomy in the treatment of low anal fistula in infants and children.Methods:60 children with low anal fistula who were admitted to our hospital from October 2021 to March 2022 and met the inclusion criteria were randomly divided into two groups of 30 cases each;the treatment group was treated with anal adenectomy and virtual hanging wire surgery,and the control group was treated with anal fistula resection.The clinical efficacy after treatment was compared.Results:The total effective rate of both groups was 96.67%and the difference between the two groups was not statistically significant(P>0.05).The postoperative pain score of the treatment group was lower than that of the control group(P<0.05).The length of hospitalization and healing time of the treatment group was lower than that of the control group(P<0.05).The anal function of the patients in both groups was normal,and there was no adverse reaction.Conclusion:Anal gland excision and virtual hanging surgery for the treatment of low anal fistula in infants and children have the advantages of mild pain,reduced length of hospitalization,short healing time,and better patient experience as compared to anal fistula excision.
文摘Dear Editor,I am responding to Zou and Li's,The missing perilymph sign on MRI indicates a perilymphatic fistula:A case report Zou J,Li H.Journal of Otology,2025, 20(1):1-4.https://doi.org/10.26599/JOTO.2025.9540001 proposing the"missing perilymph"sign on MRI as a novel radiological indicator of perilymphatic fistula(PLF).This study adds to the growing body of work seeking objective,non-invasive diagnostic methods for PLF,a condition that has long eluded definitive radiological confirmation.The avoidance of gadolinium contrast in the imaging technique is an additional strength,given increasing awareness of gadoliniumassociated risks (Starekova et al.,2024).
