1
|
Brusciano L, Brillantino A, Pellino G, Marinello F, Baeten CI, Digesu A, Naldini G, Gambardella C, Lucido FS, Sturiale A, Gualtieri G, Riss S, Docimo L. Sacral nerve modulation for patients with fecal incontinence: long-term outcome and effects on sexual function. Updates Surg 2023:10.1007/s13304-023-01570-z. [PMID: 37442886 PMCID: PMC10359216 DOI: 10.1007/s13304-023-01570-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 05/27/2023] [Indexed: 07/15/2023]
Abstract
Sacral nerve modulation has become an established treatment for fecal and urinary incontinence, and sexual disorders. The objective of this study was to evaluate the long-term outcome of sacral neuromodulation in patients with fecal or combined fecal and urinary incontinence (double incontinence), assessing its safety, efficacy, and impact on quality of life and sexual function. This was a multicentric, retrospective, cohort study including patients with fecal or double incontinence who received sacral neuromodulation at seven European centers between 2007 and 2017 and completed a 5-year follow-up. The main outcome measures included improvements of incontinence symptoms and quality of life compared with baseline, evaluated using validated tools and questionnaires at 1-, 6-, 12-, 36- and 60-month follow-up. 108 (102 women, mean age 62.4 ± 13.4 years) patients were recruited, of whom 88 (81.4%) underwent definitive implantation of the pacemaker. Patients' baseline median Cleveland Clinic Incontinence Score was 15 (10-18); it decreased to 2 (1-4) and 1 (1-2) at the 12- and 36-month follow-up (p < 0.0001), remaining stable at the 5-year follow-up. Fecal incontinence quality of life score improved significantly. All patients with sexual dysfunction (n = 48) at baseline reported symptom resolution at the 5-year follow-up. The study was limited by the retrospective design and the relatively small patient sample. Sacral nerve modulation is an effective treatment for fecal and double incontinence, achieving satisfactory long-term success rates, with resolution of concomitant sexual dysfunction.
Collapse
Affiliation(s)
- Luigi Brusciano
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy.
| | | | - Gianluca Pellino
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
- Colorectal Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Franco Marinello
- Colorectal Surgery, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Coen Im Baeten
- Department of Surgery, Groene Hart Hospital, Gouda, The Netherlands
| | - Alex Digesu
- Department of Urogynaecology, Imperial College NHS Healthcare, London, UK
| | - Gabriele Naldini
- Proctology and Perineal Surgical Unit - Proctology and Pelvic Floor Multidisciplinary Clinical Center, Universitary Hospital of Pisa, Pisa, Italy
| | - Claudio Gambardella
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Saverio Lucido
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alessandro Sturiale
- Proctology and Perineal Surgical Unit - Proctology and Pelvic Floor Multidisciplinary Clinical Center, Universitary Hospital of Pisa, Pisa, Italy
| | - Giorgia Gualtieri
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Stefan Riss
- Department of Surgery, Medical University Vienna, Vienna, Austria
| | - Ludovico Docimo
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| |
Collapse
|
2
|
Gambardella C, Brusciano L, Brillantino A, Parisi S, Lucido FS, Del Genio G, Tolone S, Allaria A, Di Saverio S, Pizza F, Sturiale A, Docimo L. Mid-term efficacy and postoperative wound management of laser hemorrhoidoplasty (LHP) vs conventional excisional hemorrhoidectomy in grade III hemorrhoidal disease: the twisting trend. Langenbecks Arch Surg 2023; 408:140. [PMID: 37020091 PMCID: PMC10076349 DOI: 10.1007/s00423-023-02879-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 03/31/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE Hemorrhoidal disease (HD) is a common condition, and several surgical techniques have been proposed to date without being able to achieve definitive consensus on their use and indications. Laser hemorrhoidoplasty (LHP) is a minimally invasive procedure for HD treatment determining the shrinkage of the hemorrhoidal piles by diode laser limiting the postoperative discomfort and pain. The aim of the current study was to evaluate the postoperative outcomes of HD patients undergoing LHP vs conventional Milligan-Morgan hemorrhoidectomy (MM). METHOD Postoperative pain, wound care management, symptoms' resolution, patients' quality of life, and length of return to daily activity of grade III symptomatic HD patients undergoing LHP vs MM were retrospectively evaluated. The patients were followed-up for recurrence of prolapsed hemorrhoid or symptoms. RESULT From January 2018 to December 2019, 93 patients received conventional Milligan Morgan as control group and 81 patients received laser hemorrhoidoplasty treatment using a 1470-nm diode laser. No significant intraoperative complications occurred in both groups. Laser hemorrhoidoplasty patients experienced lower postoperative pain score (p < 0.0001) and smoother wound management. After 25 ± 8 months follow-up, the recurrence of symptoms occurred in 8.1% after Milligan-Morgan and 21.6% after laser hemorrhoidoplasty (p < 0.05) with a similar Rorvik score (7.8 ± 2.6 in LHP group vs 7.6 ± 1.9 in MM group, p = 0.12). CONCLUSION LHP demonstrated high efficacy in selected HD patients guaranteeing lower postoperative pain, easier wound care, higher rate of symptoms resolution, and greater patient appreciation compared to MM, even though it had a higher recurrence rate. Larger comparative studies are needed to address this issue.
Collapse
Affiliation(s)
- Claudio Gambardella
- Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy.
| | - Luigi Brusciano
- Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Antonio Brillantino
- Department of Emergency Surgery, "A. Cardarelli" Hospital, Via A. Cardarelli 9, Naples, Italy
| | - Simona Parisi
- Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Francesco Saverio Lucido
- Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Gianmattia Del Genio
- Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Salvatore Tolone
- Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Alfredo Allaria
- Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Salomone Di Saverio
- Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 OQQ, UK
| | - Francesco Pizza
- Division of General and Emergency Surgery, Asl Napoli 2 nord, Frattamaggiore, Naples, Italy
| | - Alessandro Sturiale
- Proctological and Perineal Surgical Unit, Cisanello University Hospital, Via Paradisa 2, Pisa, Italy
| | - Ludovico Docimo
- Division of General, Oncological, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| |
Collapse
|
3
|
Lin L, Wang Z, Zhang Q, Wang C, Zhang Z. Application of Transumbilical Laparoscopic Surgery on Low/Ultralow Rectal Cancer for Anal Sphincter Preservation. J Laparoendosc Adv Surg Tech A 2022; 32:740-746. [PMID: 35020487 DOI: 10.1089/lap.2021.0586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Rectal cancer is a common malignant tumor in the gastrointestinal tract. This work compares the effects of transumbilical laparoscopic surgery (TULS) and laparoscopic-assisted surgery on the anus-preserving effect of low/ultralow rectal cancer. Materials and Methods: Eighty patients with rectal cancer admitted to our hospital from February 2011 to July 2016 were randomly selected and divided into the laparoscopic group and TULS group, 40 cases in each group, all underwent radical anorectal cancer radical surgery. Statistical analysis was performed on surgical-related indicators in the two groups. Results: Two patients converted to open surgery were excluded. Five patients were excluded because of radical abdomen perineal resection for rectal cancer. Six patients were converted to TULS from laparoscopic surgery. Sixty-seven patients in the experimental group successfully completed anus-sparing surgery, and none died during the operation. The compliance rate of the distance between the lower edge of the tumor and the incision edge of the specimen in the TULS group was better than that in the laparoscopic group (P < .05). There were no significant differences between the two groups in terms of surgical time, blood loss, number of lymph node dissections, functional time of voluntary defecation and postoperative complications, tumor-free recurrence rate at 3 years, and 3-year survival rate after surgery (P > .05). Conclusions: The TULS method is safe and feasible in low and ultralow rectal cancer surgery. It has more advantages than laparoscopic-assisted surgery for anus preservation.
Collapse
Affiliation(s)
- Lin Lin
- Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhanwen Wang
- Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Quanchao Zhang
- Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Canfeng Wang
- Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Zhanxue Zhang
- Department of General Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| |
Collapse
|
4
|
Khan HM, Gowda VSS, Ramesh BS, Sandeep D. A comparative evaluation of laser hemorrhoidoplasty versus open surgical hemorrhoidectomy treatment of grade III and IV hemorrhoids. A prospective observational study. JOURNAL OF CLINICAL AND INVESTIGATIVE SURGERY 2021. [DOI: 10.25083/2559.5555/6.1.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to evaluate and compare the efficacy and outcomes of laser hemorrhoidoplasty with that of open surgical hemorrhoidectomy. This prospective observational study consists of 50 subjects in each group. The open surgery group underwent a standardized Milligan-Morgan technique, and the laser group underwent laser hemorrhoidoplasty with a diode laser of 1470 nm (LASOTRONIX), 8.5 watts with a continuous pulse. Postoperative pain was considered as the primary outcome and was evaluated in both groups using the visual analog scale. There was a statistically significant difference between the two groups in VAS score at different follow-up period, with a mean score of 2.3±1.05 and 5.1±1.11 (24 hours) for the laser hemorrhoidoplasty group and open surgery group, respectively (p value < 0.008). There was an improvement in VAS score in the laser hemorrhoidoplasty group compared to the conventional open surgical group in 1, 7, 14, 21, and 30 days follow up.
Collapse
|
5
|
Obstructed defecation syndrome associated with paradoxical puborectalis contraction: osteopathic treatment versus anal biofeedback. Results of a pilot study. Tech Coloproctol 2021; 25:589-595. [PMID: 33638728 DOI: 10.1007/s10151-020-02381-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 11/24/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Biofeedback is the most widespread rehabilitative therapy for the treatment of anismus after failed conservative treatment. Osteopathy represents an alternative therapy for constipation. The aim of this study was to evaluate short- and long-term results of osteopathic treatment as compared to biofeedback in patients with dyssynergic defecation. METHODS This was a prospective cohort pilot study on 30 patients with dyssynergic defecation enrolled at the Colorectal Clinic of the University Hospital of Ferrara, Italy, from May 2015 to May 2016 and followed until May 2020. Dyssynergic defecation was defined as the inappropriate contraction of the pelvic floor or less than 20% relaxation of basal resting sphincter pressure (on anal manometry) with adequate propulsive forces during attempted defecation. Dyssynergic patients were divide into 2 treatment groups: 15 patients had osteopathy and 15 patients had biofeedback. Before and 3 months after rehabilitation treatment, all patients had anorectal manometry, defecography, and ultrasound, and were evaluated with the Cleveland Clinic Florida (CCF) constipation score, obstructed defecation syndrome (ODS) score, Colo-rectal-anal Distress Inventory (CRADI-8), Colo-rectal-anal Impact Questionnaire (CRAIQ-7), and the Brusciano Score (BS). To evaluate the efficacy of osteopathy and biofeedback in the long-term, all patients completed the above-mentioned questionnaires 5 years later via a telephone interview. RESULTS The two treatments were similarly effective in the short term with reduction in questionnaires scores, and increase in the percentage of anal sphincter release at straining at anorectal manometry in both groups. The ODS score was significantly reduced in biofeedback group (p = 0.021). The 3-month post-treatment BS was lower in the osteopathy group, but this just failed to reach statistical significance (p = 0.050). Periodic rehabilitation reinforcements were provided. The CCF constipation score decreased significantly in the osteopathy group (p = 0.023) after 5 years. CONCLUSIONS Osteopathy is a promising treatment for dyssynergic defecation, and it can be associated with biofeedback.
Collapse
|
6
|
Brusciano L, Gualtieri G, Gambardella C, Del Genio G, Tolone S, Lucido FS, Terracciano G, Sturiale A, Docimo L. ESNM Guidelines on functional constipation in adults: Further reflections and considerations. Neurogastroenterol Motil 2020; 32:e13915. [PMID: 32515153 DOI: 10.1111/nmo.13915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/01/2020] [Accepted: 05/14/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Luigi Brusciano
- Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giorgia Gualtieri
- Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy
| | - Claudio Gambardella
- Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Cardiothoracic Sciences, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianmattia Del Genio
- Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy
| | - Salvatore Tolone
- Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy
| | - Francesco Saverio Lucido
- Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianmattia Terracciano
- Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Sturiale
- Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Cardiothoracic Sciences, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Ludovico Docimo
- Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
7
|
Brusciano L, Gambardella C, Del Genio G, Tolone S, Lucido FS, Terracciano G, Gualtieri G, Docimo L. OUTLET OBSTRUCTED CONSTIPATION AND FECAL INCONTINENCE: IS REHABILITATION TREATMENT THE WAY? MYTH OR REALITY. ARQUIVOS DE GASTROENTEROLOGIA 2020; 5757:198-202. [PMID: 32401951 DOI: 10.1590/s0004-2803.202000000-38] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 02/12/2020] [Indexed: 12/15/2022]
Abstract
Pelvic floor rehabilitation aims to address perineal functional and anatomic alterations as well as thoraco-abdominal mechanic dysfunctions leading to procto-urologic diseases like constipation, fecal and urinary incontinence, and pelvic pain. They require a multidimensional approach, with a significant impact on patients quality of life. An exhaustive clinical and instrumental protocol to assess defecation disorders should include clinical and instrumental evaluation as well as several clinical/physiatric parameters. All these parameters must be considered in order to recognize and define any potential factor playing a role in the functional aspects of incontinence, constipation and pelvic pain. After such evaluation, having precisely identified any thoraco-abdomino-perineal anatomic and functional alterations, a pelvi-perineal rehabilitation program can be carried out to correct the abovementioned alterations and to obtain clinical improvement. The success of the rehabilitative process is linked to several factors such as a careful evaluation of the patient, aimed to select the most appropriate and specific targeted rehabilitative therapy, the therapist's scrupulous hard work, especially as regards the patient's emotional and psychic state, and finally the patient's compliance in undertaking the therapy itself, especially at home. These factors may deeply influence the overall outcomes of the rehabilitative therapies, ranging from "real" success to illusion "myth".
Collapse
Affiliation(s)
- Luigi Brusciano
- University of Campania "Luigi Vanvitelli", Division of General, Mininvasive and Bariatric Surgery, Naples, Italy
| | - Claudio Gambardella
- University of Campania "Luigi Vanvitelli", Division of General, Mininvasive and Bariatric Surgery, Naples, Italy.,University of Campania "Luigi Vanvitelli", School of Medicine, Department of Cardiothoracic Sciences, Naples, Italy
| | - Gianmattia Del Genio
- University of Campania "Luigi Vanvitelli", Division of General, Mininvasive and Bariatric Surgery, Naples, Italy
| | - Salvatore Tolone
- University of Campania "Luigi Vanvitelli", Division of General, Mininvasive and Bariatric Surgery, Naples, Italy
| | - Francesco Saverio Lucido
- University of Campania "Luigi Vanvitelli", Division of General, Mininvasive and Bariatric Surgery, Naples, Italy
| | - Gianmattia Terracciano
- University of Campania "Luigi Vanvitelli", Division of General, Mininvasive and Bariatric Surgery, Naples, Italy
| | - Giorgia Gualtieri
- University of Campania "Luigi Vanvitelli", Division of General, Mininvasive and Bariatric Surgery, Naples, Italy
| | - Ludovico Docimo
- University of Campania "Luigi Vanvitelli", Division of General, Mininvasive and Bariatric Surgery, Naples, Italy
| |
Collapse
|
8
|
Brusciano L, Gambardella C, Terracciano G, Gualtieri G, Schiano di Visconte M, Tolone S, Del Genio G, Docimo L. Postoperative discomfort and pain in the management of hemorrhoidal disease: laser hemorrhoidoplasty, a minimal invasive treatment of symptomatic hemorrhoids. Updates Surg 2019; 72:851-857. [PMID: 31760588 DOI: 10.1007/s13304-019-00694-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/16/2019] [Indexed: 02/08/2023]
Abstract
Hemorrhoidal disease (HD) treatment still remains controversial. In fact, despite many surgical progresses, postoperative pain, and discomfort remain the major weaknesses. Laser hemorrhoidoplasty (LHP) is a minimal invasive procedure for HD treatment determining the shrinkage of the hemorrhoidal piles by diode laser. The aim of the current study is to analyze the feasibility and efficacy of LHP in patients with II-III degrees hemorrhoids. Consecutive patients with II-III degree hemorrhoids were enrolled in the study and underwent an LHP treatment using a 1470-nm diode laser. Operative time, postoperative pain and complications, resolution of symptoms, and length of return to daily activity were prospectively evaluated. Recurrence of prolapsed hemorrhoid or symptoms at a minimum follow-up of 6 months was evaluated. Fifty patients (28 males and 22 females) were enrolled in the study. No significant intraoperative complications occurred. Postoperative pain score (at 12, 18, and 24 h postoperatively), evaluated through visual analogue scale, was extremely low (mean value 2). No postoperative spontaneous bleeding occurred. The 100% of our population came back to daily activity 2 days after surgery. At a mean follow-up period of 8.6 months, we reported a recurrence rate of 0%. LHP demonstrated a large efficacy in selected patients. The greatest strength points were low postoperative pain, the presence of slightly significant peri-anal wounds, no special anal hygienic measures and low surgical time. Thus, resulting in a negligible postoperative discomfort, LHP could be considered a painless and minimal invasive technique in the treatment of HD.
Collapse
Affiliation(s)
- Luigi Brusciano
- University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Claudio Gambardella
- University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy.,Department of Cardiothoracic Sciences, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gianmattia Terracciano
- University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Giorgia Gualtieri
- University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | | | - Salvatore Tolone
- University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Gianmattia Del Genio
- University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy
| | - Ludovico Docimo
- University of Study of Campania "Luigi Vanvitelli", via Luigi Pansini n° 5, 80131, Naples, Italy.
| |
Collapse
|
9
|
GAMBARDELLA C, BRUSCIANO L, DEL GENIO G, TOLONE S, TERRACCIANO G, GUALTIERI G, LUCIDO FS, DOCIMO L. Predictive parameters to identify incontinent patients amenable for rehabilitation treatment: the muscular synergies evaluation. ARQUIVOS DE GASTROENTEROLOGIA 2019; 56:452-453. [DOI: 10.1590/s0004-2803.201900000-76] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Claudio GAMBARDELLA
- University of Campania “Luigi Vanvitelli”, Italy; University of Campania “Luigi Vanvitelli”, Italy
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Brusciano L, Gambardella C, Tolone S, Del Genio G, Terracciano G, Gualtieri G, Schiano di Visconte M, Docimo L. An imaginary cuboid: chest, abdomen, vertebral column and perineum, different parts of the same whole in the harmonic functioning of the pelvic floor. Tech Coloproctol 2019; 23:603-605. [PMID: 31065825 DOI: 10.1007/s10151-019-01996-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/02/2019] [Indexed: 01/29/2023]
Affiliation(s)
- L Brusciano
- XI Division of General, Minimally Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy.
| | - C Gambardella
- XI Division of General, Minimally Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy.,Department of Cardiothoracic Sciences, School of Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - S Tolone
- XI Division of General, Minimally Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - G Del Genio
- XI Division of General, Minimally Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - G Terracciano
- XI Division of General, Minimally Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | - G Gualtieri
- XI Division of General, Minimally Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| | | | - L Docimo
- XI Division of General, Minimally Invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli" Naples, via Luigi Pansini n° 5, 80131, Naples, Italy
| |
Collapse
|
11
|
Brusciano L, Tolone S, Limongelli P, Del Genio G, Messina F, Martellucci J, Lanza Volpe M, Longo A, Docimo L. Anatomical and Functional Features of the Internal Rectal Prolapse With Outlet Obstruction Determined With 3D Endorectal Ultrasonography and High-Resolution Anorectal Manometry: An Observational Case-Control Study. Am J Gastroenterol 2018; 113:1247-1250. [PMID: 29915399 DOI: 10.1038/s41395-018-0141-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 05/04/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To investigate correlation between rectal wall thickness (RWT) and anorectal pressures, in obstructed defecation syndrome (ODS) patients caused by internal rectal prolapse. METHODS ODS patients and healthy volunteers (HVs) underwent 3D endorectal ultrasound (3D-EUS) and high-resolution anorectal manometry (HRAM); RWT, total rectal wall volume (TRWV), pushing endorectal pressure (PEP), recto-anal gradient were determined RESULTS: We enrolled 35 ODS patients and 25 HVs. Patients showed markedly decreased TRWV, PEP, and recto-anal gradient. Linear correlation was found between markedly reduced TRWV and markedly hypotonic PEP. CONCLUSIONS HRAM and 3D-EUS could be performed in ODS assessment, to better understand rectal function.
Collapse
Affiliation(s)
- Luigi Brusciano
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli", Naples, Italy. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Largo Brambilla 3, Florence, Italy. St. Elizabeth Hospital, Wien, Austria. These authors contributed equally: Luigi Brusciano and Salvatore Tolone
| | - Salvatore Tolone
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli", Naples, Italy. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Largo Brambilla 3, Florence, Italy. St. Elizabeth Hospital, Wien, Austria. These authors contributed equally: Luigi Brusciano and Salvatore Tolone
| | - Paolo Limongelli
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli", Naples, Italy. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Largo Brambilla 3, Florence, Italy. St. Elizabeth Hospital, Wien, Austria. These authors contributed equally: Luigi Brusciano and Salvatore Tolone
| | - Gianmattia Del Genio
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli", Naples, Italy. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Largo Brambilla 3, Florence, Italy. St. Elizabeth Hospital, Wien, Austria. These authors contributed equally: Luigi Brusciano and Salvatore Tolone
| | - Federico Messina
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli", Naples, Italy. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Largo Brambilla 3, Florence, Italy. St. Elizabeth Hospital, Wien, Austria. These authors contributed equally: Luigi Brusciano and Salvatore Tolone
| | - Jacopo Martellucci
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli", Naples, Italy. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Largo Brambilla 3, Florence, Italy. St. Elizabeth Hospital, Wien, Austria. These authors contributed equally: Luigi Brusciano and Salvatore Tolone
| | - Mariachiara Lanza Volpe
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli", Naples, Italy. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Largo Brambilla 3, Florence, Italy. St. Elizabeth Hospital, Wien, Austria. These authors contributed equally: Luigi Brusciano and Salvatore Tolone
| | - Antonio Longo
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli", Naples, Italy. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Largo Brambilla 3, Florence, Italy. St. Elizabeth Hospital, Wien, Austria. These authors contributed equally: Luigi Brusciano and Salvatore Tolone
| | - Ludovico Docimo
- Department of Medical, Surgical, Neurologic, Metabolic and Aging Sciences, General, Mininvasive and Obesity Surgery Unit, Master of Coloproctology, Master of Pelvic Floor Rehabilitation, University of Campania "Luigi Vanvitelli", Naples, Italy. General, Emergency and Mini-invasive Surgery, Careggi University Hospital, Largo Brambilla 3, Florence, Italy. St. Elizabeth Hospital, Wien, Austria. These authors contributed equally: Luigi Brusciano and Salvatore Tolone
| |
Collapse
|
12
|
Should Perineal Descent Be Managed as a Multifactorial Clinicopathologic Entity in Patients With Obstructed Defecation? Dis Colon Rectum 2017; 60:e9. [PMID: 28059924 DOI: 10.1097/dcr.0000000000000772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|
13
|
The Author Replies. Dis Colon Rectum 2017; 60:e9-e10. [PMID: 28059925 DOI: 10.1097/dcr.0000000000000771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
|