Displaying publications 1 - 20 of 37 in total

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  1. Thambidorai CR, Raghu R, Zulfiqar A
    Pediatr Surg Int, 2008 Feb;24(2):161-5.
    PMID: 17985137
    Different criteria have been used in literature to describe the anterior ectopic anus (AEA) anomaly, resulting in uncertainty over its prevalence, association with constipation and definition of the indications for surgery. It has been recently proposed that the term AEA should be restricted to anomalies in which a normal appearing anal orifice is located in the perineum in a more anterior location than normal, with an anal canal of normal calibre that is shown by electrical stimulation to be surrounded by the voluntary external anal sphincter (EAS). We report about four infants, three females and one male, who presented with constipation and had an anteriorly located anal orifice of normal calibre. The anal position index measured clinically was less than 0.34 in all the female patients and 0.44 in the male patient. In preoperative magnetic resonance imaging (MRI), the EAS was distributed all around the circumference of the anal canal, including the ventral aspect of the anal canal, in all the patients. Preoperative MRI documentation of sphincter distribution is recommended for the diagnosis of AEA, as it would help in better definition of its association with constipation and the results of surgical management.
    Matched MeSH terms: Anal Canal/abnormalities*; Anal Canal/surgery
  2. Ing DK
    Med J Malaysia, 1977 Sep;32(1):71-4.
    PMID: 609350
    Matched MeSH terms: Anal Canal*
  3. Piozzi GN, Khobragade K, Aliyev V, Asoglu O, Bianchi PP, Butiurca VO, et al.
    Colorectal Dis, 2023 Sep;25(9):1896-1909.
    PMID: 37563772 DOI: 10.1111/codi.16704
    AIM: Intersphincteric resection (ISR) is an oncologically complex operation for very low-lying rectal cancers. Yet, definition, anatomical description, operative indications and operative approaches to ISR are not standardized. The aim of this study was to standardize the definition of ISR by reaching international consensus from the experts in the field. This standardization will allow meaningful comparison in the literature in the future.

    METHOD: A modified Delphi approach with three rounds of questionnaire was adopted. A total of 29 international experts from 11 countries were recruited for this study. Six domains with a total of 37 statements were examined, including anatomical definition; definition of intersphincteric dissection, intersphincteric resection (ISR) and ultra-low anterior resection (uLAR); indication for ISR; surgical technique of ISR; specimen description of ISR; and functional outcome assessment protocol.

    RESULTS: Three rounds of questionnaire were performed (response rate 100%, 89.6%, 89.6%). Agreement (≥80%) reached standardization on 36 statements.

    CONCLUSION: This study provides an international expert consensus-based definition and standardization of ISR. This is the first study standardizing terminology and definition of deep pelvis/anal canal anatomy from a surgical point of view. Intersphincteric dissection, ISR and uLAR were specifically defined for precise surgical description. Indication for ISR was determined by the rectal tumour's maximal radial infiltration (T stage) below the levator ani. A new surgical definition of T3isp was reached by consensus to define T3 low rectal tumours infiltrating the intersphincteric plane. A practical flowchart for surgical indication for uLAR/ISR/abdominoperineal resection was developed. A standardized ISR surgical technique and functional outcome assessment protocol was defined.

    Matched MeSH terms: Anal Canal
  4. Lee YY, Erdogan A, Yu S, Dewitt A, Rao SSC
    J Neurogastroenterol Motil, 2018 Jul 30;24(3):460-468.
    PMID: 29879762 DOI: 10.5056/jnm17081
    Background/Aims: Whether high-resolution anorectal pressure topography (HRPT), having better fidelity and spatio-temporal resolution is comparable to waveform manometry (WM) in the diagnosis and characterization of defecatory disorders (DD) is not known.

    Methods: Patients with chronic constipation (Rome III) were evaluated for DD with HRPT and WM during bearing-down "on-bed" without inflated rectal balloon and "on-commode (toilet)" with 60-mL inflated rectal balloon. Eleven healthy volunteers were also evaluated.

    Results: Ninety-three of 117 screened participants (F/M = 77/16) were included. Balloon expulsion time was abnormal (> 60 seconds) in 56% (mean 214.4 seconds). A modest correlation between HRPT and WM was observed for sphincter length (R = 0.4) and likewise agreement between dyssynergic subtypes (κ = 0.4). During bearing down, 2 or more anal pressure-segments (distal and proximal) could be appreciated and their expansion measured with HRPT but not WM. In constipated vs healthy participants, the proximal segment was more expanded (2.0 cm vs 1.0 cm, P = 0.003) and of greater pressure (94.8 mmHg vs 54.0 mmHg, P = 0.010) during bearing down on-commode but not on-bed.

    Conclusions: Because of its better resolution, HRPT may identify more structural and functional abnormalities including puborectal dysfunction (proximal expansion) than WM. Bearing down on-commode with an inflated rectal balloon may provide additional dimension in characterizing DD.

    Matched MeSH terms: Anal Canal
  5. Hui Shin S, Niccolo Piozzi G, Mayuha Rusli S, Min Choo J, Gu Kang S, Kim SH
    Dis Colon Rectum, 2023 Mar 01;66(3):e118-e119.
    PMID: 36630407 DOI: 10.1097/DCR.0000000000002516
    Matched MeSH terms: Anal Canal/surgery
  6. Ramasamy P, Md Nor A, Kamil NA, Harun N, Yusof MM, Md Hassan MZ
    Malays J Med Sci, 2010 Oct;17(4):62-6.
    PMID: 22135563 MyJurnal
    Myxoid liposarcoma is the major subtype of liposarcoma and commonly presents in the extremities, particularly in the thigh. We introduce an unusual case of a myxoid liposarcoma presenting as a large perineal swelling occupying the para-rectal and para-anal spaces in a 49-year-old male patient. The diagnosis, management, and prognosis of myxoid liposarcoma are discussed. A literature review is performed for myxoid liposarcoma.
    Matched MeSH terms: Anal Canal
  7. Somasundaram K
    Aust N Z J Surg, 1978 Aug;48(4):356-9.
    PMID: 282864
    This 10-year review of surgical conditions in infants at the University Hospital, Kuala Lumpur, highlights some of the more common problems encountered and outlines their management. Anorectal agenesis and Hirschsprung's disease were seen relatively more frequently than other anomalies of the gastrointestinal tract. The management of these two conditions and the operation of colostomy and its complications are singled out and presented in some detail.
    Matched MeSH terms: Anal Canal/abnormalities*; Anal Canal/surgery
  8. Shanwani A, Nor AM, Amri N
    Dis Colon Rectum, 2010 Jan;53(1):39-42.
    PMID: 20010348 DOI: 10.1007/DCR.0b013e3181c160c4
    This study was designed to assess the total anal sphincter-saving technique of ligating the intersphincteric fistula tract for the treatment of fistula-in-ano.
    Matched MeSH terms: Anal Canal
  9. Raja Ram NK, Chan KK, Md Nor SF, Sagap I
    Colorectal Dis, 2020 12;22(12):2199-2203.
    PMID: 32780561 DOI: 10.1111/codi.15305
    AIM: Fistula-in-ano (FIA) is an anomalous passage between perianal skin and the anal canal or the rectum that presents many management difficulties. Ligation of intersphincteric fistula tract (LIFT) was introduced as a cost-effective sphincter-saving procedure with a reported success rate of 94.4%. Unfortunately, this procedure is technically challenging, and recently submucosal ligation of fistula tract (SLOFT), a simplification of LIFT, was proposed. Our aim was to assess the SLOFT technique over a longer follow-up period to determine its effectiveness.

    METHOD: A prospective observational study was performed in 47 patients with FIA treated by SLOFT from September 2017 to February 2019.

    RESULTS: There were 47 patients, of whom 33(70.2%) were men. The median age was 39 years (range 30-50 years). All the patients had primary FIA of cryptoglandular origin. The patients were followed up for 1 year and were postoperatively assessed at 2, 4, 12 and 24 weeks and 1 year. The median body mass index was 27.3 kg/m2 (range 24.3-29.4 kg/m2 ) and the median duration of surgery was 15 min (range 13-20 min). Most (83.0%) of the fistulas were trans-sphincteric. The success rates at the end of 24 weeks and 1 year were 87.2% and 80.9%, respectively. No postoperative incontinence was recorded.

    CONCLUSION: In our series the success rate of SLOFT was 80.9%. There were no sphincter-related complications. Repeat SLOFT was feasible for cases of recurrence. Therefore, SLOFT should be considered an alternative sphincter-saving procedure to LIFT for the management of FIA.

    Matched MeSH terms: Anal Canal
  10. Roger, A.I., Rachel, Anne J.
    MyJurnal
    A congenital urethrocutaneous fistula is a rare anomaly which was first described in 1962 by Gupta. Clinically, children present when their guardian is alarmed by either frequent urinary dribbling or unusual stream when they pass urine. This congenital anomaly can present in isolation or be accompanied by a chordee, hypospadia and anorectal malformations in a newborn. The surgical management will either be a primary repair of the fistula or converting it to a hypospadia before proceeding with a single or staged hypospadia repair. Surgical technique will depend on the local tissue factors and associated anomalies.
    Matched MeSH terms: Anal Canal
  11. Othman BH, Toda T, Kikuchi T
    Zookeys, 2016.
    PMID: 27551211 DOI: 10.3897/zookeys.605.8562
    A new species of Leptostraca, Nebalia terazakii sp. n. is described and figured. The species was sampled from the coral reefs of Pulau Payar Marine Park, Langkawi, Malaysia. There are 32 existing species of Nebalia but Nebalia terazakii sp. n. can be distinguished from the other known species of Nebalia by the following combination of characters: the rostrum is 1.89 times as long as wide and the eyes have no dorsal papilla or lobes. Article 4 of the antennular peduncle has one short thick distal spine. The proximal article of the endopod of maxilla 2 is shorter than the distal, a feature peculiar to Nebalia terazakii sp. n., the exopod of maxilla 2 is longer than article 1 of the endopod, the posterior dorsal borders of the pleonites 6 to 7 are provided with distally sharp denticles, anal plate with prominent lateral shoulder and finally, the terminal seta of the caudal rami is 1.17 times the length of the entire rami.
    Matched MeSH terms: Anal Canal
  12. S,Praveen, TW, Khor, L, James, GC, Teh, S, Febra
    MyJurnal
    Penetrating injuries to bladder occur in 20 % of cases. Synchronous bladder and rectal perforation occur in 30-64 % of cases. The management of rectal and bladder injuries depend on whether it is an extra-peritoneal or intra-peritoneal injury. We hereby, report a case of penetrating trauma in a 13 year old boy who fell off a tropical fruit (Rambutan - Nephelium lappaceum) tree. He sustained an extra-peritoneal rectal injury with intra-peritoneal bladder injury. The rectal injury was repaired primarily via per anal route while the bladder injury needed an open repair following laparotomy. Upon removal of bladder clots, a leaf of the ‘Rambutan’ tree was found intra-vesically. It was removed and bladder repaired as per standard method. We review the literature on rare intra-vesicle foreign bodies and discuss the treatment of synchronous rectal and bladder injuries.
    Matched MeSH terms: Anal Canal
  13. Thambidorai CR, Qureshi MA, Shukri J, Zulfiqar A
    Med J Malaysia, 2005 Jun;60(2):226-8.
    PMID: 16114166
    Posterior sagittal anorectoplasty (PSARP) is preferred by most pediatric surgeon and intermediate types of anorectal anomalies (ARA) in infants. In this report, we describe two girls who presented in their late teens with ARA and were treated by PSARP. Prior to this report, only two adult females with congenital rectovaginal fistulae treated by PSARP have been reported. Megarectum is a feature in late presentation of ARA and requires rectal tapering during PSARP. The functional outcome in late presentation of ARA is discussed.
    Matched MeSH terms: Anal Canal/surgery*
  14. Kim M, Meurette G, Ragu R, Wyart V, Lehur PA
    Ann Surg, 2019 02;269(2):310-314.
    PMID: 28902668 DOI: 10.1097/SLA.0000000000002512
    OBJECTIVE: Magnetic anal sphincter augmentation is a novel surgical option in the treatment of severe fecal incontinence. This study aimed to analyze functional results, quality of life, and satisfaction after implantation in the mid-term, and to identify factors associated with success of this new treatment.

    METHODS: All patients, who underwent magnetic anal sphincter augmentation procedure at a single center between December 2008 and January 2016, were consecutively included. Symptom severity [Cleveland Clinic Incontinence Score (CCIS)], quality of life [Fecal-Incontinence Quality of Life Questionnaire (FIQL)], bowel diary data, and patients' satisfaction were assessed before and after implantation.

    RESULTS: Forty-five patients (43 female), mean (s.d.) age 66.82 (±10.07), were followed for a median of 36 months (range 6-84). Two patients were explanted and 1 lost to follow-up. On a 3-week diary, major leakage rate significantly improved as did CCIS and FIQL. No significant difference was seen for flatus and minor leaks. Postoperative decrease of CCIS by ≥5.5 points correlated best with satisfaction, expressed by 22 patients (48% in intention-to-treat analysis). An independent predictive factor for success after implantation was no previous fecal incontinence surgical treatment.

    CONCLUSIONS: Satisfaction, functional, and quality of life outcomes improve significantly following magnetic anal sphincter augmentation.

    Matched MeSH terms: Anal Canal/surgery*
  15. Wei F, Gaisa MM, D'Souza G, Xia N, Giuliano AR, Hawes SE, et al.
    Lancet HIV, 2021 09;8(9):e531-e543.
    PMID: 34339628 DOI: 10.1016/S2352-3018(21)00108-9
    BACKGROUND: Robust age-specific estimates of anal human papillomavirus (HPV) and high-grade squamous intraepithelial lesions (HSIL) in men can inform anal cancer prevention efforts. We aimed to evaluate the age-specific prevalence of anal HPV, HSIL, and their combination, in men, stratified by HIV status and sexuality.

    METHODS: We did a systematic review for studies on anal HPV infection in men and a pooled analysis of individual-level data from eligible studies across four groups: HIV-positive men who have sex with men (MSM), HIV-negative MSM, HIV-positive men who have sex with women (MSW), and HIV-negative MSW. Studies were required to inform on type-specific HPV infection (at least HPV16), detected by use of a PCR-based test from anal swabs, HIV status, sexuality (MSM, including those who have sex with men only or also with women, or MSW), and age. Authors of eligible studies with a sample size of 200 participants or more were invited to share deidentified individual-level data on the above four variables. Authors of studies including 40 or more HIV-positive MSW or 40 or more men from Africa (irrespective of HIV status and sexuality) were also invited to share these data. Pooled estimates of anal high-risk HPV (HR-HPV, including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68), and HSIL or worse (HSIL+), were compared by use of adjusted prevalence ratios (aPRs) from generalised linear models.

    FINDINGS: The systematic review identified 93 eligible studies, of which 64 contributed data on 29 900 men to the pooled analysis. Among HIV-negative MSW anal HPV16 prevalence was 1·8% (91 of 5190) and HR-HPV prevalence was 6·9% (345 of 5003); among HIV-positive MSW the prevalences were 8·7% (59 of 682) and 26·9% (179 of 666); among HIV-negative MSM they were 13·7% (1455 of 10 617) and 41·2% (3798 of 9215), and among HIV-positive MSM 28·5% (3819 of 13 411) and 74·3% (8765 of 11 803). In HIV-positive MSM, HPV16 prevalence was 5·6% (two of 36) among those age 15-18 years and 28·8% (141 of 490) among those age 23-24 years (ptrend=0·0091); prevalence was 31·7% (1057 of 3337) among those age 25-34 years and 22·8% (451 of 1979) among those age 55 and older (ptrend<0·0001). HPV16 prevalence in HIV-negative MSM was 6·7% (15 of 223) among those age 15-18 and 13·9% (166 of 1192) among those age 23-24 years (ptrend=0·0076); the prevalence plateaued thereafter (ptrend=0·72). Similar age-specific patterns were observed for HR-HPV. No significant differences for HPV16 or HR-HPV were found by age for either HIV-positive or HIV-negative MSW. HSIL+ detection ranged from 7·5% (12 of 160) to 54·5% (61 of 112) in HIV-positive MSM; after adjustment for heterogeneity, HIV was a significant predictor of HSIL+ (aPR 1·54, 95% CI 1·36-1·73), HPV16-positive HSIL+ (1·66, 1·36-2·03), and HSIL+ in HPV16-positive MSM (1·19, 1·04-1·37). Among HPV16-positive MSM, HSIL+ prevalence increased with age.

    INTERPRETATION: High anal HPV prevalence among young HIV-positive and HIV-negative MSM highlights the benefits of gender-neutral HPV vaccination before sexual activity over catch-up vaccination. HIV-positive MSM are a priority for anal cancer screening research and initiatives targeting HPV16-positive HSIL+.

    FUNDING: International Agency for Research on Cancer.

    Matched MeSH terms: Anal Canal/virology*
  16. Sulaiman AS, Ahmad S, Ismail NA, Rahman RA, Jamil MA, Mohd Dali AZ
    Saudi Med J, 2013 Aug;34(8):819-23.
    PMID: 23974453
    To evaluate the prevalence of obstetrical anal sphincter injuries (OASIS), which include third and fourth degree perineal tears in primigravida in routine versus selective mediolateral episiotomy. Secondly, to determine the rate of episiotomy in local settings.
    Matched MeSH terms: Anal Canal/injuries*
  17. Mat Bah MN, Zahari N, Kasim AS, Mohamed Sharif NL
    Eur J Pediatr, 2024 Jan;183(1):271-279.
    PMID: 37870607 DOI: 10.1007/s00431-023-05292-7
    Limited data on the survival of anorectal malformation (ARM) patients from lower- and middle-income countries is available. This retrospective population-based study from the State of Johor, Malaysia, determines the incidence, mortality rate, and survival of ARM patients and factors associated with mortality. Kaplan-Meier survival analysis was used to estimate the survival of ARM patients at 1, 5, and 10 years. In addition, multivariate Cox regression analysis was used to analyze mortality-related factors. There were 175 ARM patients among 803,850 live births, giving an overall ARM incidence of 2.2 (95% confidence interval [CI], 1.9 to 2.5) per 10,000 live births. The male-to-female ratio was 1.5:1. There were 122 (69%) non-isolated ARM, of which 41 were Trisomy-21 and 34 had VACTERL association. Seventy-three (42%) had congenital heart disease (CHD), with 38 severe and 35 non-severe CHD. Overall, 33 (19%) patients died, with a median age of death of 5.7 months (interquartile range (IQR) 25 days to 11.2 months). The overall estimated 1-, 5-, and 10-year survival rate for ARM patients was 82% (95% CI, 76-89%), 77% (95% CI, 70-84%), and 77% (95% CI, 70-84%), respectively. Univariate analysis shows that non-isolated ARM, VACTERL association, and severe CHD were associated with mortality. However, only severe CHD is the independent factor associated with mortality, with a hazard ratio of 4.0 (95% CI, 1.9-8.4).  Conclusion: CHD is common among ARM patients, and one in five ARM patients had a severe cardiac defect, significantly affecting their survival. What is Known: • VACTERL association and congenital heart disease are common in patient with anorectal malformation. • Low birth weight and prematurity are associated with a lower rate of survival. What is New: • Congenital heart disease is common in ARM patients in a middle-income country. • Severe congenital heart disease plays a significant role in the survival of patients with an anorectal malformation in lower- and middle-income countries.
    Matched MeSH terms: Anal Canal/abnormalities*
  18. Guzmán Rojas RA, Kamisan Atan I, Shek KL, Dietz HP
    Ultrasound Obstet Gynecol, 2015 Sep;46(3):363-6.
    PMID: 25766889 DOI: 10.1002/uog.14845
    To determine the prevalence of evidence of residual obstetric anal sphincter injury, to evaluate its association with anal incontinence (AI) and to establish minimal diagnostic criteria for significant (residual) external anal sphincter (EAS) trauma.
    Matched MeSH terms: Anal Canal/injuries*; Anal Canal/ultrasonography
  19. Tan WS, Md Hasan Z, Sanmugam A, Singaravel S, Abdullah MY, Nah SA
    J Pediatr Surg, 2023 Feb;58(2):241-245.
    PMID: 36384936 DOI: 10.1016/j.jpedsurg.2022.10.031
    INTRODUCTION: Anorectal manometry may be useful to objectively evaluate anorectal function following definitive pullthrough for Hirschsprung Disease (HD) but there is little published data. Our study aims to investigate anorectal manometry findings and their association with bowel function.

    METHODOLOGY: This was a prospective observational study. Convenience sampling method was used to recruit all HD patients who had definitive pullthrough from January 2019 to December2020 in our institution. High-resolution anorectal manometry (HRAM) was used to record anal resting pressure (ARP), length of high-pressure zone (HPZ), and presence/absence of recto-anal inhibitory reflex (RAIR). The Paediatric Incontinence/Constipation Scoring System (PICSS) was scored for all participants. PICSS is a validated questionnaire with scores mapped to an age-specific normogram to denote constipation, incontinence, and their combinations. Non-parametric and chi-square tests at significance p<0.05 were conducted to examine the relationship between PICSS categories and manometry findings. Ethical approval was obtained.

    RESULTS: There were 32 participants (30 boys). Median age at participation was 26.5 months (range: 13.8-156). Twenty-four (75%) had transanal pullthrough, 8(25%) underwent Duhamel procedure. PICSS scored 10(31.3%) as normal, 8(25%) as constipation, 10(31.3%) as incontinent, and 4(12.5%) as mixed. RAIR was present in 12 patients (37.5%). HPZ, maximum ARP, mean ARP were comparable across all PICSS groups without statistically significant differences. Presence of RAIR was not significantly associated with any PICSS groups (p = 0.13).

    CONCLUSION: Bowel function does not appear to be significantly associated with HRAM findings after definitive pullthrough for HD, but our study is limited by small sample size. RAIR was present in 37.5% patients after pullthrough.

    LEVEL OF EVIDENCE: Level II.

    Matched MeSH terms: Anal Canal
  20. Paka C, Atan IK, Dietz HP
    Tech Coloproctol, 2016 Feb;20(2):123-8.
    PMID: 26573810 DOI: 10.1007/s10151-015-1397-z
    Patient self-report is important in the assessment of the impact of anal incontinence (AI) on quality of life. This study aimed to (1) determine the correlation between total St. Mark's Incontinence Score (SMIS) and a single-item visual analogue scale (VAS) for bother from AI, and (2) determine the correlation between individual components of SMIS and VAS.
    Matched MeSH terms: Anal Canal/physiopathology
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