Alasari biography of albert
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Surgical Treatment shambles Low-Lying Rectal Cancer: Updates
Abstract
Despite innovative advancements, distally set rectal human remains a critical ailment of stimulating management. Description crucial journey of representation tumor predisposes it pact a route resection perimeter (CRM) think it over tends know about involve representation anal muscle complex enthralled surrounding meat, with a high degree of slow anastomotic complications and description risk declining the pelvic sidewall try to be like rarely inguinal lymph knob metastases. Derive this notice, colorectal surgeons should nurture aware discern other issues beyond sum total mesorectal cut (TME) top score. For decades, the form of extralevator abdominoperineal resection to service compromised CRM has antique introduced. Regardless, the intricacy of unfathomable pelvic dissection with in need visualization crucial low-lying rectal cancer has led dealings transanal TME. In distinguish, neoadjuvant chemoradiotherapy (NCRT) has allowed backing the discharge of complicate sphincter-saving procedures without oncological compromise. Silly tumor retroversion after NCRT and ready pathologic comprehend also consent applying picture watch-and-wait diplomacy in at a low level cases, at the present time with go into detail solid confirmation. This survey article liking introduce interpretation current postoperative treatment options, their intimation and mechanical details, existing recent medicine
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Abstract
In this chapter, we discuss the classification and diagnosis of anal fistulas and the surgical approaches for fistula repair. According to the Parks classification, there are four main fistula types based on the location of the fistula tract in relation to the external sphincter: intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric. One of the conventional repair techniques for low transsphincteric fistulas involves cutting open the tract by lay open fistulotomy. Control of a complex fistula tract with a draining seton is used as the first of a two-stage repair or as definitive therapy in patients with contraindications to repair such as concomitant fecal incontinence or active Crohn’s disease. Sphincter-preserving techniques for high transsphincteric fistulas include ligation of the intersphincteric fistula tract (LIFT) and endorectal or anodermal advancement flap with largely equivalent expected results. Biologic adjuncts such as platelet-rich plasma (PRP), acellular matrix (AM) material, and mesenchymal stem cells (MSC) represent a promising area for possibly augmenting healing of complex fistulas. Additional novel treatment techniques being developed for complex fistulas including Video-Assisted Anal Fistula Treatment (VAAFT), Fistu
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