AIMTo assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction （ASBO）.METHODSA systematic search of PubMed （MEDLINE）, CINAHL, the Cochrane Library and Ichushi Web wa...AIMTo assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction （ASBO）.METHODSA systematic search of PubMed （MEDLINE）, CINAHL, the Cochrane Library and Ichushi Web was conducted, and the reference lists of review articles were hand-searched. The outcomes of interest were the incidence rate of surgery, the length of hospital days and mortality. The quality of the included studies, publication bias and between-study heterogeneity were also assessed.RESULTS Three randomized controlled trials （RCTs） and three retrospective cohort studies were selected for analysis. In the three RCTs, Daikenchuto signifcantly reduced the incidence of surgery （pOR = 0.13; 95%CI： 0.03-0.50）. Similarly, Daikenchuto signifcantly reduced the incidence of surgery （pOR = 0.53; 95%CI： 0.32-0.87） in the three cohort studies. The length of hospital stay and mortality were not measured or described consistently.CONCLUSIONThe present meta-analysis demonstrates that admini-stering Daikenchuto is associated with a lower incidence of surgery for patients with postoperative ASBO in the Japanese population. In order to better generalize these results, additional studies will be needed.展开更多
We report a unique case of a patient who underwent cystectomy with ileal conduit for nonmalignant bladder disease.Pa postoperatively developed stomal necrosis which was managed conservatively but after few months ther...We report a unique case of a patient who underwent cystectomy with ileal conduit for nonmalignant bladder disease.Pa postoperatively developed stomal necrosis which was managed conservatively but after few months there was severe stomal stenosis and retraction and patient ended up with bilateral nephrostomies.On planned open abdominal exploration with intention to refashion stoma,after resection of distal stenosed segment we found that it was impossible to mobilize proximal portion of conduit due to severe small bowel adhesions.We used a unique approach of creating one more ileal conduit,bringing it as a new stoma on one side and anastomosing its other side with proximal one(ileal conduit over conduit)to augment deficient portion.This technique is not mentioned in the literature and as such we are reporting same as it can help many urologists who may encounter such problems.展开更多
文摘AIMTo assess the effectiveness of Daikenchuto for patients with postoperative adhesive small bowel obstruction （ASBO）.METHODSA systematic search of PubMed （MEDLINE）, CINAHL, the Cochrane Library and Ichushi Web was conducted, and the reference lists of review articles were hand-searched. The outcomes of interest were the incidence rate of surgery, the length of hospital days and mortality. The quality of the included studies, publication bias and between-study heterogeneity were also assessed.RESULTS Three randomized controlled trials （RCTs） and three retrospective cohort studies were selected for analysis. In the three RCTs, Daikenchuto signifcantly reduced the incidence of surgery （pOR = 0.13; 95%CI： 0.03-0.50）. Similarly, Daikenchuto signifcantly reduced the incidence of surgery （pOR = 0.53; 95%CI： 0.32-0.87） in the three cohort studies. The length of hospital stay and mortality were not measured or described consistently.CONCLUSIONThe present meta-analysis demonstrates that admini-stering Daikenchuto is associated with a lower incidence of surgery for patients with postoperative ASBO in the Japanese population. In order to better generalize these results, additional studies will be needed.
文摘We report a unique case of a patient who underwent cystectomy with ileal conduit for nonmalignant bladder disease.Pa postoperatively developed stomal necrosis which was managed conservatively but after few months there was severe stomal stenosis and retraction and patient ended up with bilateral nephrostomies.On planned open abdominal exploration with intention to refashion stoma,after resection of distal stenosed segment we found that it was impossible to mobilize proximal portion of conduit due to severe small bowel adhesions.We used a unique approach of creating one more ileal conduit,bringing it as a new stoma on one side and anastomosing its other side with proximal one(ileal conduit over conduit)to augment deficient portion.This technique is not mentioned in the literature and as such we are reporting same as it can help many urologists who may encounter such problems.
