How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success
Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the en...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Yamataka, Atsuyuki [verfasserIn] Yazaki, Yuta [verfasserIn] Koga, Hiroyuki [verfasserIn] Lane, Geoffrey J. [verfasserIn] Ochi, Takanori [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2018 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: Pediatric surgery international - Berlin : Springer, 1986, 35(2018), 2 vom: 01. Nov., Seite 199-202 |
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| Übergeordnetes Werk: |
volume:35 ; year:2018 ; number:2 ; day:01 ; month:11 ; pages:199-202 |
| Links: |
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| DOI / URN: |
10.1007/s00383-018-4395-1 |
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| Katalog-ID: |
SPR004732626 |
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| 100 | 1 | |a Yamataka, Atsuyuki |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success |
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| 520 | |a Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. Conclusion Thorough exposure of the entire SAC, which is crucial for adequate TAPT, is greatly facilitated by patient positioning. | ||
| 650 | 4 | |a Hirschsprung’s disease |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Transanal pull-through |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Anorectal line |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Surgical anal canal |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Yazaki, Yuta |e verfasserin |4 aut | |
| 700 | 1 | |a Koga, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Lane, Geoffrey J. |e verfasserin |4 aut | |
| 700 | 1 | |a Ochi, Takanori |e verfasserin |4 aut | |
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10.1007/s00383-018-4395-1 doi (DE-627)SPR004732626 (SPR)s00383-018-4395-1-e DE-627 ger DE-627 rakwb eng 610 ASE 44.65 bkl 44.67 bkl Yamataka, Atsuyuki verfasserin aut How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. Conclusion Thorough exposure of the entire SAC, which is crucial for adequate TAPT, is greatly facilitated by patient positioning. Hirschsprung’s disease (dpeaa)DE-He213 Transanal pull-through (dpeaa)DE-He213 Anorectal line (dpeaa)DE-He213 Surgical anal canal (dpeaa)DE-He213 Yazaki, Yuta verfasserin aut Koga, Hiroyuki verfasserin aut Lane, Geoffrey J. verfasserin aut Ochi, Takanori verfasserin aut Enthalten in Pediatric surgery international Berlin : Springer, 1986 35(2018), 2 vom: 01. Nov., Seite 199-202 (DE-627)254638937 (DE-600)1463010-2 1437-9813 nnns volume:35 year:2018 number:2 day:01 month:11 pages:199-202 https://dx.doi.org/10.1007/s00383-018-4395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 ASE 44.67 ASE AR 35 2018 2 01 11 199-202 |
| spelling |
10.1007/s00383-018-4395-1 doi (DE-627)SPR004732626 (SPR)s00383-018-4395-1-e DE-627 ger DE-627 rakwb eng 610 ASE 44.65 bkl 44.67 bkl Yamataka, Atsuyuki verfasserin aut How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. Conclusion Thorough exposure of the entire SAC, which is crucial for adequate TAPT, is greatly facilitated by patient positioning. Hirschsprung’s disease (dpeaa)DE-He213 Transanal pull-through (dpeaa)DE-He213 Anorectal line (dpeaa)DE-He213 Surgical anal canal (dpeaa)DE-He213 Yazaki, Yuta verfasserin aut Koga, Hiroyuki verfasserin aut Lane, Geoffrey J. verfasserin aut Ochi, Takanori verfasserin aut Enthalten in Pediatric surgery international Berlin : Springer, 1986 35(2018), 2 vom: 01. Nov., Seite 199-202 (DE-627)254638937 (DE-600)1463010-2 1437-9813 nnns volume:35 year:2018 number:2 day:01 month:11 pages:199-202 https://dx.doi.org/10.1007/s00383-018-4395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 ASE 44.67 ASE AR 35 2018 2 01 11 199-202 |
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10.1007/s00383-018-4395-1 doi (DE-627)SPR004732626 (SPR)s00383-018-4395-1-e DE-627 ger DE-627 rakwb eng 610 ASE 44.65 bkl 44.67 bkl Yamataka, Atsuyuki verfasserin aut How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. Conclusion Thorough exposure of the entire SAC, which is crucial for adequate TAPT, is greatly facilitated by patient positioning. Hirschsprung’s disease (dpeaa)DE-He213 Transanal pull-through (dpeaa)DE-He213 Anorectal line (dpeaa)DE-He213 Surgical anal canal (dpeaa)DE-He213 Yazaki, Yuta verfasserin aut Koga, Hiroyuki verfasserin aut Lane, Geoffrey J. verfasserin aut Ochi, Takanori verfasserin aut Enthalten in Pediatric surgery international Berlin : Springer, 1986 35(2018), 2 vom: 01. Nov., Seite 199-202 (DE-627)254638937 (DE-600)1463010-2 1437-9813 nnns volume:35 year:2018 number:2 day:01 month:11 pages:199-202 https://dx.doi.org/10.1007/s00383-018-4395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 ASE 44.67 ASE AR 35 2018 2 01 11 199-202 |
| allfieldsGer |
10.1007/s00383-018-4395-1 doi (DE-627)SPR004732626 (SPR)s00383-018-4395-1-e DE-627 ger DE-627 rakwb eng 610 ASE 44.65 bkl 44.67 bkl Yamataka, Atsuyuki verfasserin aut How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. Conclusion Thorough exposure of the entire SAC, which is crucial for adequate TAPT, is greatly facilitated by patient positioning. Hirschsprung’s disease (dpeaa)DE-He213 Transanal pull-through (dpeaa)DE-He213 Anorectal line (dpeaa)DE-He213 Surgical anal canal (dpeaa)DE-He213 Yazaki, Yuta verfasserin aut Koga, Hiroyuki verfasserin aut Lane, Geoffrey J. verfasserin aut Ochi, Takanori verfasserin aut Enthalten in Pediatric surgery international Berlin : Springer, 1986 35(2018), 2 vom: 01. Nov., Seite 199-202 (DE-627)254638937 (DE-600)1463010-2 1437-9813 nnns volume:35 year:2018 number:2 day:01 month:11 pages:199-202 https://dx.doi.org/10.1007/s00383-018-4395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 ASE 44.67 ASE AR 35 2018 2 01 11 199-202 |
| allfieldsSound |
10.1007/s00383-018-4395-1 doi (DE-627)SPR004732626 (SPR)s00383-018-4395-1-e DE-627 ger DE-627 rakwb eng 610 ASE 44.65 bkl 44.67 bkl Yamataka, Atsuyuki verfasserin aut How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success 2018 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. Conclusion Thorough exposure of the entire SAC, which is crucial for adequate TAPT, is greatly facilitated by patient positioning. Hirschsprung’s disease (dpeaa)DE-He213 Transanal pull-through (dpeaa)DE-He213 Anorectal line (dpeaa)DE-He213 Surgical anal canal (dpeaa)DE-He213 Yazaki, Yuta verfasserin aut Koga, Hiroyuki verfasserin aut Lane, Geoffrey J. verfasserin aut Ochi, Takanori verfasserin aut Enthalten in Pediatric surgery international Berlin : Springer, 1986 35(2018), 2 vom: 01. Nov., Seite 199-202 (DE-627)254638937 (DE-600)1463010-2 1437-9813 nnns volume:35 year:2018 number:2 day:01 month:11 pages:199-202 https://dx.doi.org/10.1007/s00383-018-4395-1 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_152 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_711 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4012 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4328 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.65 ASE 44.67 ASE AR 35 2018 2 01 11 199-202 |
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Enthalten in Pediatric surgery international 35(2018), 2 vom: 01. Nov., Seite 199-202 volume:35 year:2018 number:2 day:01 month:11 pages:199-202 |
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Enthalten in Pediatric surgery international 35(2018), 2 vom: 01. Nov., Seite 199-202 volume:35 year:2018 number:2 day:01 month:11 pages:199-202 |
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Hirschsprung’s disease Transanal pull-through Anorectal line Surgical anal canal |
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Pediatric surgery international |
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Yamataka, Atsuyuki @@aut@@ Yazaki, Yuta @@aut@@ Koga, Hiroyuki @@aut@@ Lane, Geoffrey J. @@aut@@ Ochi, Takanori @@aut@@ |
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2018-11-01T00:00:00Z |
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We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. 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Yamataka, Atsuyuki |
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Yamataka, Atsuyuki ddc 610 bkl 44.65 bkl 44.67 misc Hirschsprung’s disease misc Transanal pull-through misc Anorectal line misc Surgical anal canal How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success |
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610 ASE 44.65 bkl 44.67 bkl How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success Hirschsprung’s disease (dpeaa)DE-He213 Transanal pull-through (dpeaa)DE-He213 Anorectal line (dpeaa)DE-He213 Surgical anal canal (dpeaa)DE-He213 |
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How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success |
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How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success |
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Yamataka, Atsuyuki Yazaki, Yuta Koga, Hiroyuki Lane, Geoffrey J. Ochi, Takanori |
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Yamataka, Atsuyuki |
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how best to expose the entire surgical anal canal in the operative field during transanal pull-through for hirschsprung’s disease: a crucial step that determines success |
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How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success |
| abstract |
Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. Conclusion Thorough exposure of the entire SAC, which is crucial for adequate TAPT, is greatly facilitated by patient positioning. |
| abstractGer |
Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. Conclusion Thorough exposure of the entire SAC, which is crucial for adequate TAPT, is greatly facilitated by patient positioning. |
| abstract_unstemmed |
Purpose During transanal pull-through (TAPT) for Hirschsprung’s disease (HD), exposing the entire surgical anal canal (SAC) including the squamo-columnar junction, or anorectal line (ARL) is a crucial step for minimizing problematic postoperative bowel function. We present a hint for exposing the entire SAC. Method Histologically, the ARL represents the junction of proximal unilayer columnar colorectal mucosa with distal stratified squamous epithelium and is the proximal limit of the SAC. It is an obvious landmark; proximal mucosa is vivid pink and distal mucosa is more whitish. We use the Lone Star (LS) self-retaining retractor system to expose the ARL. Before we attach the LS hooks to the anal sinuses on the dentate line full-circle, we place 3/0 sutures at 0, 3, 6, and 9 o’clock around the anus to expose the anal sinuses. If the patient’s buttocks cannot be positioned as described or the patient is too high on the table, the LS ring does not sit well, resulting only in dilatation and lengthening of the SAC without prolapse. By hanging the patient’s buttocks 5 cm over the end of the table, the LS ring sits snugly and the ARL and entire SAC prolapse to the anal verge. Results Good positioning, as described, greatly facilitated dissection in 61/68 TAPT cases, while poor exposure hindered treatment in 7/68. Conclusion Thorough exposure of the entire SAC, which is crucial for adequate TAPT, is greatly facilitated by patient positioning. |
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How best to expose the entire surgical anal canal in the operative field during transanal pull-through for Hirschsprung’s disease: a crucial step that determines success |
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| score |
7.3994513 |