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Ying Guo, J. Lynn Palmer, Loren Shen, Guddi Kaur, Jie Willey, Tao Zhang, Eduardo Bruera, Jean-Paul Wolinsky and Ziya L. Gokaslan

associated with the level and extent of spinal nerve severance during the sacrectomy. 2 In addition, serious wound complications following sacrectomy have been reported in as many as 25 to 46% of the patients. 8, 18, 20 Depending on the individual surgeon's preference and knowledge, patients treated with sacrectomy may or may not also undergo a colostomy for bowel diversion. Based on our clinical experience, we have observed more wound infections in patients who experienced postoperative bowel incontinence, which led to wound infection, longer LOS, and delayed healing

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Scott A. Meyer and Praveen V. Mummaneni

appears that the hematoma was absorbed by 4 months postoperatively. These complications are important to note because, as the authors point out, some centers perform this surgery as an outpatient procedure. The 2 patients with rectal injuries in this series required a diverting ileostomy and/or colostomy as part of the surgical repair of the injury. The authors suggest that adhesions from prior abdominal procedures may place a patient at increased risk for a rectal injury during the AxiaLIF. Therefore, surgeons should ask patients if they have a history of colorectal

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Demitre Serletis, Sami Khoshyomn, J. Ted Gerstle and James T. Rutka

normal. No motor or sensory deficits were noted. A vaginoscopy confirmed a vaginal wall perforation, which was treated conservatively. A rectal laceration was demonstrated by sigmoidoscopy, necessitating a laparoscopic loop colostomy. The patient's abdominal computerized tomography (CT) scans revealed a punched-out hole in the anterior aspect of the second sacral vertebra with retropulsion of a bone fragment into the sacral canal ( Fig. 1 ). During her hospital course, the patient remained neurologically intact, with no evidence of nerve root compression or

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Alvaro Arjona Sánchez, Carlos Diaz Iglesias, Cesar Díaz López, David Martínez Cecilia, Jaime Alonso Gómez, Jose Gómez Barbadillo and Sebastian Rufian Peña

colostomy was performed. We resected the fistula and rectum because the fistula hole in the wall of rectum was too large to close; therefore, an anastomosis was not possible because the zone was infected, and the risk for an anastomotic leak was very high. This was closed and sealed with sponge of fibrinogen and thrombin (TachoSil). The pelvic peritoneum was restored. Postoperative Course The postoperative course was uneventful, following specific antibiotic treatment of Enterococcus faecalis and Escherichia coli . The pathological findings revealed a meningocele

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B. L. Crue Jr. and E. M. Todd

, San Gabriel, California. The histologically verified pathological diagnoses were carcinoma of the rectum (3 cases), cervix (2 cases), bladder (1 case), anus (1 case), and 1 case of primary liposarcoma of the perineum. At the time of rhizotomy all 8 patients had functioning colostomies and 6 had either ileal urinary bladders or long-standing drainage by urethral catheter. Allwere reasonably good surgical risks and had a reasonable life expectancy. All patients were on large doses of narcotics. All were ambulatory. In all cases attempts at surgical cure had been

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Lewis J. Brown

wounds of the right arm, leg, buttock, and abdomen. X-rays of the cranium revealed several small metallic fragments in the left parietal area. There was no evidence of indriven bony fragments. Under local anesthesia the superficial wound of the right frontotemporal area was explored; the calvarium was intact, and the wound was therefore closed uneventfully. The patient then underwent an exploratory laparotomy for closure of penetrating wounds of the sigmoid colon and ileum and for a laceration of the urinary bladder. A colostomy and a suprapubic cystotomy were

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Warwick J. Peacock and Judith A. Murovic

birth at the child's lumbosacral region. She also had a malformed pelvis, an omphalocele, bladder exstrophy with no urethra, absent external genitalia, and an imperforate anus. The 26-year-old mother had not taken any medications during pregnancy. The father was 27 years old and the child had one sibling, a 10-year-old brother in good health. The paternal family history was positive for hydrocephalus (the father's brother's child). At 2 days of age the patient underwent surgical closure of the abdominal wall, a colostomy since no retrosigmoid colon was present, and

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Jennifer E. Kim, John Pang, Joani M. Christensen, Devin Coon, Patricia L. Zadnik, Jean-Paul Wolinsky, Ziya L. Gokaslan, Ali Bydon, Daniel M. Sciubba, Timothy Witham, Richard J. Redett and Justin M. Sacks

, periprocedural complications, and technical and clinical outcomes. Preoperative risk factors for wound complications were recorded from patients' electronic medical records and were defined as body mass index (BMI) > 30, history of diabetes mellitus (DM), smoking, hyperlipidemia, hypercholesterolemia, decreased serum albumin, history of neoadjuvant chemotherapy or radiation therapy (RT), previous spine or abdominal surgery, and prior or concurrent colostomy. Inclusion criteria for surgery included consenting patients who were medically cleared for surgical intervention

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Stepan V. Domovitov, Chandhanarat Chandhanayingyong, Patrick J. Boland, David G. McKeown and John H. Healey

fusion, allograft, internal fixation Revision of IF AVN, skin necrosis, rectal fistula, flap closure, colostomy Pain, pressure Sx Intact 2 mos: curette, cryo 7 mos: wedge NED (6.3 yrs) 7 * 31, M S1–5 — 50.4 Gy — P Cryo — — None Pain, sciatica Intact No No NED (25 mos) 8 25, F S1–2 Yes (x4) 50 Gy — P Cryo SI fusion, autograft, internai fixation Union, broken rod, but stable None Pain, sciatica, problem in bladder emptying Normal bladder, painful sciatica after RT No No NED (7 yrs) 9

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Gerald J. Riccardello Jr., Luke K. Barr and Luigi Bassani

Passage of catheter per rectum Bowel Overnight observation Asymptomatic 2 Chen, 2000 4 mos 16 yrs 12 yrs Anal protrusion of shunt; otherwise asymptomatic Colon Tube removed via colonoscopy Peritonitis requiring colostomy; recovered 3 O'Donoghue et al., 2002 8 yrs 33 yrs <1 yr Anal protrusion of shunt; otherwise asymptomatic Colon Tube extracted per anus Patient remained asymptomatic w/o complication 4 Thipphavong et al., 2004 7 mos/10 yrs 12 yrs 4 mos/2 yrs Right ab pain w/white cell count of 16,300 cells/mm 3