Michael E. Pezim

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One hundred and four patients were treated by restorative proctocolectomy with ileal reservoir for ulcerative colitis and familial polyposis. Three different designs of reservoir were used (triple loop 68, double loop 13, quadruple loop 23). There were no postoperative deaths but six (5.8 per cent) had the reservoir removed. Rates for pelvic sepsis were 25,(More)
The aim of this study was to assess the accuracy of technetium 99m-labeled red cell scintigraphy in localizing the site of lower gastrointestinal bleeding. The outcome of 203 patients undergoing technetium 99m-labeled red cell scintigraphy was reviewed, and the scan result was compared with the true site of bleeding. The true site of bleeding was determined(More)
In an attempt to determine whether "high ligation" of the inferior mesenteric artery during surgery for cancer of the rectum and rectosigmoid confers any significant 5-year survival advantage over "low ligation," the outcome of 1370 patients was reviewed. There were 784 patients in whom the inferior mesenteric artery was ligated below the origin of the left(More)
Anorectal function and colonic transit was assessed in 17 severely constipated patients and 15 age-matched controls. The constipated patients were divided into those who had "immobile perineum" (perineal descent < or = 1.0 cm during attempted defecation) and those who had a normal descent (> 1.0 cm) of the perineum. When constipation was accompanied by an(More)
Fifty-five patients who had undergone restorative proctocolectomy with a pelvic ileal reservoir between 3 and 82 months previously were sent a detailed questionnaire to assess their quality of life. All patients had experienced an ileostomy at some time. Fifty-one (94 per cent) returned completed questionnaires. The average frequency of evacuation from the(More)
The objective of this study was to assess the prophylactic efficacy of cefoxitin, ceftizoxime, and metronidazole-gentamicin in colorectal surgery. A double-blind, randomized prospective clinical trial design was used in a Canadian tertiary care teaching hospital. Patients were randomized to one of three treatment groups and received three doses of a study(More)
A total of 24 patients underwent treatment for horseshoe fistula-in-ano. In 3 patients the disease was bilateral; in 21 unilateral. Treatment consisted of deroofing the postanal space with division of overlying external sphincter muscle by seton. In 22 cases (92%), lateral wings were deroofed. At 23 months (range: 5 to 45 months), 23 cases (96%) have(More)
PURPOSE The majority of recent American articles on management of colon trauma promote liberal use of primary repair. The extent to which Canadian surgeons have embraced such recommendations is unknown. METHOD To determine the current attitude of Canadian surgeons toward the use of primary repair, we surveyed the members of The Canadian Association of(More)
The ileal pouch-anal procedure maintains enteric continence by preserving critical physiological mechanisms. The reservoir, although possessing somewhat different physiologic characteristics than the rectum, provides sufficient storage capacity to enable the patient to resume most daily activities. The intact anorectal angle continues to perform its pivotal(More)
If, during restorative proctocolectomy, the most distal segment of the terminal ileum is not incorporated into the reservoir during J-pouch construction, it will remain as an appendage and may twist upon itself and obstruct. Two cases in which this resulted in significant complications are described.