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Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland

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https://www.readbyqxmd.com/read/28628271/surgical-treatment-of-trans-sphincteric-anal-fistulas-with-the-fat-graft-technique-a-minimally-invasive-procedure
#1
N Stroumza, G Fuzco, J Laporte, R Nail Barthelemy, S Houry, M Atlan
AIM: Anal fistulas are common pathologies with a significant social impact; however their treatment is often complex and the recurrence rate can be significant. Some surgical treatments for fistula are also associated with the risk of sphincter injury. In this technical note, we aim to evaluate the feasibility and efficacy of the Fat GRAFT technique (Fat Grafting in Anal Fistula Treatment) in the treatment of recurrent anal fistulas. METHOD: All patients presenting with recurrent trans-sphincteric anal fistulas over an 18-month period were included...
June 19, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28622448/ileocecal-valve-syndrome-after-surgery-in-adult-patients-myth-or-reality
#2
S Palmisano, M Silvestri, M Troian, P Germani, F Giudici, N de Manzini
AIM: The onset of symptoms after ileocecal valve (ICV) removal may be perceived as an unwanted effect of surgery and induce patients to bring unnecessary litigation against surgeons. The aim of our study is to assess the real impact on the quality of life of patients whose ICV was surgically removed, using three validated questionnaires. METHOD: In patients who had their ICV removed surgically, the Gastrointestinal Quality of life (GIQLI) questionnaire and those used by the European Organization for research and Treatment of Cancer (EORTC) were administered pre and post surgery...
June 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28622435/single-port-laparoscopic-ileocaecal-resection-for-crohn-s-disease-a-multicentre-comparison-with-multi-port-laparoscopy
#3
Michele Carvello, E Joline de Groof, Anthony de Buck van Overstraeten, Matteo Sacchi, Albert M Wolthuis, Christianne J Buskens, André D'Hoore, Willem A Bemelman, Antonino Spinelli
BACKGROUND AND AIMS: Single port (SP) ileocecal resection (ICR) is an established technique but there are no large studies comparing SP and multi-port (MP) laparoscopic surgery in Crohn's disease (CD). The aim of this study was to compare postoperative pain scores and analgesia requirements after SP and MP laparoscopic ICR for CD. METHODS: This was a retrospective study of patients undergoing SP or MP ICR for CD in three tertiary referral centres from February 1999-October 2014...
June 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28621457/core-outcome-research-measures-in-anal-cancer
#4
LETTER
Rebecca Fish, David Sebag-Montefiore, Caroline Sanders, Paula Williamson, Andrew Renehan
We would like to draw attention of the readership to the problems associated with outcome heterogeneity in clinical trials, with particular reference to anal cancer. Outcome heterogeneity, and the related issue of reporting outcome bias, is a barrier to evidence synthesis [1] [2], particularly in rare diseases where few randomised trials are published. A recent review [3] of trials of chemoradiation for anal squamous cell carcinoma (ASCC) highlights the heterogeneity observed in reporting outcomes and calls for the development of a core set of outcomes...
June 16, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28618156/gelpoint-%C3%A2-path-mini-for-transanal-resection-of-rectal-polyp-video-vignette
#5
LETTER
David R C James, Aisling Hogan, Roel Hompes, Chris Cunningham
Transanal resection (TAR) is playing an increasing role in the management of early rectal cancer and in the treatment of polyps not amenable to endoscopic resection [1]. There are clear benefits to the concept of organ preservation for rectal surgery. Numerous flexible and rigid platforms exist for TAR. Commonly used platforms include Transanal Endoscopic Microsurgery (TEMS), Transanal Endoscopic Operations (TEO) and the GelPoint(®) Path port. These come with their respective advantages; however, a potential downside is their size causing damage to the anal canal and sphincter complex potentially leading to incontinence [2]...
June 15, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28614625/modified-sentinel-lymph-node-technique-combined-with-endoluminal-loco-regional-resection-for-the-treatment-of-rectal-tumors-a-fourteen-year-experience
#6
Silvia Quaresima, Alessandro M Paganini, Giancarlo D'Ambrosio, Pietro Ursi, Andrea Balla, Emanuele Lezoche
AIM: After Endoluminal Loco-Regional Resection (ELRR) by Transanal Endoscopic Microsurgey (TEM) the N parameter may remain undefined. Nucleotide-Guided Mesorectal Excision (NGME) improves the lymph nodes harvest. The aim of the present study is to evaluate the long term oncological results after ELRR with NGME. METHOD: A total of 57 patients were enrolled over the period January 2001 to June 2015.ed. All patients underwent ELRR by TEM. Prior to surgery, 99m-Technetium-marked nanocolloid was injected in the peritumoral submucosa...
June 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28614620/a-systematic-review-of-segmental-vs-subtotal-colectomy-and-subtotal-colectomy-vs-total-proctocolectomy-for-colonic-crohn-s-disease
#7
REVIEW
Imerio Angriman, Giovanni Pirozzolo, Romeo Bardini, Francesco Cavallin, Carlo Castoro, Marco Scarpa
AIM: Surgical management of colonic Crohn's disease (CD) is still unclear because different procedures can be adopted. The choice of operation is dependent on the involvement of colonic disease but the advantages and disadvantages of the extent of resection are still debated. METHOD: The aim of the present study is to evaluate the differences in short-term and long-term outcomes of adult patients with colonic CD, who underwent either subtotal colectomy and ileorectal anastomosis (STC) or segmental colectomy (SC) or total proctocolectomy and end ileostomy (TPC)...
June 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28612478/high-stoma-prevalence-and-stoma-reversal-complications-following-anterior-resection-for-rectal-cancer-a-population-based-multi-centre-study
#8
Klas Holmgren, Daniel Kverneng Hultberg, Markku M Haapamäki, Peter Matthiessen, Jörgen Rutegård, Martin Rutegård
AIM: Fashioning a defunctioning stoma is common when performing an anterior resection for rectal cancer in order to avoid and mitigate consequences of an anastomotic leakage. We investigated the permanent stoma prevalence, factors influencing stoma outcome and complication rates following stoma reversal surgery. METHODS: Patients who had undergone an anterior resection for rectal cancer between 2007 and 2013 in the Northern healthcare region were identified using the Swedish Colorectal Cancer Registry and were followed until the end of 2014 regarding stoma outcome...
June 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28612460/defining-low-anterior-resection-syndrome-a-systematic-review-of-the-literature
#9
REVIEW
C Keane, C Wells, G O'Grady, I P Bissett
BACKGROUND: There is increasing awareness of the poor functional outcome many patients suffer after sphincter-preserving rectal resection, termed 'low anterior resection syndrome' (LARS). There is no consensus definition of LARS and varying instruments have been employed to measure functional outcome, complicating research into prevalence, contributing factors, and potential therapies. AIM: To describe the instruments and outcome measures used in studies of post-low anterior resection bowel dysfunction and identify major themes used in the assessment of LARS...
June 14, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28603932/prognostic-significance-of-tumour-regression-grade-after-neoadjuvant-chemoradiotherapy-for-a-cohort-of-locally-advanced-rectal-cancer-patients-an-8-year-retrospective-single-institutional-study
#10
Lai Xu, Songhua Cai, Tixian Xiao, Yanyu Chen, Huizhong Qiu, Bin Wu, Guole Lin, Xiyu Sun, Junyang Lu, Weixun Zhou, Yi Xiao
AIM: Locally advanced rectal cancer (LARC) is frequently treated with neoadjuvant chemoradiotherapy (NACRT) to reduce the risk of local recurrence and improve survival. Tumour response to NACRT is variable and may influence the prognosis after subsequent surgery. This study compared the prognostic values of tumour regression grade (TRG) and neoadjuvant pathologic (ypTNM) downstaging in stage II and III rectal cancer patients treated with NACRT followed by curative surgery. METHOD: This study included 185 LARC patients treated with long-course radiotherapy (45 Gy in 25 fractions) plus 5-fluorouracil over 5 weeks between 2005 and 2013...
June 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28603931/fistulating-crohn-s-terminal-ileitis-involving-sigmoid-colon-left-salpinx-and-urinary-bladder-laparoscopic-approach-video-vignette
#11
LETTER
D M Layfield, F Luvisetto, V Celentano
Widespread use of laparoscopic surgery in inflammatory bowel disease (IBD) has been limited due to technical constraints. The inflammation encountered in Crohn's Disease (CD) is often multifocal and makes a minimally invasive approach challenging due to a thickened mesentery, as well as the potential for fistulas, abscesses, and large phlegmons [1]. All these factors, together with long term use of steroids and malnutrition, can increase the morbidity up to 10-15% [2]. This article is protected by copyright...
June 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28603905/self-expanding-metallic-stent-sems-for-large-bowel-obstruction-evidence-based-analysis-results
#12
LETTER
Alberto Mangano, Luca La Colla, Laura Marciano, Roger W Motson
We read with interest the article published by Young et al. who are to be congratulated for performing a prospective consecutive uncontrolled trial of 100 patients to assess the outcome of the self-expanding metallic stent (SEMS) for large bowel obstruction (1). Even though this article was published in 2011 this topic is still the subject of current scientific debate (2). This article is protected by copyright. All rights reserved.
June 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28603860/inferior-mesenteric-vein-as-initial-landmark-for-laparoscopic-medial-to-lateral-dissection-of-descending-colon-video-vignette
#13
LETTER
Alvaro Garcia-Granero, Gabriela Wagner Tustanowski, Luis Sánchez-Guillén, Delfina Fletcher Sanfeliu, Matteo Frasson, Blas Flor Lorente, Francisco Martinez-Soriano
The root of the inferior mesenteric artery is an important area where autonomic nerves are close by, the dissection can be hard and laborious in order to avoid nerve damage; and the separation of mesocolon and retroperitoneum in this area can sometimes be difficult. The inferior mesenteric vein dissection is an alternative option as the first step during medial to lateral approach of laparoscopic left mesocolon mobilisation, as we have shown in this video based on two real cases and two anatomical cadaveric dissection...
June 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28590033/radiological-and-pathological-evaluation-of-the-level-of-arterial-division-after-colon-cancer-surgery
#14
Ditte Louise E Munkedal, Mona Rosenkilde, Dennis Tønner Nielsen, Thorbjørn Sommer, Nicholas P West, Søren Laurberg
AIM: In aiming to cure patients with colorectal cancer surgery, the surgeon must carefully dissect the mesocolon and mesorectum and divide the vascular pedicle as near to its origin so as to include all local lymph nodes. This has been termed Complete Mesocolic Excision (CME). The distance from distal vascular tie to the bowel wall in the fixed specimen is an indication as to the quality of surgery but this does not assess the length of the residual vascular pedicle and by implication, residual lymph nodes...
June 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28589634/systematic-review-and-meta-analysis-of-the-role-of-metronidazole-in-post-haemorrhoidectomy-pain-relief
#15
REVIEW
Njr Lyons, J B Cornille, S Pathak, P Charters, I R Daniels, N J Smart
AIM: Conventional haemorrhoidectomy is still considered as the reference standard for the management of severe or recurrent haemorrhoids. Pain is reported by patients to be the most common post operative complication. Although the literature lacks a consensus on its effectiveness, Metronidazole is often used to reduce post operative pain.. We have performed a meta-analysis of all randomised controlled trials (RCTs) that investigated the use of metronidazole for pain relief after haemorrhoidectomy...
June 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28586509/association-between-neoadjuvant-chemoradiation-and-survival-for-patients-with-locally-advanced-rectal-cancer
#16
Zhifei Sun, Mohamed A Adam, Jina Kim, Megan C Turner, Deborah A Fisher, Kingshuk Roy Choudhury, Brian G Czito, John Migaly, Christopher R Mantyh
AIM: To examine the overall survival differences of neoadjuvant therapy modalities: no therapy, chemotherapy alone, radiation alone, and chemoradiation in a large cohort of patients with locally advanced rectal cancer. METHOD: Adults with clinical stage II and III rectal adenocarcinoma were selected from the National Cancer Database and grouped by type of neoadjuvant therapies received: no therapy, chemotherapy only, radiotherapy only, or chemoradiation. Multivariable regression methods were used to compare adjusted differences in perioperative outcomes and overall survival...
June 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28586159/reply-to-emile-et-al
#17
LETTER
Sinan Albayati, Matthew J Morgan
We thank Emile et al for their interest in our work and we appreciate their comments. With regard to their first comment, while it is true that 48.8% did not have complete resolution of obstructed defecation symptoms, 75% of our patients reported improvement in symptoms, which is in line with the improvement figure they quoted. We acknowledge that one limitation of this work is that we have not used preoperative and postoperative validated symptom severity scores, which would have made our results more comparable with the literature...
June 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28586145/ct-colonography-practice-at-a-university-teaching-hospital-improving-standards
#18
LETTER
Sarah Sharp, Janine Lee, Sumita Chawla
My colleagues and I have recently completed a qualitative and quantitative assurance audit of CT colonography (CTC) at our University Hospital, under the auspices of the NHS Bowel cancer screening programme (BCSP) As readers will be aware, CTC standards are audited annually as recommended by the Royal College of Radiology and the British Society of Gastrointestinal and Abdominal Radiology. This article is protected by copyright. All rights reserved.
June 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28561438/a-case-of-caecal-perforation-treated-by-laparoscopic-caecectomy
#19
LETTER
C Reid, H Mohan, R Cahill
Here we present the case of a 61year old male who developed peritonitis secondary to a caecal perforation and was managed laparoscopically by means of a caecectomy. Our patient initially presented to the emergency department with a four week history of bone pain and weight loss and was admitted and diagnosed with multiple myeloma (MM). He was commenced on combination therapy of Revlimide (lenalidomide), Velcade and Dexamethasone (RVD) and had just finished his first cycle when he developed sudden onset abdominal pain and diffuse tenderness...
May 31, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28561326/symptom-improvement-recurrence-and-infection-after-laparoscopic-ventral-rectopexy-using-biologic-mesh
#20
LETTER
Sameh Hany Emile, Hossam Elfeki
We read with great interest the article titled "Laparoscopic ventral rectopexy for rectal prolapse and rectal intussusception using a biological mesh" [1] published in Colorectal Disease. We believe this work is an important addition to the current literature on laparoscopic ventral Mesh rectopexy (LVMR) for rectal prolapse; however we do have a few remarks on this manuscript. This article is protected by copyright. All rights reserved.
May 31, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
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