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International Journal of Colorectal Disease

Marco J Tomassi, Maher A Abbas, Daniel D Klaristenfeld
PURPOSE: To determine the impact of expectant management surveillance for patients at risk for squamous cell carcinoma of the anus (SCCA). METHODS: Adult patients at risk for anal cancer, specifically those with human immunodeficiency virus (HIV) or known human papilloma virus (HPV) infections (anal dysplasia, anogenital warts, cervical dysplasia, or cervical cancer), underwent expectant management surveillance with targeted therapy of only grossly abnormal or symptomatic anoderm lesions...
September 22, 2018: International Journal of Colorectal Disease
Elina Lietzén, Juha M Grönroos, Jukka-Pekka Mecklin, Ari Leppäniemi, Pia Nordström, Tero Rautio, Tuomo Rantanen, Juhani Sand, Hannu Paajanen, Anne Kaljonen, Paulina Salminen
PURPOSE: Appendiceal tumors are rare, but high neoplasm rates have been reported at interval appendectomy after periappendicular abscess. Non-operative management of uncomplicated acute appendicitis has shown promising results. The data on appendiceal tumor incidence and presentation among acute appendicitis patients is limited, especially in patient cohorts differentiating between uncomplicated and complicated acute appendicitis. Objective was to assess appendiceal tumor incidence and tumor association to appendicitis in patients with uncomplicated and complicated acute appendicitis...
September 22, 2018: International Journal of Colorectal Disease
James Wei Tatt Toh, Kevin Phan, Grahame Ctercteko, Nimalan Pathma-Nathan, Toufic El-Khoury, Arthur Richardson, Gary Morgan, Reuben Tang, Mingjuan Zeng, Susan Donovan, Daniel Chu, Gregory Kennedy, Kerry Hitos
BACKGROUND: There is significant variation in the use of mechanical bowel preparation and oral antibiotics prior to left-sided elective colorectal surgery. There has been no consensus internationally. METHODS: This was a retrospective analysis of the 2015 American College of Surgeons National Surgical Quality Improvement Program database. Patients were divided into four groups: those who had mechanical bowel preparation with oral antibiotics, mechanical bowel preparation alone, oral antibiotics alone and no preparation...
September 20, 2018: International Journal of Colorectal Disease
Adiela Correa-Marinez, Jacob Grenabo, David Bock, Anette Wedin, Eva Angenete
PURPOSE: A loop colostomy may reduce the risk of severe intraabdominal complications in patients with obstructing colorectal cancer compared to an end colostomy. The aim of this study was to relate complications to the type of stoma, and a secondary aim was to evaluate whether the type of colostomy had an impact on time until oncological/surgical treatment. METHODS: All patients who underwent surgery and received a deviating colostomy due to obstructing colorectal cancer between January 2011 and December 2015 in five Swedish hospitals in Region Västra Götaland were included (n = 289)...
September 17, 2018: International Journal of Colorectal Disease
Nan Lan, Bo Shen, Jianping Wang
PURPOSE: Model of End-Stage Liver Disease (MELD) score was developed to predict mortality in patients with liver disease. The aim of this study was to investigate the relationship between preoperative MELD score and 30-day surgical outcomes using the American College of Surgeons National Surgical Quality Improvement Program. METHODS: Patients with ulcerative colitis (UC) (ICD: 556.X) who underwent colectomy were identified from NSQIP 2005 to 2013. The primary outcomes were bleeding complications, and overall morbidity and mortality...
September 15, 2018: International Journal of Colorectal Disease
Simon J G Richards, Frank A Frizelle, John A Geddes, Tim W Eglinton, Mark B Hampton
OBJECTIVE: To describe the current definitions, aetiology, assessment tools and clinical implications of frailty in modern surgical practice. BACKGROUND: Frailty is a critical issue in modern surgical practice due to its association with adverse health events and poor post-operative outcomes. The global population is rapidly ageing resulting in more older patients presenting for surgery. With this, the number of frail patients presenting for surgery is also increasing...
September 14, 2018: International Journal of Colorectal Disease
Akihiro Kondo, Yuichiro Tsukada, Motohiro Kojima, Yuji Nishizawa, Takeshi Sasaki, Yasuyuki Suzuki, Masaaki Ito
PURPOSE: This study aimed to clarify the frequency of distal spread and the optimal distal margin after preoperative chemotherapy for advanced low rectal cancer. METHODS: The study included patients with advanced lower rectal cancer who received preoperative chemotherapy and underwent surgery during 2012-2015. We investigated the distal spread of tumor cells, defined as the distal distance from the intramucosal distal tumor edge to the farthest tumor cells located under the submucosal layer...
September 13, 2018: International Journal of Colorectal Disease
Claire Gouriou, Marion Chambaz, Alain Ropert, Guillaume Bouguen, Véronique Desfourneaux, Laurent Siproudhis, Charlène Brochard
PURPOSE: To screen all treatments tested for solitary rectal ulcer syndrome (SRUS) without rectal prolapse and to assess their efficacy. METHOD: A systematic review was performed according to the PRISMA guidelines, focusing on the treatment of SRUS without rectal prolapse. The types of treatment and their efficacy were collected and critically assessed. RESULTS: A selection of 20 studies among the 470 publications focusing on SRUS provided suitable data for a total of 516 patients...
September 11, 2018: International Journal of Colorectal Disease
Jaan Kirss, Tarja Pinta, Tero Rautio, Pirita Varpe, Matti Kairaluoma, Marja Hyöty, Saija Hurme, Camilla Böckelman, Valtteri Kairaluoma, Sinikka Salmenkylä, Mikael Victorzon
PURPOSE: The aim of this multicentre study was to analyse the effects of patent sphincter lesions and previous sphincter repair on the results of sacral neuromodulation (SNM) treatment on patients with faecal incontinence (FI). METHODS: Patients examined by endoanal ultrasound (EAUS) with FI as the indication for SNM treatment were included in the study. Data was collected from all the centres providing SNM treatment in Finland and analysed for differences in treatment outcomes...
September 10, 2018: International Journal of Colorectal Disease
Jacopo Giuliani, Andrea Bonetti
PURPOSE: In light of the relevant expenses of pharmacological interventions, it might be interesting to make a balance between the cost of the new drugs administered and the added value represented by the improvement in progression free survival (PFS) in first-line for metastatic colorectal cancer CRC (mCRC). METHODS: Phase III randomized controlled trials (RCTs) that compared at least two first-line chemotherapy regimens for mCRC patients were evaluated. Differences in PFS between the different arms were compared with the pharmacological costs (at the pharmacy of our hospital)...
September 8, 2018: International Journal of Colorectal Disease
J Bollo, P Salas, M C Martinez, P Hernandez, A Rabal, E Carrillo, E Targarona
BACKGROUND: Colorectal cancer (CRC) is the third most frequent cancer diagnosed in men and the second in women. Laparoscopic surgery has been a technical revolution in colorectal surgery, facilitating a better recovery of patients with lower morbidity and better esthetic results, compared to traditional surgery via laparotomy, without compromising safety and long-term oncological results. PURPOSE: The trial is a randomized controlled trial indented to evaluate the two interventions with thorough measurements of the postoperative variables and complications to improve the evaluation of the surgical technique...
September 6, 2018: International Journal of Colorectal Disease
Tomohiro Yamaguchi, Yusuke Kinugasa, Akio Shiomi, Hiroyasu Kagawa, Yushi Yamakawa, Akinobu Furuatni, Shoichi Manabe, Yusuke Yamaoka, Hitoshi Hino
PURPOSE: Scientific evidence supporting robotic-assisted laparoscopic surgery (RALS) for rectal cancer remains inconclusive because most previous reports were retrospective case series or case-control studies, with few reports focusing on long-term oncological outcomes with a large volume of patients. The aim of this study was to clarify the short- and long-term outcomes of a large number of consecutive patients with rectal cancer who underwent RALS in a single high-volume center. METHODS: The records of 551 consecutive patients who underwent RALS for rectal adenocarcinoma between December 2011 and March 2017 were examined to reveal the short-term outcomes...
September 6, 2018: International Journal of Colorectal Disease
Michele Schiano di Visconte, Gabriele Bellio
BACKGROUND: Rectal advancement flap is the standard surgical treatment for complex cryptoglandular anal fistulas, while Permacol™ collagen paste is considered an innovative treatment option for anorectal fistulas. This study aimed to compare the clinical outcomes of patients with complex cryptoglandular fistulas treated by endorectal advancement flap versus Permacol™ paste. METHODS: This study was a retrospective analysis of patients with complex cryptoglandular anal fistulas...
September 5, 2018: International Journal of Colorectal Disease
Michele Podetta, Riccardo Scarpa Cosimo, Guillaume Zufferey, Karel Skala, Frederic Ris, Bruno Roche, Nicolas Christian Buchs
PURPOSE: Mucosal advancement flap (MAF) is the best option for complex anal fistula (AF) treatment. Recurrence is not rare and the best surgical option for his handling is a challenge considering the incontinence risk and the healing rate. We aimed to determine the feasibility and outcomes of a second MAF for recurrent complex AF previously treated with mucosal advancement flap. METHODS: We retrospectively identified 32 patients undergoing two or more MAF for recurrent AF in a larger cohort of 121 consecutive cases of MAF operated by the same senior colorectal surgeon...
September 5, 2018: International Journal of Colorectal Disease
Seon Heui Lee, Dong Hyun Kim, Sang Woo Lim
PURPOSE: Few studies have compared robotic and laparoscopic intersphincteric resection (ISR) in rectal cancer. Therefore, we performed a meta-analysis of recently published studies to compare perioperative outcomes of ISR for the treatment of low rectal cancer. METHODS: We performed a systematic literature search of the Ovid-Medline, Ovid-EMBASE, and Cochrane Central Register of Controlled Trials databases for studies comparing robotic and laparoscopic ISR in patients with low rectal cancer...
September 5, 2018: International Journal of Colorectal Disease
Mia Kim, Corinna Rosenbaum, Nicolas Schlegel, Christian Grumaz, Kai Sohn, Christoph Isbert, Heike Walles, Marco Metzger
PURPOSE: Although various strategies exist for chronic constipation therapy, the pathogenesis of chronic constipation is still not completely understood. The aim of this exploratory experimental study is to elucidate alterations of the autonomous enteric nervous system at the molecular level in patients with obstructed defecation, who represent one of the most predominant groups of constipated patients. METHODS: Full-thickness rectal wall samples of patients with obstructed defecation were analyzed and compared with controls...
September 3, 2018: International Journal of Colorectal Disease
Volkan Ozben, Gokhan Ozuner, Ozgen Isik, Emre Gorgun, Luca Stocchi, Xiaobo Liu
PURPOSE: The role of omentoplasty in the prevention of anastomotic leak (AL) in colorectal surgery is controversial. The aim of this study was to evaluate the impact of omentoplasty on AL and septic complications after low pelvic anastomosis using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. METHODS: The ACS-NSQIP database was queried for patients who underwent segmental colectomy with low pelvic anastomosis by using 2012 targeted colectomy participant use data file...
August 31, 2018: International Journal of Colorectal Disease
Masahide Ebi, Shoko Nakagawa, Yoshiharu Yamaguchi, Yasuhiro Tamura, Shinya Izawa, Yasutaka Hijikata, Takaya Shimura, Yasushi Funaki, Naotaka Ogasawara, Makoto Sasaki, Takashi Joh, Kunio Kasugai
BACKGROUND: Endoscopic resection is recommended for rectal neuroendocrine tumors < 1 cm in diameter; the three techniques (mucosal resection, submucosal dissection, and mucosal resection with variceal ligation device) of endoscopic resection of neuroendocrine tumor were reported; however, the optimal endoscopic technique remains unclear. PURPOSE: We compared the efficacy and safety of three endoscopic rectal neuroendocrine tumor resection methods. METHODS: We retrospectively enrolled 52 patients with rectal neuroendocrine tumors treated by endoscopy at Aichi Medical University Hospital and Nagoya City University Hospital between May 2003 and June 2017...
August 30, 2018: International Journal of Colorectal Disease
Laura Z Hyde, Ahmed M Al-Mazrou, Ben A Kuritzkes, Kunal Suradkar, Neda Valizadeh, Ravi P Kiran
PURPOSE: This study aims to assess factors associated with preventable readmissions after colorectal resection. METHODS: All readmissions following colorectal resection from May 2013 to May 2016 at an academic medical center were reviewed. Readmissions that could be prevented were identified. Factors associated with preventable readmission were assessed using logistic regression. RESULTS: Of 686 patients discharged during the study period, there were 75 patients (11%) with unplanned readmission...
August 30, 2018: International Journal of Colorectal Disease
Gabriele Naldini, Bernardina Fabiani, Alessandro Sturiale, Tommaso Simoncini
PURPOSE: The pelvic floor is considered as a single anatomical and functional unit, consisting of several structures that suspend the pelvic organs maintaining their function. For this reason, a multi-compartmental prolapse is a common disease that needs a multidisciplinary pelvic floor team in order to be treated. The aim of the authors is to suggest a treatment algorithm to better approach complex pelvic organ prolapse. METHODS: A multidisciplinary pelvic floor team was set up 7 years ago...
August 27, 2018: International Journal of Colorectal Disease
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