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Clinics in Colon and Rectal Surgery

journal
https://www.readbyqxmd.com/read/27582655/parastomal-hernia-avoidance-and-treatment-in-the-21st-century
#1
Sean C Glasgow, Sekhar Dharmarajan
Despite medical and surgical advances leading to increased ability to restore or preserve gastrointestinal continuity, creation of stomas remains a common surgical procedure. Every ostomy results in a risk for subsequent parastomal herniation, which in turn may reduce quality of life and increase health care expenditures. Recent evidence-supported practices such as utilization of prophylactic reinforcement, attention to stoma placement, and laparoscopic-based stoma repairs with mesh provide opportunities to both prevent and successfully treat parastomal hernias...
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582654/optimizing-treatment-for-rectal-prolapse
#2
Jennifer Hrabe, Brooke Gurland
Rectal prolapse is associated with debilitating symptoms and leads to both functional impairment and anatomic distortion. Symptoms include rectal bulge, mucous drainage, bleeding, incontinence, constipation, tenesmus, as well as discomfort, pressure, and pain. The only cure is surgical. The optimal surgical repair is not yet defined though laparoscopic rectopexy with mesh is emerging as a more durable approach. The chosen approach should be individually tailored, taking into account factors such as presence of pelvic floor defects and coexistence of vaginal prolapse, severe constipation, surgical fitness, and whether the patient has had a previous prolapse procedure...
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582653/fecal-incontinence-epidemiology-impact-and-treatment
#3
Katarzyna Bochenska, Anne-Marie Boller
Fecal incontinence (FI) is a chronic and debilitating condition that carries a significant health, economic, and social burden. FI has a considerable psychosocial and financial impact on patients and their families. A variety of treatment modalities are available for FI including behavioral and dietary modifications, pharmacotherapy, pelvic floor physical therapy, bulking agents, anal sphincteroplasty, sacral nerve stimulation, artificial sphincters, magnetic sphincters, posterior anal sling, and colostomy.
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582652/epidemiologic-analysis-of-diverticulitis
#4
Marie D Jena, Peter W Marcello, Patricia L Roberts, Thomas E Read, David J Schoetz, Jason F Hall, Todd Francone, Rocco Ricciardi
The aim of this article is to evaluate geographic variation in the incidence of diverticulitis and examine behavioral and environmental factors associated with high rates of diverticulitis across the United States. We used state hospital discharge data from 20 states to determine rates of inpatient diverticulitis from January 2002 to December 2004 at patient's county of residence. Next, we merged the county level data with behavioral and environmental survey data from the Behavioral Risk Factor Surveillance System (BRFSS)...
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582651/gut-microbiota-and-colorectal-surgery-impact-on-postoperative-complications
#5
REVIEW
Andrew J Russ, Mark A Casillas
Colorectal anastomotic leakage is a dreaded complication after colorectal surgery and causes high morbidity and mortality. The pathophysiology of anastomotic healing remains unclear despite numerous studies. In this article, our aim is to provide different perspectives on what is known about the role of the gastrointestinal tract microbiome and its relation to anastomotic integrity.
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582650/postoperative-complications-looking-forward-to-a-safer-future
#6
REVIEW
Sarah E Tevis, Gregory D Kennedy
Colorectal surgery patients frequently suffer from postoperative complications. Patients with complications have been shown to be at higher risk for mortality, poor oncologic outcomes, additional complications, and worse quality of life. Complications are increasingly recognized as markers of quality of care with more use of risk-adjusted national surgical databases and increasing transparency in health care. Quality improvement work in colorectal surgery has identified methods to decrease complication rates and improve outcomes in this patient population...
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582649/low-anterior-resection-syndrome-current-management-and-future-directions
#7
REVIEW
Timothy J Ridolfi, Nicholas Berger, Kirk A Ludwig
Outcomes for rectal cancer surgery have improved significantly over the past 20 years with increasing rates of survival and recurrence, specifically local recurrence. These gains have been realized during a period of time in which there has been an increasing emphasis on sphincter preservation. As we have become increasingly aggressive in avoiding resection of the anus, we have begun accepting bowel dysfunction as a normal outcome. Low anterior resection syndrome, defined as a constellation of symptoms including incontinence, frequency, urgency, or feelings of incomplete emptying, has a significant impact on quality of life and results in many patients opting for a permanent colostomy to avoid these symptoms...
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582648/the-multidisciplinary-management-of-colorectal-cancer-present-and-future-paradigms
#8
REVIEW
Chelsie K Sievers, Jeremy D Kratz, Luke D Zurbriggen, Noelle K LoConte, Sam J Lubner, Natalya Uboha, Daniel Mulkerin, Kristina A Matkowskyj, Dustin A Deming
As treatment strategies for patients with colorectal cancer advance, there has now become an ever-increasing need for multidisciplinary teams to care for these patients. Recent investigations into the timing and duration of perioperative therapy, as well as, the rise of molecular profiling have led to more systemic chemotherapeutic options. The most efficacious use, in terms of timing and patient selection, of these therapies in the setting of modern operative and radiotherapy techniques requires the generation of care teams discussing cases at multidisciplinary conferences...
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582647/future-of-minimally-invasive-colorectal-surgery
#9
REVIEW
Matthew Whealon, Alessio Vinci, Alessio Pigazzi
Minimally invasive surgery is slowly taking over as the preferred operative approach for colorectal diseases. However, many of the procedures remain technically difficult. This article will give an overview of the state of minimally invasive surgery and the many advances that have been made over the last two decades. Specifically, we discuss the introduction of the robotic platform and some of its benefits and limitations. We also describe some newer techniques related to robotics.
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582646/endoluminal-therapy-in-colorectal-cancer
#10
REVIEW
Katherine A Kelley, V Liana Tsikitis
Appropriate endoscopic resection for colorectal polyps can present a challenge to endoscopists, as these lesions may harbor malignancy. With recent advances in endoscopy, however, we are now entering an exciting frontier of endoscopic therapy for gastrointestinal lesions. These techniques include endoluminal mucosal resection and endoscopic submucosal dissection, which may be utilized on several colonic lesions. This article will discuss these principle endoscopic techniques, their outcomes, and briefly highlight their influence on endoscopic interventions, including transanal endoscopic microsurgery and natural orifice transluminal endoscopic surgery...
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582645/beyond-histologic-staging-emerging-imaging-strategies-in-colorectal-cancer-with-special-focus-on-magnetic-resonance-imaging
#11
REVIEW
Tyler J Fraum, Joseph W Owen, Kathryn J Fowler
Imaging plays an increasingly important role in the staging and management of colorectal cancer. In recent years, magnetic resonance imaging (MRI) has supplanted transrectal ultrasound as the preferred modality for the locoregional staging of rectal cancer. Furthermore, the advent of both diffusion-weighted imaging and hepatobiliary contrast agents has significantly enhanced the ability of MRI to detect colorectal liver metastases. In clinical practice, MRI routinely provides prognostic information, helps to guide surgical strategy, and determines the need for neoadjuvant therapies related to both the primary tumor and metastatic disease...
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582644/advances-in-biomarkers-going-beyond-the-carcinoembryonic-antigen
#12
REVIEW
Nicole E Lopez, Carrie Y Peterson
Using biologically available markers to guide treatment decisions in colorectal cancer care is becoming increasingly common, though our understanding of these biomarkers is in its infancy. In this article, we will discuss how this area is rapidly changing, review important biomarkers being used currently, and explain how the results influence clinical decision-making. We will also briefly discuss the possibility of a liquid biopsy and explore several exciting and new options.
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582643/familial-colorectal-cancer-understanding-the-alphabet-soup
#13
REVIEW
Matthew D Giglia, Daniel I Chu
While most colorectal cancers (CRCs) originate from nonhereditary spontaneous mutations, one-third of cases are familial or hereditary. Hereditary CRCs, which account for < 5% of all CRCs, have identifiable germline mutations and phenotypes, such as Lynch syndrome and familial adenomatous polyposis (FAP). Familial CRCs, which account for up to 30% of CRCs, have no identifiable germline mutation or specific pattern of inheritance, but higher-than-expected incidence within a family. Since the discovery that certain genotypes can lead to development of CRC, thousands of mutations have now been implicated in CRC...
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582642/hot-topics-in-colorectal-surgery
#14
Gregory D Kennedy
No abstract text is available yet for this article.
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27582641/gregory-d-kennedy-md-phd
#15
Scott R Steele
No abstract text is available yet for this article.
September 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27247542/management-of-the-perineal-defect-after-abdominoperineal-excision
#16
REVIEW
Colin Peirce, Sean Martin
The optimal management of the perineal defect following abdominoperineal excision for anorectal malignancy remains a source of debate. The repopularization of extralevator resection means colorectal surgeons are confronted with larger perineal wounds. There are several surgical options available-primary perineal closure and drainage, omentoplasty, biological or synthetic mesh placement, musculocutaneous flap repair, and negative wound pressure therapy. These options are discussed along with the potential benefits and complications of each...
June 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27247541/the-difficult-stoma-challenges-and-strategies
#17
REVIEW
Scott A Strong
The problems that a patient experiences after the creation of a temporary or permanent stoma can result from many factors, but a carefully constructed stoma located in an ideal location is typically associated with appropriate function and an acceptable quality of life. The construction of the stoma can be confounded by many concomitant conditions that increase the distance that the bowel must traverse or shorten the bowel's capacity to reach. Stomas can be further troubled by a variety of problems that potentially arise early in the recovery period or months later...
June 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27247540/genitourinary-considerations-in-reoperative-and-complex-colorectal-surgery
#18
REVIEW
Azah A Althumairi, Jonathan E Efron
Genitourinary structures are at risk of injury during colorectal surgery. The incidence of injury is low; however, the risk is higher in cases involving severe inflammatory or infectious processes, locally advanced or recurrent cancer, previous radiation, and reoperation. Consideration of the anatomical relationship between the genitourinary system, and the colon and rectum is crucial to avoid injuries. Intraoperative diagnostic techniques such as intravenous pyelogram (IVP), fluoroscopic cystogram, or retrograde urethrogram can aid in identifying suspected injuries...
June 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27247539/management-of-colorectal-anastomotic-leak
#19
REVIEW
Michael S Thomas, David A Margolin
The aim of this article is to present strategies for preventing and managing the failure of the surgical restoration of intestinal continuity. Despite improvements in surgical technique and perioperative care, anastomotic leaks still occur, and with them occur increased morbidity, mortality, length of stay, and costs. Due to the devastating consequences for patients with failed anastomoses, there have been a myriad of materials and techniques used by surgeons to create better intestinal anastomoses. We will also discuss the management strategies for anastomotic leak when they do inevitably occur...
June 2016: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/27247538/enterocutaneous-fistula-proven-strategies-and-updates
#20
REVIEW
Irena Gribovskaja-Rupp, Genevieve B Melton
Management of enterocutaneous fistula represents one of the most protracted and difficult problems in colorectal surgery with substantial morbidity and mortality rates. This article summarizes the current classification systems and successful management protocols, provides an in-depth review of fluid resuscitation, sepsis control, nutrition management, medication management of output quantity, wound care, nonoperative intervention measures, operative timeline, and considerations, and discusses special considerations such as inflammatory bowel disease and enteroatmospheric fistula...
June 2016: Clinics in Colon and Rectal Surgery
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