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Clinics in Colon and Rectal Surgery

journal
https://www.readbyqxmd.com/read/28381946/combined-endoscopic-laparoscopic-surgery-procedures-for-colorectal-surgery
#1
REVIEW
Sarah B Placek, Jeffrey Nelson
Colonoscopy is the standard of care for screening and surveillance of colorectal cancers. Removal of adenomatous polyps prevents the transformation of adenomas to potential adenocarcinoma. While most polyps are amenable to simple endoscopic polypectomy, difficult polyps that are large, broad-based, or located in haustral folds or in tortuous colon segments can present a challenge for endoscopists. Traditionally, patients with endoscopically unresectable polyps have been referred for oncologic surgical resection due to the underlying risk of malignancy within the polyp; however, the majority of these polyps are benign on final pathology...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381945/colonoscopy-advanced-and-emerging-techniques-a-review-of-colonoscopic-approaches-to-colorectal-conditions
#2
REVIEW
Anjali S Kumar, Jennifer Kim Lee
A complete colonoscopy is key in the diagnostic and therapeutic approaches to a variety of colorectal diseases. Major challenges are incomplete polyp removal and missed polyps, particularly in the setting of a difficult colonoscopy. There are a variety of both well-established and newer techniques that have been developed to optimize polyp detection, perform complete polypectomy, and endoscopically treat various complications and conditions such as strictures and perforations. The objective of this article is to familiarize the colorectal surgeon with techniques utilized by advanced endoscopists...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381944/tips-tricks-and-technique-for-laparoscopic-colectomy
#3
REVIEW
Alexandra Briggs, Joel Goldberg
In the United States, there are in excess of 300,000 operations for diseases of the colon yearly. Minimally invasive colectomy became a reality early in the 21st century with the advent of laparoscopic colectomy. The goal of minimally invasive colectomy is to improve postoperative pain control, decrease length of hospital stay, decrease recovery time, decrease complications, and thereby decrease the cost of colon resections. There are many facets to laparoscopic colectomy, including completely laparoscopic approach versus hand-assisted approach and the medial versus lateral approach...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381943/transanal-total-mesorectal-excision-a-novel-approach-to-rectal-surgery
#4
REVIEW
Pasithorn A Suwanabol, Justin A Maykel
Less invasive approaches continue to be explored and refined for diseases of the colon and rectum. The current gold standard for the surgical treatment of rectal cancer, total mesorectal excision (TME), is a technically precise yet demanding procedure with outcomes measured by both oncologic and functional outcomes (including bowel, urinary, and sexual). To date, the minimally invasive approach to rectal cancer has not yet been perfected, leaving ample opportunity for rectal surgeons to innovate. Transanal TME has recently emerged as a safe and effective technique for both benign and malignant diseases of the rectum...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381942/transanal-minimally-invasive-surgery
#5
REVIEW
Earl V Thompson, Joshua I S Bleier
Transanal endoscopic surgery (TES) techniques encompass a variety of approaches, including transanal endoscopic microsurgery and transanal minimally invasive surgery. These allow a surgeon to perform local excision of rectal lesions with minimal morbidity and the potential to spare the need for proctectomy. As understanding of the long-term outcomes from these procedures has evolved, so have the indications for TES. In this study, we review the development of TES, its early results, and the evolution of new surgical techniques...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381941/laparoscopy-for-rectal-cancer
#6
REVIEW
Chady Atallah, Jonathan E Efron
It is evident that the use of laparoscopy in the management of rectal cancer has gained popularity in the last few years. It is still, however, not widely accepted as the standard of care. Multiple randomized trials have shown that short-term outcomes and perioperative morbidity and mortality of laparoscopic proctectomy are equivalent to open surgery. However, data regarding long-term oncologic outcomes are still scarce, with only a few randomized trials reporting similar outcomes in both laparoscopic and open group...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381940/laparoscopy-for-colon-cancer
#7
REVIEW
Brenton R Franklin, Michael P McNally
The use of laparoscopy has become widespread across many surgical specialties. Its utility as treatment for colon cancer was initially met with hesitancy due to concern for port site and wound recurrences; however, this was later disproven by large retrospective series. Subsequently, there have been multiple, large, prospective, randomized studies evaluating laparoscopic versus open colectomy for colon cancer. All studies yielded similar results and showed no statistical difference in overall survival, disease-free survival, and recurrence...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381939/laparoscopy-for-benign-diseases-of-the-colon
#8
REVIEW
Radhika Smith, David J Maron
Laparoscopic surgery has revolutionized the delivery of care to the surgical patient undergoing colorectal resection. Since the first laparoscopic-assisted colectomy in 1991, significant advances have been made in minimally invasive colorectal surgery. For many benign conditions, laparoscopic colectomy has been proven to be safe and effective, and in some instances superior when compared with open surgery. Complex laparoscopic resections such as those for diverticulitis and inflammatory bowel disease have also been shown to have equivalent outcomes when compared with open surgery...
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381938/laparoscopy-endoscopy-and-minimally-invasive-colorectal-surgery
#9
James E Duncan
No abstract text is available yet for this article.
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28381937/james-e-duncan-md-facs-fascrs
#10
Scott R Steele
No abstract text is available yet for this article.
April 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144215/functional-disorders-slow-transit-constipation
#11
REVIEW
John Tillou, Vitaliy Poylin
Constipation is a very common complaint, with slow-transit constipation (STC) accounting for a significant proportion of cases. Old age, female gender, psychiatric illness, and history of sexual abuse are all associated with STC. The exact cause of STC remains elusive; however, multiple immune and cellular changes have been demonstrated. Diagnosis requires evidence of slowed colonic transit which may be achieved via numerous modalities. While a variety of medical therapies exist, these are often met with limited success and a minority of patients ultimately require operative intervention...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144214/functional-disorders-rectocele
#12
REVIEW
W Conan Mustain
Rectoceles are a very common finding in patients, and symptoms most commonly include pelvic pain, pressure, or difficulty with passing stool. However, there are often other associated pelvic floor disorders that accompany rectoceles, making the clinical significance of it in an individual patient often hard to determine. When evaluating a patient with a rectocele, a thorough history and physical exam must be conducted to help delineate other causes of these symptoms. Treatment consists of addressing other defecatory disorders through various methods, with surgery reserved for select cases in which obstructed defecation is well documented...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144213/abdominal-approaches-to-rectal-prolapse
#13
REVIEW
Kyla Joubert, Jonathan A Laryea
Rectal prolapse is a debilitating condition with a complex etiology. Symptoms are most commonly prolapse of the rectum and pain with bowel movements or straining, with worsening fecal incontinence over time due to progressive stretching of the anal sphincters. Physical findings are fairly consistent from patient to patient-most notably diastasis of the levator ani muscles, deep pouch of Douglas, redundant sigmoid colon, a mobile mesorectum, and occasionally a solitary rectal ulcer. Evaluation includes a physical exam or imaging demonstrating the prolapse, and evaluating for other causes of pelvic floor dysfunction...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144212/methods-of-evaluation-of-anorectal-causes-of-obstructed-defecation
#14
REVIEW
Anne C Fabrizio, Yewande Alimi, Anjali S Kumar
Obstructed defecation is a complex disorder that results in impaired propagation of stool from the rectum. It is one of the major subtypes of functional constipation and can be secondary to either functional or anatomic etiologies. Patients with obstructed defecation typically present with symptoms of abdominal discomfort, a sensation of incomplete evacuation and rectal obstruction, passage of hard stools, the need for rectal or vaginal digitation, excessive straining, and reduced stool frequency. Evaluation of obstructed defecation is multimodal, starting with a thorough history and physical examination with focus on the abdominal, perineal, and rectal examination...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144211/volvulus-of-the-small-bowel-and-colon
#15
REVIEW
Muneera R Kapadia
Volvulus of the intestines may involve either the small bowel or colon. In the pediatric population, small bowel volvulus is more common, while in the adult population, colonic volvulus is more often seen. The two most common types of colonic volvulus include sigmoid and cecal volvulus. Prompt diagnosis and treatment is imperative, otherwise bowel ischemia may ensue. Treatment often involves emergent surgical exploration and bowel resection.
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144210/intestinal-intussusception-etiology-diagnosis-and-treatment
#16
REVIEW
Priscilla Marsicovetere, S Joga Ivatury, Brent White, Stefan D Holubar
Intussusception is defined as the invagination of one segment of the bowel into an immediately adjacent segment of the bowel. Idiopathic ileocolic intussusception is the most common form in children and is typically managed with nonoperative reduction via pneumatic and/or hydrostatic enemas. In the adult population, intussusception is uncommon and occurs more often in the small intestine than in the colon. It is associated with lead point pathology in most symptomatic cases presenting as bowel obstruction. When lead point pathology is present in adult small bowel intussusception, it is usually benign, though when malignant it is most frequently due to diffuse metastatic disease, for example, melanoma...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144209/functional-disorders-of-constipation-paradoxical-puborectalis-contraction-and-increased-perineal-descent
#17
REVIEW
Isaac Payne, Leander M Grimm
Paradoxical puborectalis contraction (PPC) and increased perineal descent (IPD) are subclasses of obstructive defecation. Often these conditions coexist, which can make the evaluation, workup, and treatment difficult. After a thorough history and examination, workup begins with utilization of proven diagnostic modalities such as cinedefecography and anal manometry. Advancements in technology have increased the surgeon's diagnostic armamentarium. Biofeedback and pelvic floor therapy have proven efficacy for both conditions as first-line treatment...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144208/evaluation-diagnosis-and-medical-management-of-rectal-prolapse
#18
REVIEW
Jamie A Cannon
Full-thickness rectal prolapse, or procidentia, is the passage of the full-thickness wall of the rectum beyond the anal sphincters. This condition results in pain and fecal incontinence which greatly impairs the quality of life of those afflicted. It is associated with several anatomic abnormalities, including decreased anal sphincter tone, levator muscle diastasis, and a deep anterior cul-de-sac. The diagnosis of rectal prolapse is made based on physical examination, although several other modalities are used to provide additional information about the patients' condition...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144207/perineal-approaches-to-rectal-prolapse
#19
REVIEW
Louis R Barfield
Full-thickness rectal prolapse is a painful and debilitating condition that often responds well to surgical intervention. The best method of surgical repair is a matter of debate. Historically, perineal approaches have been thought to have inferior outcomes and were therefore reserved for elderly and unfit patients. Despite recent data calling that into question, perineal approaches are still commonly performed and have their role. We present risks and benefits along with a description of perineal approaches for surgical treatment of rectal prolapse...
February 2017: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/28144206/functional-disorders-rectoanal-intussusception
#20
REVIEW
Kristen Blaker, Joselin L Anandam
Rectoanal intussusception is an invagination of the rectal wall into the lumen of the rectum. Patients may present with constipation, incomplete evacuation, incontinence, or may be asymptomatic. Defecography has been the gold standard for detection. Magnetic resonance imaging defecography and dynamic anal endosonography are alternatives to conventional defecography. However, both methods are not as sensitive as conventional defecography. Treatment options range from conservative/medical treatment such as biofeedback to surgical procedures such as Delorme, rectopexy, and stapled transanal rectal resection...
February 2017: Clinics in Colon and Rectal Surgery
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