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Clinics in Colon and Rectal Surgery

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https://www.readbyqxmd.com/read/29720906/development-of-preclinical-models-to-understand-and-treat-colorectal-cancer
#1
REVIEW
Judith S Sebolt-Leopold
The establishment and validation of preclinical models that faithfully recapitulate the pathogenesis and treatment response of human colorectal cancer (CRC) is critical to expedient therapeutic advances in the clinical management of this disease. Integral to the application of precision medicine for patients diagnosed with metastatic CRC is the need to understand the molecular determinants of response for a given therapy. Preclinical models of CRC have proven invaluable in answering many of our basic questions relating to the molecular aberrations that drive colorectal tumor progression...
May 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29720905/the-role-of-the-gut-microbiome-in-colorectal-cancer
#2
REVIEW
Grace Y Chen
There is increasing evidence that the gut microbiome, which consists of trillions of microbes representing over 1,000 species of bacteria with over 3 million genes, significantly impacts intestinal health and disease. The gut microbiota not only is capable of promoting intestinal homeostasis and antitumor responses but can also contribute to chronic dysregulated inflammation as well as have genotoxic effects that lead to carcinogenesis. Whether the gut microbiota maintains health or promotes colon cancer may ultimately depend on the composition of the gut microbiome and the balance within the microbial community of protective and detrimental bacterial populations...
May 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29720904/emerging-systemic-therapies-for-colorectal-cancer
#3
REVIEW
Christine M Veenstra, John C Krauss
Despite advances over the past 20 years in colorectal cancer (CRC) screening, diagnosis, and treatment, survival outcomes remain suboptimal. Five-year survival for patients with locally advanced CRC is 69%; 5-year survival drops to 12% for patients with metastatic disease. Novel, effective systemic therapies are needed to improve long-term outcomes. In this review, we describe currently available systemic therapies for the treatment of locally advanced and metastatic CRC and discuss emerging therapies, including encouraging advances in identifying novel targeted agents and exciting responses to immunotherapeutic agents...
May 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29720903/colorectal-cancer-in-inflammatory-bowel-disease
#4
REVIEW
Ryan W Stidham, Peter D R Higgins
Patients with inflammatory bowel disease (IBD) are at significantly increased risk of colorectal cancer (CRC), principally resulting from the pro-neoplastic effects of chronic intestinal inflammation. Epidemiologic studies continue to highlight the increased risk of CRC in IBD. However, the incidence has declined over the past 30 years, attributed to both successful CRC-surveillance programs and improved control of mucosal inflammation. Risk factors that further increase the risk of IBD-related CRC include disease duration, extent and severity, the presence of inflammatory pseudopolyps, coexistent primary sclerosing cholangitis, and a family history of CRC...
May 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29720902/translational-research-in-familial-colorectal-cancer-syndromes
#5
REVIEW
Molly M Ford
Growing knowledge of inherited colorectal cancer syndromes has led to better surveillance and better care of this subset of patients. The most well-known entities, including Lynch syndrome and familial adenomatous polyposis, are continually being studied and with the advent of more sophisticated genetic testing, additional genetic discoveries have been made in the field of inherited cancer. This article will summarize many of the updates to both the familiar and perhaps less familiar syndromes that can lead to inherited or early-onset colorectal cancer...
May 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29720901/updates-on-translational-research-on-prevention-of-polyps-and-colorectal-cancer
#6
REVIEW
Elena M Stoffel
Morbidity and mortality from colorectal cancer (CRC) can be effectively reduced through early detection and prevention. To date, strategies for managing CRC risk have focused primarily on secondary prevention, through screening asymptomatic individuals for colorectal neoplasia. In the United States, implementation of screening among individuals age ≥50 has led to not only decreased CRC-related mortality but also reduced CRC incidence through colonoscopic removal of precancerous polyps. In contrast to screening's endpoint of early detection, the goal of primary prevention of CRC is to arrest and/or reverse colorectal carcinogenesis...
May 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29720900/update-on-sporadic-colorectal-cancer-genetics
#7
REVIEW
Karin M Hardiman
Our understanding of the genetics of colorectal cancer has changed dramatically over recent years. Colorectal cancer can be classified in multiple different ways. Along with the advent of whole-exome sequencing, we have gained an understanding of the scale of the genetic changes found in sporadic colorectal cancer. We now know that there are multiple pathways that are commonly involved in the evolution of colorectal cancer including Wnt/β-catenin, RAS, EGFR, and PIK3 kinase. Another recent leap in our understanding of colorectal cancer genetics is the recognition that many, if not all tumors, are actually genetically heterogeneous within individual tumors and also between tumors...
May 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29720899/translational-research-in-colorectal-cancer
#8
Karin M Hardiman
No abstract text is available yet for this article.
May 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29720898/karin-m-hardiman-md-phd
#9
Scott R Steele
No abstract text is available yet for this article.
May 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487497/current-approaches-to-pediatric-polyposis-syndromes
#10
REVIEW
Aodhnait S Fahy, Christopher R Moir
Colorectal adenomatous polyposis syndromes encompass a diverse group of disorders with varying modes of inheritance and penetrance. Children may present with overt disease or within screening programs for families at high risk. We provide an overview of the array of pediatric polyposis syndromes, current screening recommendations, and surgical indications and technical considerations. Optimal disease management for these pediatric patients is still evolving and has implications for screening, surveillance, pediatric surgical management, and transition of care gastroenterologic neoplasia physicians and surgeons...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487496/enteric-duplication
#11
REVIEW
Paul M Jeziorczak, Brad W Warner
Enteric duplications have been described throughout the entire gastrointestinal tract. The usual perinatal presentation is an abdominal mass. Duplications associated with the foregut have associated respiratory symptoms, whereas duplications in the midgut and hindgut can present with obstructive symptoms, perforation, nausea, emesis, hemorrhage, or be asymptomatic, and identified as an incidental finding. These are differentiated from other cystic lesions by the presence of a normal gastrointestinal mucosal epithelium...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487495/meconium-ileus
#12
REVIEW
John H T Waldhausen, Morgan Richards
Cystic fibrosis is one of the most common inheritable traits in Caucasians. Meconium ileus and its potential complications are the most likely reasons that these patients will need surgical care. Surgical intervention is usually needed in the neonatal period but may also be required later in life. This article discusses the various ways cystic fibrosis can affect the gastrointestinal tract. Both the operative and nonoperative management of complicated and uncomplicated meconium ileus are discussed in the neonatal period as well as long-term issues, such as distal intestinal obstructive syndrome, fibrosing colonopathy, and rectal prolapse, all of which may be seen in older children and adults...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487494/anorectal-complaints-hemorrhoids-fissures-abscesses-fistulae
#13
REVIEW
Ramin Jamshidi
Anorectal complaints are not uncommon in pediatric care, but the etiology and management can differ significantly from adults. Age is an important factor when considering etiology and management, distinguishing between infants, children, and adolescents. For all ages, malignancy is rarely a consideration, but a thorough examination of infants and children typically requires deep sedation or general anesthesia. Very little primary literature or evidence exists to guide care; so there are many opportunities for careful study to enhance our understanding beyond personal experience and historical practice patterns...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487493/pediatric-rectal-prolapse
#14
REVIEW
Rebecca M Rentea, Shawn D St Peter
Rectal prolapse is a common and self-limiting condition in infancy and early childhood. Most cases respond to conservative management. Patients younger than 4 years with an associated condition have a better prognosis. Patients older than 4 years require surgery more often than younger children. Multiple operative and procedural approaches to rectal prolapse exist with variable recurrence rates and without a clearly superior operation. These include sclerotherapy, Thiersch's anal cerclage, Ekehorn's rectopexy, laparoscopic suture rectopexy, and posterior sagittal rectopexy...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487492/chronic-intestinal-pseudo-obstruction
#15
REVIEW
Khalil El-Chammas, Manu R Sood
Chronic intestinal pseudo-obstruction (CIP) is defined by either continuous or intermittent symptoms of bowel obstruction in the absence of fixed lumen excluding lesion. CIP includes a heterogeneous group of disorders which result either from diseases affecting the enteric neurons and smooth muscle lining or those involving the autonomic innervation of the bowel. Symptoms associated with CIP are nonspecific, which can sometimes contribute to the delay in recognizing the condition and making the correct diagnosis...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487491/surgical-management-of-idiopathic-constipation-in-pediatric-patients
#16
REVIEW
Lily S Cheng, Allan M Goldstein
Constipation is a common childhood problem, but an anatomic or physiologic cause is identified in fewer than 5% of children. By definition, idiopathic constipation is a diagnosis of exclusion. Careful clinical evaluation and thoughtful use of imaging and other testing can help exclude specific causes of constipation and guide therapy. Medical management with laxatives is effective for the majority of constipated children. For those patients unresponsive to medications, however, several surgical options can be employed, including anal procedures, antegrade colonic enemas, colorectal resection, and intestinal diversion...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487490/pediatric-crohn-s-disease
#17
REVIEW
Daniel von Allmen
The incidence of Crohn's disease in the pediatric population is increasing. While pediatric patients with Crohn's disease exhibit many of the characteristics of older patients, there are important differences in the clinical presentation and course of disease that can impact the clinical decisions made during treatment. The majority of children are diagnosed in the early teen years, but subgroups of very early onset and infantile Crohn's present much earlier and have a unique clinical course. Treatment paradigms follow the traditional laddered approach, but growth and development represent special considerations that must be given to pediatric-specific complications of the treatment and disease...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487489/medical-and-surgical-management-of-pediatric-ulcerative-colitis
#18
REVIEW
José M Cabrera, Thomas T Sato
Inflammatory bowel disease (IBD) describes a spectrum of idiopathic, lifelong, and progressive intestinal inflammatory conditions that includes Crohn's disease, ulcerative colitis, and indeterminate colitis. A worldwide increase in the incidence of IBD has been observed. In comparison to adults, IBD occurring during childhood and adolescence has several unique clinical characteristics and surgical management issues. In this article, we provide an overview contrasting these important differences.
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487488/anorectal-malformations
#19
REVIEW
Richard J Wood, Marc A Levitt
Anorectal malformation are common congenital problems occurring in 1 in 5,000 births and have a spectrum of anatomical presentations, requiring individualized treatments for the newborn, sophisticated approaches to the definitive reconstruction, and management of long-term treatments and outcomes. Associated anomalies related to the cardiac, renal, gynecologic, orthopedic, spinal, and sacral systems impact care and prognosis. Long-term results are good provided there is an accurate anatomical reconstruction and a focus on maximizing of functional results...
March 2018: Clinics in Colon and Rectal Surgery
https://www.readbyqxmd.com/read/29487487/hirschsprung-disease-beyond-infancy
#20
REVIEW
Casey M Calkins
Hirschsprung disease (HD) is a common cause of neonatal intestinal obstruction in which a variable segment of the distal intestinal tract lacks the normal enteric nervous system elements. Affected individuals present with varying degrees of obstructive symptoms, but today most patients are diagnosed within the first several months of life owing to the well-recognized symptoms and the ease of making the diagnosis by way of the bedside suction rectal biopsy. Thus, for the adult general or colorectal surgeon, the vast majority of patients who present for evaluation will have already undergone surgical treatment within the first year of life by a pediatric surgeon...
March 2018: Clinics in Colon and Rectal Surgery
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