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https://www.readbyqxmd.com/read/28534070/total-abdominal-colectomy-vs-restorative-total-proctocolectomy-as-the-initial-approach-to-medically-refractory-ulcerative-colitis
#1
Jinyu Gu, Luca Stocchi, Jeanie Ashburn, Feza H Remzi
PURPOSE: There is scant data assessing the consequences of staging restorative proctocolectomy for ulcerative colitis. The aim of the study is to compare outcomes of initial vs. staged restorative proctocolectomy. METHODS: Patients completing restorative proctocolectomy, including ileostomy reversal, during 2006-2012 were identified from an IRB-approved database. Demographics, treatment variables, and perioperative outcomes were assessed. RESULTS: Out of 521 patients, 322 (62%) underwent initial total abdominal colectomy before restorative proctectomy...
May 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28533998/ipilimumab-as-a-cause-of-severe-pan-colitis-and-colonic-perforation
#2
Raj Shah, Danielle Witt, Talal Asif, Fahad F Mir
Ipilimumab is a human monoclonal antibody that functions as a cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitor that is used to treat malignant melanoma. Due to ipilimumab's removal of immune regulation, specifically through the inactivation of CTLA-4, it is commonly associated with inflammatory and autoimmune events. Gastrointestinal (GI) related immune-related adverse events such as diarrhea occur in 29% of patients with 7.6% of patients specifically suffering from colitis. We describe a case of colonic perforation with ipilimumab use...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28531577/the-effect-of-isotonic-drinks-on-electrolyte-abnormalities-of-ileostomy-patients-preliminary-results
#3
Antigoni Chalkia, Athanasios Migdanis, Georgios Koukoulis, Ioannis Mamaloudis, Ioannis Migdanis, Eleni Malisiova, Ioannis Gioulbasanis, Georgios Tzovaras
No abstract text is available yet for this article.
June 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28523723/patient-characteristics-and-surgery-related-factors-associated-with-patient-reported-recovery-at-1-and-6%C3%A2-months-after-colorectal-cancer-surgery
#4
J Jakobsson, E Idvall, C Kumlien
Predictors for postoperative recovery after colorectal cancer surgery are usually investigated in relation to length of stay (LoS), readmission, or 30-day morbidity. This study describes patient characteristics and surgery-related factors associated with patient-reported recovery 1 and 6 months after surgery. In total, 153 consecutively included patients who were recovering from colorectal cancer surgery reported their level of recovery using the Postoperative Recovery Profile. Multiple logistic regression analysis was used to calculate associations with recovery, defined as good or poor, divided into five recovery dimensions: physical symptoms, physical functions, psychological, social and activity...
May 19, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28523361/can-laparoscopic-surgery-prevent-incisional-hernia-in-patients-with-crohn-s-disease-a-comparison-study-of-750-patients-undergoing-open-and-laparoscopic-bowel-resection
#5
Tomas M Heimann, Santosh Swaminathan, Adrian J Greenstein, Alexander J Greenstein, Sergey Khaitov, Randolph M Steinhagen, Barry A Salky
BACKGROUND: Incisional hernia (IH) is a frequent occurrence following open surgery for Crohn's disease (CD). This study compares the IH rates of patients with CD undergoing open versus laparoscopic bowel resection. METHODS: Seven hundred and fifty patients with CD operated by the authors at the Mount Sinai Medical Center, New York, USA, were reviewed from a prospectively maintained surgical database. Five hundred patients with Crohn's disease undergoing open surgery were compared to 250 patients undergoing laparoscopic bowel resection...
May 18, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28514887/transanal-inspection-and-management-of-low-colorectal-anastomosis-performed-with-a-new-technique-the-ticrant-study
#6
Francesco Crafa, Sebastian Smolarek, Giulia Missori, Mostafa Shalaby, Silvia Quareisma, Adele Noviello, Diletta Cassini, Pasquale Ascenzi, Luana Franceschilli, Paolo Delrio, Giannandrea Baldazzi, Ucchino Giampiero, Jacques Megevand, Giovanni Maria Romano, Pierpaolo Sileri
BACKGROUND: Anastomotic leakage is one of the most serious complications after rectal cancer surgery. METHOD: A prospective multicenter interventional study to assess a newly described technique of creating the colorectal and coloanal anastomosis. The primary outcome was to access the safety and efficacy of this technique in the reduction of anastomotic leak. RESULT: Fifty-three patients with rectal cancer who underwent low or ultra-low anterior resection were included in the study...
May 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28501251/dysplasia-and-cancer-in-inflammatory-bowel-disease
#7
REVIEW
Lyen C Huang, Amit Merchea
Inflammatory bowel disease is associated with an increased risk of dysplasia and cancer. Improvements in medical management and endoscopic surveillance have reduced these risks. Patients can develop cancer even in the absence of dysplasia or with indefinite or low-grade dysplasia. Most guidelines recommend starting surveillance colonoscopy 6 to 10 years after initial diagnosis with interval surveillance afterward every 1 to 5 years depending on risk and/or individual characteristics. Most patients should undergo total proctocolectomy with end ileostomy or reconstruction with ileal pouch anal anastomosis because segmental and subtotal resections carry a higher risk of metachronous cancers...
June 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/28500611/-restorative-proctocolectomy-for-ulcerative-colitis-long-term-functional-results-and-quality-of-life
#8
REVIEW
E Rijcken, N Senninger, R Mennigen
Restorative proctocolectomy with ileo-pouch-anal anastomosis is the standard procedure for ulcerative colitis. It provides complete removal of the diseased colorectum, avoids permanent ileostomy and allows the preservation of continence. Functional results and quality of life after restorative proctocolectomy are of great importance. Patients usually have 5-6 bowel movements per day, and continence is satisfactory in more than 90% of patients. A good pouch function strongly correlates with high quality of life...
May 12, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28498636/study-protocol-evaluating-the-use-of-bowel-stimulation-before-loop-ileostomy-closure-to-reduce-postoperative-ileus-a-multicenter-randomized-controlled-trial
#9
Richard Garfinkle, Nora Trabulsi, Nancy Morin, Terry Phang, Sender Liberman, Liane Feldman, Gerald Fried, Marylise Boutros
AIM: Postoperative ileus is the most commonly observed morbidity following ileostomy closure. Studies have demonstrated that the defunctionalized bowel of a loop ileostomy undergoes a series of functional and structural changes, such as atrophy of the intestinal villi and muscular layers, which may contribute to ileus. A single-center study in Spain demonstrated that preoperative bowel stimulation via the distal limb of the loop ileostomy decreased postoperative ileus, length of stay, and time to gastrointestinal function...
May 12, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28497757/safety-and-tolerability-of-veliparib-combined-with-capecitabine-plus-radiotherapy-in-patients-with-locally-advanced-rectal-cancer-a-phase-1b-study
#10
Brian G Czito, Dustin A Deming, Gayle S Jameson, Mary F Mulcahy, Houman Vaghefi, Matthew W Dudley, Kyle D Holen, Angela DeLuca, Rajendar K Mittapalli, Wijith Munasinghe, Lei He, John R Zalcberg, Samuel Y Ngan, Philip Komarnitsky, Michael Michael
BACKGROUND: Further optimisation of present standard chemoradiation is needed in patients with locally advanced rectal cancer. Veliparib, an oral poly(ADP-ribose) polymerase inhibitor, has been shown to enhance the antitumour activity of chemotherapy and radiotherapy in preclinical models. We aimed to establish the maximum tolerated dose and establish the recommended phase 2 dose of veliparib combined with neoadjuvant capecitabine and radiotherapy. METHODS: This phase 1b, open-label, multicentre, dose-escalation study was done at six hospitals (one in Australia and five in the USA)...
June 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28485190/complications-and-morbidity-associated-with-loop-ileostomies-in-patients-with-ulcerative-colitis
#11
J Park, B Gessler, M Block, E Angenete
BACKGROUND AND AIMS: Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting. MATERIAL AND METHODS: Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively...
May 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28469372/a-rare-case-of-crohn-s-ileitis-in-a-patient-with-constitutional-mismatch-repair-deficiency
#12
Pavlos Kaimakliotis, Francis Giardiello, Ogechukwu Eze, Brindusa Truta
Constitutional mismatch repair deficiency (CMMRD), a variant of Lynch syndrome, is a rare disease characterized by café-au-lait spots, oligopolyposis, glioblastoma and lymphoma. A 24-year-old male, under surveillance for CMMRD, developed Crohn's ileitis after total colectomy with end ileostomy for colorectal cancer and failed to respond to oral corticosteroids. The patient underwent induction and maintenance of remission with vedolizumab infusions. We report the first patient with CMMRD developing Crohn's disease...
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28462383/interdependency-of-egf-and-glp-2-signaling-in-attenuating-mucosal-atrophy-in-a-mouse-model-of-parenteral-nutrition
#13
Yongjia Feng, Farok R Demehri, Weidong Xiao, Yu-Hwai Tsai, Jennifer C Jones, Constance D Brindley, David W Threadgill, Jens J Holst, Bolette Hartmann, Terrence A Barrett, Daniel H Teitelbaum, Peter J Dempsey
BACKGROUND & AIMS: Total parenteral nutrition (TPN), a crucial treatment for patients who cannot receive enteral nutrition, is associated with mucosal atrophy, barrier dysfunction, and infectious complications. Glucagon-like peptide-2 (GLP-2) and epidermal growth factor (EGF) improve intestinal epithelial cell (IEC) responses and attenuate mucosal atrophy in several TPN models. However, it remains unclear whether these 2 factors use distinct or overlapping signaling pathways to improve IEC responses...
May 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28462379/prolonged-absence-of-mechanoluminal-stimulation-in-human-intestine-alters-the-transcriptome-and-intestinal-stem-cell-niche
#14
Minna M Wieck, Christopher R Schlieve, Matthew E Thornton, Kathryn L Fowler, Mubina Isani, Christa N Grant, Ashley E Hilton, Xiaogang Hou, Brendan H Grubbs, Mark R Frey, Tracy C Grikscheit
BACKGROUND & AIMS: For patients with short-bowel syndrome, intestinal adaptation is required to achieve enteral independence. Although adaptation has been studied extensively in animal models, little is known about this process in human intestine. We hypothesized that analysis of matched specimens with and without luminal flow could identify new potential therapeutic pathways. METHODS: Fifteen paired human ileum samples were collected from children aged 2-20 months during ileostomy-reversal surgery after short-segment intestinal resection and diversion...
May 2017: Cellular and Molecular Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28457330/ileostomy-creation-in-colorectal-cancer-surgery-risk-of-acute-kidney-injury-and-chronic-kidney-disease
#15
Linda Li, Kelsey S Lau, Venkat Ramanathan, Sonia T Orcutt, Shubhada Sansgiry, Daniel Albo, David H Berger, Daniel A Anaya
BACKGROUND: Ileostomy creation is associated with postoperative dehydration and readmission; however, the effect on renal function is unknown. Our goal was to characterize the impact of ileostomy creation on acute and chronic renal function. MATERIALS AND METHODS: A retrospective cohort study with patients undergoing colorectal cancer surgery at a tertiary referral institution (2005-2011). The relationship between ileostomy creation and acute kidney injury (AKI)-related readmission, severe chronic kidney disease (CKD) at 12 mo (glomerular filtration rate <30 mL/min/1...
April 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28442838/wound-outcome-following-primary-and-delayed-primary-skin-closure-techniques-after-laparotomy-for-non-traumatic-ileal-perforation-a-randomized-clinical-trial
#16
Vivek Agrawal, Mohit Kumar Joshi, Ashish Kumar Gupta, Bhupendra Kumar Jain
To study the effect of primary and delayed primary closure of skin incision on wound outcome in patients with non-traumatic ileal perforation, 68 patients of ileal perforation were studied in a prospective randomized clinical trial. Patients fulfilling inclusion criteria were divided into ileostomy and non-ileostomy groups, both of which were then randomized into two subgroups each depending on whether skin was closed primarily or in a delayed primary manner. Wound infection and dehiscence were the main outcome parameters studied...
April 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28435128/randomized-trial-on-fast-track-care-in-colorectal-surgery-for-deep-infiltrating-endometriosis
#17
Marco Scioscia, Marcello Ceccaroni, Irene Gentile, Roberto Rossini, Roberto Clarizia, Davide Brunelli, Giacomo Ruffo
STUDY OBJECT: To study the application of a fast-track care protocol in colorectal surgery for deep infiltrating endometriosis. Bowel endometriosis is an infrequent but not rare condition that often needs intestinal surgery and imposes a high economic burden on society. DESIGN: Prospective randomized trial (Canadian Task Force I). SETTING: Tertiary referral center. PATIENTS: We randomly assigned 227 patients with preoperative evidence of bowel endometriosis to a fast-track (no preoperative bowel preparation, early restoration of diet, no postoperative antibiotics, and early post-operative mobilization) or conventional care for laparoscopic intestinal surgery...
April 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28434582/effectiveness-between-early-and-late-temporary-ileostomy-closure-in-patients-with-rectal-cancer-a-prospective-study
#18
Li Zhen, Yanan Wang, Ze Zhang, Tongwei Wu, Ruoyan Liu, Tingting Li, Liying Zhao, Haijun Deng, Xiaolong Qi, Guoxin Li
A temporary stoma is often used in rectal cancer surgery to protect a distal anastomosis, which remains a major concern after rectal cancer surgery, particularly after low anterior resection. The temporary stoma is scheduled for closure. However, the optimal time of closure of the protecting stoma remains unclear because of sparse studies and data. We aimed to detect the efficacy between early and late temporary ileostomy closure in patients with rectal cancer during or after neoadjuvant chemoradiotherapy. We conducted a prospective, 2-group design between early and late ileostomy closure group in patients after rectal cancer surgery with temporary stoma...
March 2, 2017: Current Problems in Cancer
https://www.readbyqxmd.com/read/28433044/-laparoscopic-diverting-ileostomy-in-rectal-cancer-surgery
#19
P Ihnát, P Vávra, P Guňková, A Zatloukal, S Czudek, P Zonča
INTRODUCTION: Low anterior resection (LAR) with total mesorectal excision (TME) represents the gold standard for patients with low rectal carcinoma. Protective ileostomy (PI) is commonly performed during LAR in an effort to protect low rectal anastomosis. The aim of this study is to analyse outcomes in our own patient population, focusing on morbidity associated with PI. METHOD: A retrospective clinical study of patients operated on between 2013 and 2015 was conducted in University Hospital Ostrava...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28426557/loop-ileostomy-vs-total-colectomy-as-surgical-treatment-for-clostridium-difficile-associated-disease-an-eastern-association-for-the-surgery-of-trauma-multicenter-trial
#20
Paula Ferrada, Rachael Callcut, Martin D Zielinski, Brandon Bruns, Daniel Dante Yeh, Tanya L Zakrison, Jonathan P Meizoso, Babak Sarani, Richard D Catalano, Peter Kim, Valerie Plant, Amelia Pasley, Linda A Dultz, Asad J Choudhry, Elliott R Haut
OBJECTIVES: The mortality of patients with Clostridum Dificile Associated Disease (CDAD) requiring surgery continues to be very high. Loop ileostomy (LI) was introduced as an alternative procedure to total colectomy (TC) for CDAD by a single center study. To date, no reproducible results have been published. The objective of this study is to compare these two procedures in a multicentric approach to help the surgeon decide what procedure is best suited for the patient in need. METHODS: This was a retrospective multicenter study conducted under the sponsorship of the Eastern Association for the Surgery of Trauma (EAST)...
April 20, 2017: Journal of Trauma and Acute Care Surgery
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