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Abhijit Chandra, Brijesh Mishra, Saket Kumar, Nikhil Chopra, Vivek Gupta, Amit Dangi, Pavan Kumar Gorla, Vishal Gupta
BACKGROUND: Severe fecal incontinence has a significant negative impact on patient well-being. Current surgical methods of total anorectal reconstruction to substitute a colostomy have suboptimal results. A composite graft using antropyloric valve transposition and gracilis wrap has been described with good outcomes. However, this procedure requires extensive training of patients. Gluteus maximus, an accessory muscle for continence, may be better suited for this purpose. OBJECTIVE: The purpose of this study was to evaluate the outcomes of composite antropylorus-gluteus graft for intractable fecal incontinence...
January 2019: Diseases of the Colon and Rectum
Faith Qi-Hui Leong, Dedrick Kok Hong Chan, Ker-Kan Tan
Purpose: Perianal adenocarcinoma arising from a chronic anorectal fistula is a rare condition for which the natural history and optimal management are not well established. For that reason, we conducted a retrospective analysis of 5 consecutive patients with a perianal adenocarcinoma arising from a chronic anorectal fistula managed at our institution from January 2014 to December 2015. Methods: The patients were identified from a prospectively collected colorectal cancer database that included all patients managed for colorectal cancer at our institution...
December 3, 2018: Annals of Coloproctology
Jiagang Han, Zhenjun Wang, Yong Dai, Xiaorong Li, Qun Qian, Guiying Wang, Guanghui Wei, Weigen Zeng, Liangang Ma, Baocheng Zhao, Yanlei Wang, Kaiyan Yang, Zhao Ding, Xuhua Hu
OBJECTIVE: To evaluate the safety and feasibility of neoadjuvant chemotherapy prior elective surgery following self-expanding metallic stents (SEMS) for complete obstructive left hemicolon cancer. METHODS: This prospective, multicenter, open-labelled trial was approved by the Ethics Committee of Beijing Chaoyang Hospital, Capital Medical University(2016-ke-161-1) and registered in (NCT02972541). INCLUSION CRITERIA: (1)age between 18 and 75 years old;(2) adenocarcinoma confirmed by pathology;(3) left hemicolon cancer confirmed by clinical manifestations and imaging examinations with the distance to anal verge > 15 cm; (4) resectable cancer evaluated by imaging examination without distant metastasis; (5) Eastern Cooperative Oncology Group (ECOG) score ≤ 1 or Karnofsky Performance Scale (KPS) > 70, indicating tolerance of neoadjuvant chemotherapy and operation; (6) absence of chemotherapy or radiotherapy within past six months; (7) bone marrow system and hepatorenal function: hemoglobin ≥ 90 g/L, neutrophil ≥ 1...
November 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Sheng-Dong Pan, Xiao-Hong Chen, Hao-Yu Shen, Xiao-Ping Li, Mei-Qiang Cai, Yong-Gang Zhao, Mi-Cong Jin
This article has been retracted at the request of the Editor after the corresponding author pointed the Editor to comments from an anonymous reader. The article reports electron micrographs of different preparations while showing identical images as used in previous publications by the same authors. The particles in Fig. 4C (SEM image of Fe3O4@SiO2) are identical to each other and the corresponding author confirmed that these have been copy-pasted. In addition, these particles have previously been communicated as different substances in Fig...
January 10, 2019: Analytica Chimica Acta
Petros Bangeas, Kostnantinos Drevelegas, Christina Agorastou, Lazaros Tzounis, Aggeliki Chorti, Daniel Paramythiotis, Antonis Michalopoulos, George Tsoulfas, Vassileios N Papadopoulos, Aristomenis Exadaktylos, Jasjit S Suri
3D printing is a rapidly advancing technology which represents a significant technological achievement that could be useful in a variety of biomedical applications. In the field of surgery, 3D printing is envisioned as a significant step in the areas of surgical planning, education and training. The 3D printed models are considered as high quality and efficient educational tools. In this paper A randomized controlled trial was performed to compare the educational role of 3D printed models with that of the conventional MRI films in the training of surgical residents...
January 1, 2019: Frontiers in Bioscience (Elite Edition)
Atif Iqbal, Aimal Khan, Thomas J George, Sanda Tan, Peihua Qiu, Kai Yang, Jose Trevino, Steven Hughes
BACKGROUND: Objective criteria to predict difficult pelvic dissection with prognostic significance are lacking. Previous studies have focused on predicting intraoperative conversion and not evaluated factors specific to pelvic surgery. We aimed to develop an objective, prognostic, preoperative assessment to predict difficult pelvic dissections and clinical outcomes. Such a model is much needed, may facilitate objective comparisons between rectal cancer centers, or may serve as a stratification variable in clinical trials...
December 2018: Journal of Surgical Research
Paul M Cavallaro, Kyle Staller, Lieba R Savitt, Holly Milch, Kevin Kennedy, Milena M Weinstein, Rocco Ricciardi, Liliana G Bordeianou
BACKGROUND: Recently, there has been a trend toward surgical management of internal intussusception despite an unclear correlation with constipation symptoms. OBJECTIVE: This study characterizes constipation in patients with obstructed defecation syndrome and identifies whether internal intussusception or other diagnoses such as irritable bowel syndrome may be contributing to symptoms. DESIGN: Patients evaluated for obstructed defecation at a pelvic floor disorder center were studied from a prospectively maintained database...
November 15, 2018: Diseases of the Colon and Rectum
Friyan Turel, Nishamini Subramaniam, Janek Bienkiewicz, Talia Friedman, Hans Peter Dietz
OBJECTIVE: Three/Four dimensional translabial ultrasound (TLUS) is gaining popularity for assessment of anal sphincter trauma, although repeatability data is lacking. This study aimed to determine TLUS repeatability for external anal sphincter trauma and compare the performance of a novice with that of an experienced investigator. METHODS: This is a retrospective study analysing archived ultrasound datasets of 103 patients. Each was assessed twice between 2012 and 2016 at an average interval of 260 (1-1100) days...
November 13, 2018: Ultrasound in Obstetrics & Gynecology
Jia Kang, Meng Mao, Ye Zhang, Fang-Fang Ai, Lan Zhu
RATIONALE: Vertebral defect, anal atresia, cardiac defect, tracheoesophageal fistula/esophageal atresia, renal defect, and limb defect (VACTERL) association and Müllerian duct anomalies are rare conditions. We present a rare condition with the co-occurrence of the VACTERL association and Müllerian duct hypoplasia to characterize patients' clinical presentations, outcomes, and treatment. PATIENT CONCERNS: An 11-year-old girl presented to our hospital with severe lower abdominal pain, lower vaginal atresia with enlargement of the upper vagina and a bicornuate uterus with a Y-shaped uterine cavity filled with hematometra on pelvic magnetic resonance imaging...
November 2018: Medicine (Baltimore)
Atsushi Ogura, Tsuyoshi Konishi, Chris Cunningham, Julio Garcia-Aguilar, Henrik Iversen, Shigeo Toda, In Kyu Lee, Hong Xiang Lee, Keisuke Uehara, Peter Lee, Hein Putter, Cornelis J H van de Velde, Geerard L Beets, Harm J T Rutten, Miranda Kusters
PURPOSE: Improvements in magnetic resonance imaging (MRI), total mesorectal excision (TME) surgery, and the use of (chemo)radiotherapy ([C]RT) have improved local control of rectal cancer; however, we have been unable to eradicate local recurrence (LR). Even in the face of TME and negative resection margins (R0), a significant proportion of patients with enlarged lateral lymph nodes (LLNs) suffer from lateral LR (LLR). Japanese studies suggest that the addition of an LLN dissection (LLND) could reduce LLR...
November 7, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
María Julieta González, Mónica Rebollo Polo, Pablo Ripollés, Rosa Gassió, Aída Ormazabal, Cristina Sierra, Roser Colomé Roura, Rafael Artuch, Jaume Campistol
BACKGROUND: Despite dietary intervention, individuals with early treated phenylketonuria (ETPKU) could present neurocognitive deficits and white matter (WM) abnormalities. The aim of the present study was to evaluate the microstructural integrity of WM pathways across the whole brain in a cohort of paediatric ETPKU patients compared with healthy controls (HCs), by collecting DTI-MRI (diffusion tensor magnetic resonance imaging) data and diffusion values (mean diffusivity (MD), radial diffusivity (RD) and fractional anisotropy (FA))...
October 26, 2018: Orphanet Journal of Rare Diseases
Matthew M Symer, Heather L Yeo
Anal cancer is a rare condition, although its incidence has been increasing over the past several decades, particularly in women. The majority of anal cancers are squamous cell cancers and are linked with human papilloma virus (HPV) infection. Recent work in HPV basic science has delineated the mechanism by which the virus leads to the development of anal cancer. With widespread availability of an HPV vaccine since 2006, vaccination has become an important strategy for anal cancer prevention. However, in the US, there remain no guidelines for anal cancer screening...
2018: F1000Research
Hirofumi Suzumura, Masashi Tsuruta, Hirotoshi Hasegawa, Koji Okabayashi, Takashi Ishida, Yusuke Asada, Akitsugu Makino, Shigeo Okuda, Yuko Kitagawa
PURPOSE: We aimed to clarify the impact of the apparent diffusion coefficient (ADC) value of the mesorectum from preoperative magnetic resonance imaging (MRI) on surgical difficulty in laparoscopic anterior resection (Lap-AR) for rectal cancer. METHODS: In total, 67 patients who had undergone curative Lap-AR for rectal cancer in our hospital from January 2008 to March 2015 and had preoperative MRI findings available were included. We randomly calculated the average ADC in three regions of the mesorectum at the level of the upper edge of the superior border of the femur...
October 19, 2018: Surgery Today
Preeti Shashi, Bo Shen
BACKGROUND: Megapouch is a rare functional complication of restorative proctocolectomy with ileal pouch-anal anastomosis characterized by pouch ± small bowel dilatation with no evidence of obstruction on endoscopy and imaging. Little is known about clinical characteristics and outcomes of this entity. METHODS: We included all patients diagnosed with megapouch at our institution, identified from a pouch database. Data on baseline characteristics, management, and outcomes were documented and analyzed from electronic medical records...
October 16, 2018: Surgical Endoscopy
Georgios Exarchos, Linda Metaxa, Antonios Gklavas, Vassilis Koutoulidis, Ioannis Papaconstantinou
OBJECTIVES: Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the "gold standard" procedure for patients with ulcerative colitis (UC) requiring surgical intervention. A de-functioning ileostomy is usually performed, as a step for the IPAA procedure. The aim of this study is to present the methodology and results of the routine double assessment of IPAA integrity in asymptomatic patients prior to the ileostomy reversal and evaluate its necessity. METHODS: This is a retrospective study of 61 UC patients, who underwent IPAA construction, in 2010-2016...
October 15, 2018: European Radiology
Ji-Hong Chen, Sean P Parsons, Mitra Shokrollahi, Andrew Wan, Alexander D Vincent, Yuhong Yuan, Maham Pervez, Wu Lan Chen, Mai Xue, Kailai K Zhang, Arshia Eshtiaghi, David Armstrong, Premsyl Bercik, Paul Moayyedi, Eric Greenwald, Elyanne M Ratcliffe, Jan D Huizinga
Simultaneous pressure waves (SPWs) in manometry recordings of the human colon have been associated with gas expulsion. Our hypothesis was that the SPW might be a critical component of most colonic motor functions, and hence might act as a biomarker for healthy colon motility. To that end, we performed high-resolution colonic manometry (HRCM), for the first time using an 84-sensor (1 cm spaced) water-perfused catheter, in 17 healthy volunteers. Intraluminal pressure patterns were recorded during baseline, proximal and rectal balloon distention, after a meal and following proximal and rectal luminal bisacodyl administration...
2018: Frontiers in Physiology
Zhou Yang, Guo Chunhua, Yuan Huayan, Yang Jianguo, Cheng Yong
BACKGROUND: Low rectal cancer surgery without anus conservation needs permanent ileostomy or colostomy which seriously affects the quality of life of patients. Therefore, low rectal cancer surgery not only pays attention to the safety of surgical treatment but also to the anus conservation. METHODS: Sixty-seven patients suffering from low rectal cancer had undergone laparoscopic surgery which was analyzed through retrospective study. They were divided into the anus-conserving and non-anus-conserving groups...
October 5, 2018: World Journal of Surgical Oncology
Yi-Ming Su, Yan Lin, Shu-Qiang Chen, Hong-Yi Yang, Guo-Rong Lv, Jin-Rong Lin
OBJECTIVES: To investigate the applicability and value of ultrasound (US) in the diagnosis of anorectal atresia. METHODS: Between January 2008 and January 2016, we prospectively evaluated 63,101 fetuses (gestational age, 20-38 weeks), including low- and high-risk populations using 2-dimensional US scans. An abnormal imaging finding was defined as an anal canal diameter of less than the 95% confidence interval (small anal canal) of the normal range or the absence of an anal canal and rectum...
October 2, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Ali Konan, Mehmet Ruhi Onur, Mustafa Nasuh Özmen
PURPOSE: Anal fistula is an abnormal tract or cavity between the anal canal and perianal skin. Surgical treatment of anal fistulas requires the identification of the course of the primary and secondary tracts and their relation with the sphincter musculature in order to appropriately manage them and drain any abscess. Physical examination alone is not as accurate as imaging modalities in detecting these features of the fistula, and recurrences are usually due to missed or inadequately managed infective components...
November 2018: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Zhenyu Shu, Songhua Fang, Zhongxiang Ding, Dewang Mao, Peipei Pang, Xiangyang Gong
OBJECTIVE: To explore the application value of texture analysis of magnetic resonance images (MRI) in predicting the efficacy of neoadjuvant chemoradiotherapy(nCRT) for rectal cancer. METHODS: A total of 34 rectal cancer patients who were hospitalized at Zhejiang Provincial People's Hospital from February 2015 to April 2017 were prospectively enrolled and received 3.0T MRI examination at pre-nCRT (1 day before nCRT), early stage (at 10-day after nCRT) and middle stage (at 20-day after nCRT)...
September 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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