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Colectomy

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https://www.readbyqxmd.com/read/28340389/minilaparotomy-without-general-anesthesia-for-the-treatment-of-sigmoid-volvulus-in-high-risk-patients-a-case-series-of-4-patients
#1
Ernesto L Enrique, Kareem A Hamdy
BACKGROUND: Sigmoid volvulus (SV) is a common cause of large bowel obstruction worldwide. Presenting symptoms can be nonspecific and varied amongst the elderly population, making medical and surgical management challenging. This population is at markedly increase risk of complications and mortality with surgery under general anesthesia. In this case series, we describe 4 cases of sigmoid volvulus in octogenarians. GOALS: To demonstrate that sigmoid colectomy under local anesthesia, with or without intravenous conscious sedation, is feasible and can be done safely and with a low rate of converting to a general anesthetic...
March 2, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28333202/risk-of-rectal-neoplasia-after-colectomy-and-ileorectal-anastomosis-for-ulcerative-colitis
#2
Mathieu Uzzan, Julien Kirchgesner, Nadia Oubaya, Aurélien Amiot, Jean-Marc Gornet, Philippe Seksik, Stéphane Nancey, Eddy Cotte, Matthieu Allez, Gilles Boschetti, David Laharie, Nicola de Angelis, Maria Nachury, Anne-Laure Pelletier, Vered Abitbol, Mathurin Fumery, Antoine Brouquet, Anthony Buisson, Romain Altwegg, Jacques Cosnes, Yves Panis, Xavier Treton
Introduction-: Colectomy can be required in the management of ulcerative colitis (UC). While ileal pouch anal-anastomosis (IPAA) is the recommended reconstruction technique, ileorectal anastomosis (IRA) is still performed and might present some advantages. However, the risk of rectal neoplasia might limit its indication. The aims of our study were to determine the incidence of rectal neoplasias following IRA for UC and to identify risk factors associated with rectal carcinomas. Methods-: We performed a multicenter retrospective study including patients who underwent IRA for UC from 1960 to 2014 in 13 centers...
February 21, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28332057/the-impact-of-operative-approach-on-postoperative-complications-following-colectomy-for-colon-caner
#3
Benedetto Mungo, Christina M Papageorge, Miloslawa Stem, Daniela Molena, Anne O Lidor
BACKGROUND: Colectomy is one of the most common major abdominal procedures performed in the USA. A better understanding of risk factors and the effect of operative approach on adverse postoperative outcomes may significantly improve quality of care. METHODS: Adult patients with a primary diagnosis of colon cancer undergoing colectomy were selected from the National Surgical Quality Improvement Program 2013-2015 targeted colectomy database. Patients were stratified into five groups based on specific operative approach...
March 22, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28331275/the-use-of-the-endograb%C3%A2-port-free-endocavity-retractor-in-single-incision-laparoscopic-right-hemicolectomy
#4
Yasumitsu Hirano, Masakazu Hattori, Kenji Douden, Yasuo Hashizume
The EndoGrab™ Port-Free Endocavity Retractor is an internally anchored retracting device that enables surgeons to reduce not only the number of ports and incisions but also the number of assistant surgeons. Our institution performs single-incision laparoscopic colectomy (SILC) as a routine procedure. Forty-nine patients underwent a single-incision laparoscopic right hemicolectomy. In this procedure, we use this retractor to the mesenteric tissue, including the ileocolic vessels and the mesentery of the transverse colon, and overcame the technical problems related to SILC and showed excellent short-term outcomes...
February 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#5
Scott E Regenbogen, Anne H Cain-Nielsen, Edward C Norton, Lena M Chen, John D Birkmeyer, Jonathan S Skinner
Importance: As prospective payment transitions to bundled reimbursement, many US hospitals are implementing protocols to shorten hospitalization after major surgery. These efforts could have unintended consequences and increase overall surgical episode spending if they induce more frequent postdischarge care use or readmissions. Objective: To evaluate the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions...
March 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28326894/cost-comparison-of-laparoscopic-colectomy-versus-open-colectomy-in-colon-cancer
#6
Kathryn Fitch, Andrew Bochner, Deborah S Keller
BACKGROUND: Laparoscopic colectomy has been shown to be safe, oncologically comparable, and clinically beneficial over open colectomy for colon cancer, but utilization remains low. OBJECTIVES: To evaluate the cost of laparoscopic colectomy vs. open colectomy for colon cancer. METHODS: We conducted a retrospective claims data analysis using the 2012 and 2013 Truven Health Analytics MarketScan Commercial Claims and Encounter Database. The denominator population consisted of individuals who had commercial insurance coverage in all months of 2012 and >1 month in 2013 and pharmacy coverage throughout eligibility...
March 22, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28319941/short-term-outcomes-after-simultaneous-colorectal-and-major-hepatic-resection-for-synchronous-colorectal-liver-metastases
#7
Yoshihiro Ono, Akio Saiura, Junichi Arita, Yu Takahashi, Michiro Takahashi, Yosuke Inoue
BACKGROUND/AIMS: Resection of the liver is the standard therapeutic approach for patients with hepatic metastasis and is the only therapy with curative potential. The optimal timing of surgical resection for synchronous metastases has remained controversial. METHODS: From January 1993 to December 2008, our strategy has been to use simultaneous resection for resectable synchronous colorectal and liver metastases. During this period, 115 patients underwent simultaneous colorectal and hepatic resection...
March 21, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28319493/advantages-of-robotic-right-colectomy-with-intracorporeal-anastomosis
#8
Henry J Lujan, Gustavo Plasencia, Brian X Rivera, Andres Molano, Alex Fagenson, Louis A Jane, Diego Holguin
Through retrospective review of consecutive charts, we compare the short-term and long-term clinical outcomes after robotic-assisted right colectomy with intracorporeal anastomosis (RIA) (n=89) and laparoscopic right colectomy with extracorporeal anastomosis (LEA) (n=135). Cohorts were similar in demographic characteristics, comorbidities, pathology, and perioperative outcomes (conversion, days to flatus and bowel movement, and length of hospitalization). The RIA cohort experienced statistically significant: less blood loss, shorter incision lengths, and longer specimen lengths than the LEA cohort...
March 17, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28317582/robotic-right-hemicolectomy-analysis-of-108-consecutive-procedures-and-multidimensional-assessment-of-the-learning-curve
#9
Amilcare Parisi, Luca Scrucca, Jacopo Desiderio, Alessandro Gemini, Salvatore Guarino, Francesco Ricci, Roberto Cirocchi, Giorgio Palazzini, Vito D'Andrea, Liliana Minelli, Stefano Trastulli
PURPOSE: Surgeons tend to view the robotic right colectomy (RRC) as an ideal beginning procedure to gain proficiency in robotic general and colorectal surgery. Nevertheless, oncological RRC, especially if performed with intracorporeal ileocolic anastomosis confectioning, cannot be considered a technically easier procedure. The aim of this study was to assess the learning curve of the RRC performed for oncological purposes and to evaluate its safety and efficacy investigating the perioperative and pathology outcomes in the different learning phases...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28315811/variant-two-stage-ileal-pouch-anal-anastomosis-an-innovative-and-effective-alternative-to-standard-resection-in-ulcerative-colitis
#10
Jennifer Samples, Krista Evans, Nicole Chaumont, Paula Strassle, Timothy Sadiq, Mark Koruda
BACKGROUND: Ulcerative colitis patients have been historically treated with standard single, two and three stage operative approaches. We perform a variant two-stage procedure beginning with total abdominal colectomy and end ileostomy followed by completion proctectomy and ileal pouch-anal anastomosis without a diverting loop ileostomy. The present study evaluates the effectiveness of this innovative alternative. STUDY DESIGN: Patients with ulcerative colitis admitted to UNC Hospital between 2003 and 2010 for IPAA were eligible for inclusion...
January 28, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28304125/subtotal-colectomy-for-ulcerative-colitis-lessons-learned-from-a-tertiary-centre
#11
Nicolas C Buchs, Alexander L A Bloemendaal, Christopher P J Wood, Simon Travis, Neil J Mortensen, Richard J Guy, Bruce D George
AIM: Subtotal colectomy (STC) is a well-established treatment for complicated and refractory ulcerative colitis (UC). A laparoscopic approach offers potentially improved outcomes. The aim of the study was to report our experience with STC for UC in a single large center. METHOD: From January 2007 to May 2015, all consecutive patients undergoing STC for UC were retrospectively analysed from a prospectively-managed database. Patients with known Crohn's disease or those undergoing one-stage procedures were excluded...
March 17, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28299620/patient-acuity-and-operative-technique-associated-with-post-colectomy-mortality-across-new-york-state-an-analysis-of-160-792-patients-over-20%C3%A2-years
#12
Ryan Lamm, Steven N Mathews, Jie Yang, Jihye Park, Mark Talamini, Aurora D Pryor, Dana Telem
This study sought to characterize in-hospital post-colectomy mortality in New York State. One hundred sixty thousand seven hundred ninety-two patients who underwent colectomy from 1995 to 2014 were analyzed from the all-payer New York Statewide Planning and Research Cooperative System (SPARCS) database. Linear trends of in-hospital mortality rate over 20 years were calculated using log-linear regression models. Chi-square tests were used to compare categorical variables between patients. Multivariable regression models were further used to calculate risk of in-hospital mortality associated with specific demographics, co-morbidities, and perioperative complications...
March 15, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28296784/simultaneous-degeneration-of-myenteric-plexuses-and-pelvic-parasympathetic-colonic-nerve-in-slow-transit-constipation-a-case-report
#13
Zhiqiang Cheng, Kun Zhao, Dongsong Bi
RATIONALE: Slow transit constipation (STC) is a common disease of which the etiology is still not clear. Multiple hypotheses have been proposed to explain STC, including autonomic neuropathy, disorders of the enteric nervous system and so forth. Morphological abnormalities of the enteric nerves of the colon in patients with STC have been extensively reported, while there have been no morphological reports focusing on extrinsic extramural fibers from the pelvic plexus to the distal colon (i...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28296772/metastasis-to-the-appendix-from-adenocarcinoma-of-the-ascending-colon-a-case-report
#14
Yingjie Li, Mingshan Li, Xiaoxia Li, Haiquan Sang
RATIONALE: Metastasis of cancer cells involves shedding from the primary tumor through various means to distant tissues and organs with continued growth and formation of new metastatic tumors of the same cancer type as the original tumor. The common sites for colon cancer metastases include the pelvis, retroperitoneal lymph nodes, liver, and lungs; Colon cancer metastases to the appendix are rare, as reported in this case. PATIENT CONCERNS AND DIAGNOSES: A 45-year-old man was admitted to our department with a 24-hour history of abdominal distension and incomplete obstruction...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28288068/emergency-surgery-for-medicare-beneficiaries-admitted-to-critical-access-hospitals
#15
Andrew M Ibrahim, Scott E Regenbogen, Jyothi R Thumma, Justin B Dimick
OBJECTIVE: The aim of this study was to compare the surgical outcomes of emergency operations performed at critical access and non-critical access hospitals. BACKGROUND: Critical access hospitals are often the only source of surgical care for rural populations. Previous studies have demonstrated that patients undergoing common, elective operations at these rural hospitals have similar outcomes to their urban counterparts. Little is known, however, about the quality of care these hospitals provide for emergency operations for which they are most essential...
March 10, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28286544/acute-appendicitis-inflammatory-appendiceal-mass-and-the-risk-of-a-hidden-malignant-tumor-a-systematic-review-of-the-literature
#16
REVIEW
Frederico José Ribeiro Teixeira, Sérgio Dias do Couto Netto, Eduardo Hiroshi Akaishi, Edivaldo Massazo Utiyama, Carlos Augusto Metidieri Menegozzo, Marcelo Cristiano Rocha
INTRODUCTION: Acute appendicitis is significantly common. Despite the increased use of computed tomography, the number of perforated cases has been stable in the past three decades. Between 2% and 6% of patients with acute appendicitis present appendiceal mass, often described as inflammatory phlegmon or abscess. Malignant tumors are confirmed by pathological analysis in 0.9-1.4% of all appendectomies performed to treat acute appendicitis. However, recent series demonstrate an elevated incidence of malignancies, ranging from 5...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28285209/acute-large-bowel-pseudo-obstruction-due-to-atrophic-visceral-myopathy-a-case-report
#17
Sean M Wrenn, Charles S Parsons, Michelle Yang, Ajai K Malhotra
PURPOSE: Atrophic visceral myopathy is a pathological diagnosis characterized by atrophy of the smooth muscle layers of the viscera with intact ganglia. Rarely, it can present acutely as an intestinal pseudo-obstruction. We describe a rare case report and explore how this diagnosis can be distinguished from other forms of intestinal obstruction. CASE DESCRIPTION: A 60-year-old male with a past medical history of hypothyroidism presented to the emergency department with a two-day history of worsening abdominal distention and pain associated with nausea and vomiting...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28283734/intestinal-perforation-due-to-hemorrhagic-cytomegalovirus-enteritis-in-a-patient-with-severe-uncontrolled-lupus-nephritis-a-case-and-review-of-the-literature
#18
REVIEW
Keigo Ikeda, Shihoko Nakajima, Kana Tanji, Takuya Hirai, Kaori Uomori, Shinji Morimoto, Shigeki Tomita, Masaki Fukunaga, Naoto Tamura, Iwao Sekigawa
A 31-year-old woman with systemic lupus erythematosus and lupus nephritis was treated with prednisone and immunosuppressants. After her lupus nephritis symptoms worsened, both high-dose steroid and cyclophosphamide pulse therapy were administered. The patient developed an intestinal perforation, and laparoscopic Hartmann's surgery was performed on the sigmoid colon. Serum Cytomegalovirus (CMV) antigen C7HRP was detected, and the patient was diagnosed with CMV colitis and underwent a colon resection. Severe hematochezia continued despite ganciclovir administration, and the patient underwent laparoscopic total colectomy and partial ileostomy...
March 11, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28282712/a-patient-with-desmoid-tumors-and-familial-fap-having-frame-shift-mutation-of-the-apc-gene
#19
Sanambar Sadighi, Mahsa Ghaffari-Moghaddam, Mojtaba Saffari, Mohammad Ali Mohagheghi, Reza Shirkoohi
Desmoids tumors, characterized by monoclonal proliferation of myofibroblasts, could occur in 5-10% of patients with familial adenomatous polyposis (FAP) as an extra-colonic manifestation of the disease. FAP can develop when there is a germ-line mutation in the adenomatous polyposis coli gene. Although mild or attenuated FAP may follow mutations in 5΄ extreme of the gene, it is more likely that 3΄ extreme mutations haveamore severe manifestation of thedisease. A 28-year-old woman was admitted to the Cancer Institute of Iran with an abdominal painful mass...
February 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28281115/laparoscopic-colectomy-in-obese-patients-a-comparison-of-laparoscopic-and-hand-assisted-laparoscopic-techniques
#20
Douglas M Overbey, Michelle L Cowan, Patrick W Hosokawa, Brandon C Chapman, Jon D Vogel
BACKGROUND: Recent American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP)-based evidence indicates that laparoscopic (LAP) colectomy results in improved outcomes compared to hand-assisted laparoscopic (HAL) colectomy in the general population. Previous comparative studies demonstrated that the HAL technique offers distinct advantages for obese patients. The aim of this study was to perform comparative analyses of HAL and LAP colectomy and low anterior resection (LAR) in obese patients...
March 9, 2017: Surgical Endoscopy
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