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https://www.readbyqxmd.com/read/29227855/a-case-report-of-successful-management-of-clostridium-difficile-colitis-with-antegrade-fidaxomicin-through-a-mucous-fistula-obviating-the-need-for-subtotal-colectomy
#1
Suzanne Arnott, Matthew Skancke, Sheena Chen, Bruce Abell
INTRODUCTION: Clostridium difficile is the most common cause of healthcare-associated infections and can have devastating morbidity and mortality. Traditional treatment algorithms involve intravenous metronidazole and enteric metronidazole or vancomycin. Fidaxomicin (DificidR) targets "switch regions" within RNA polymerases and effectively kills clostridium difficile bacteria and is typically administered orally primarily or through a naso/oro-gastric conduit. PRESENTATION OF CASE: 55-year-old with a recent elective surgical procedure was hospitalized with multifocal pneumonia and subsequently developed clostridium difficile colitis...
November 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29227201/early-rescue-from-acute-severe-clostridium-difficile-a-novel-treatment-strategy
#2
Biniam Kidane, Kalvin Lung, Greig McCreery, Chadia El-Khatib, Michael C Ott, Roberto Hernandez-Alejandro, Chris Vinden, Daryl Gray, Neil G Parry, Kenneth A Leslie, Tina S Mele
BACKGROUND: Severe Clostridium difficile infections (CDI) can lead to significant impediments to effective treatment. We developed a novel treatment protocol utilizing bedside gastrointestinal lavage (GIL) for the management of patients with severe, complicated CDI. We describe the development and early outcomes of non-operative bedside GIL in hospitalized patients with severe, complicated CDI following the Idea, Development, Exploration, Assessment, Long Term Study (IDEAL) framework at the Idea stage...
December 11, 2017: Surgical Infections
https://www.readbyqxmd.com/read/29225733/colorectal-surgeon-consensus-with-diverticulitis-clinical-practice-guidelines
#3
Javariah Siddiqui, Assad Zahid, Jonathan Hong, Christopher John Young
AIM: To determine the application of clinical practice guidelines for the current management of diverticulitis and colorectal surgeon specialist consensus in Australia and New Zealand. METHODS: A survey was distributed to 205 colorectal surgeons in Australia and New Zealand, using 22 hypothetical clinical scenarios. RESULTS: The response rate was 102 (50%). For 19 guideline-based scenarios, only 11 (58%) reached consensus (defined as > 70% majority opinion) and agreed with guidelines; while 3 (16%) reached consensus and did not agree with guidelines...
November 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29225684/colon-cancer-presenting-as-pseudo-obstruction-during-pregnancy-a-case-report
#4
Reeva Makhijani, Vicky H Bhagat, Mariam Fayek
The incidence of colorectal cancer in pregnancy is between 0.002 and 0.008%. Diagnosis is often delayed as symptoms of colorectal cancer can mimic as common complaints of pregnancy. We present the case of a 29-year-old with a history of chronic constipation who presented in the second trimester with abdominal pain, inability to tolerate anything orally and no bowel movement in more than three weeks. Non-contrast MRI at presentation failed to show an obstructing mass. Patient was treated conservatively for presumed pseudo-obstruction secondary to worsening constipation from chronic ondansetron use and pregnancy...
December 2017: Obstetric Medicine
https://www.readbyqxmd.com/read/29219230/similar-length-of-colon-is-removed-regardless-of-localization-in-right-sided-colonic-cancer-surgery
#5
Matthieu Siebert, Bertrand Trilling, Anna Lamotte, Nicolas Taton, Alexandre Bellier, Jean Luc Faucheron
BACKGROUND: Colorectal cancers represent a heterogenous group of tumours. While left segmental colectomy is an accepted and oncologically safe practice for left-sided colonic cancer (CC), some authors suggest that limited segmental resection of right-sided cancer should be debated in order to preserve length of the resected colon. To our knowledge, caecum and ascending CC have not been analysed as different groups of tumours. The objective of this study was to assess if, retrospectively, surgical treatment of caecal cancer differed from ascending CC...
December 8, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29218671/robotic-versus-laparoscopic-right-colectomy-an-updated-systematic-review-and-meta-analysis
#6
Leonardo Solaini, Francesca Bazzocchi, Davide Cavaliere, Andrea Avanzolini, Alessandro Cucchetti, Giorgio Ercolani
BACKGROUND: In the right colon surgery, there is a growing literature comparing the safety of robotic right colectomy (RRC) to that of laparoscopic right colectomy (LRC). With this paper we aim to systematically revise and meta-analyze the latest comparative studies on these two minimally invasive procedures. METHODS: A systematic review of studies published from 2000 to 2017 in the PubMed, Scopus, and Embase databases was performed. Primary endpoints were postoperative morbidity and mortality...
December 7, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29217947/coexistence-of-peripheral-spondyloarthritis-and-familial-adenomatous-polyposis-a-rare-case-report-with-treatment-contradictions-and-review-of-the-literature
#7
Berna Urkmez, Muge Kepekci, Sevde Ozer Posul, Aylin Rezvani
Background: The coexistence of familial adenomatous polyposis and spondyloarthritis is rarely defined in literature. The primary aim of this presentation is to report a development of peripheral arthritis in 3 years following colon surgery with the diagnosis of familial adenomatous polyposis (FAP). The secondary aim is to discuss the challenge of in treatment of refractory arthritis, which needs to be treated with biologics. However, it is not yet known well about their safety on patients who have risks for cancer development...
July 2017: Ethiopian Journal of Health Sciences
https://www.readbyqxmd.com/read/29217904/comparison-of-the-short-term-outcomes-of-laparoscopic-and-open-resections-for-colorectal-cancer-in-patients-with-a-history-of-prior-median-laparotomy
#8
Young Wan Kim, Ik Yong Kim
This study aimed to investigate the short-term outcomes of laparoscopic resection in comparison with those of open resection for colorectal cancer in patients with a history of prior median laparotomy (PML). Eighty-seven consecutive patients (87/1121, 7.8 %) with a history of PML who underwent major colorectal cancer resection were enrolled (laparoscopy, n = 40; open, n = 47). The conversion rate to open surgery was 25 % (n = 10). The laparoscopy group had a higher proportion of female patients (57...
December 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29215477/prophylactic-ureteral-catheters-for-colectomy-a-national-surgical-quality-improvement-program-based-analysis
#9
Kathleen M Coakley, Kevin R Kasten, Stephanie M Sims, Tanushree Prasad, B Todd Heniford, Bradley R Davis
BACKGROUND: Despite improvement in technique and technology, using prophylactic ureteral catheters to avoid iatrogenic ureteral injury during colectomy remains controversial. OBJECTIVE: The aim of this study was to evaluate outcomes and costs attributable to prophylactic ureteral catheters with colectomy. DESIGN: This was a retrospective study. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: The colectomy-targeted American College of Surgeons National Surgical Quality Improvement Program database from 2012 to 2014 was queried...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29210901/smoking-habits-are-strongly-associated-with-colorectal-polyps-in-a-population-based-case-control-study
#10
Naomi Fliss-Isakov, Shira Zelber-Sagi, Muriel Webb, Zamir Halpern, Revital Kariv
GOALS: The goal of this study is to test the association between lifetime smoking habits and colorectal polyps of different classifications. BACKGROUND: Smoking is an established risk factor for several cancers, including colorectal cancer. However, the association between lifetime smoking habits including intensity, duration, and cessation, and premalignant colorectal polyps is yet to be established. STUDY: A case-control study among 828 consecutive subjects aged 40 to 70 years, undergoing screening or diagnostic colonoscopy...
November 28, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29210094/infliximab-trough-concentrations-during-maintenance-therapy-are-associated-with-endoscopic-and-histologic-healing-in-ulcerative-colitis
#11
K Papamichael, S Rakowsky, C Rivera, A S Cheifetz, M T Osterman
BACKGROUND: Endoscopic and histologic healing are emerging as new therapeutic goals in ulcerative colitis (UC), as these endpoints are associated with less relapse, hospitalization and colectomy. AIM: To investigate the association of serum infliximab trough concentrations during maintenance therapy with endoscopic or histologic healing in UC. METHODS: In this multi-center retrospective cohort study, we included consecutive patients with moderate-to-severe UC on infliximab maintenance therapy who had an endoscopic evaluation and underwent therapeutic drug monitoring within three months of the colonoscopy, between February 2008 and March 2016...
December 6, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29207912/genome-wide-scan-identifies-candidate-loci-related-to-remifentanil-requirements-during-laparoscopic-assisted-colectomy
#12
Daisuke Nishizawa, Tsutomu Mieda, Miki Tsujita, Hideyuki Nakagawa, Shigeki Yamaguchi, Shinya Kasai, Junko Hasegawa, Ken-Ichi Fukuda, Akira Kitamura, Masakazu Hayashida, Kazutaka Ikeda
AIM:  Opioids are widely used as effective analgesics, but opioid sensitivity is well known to vary widely among individuals. We explored the genetic factors that contribute to individual differences in intraoperative opioid sensitivity by performing a genome-wide association study. PATIENTS & METHODS: We conducted a multistage genome-wide association study in subjects who underwent laparoscopic-assisted colectomy. RESULTS: A nonsynonymous SNP, rs199670311, within the TMEM8A gene region and intronic SNPs, including rs4839603, within the SLC9A9 gene region were significantly associated with intraoperative opioid requirements (p = 3...
December 6, 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/29206907/a-novel-bioactive-derivative-of-eicosapentaenoic-acid-epa-suppresses-intestinal-tumor-development-in-apc%C3%AE-14-mice
#13
Masako Nakanishi, Matthew P Hanley, Ruochen Zha, Yuichi Igarashi, Mark A Hull, Gary Mathias, Frank Sciavolino, James J Grady, Daniel W Rosenberg
Familial adenomatous polyposis (FAP) is a genetic disorder characterized by the development of hundreds of polyps throughout the colon. Without prophylactic colectomy, most individuals with FAP develop colorectal cancer at an early age. Treatment with eicosapentaenoic acid (EPA) in the free fatty acid form (EPA-FFA) has been shown to reduce polyp burden in FAP patients. Since high-purity EPA-FFA is subject to rapid oxidation, a stable form of EPA compound has been developed in the form of magnesium l-lysinate bis-eicosapentaenoate (TP-252)...
December 1, 2017: Carcinogenesis
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#14
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29203521/persistent-opioid-use-among-pediatric-patients-after-surgery
#15
Calista M Harbaugh, Jay S Lee, Hsou Mei Hu, Sean Esteban McCabe, Terri Voepel-Lewis, Michael J Englesbe, Chad M Brummett, Jennifer F Waljee
BACKGROUND: Despite efforts to reduce nonmedical opioid misuse, little is known about the development of persistent opioid use after surgery among adolescents and young adults. We hypothesized that there is an increased incidence of prolonged opioid refills among adolescents and young adults who received prescription opioids after surgery compared with nonsurgical patients. METHODS: We performed a retrospective cohort study by using commercial claims from the Truven Health Marketscan research databases from January 1, 2010, to December 31, 2014...
December 4, 2017: Pediatrics
https://www.readbyqxmd.com/read/29202820/hand-assisted-laparoscopic-surgery-versus-laparoscopic-right-colectomy-a-meta-analysis
#16
REVIEW
Guosen Wang, Jianping Zhou, Weiwei Sheng, Ming Dong
OBJECTIVE: The objective of this study is to systematically assess the clinical efficacy of hand-assisted laparoscopic surgery (HALS) and laparoscopic right colectomy (LRC). METHODS: The randomized controlled trials (RCTs) and non-RCTs were collected by searching electronic databases (Pubmed, Embase, and the Cochrane Library). The outcomes included intraoperative outcomes, postoperative outcomes, postoperative morbidity, and oncologic outcomes. Meta-analysis was performed using of RevMan 5...
December 4, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29202677/cronkhite-canada-syndrome-causing-pouch-outlet-obstruction-5-years-after-roux-en-y-gastric-bypass
#17
Ben Gys, Joren Mertens, Martin Ruppert, Guy Hubens
OBJECTIVE: We present the case of a 57-year-old man with a history of Roux-en-Y gastric bypass (RYGB) and colonic polyps who presented with an upper gastrointestinal obstruction based on massive stomach polyposis in the pouch. METHODS: Two months prior to this acute admission, he had undergone resection of the gastric remnant due to massive refractory intraluminal bleeding from a polypoid mass. Ten years earlier, right colectomy was performed due to hypertrophic polyposis unsuitable for endoscopic polypectomy...
December 5, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29198768/combination-oral-and-mechanical-bowel-preparations-decreases-complications-in-both-right-and-left-colectomy
#18
Emily F Midura, Andrew D Jung, Dennis J Hanseman, Vikrom Dhar, Shimul A Shah, Janice F Rafferty, Bradley R Davis, Ian M Paquette
BACKGROUND: Before elective colectomy, many advocate mechanical bowel preparation with oral antibiotics, whereas enhanced recovery pathways avoid mechanical bowel preparations. The optimal preparation for right versus left colectomy is also unclear. We sought to determine which strategy for bowel preparation decreases surgical site infection (SSI) and anastomotic leak (AL). METHODS: Elective colectomies from the National Surgical Quality Improvement Program colectomy database (2012-2015) were divided by (1) type of bowel preparation: no preparation (NP), mechanical preparation (MP), oral antibiotics (PO), or mechanical and oral antibiotics (PO/MP); and (2) type of colonic resection: right, left, or segmental colectomy...
November 30, 2017: Surgery
https://www.readbyqxmd.com/read/29198492/adequate-lymph-node-evaluation-in-the-elderly-is-associated-with-improved-survival-in-patients-with-stage-i-iii-colon-cancer-a-validation-study-using-the-national-cancer-data-base
#19
Jeffrey Reha, Shiva Kumar Reddy Mukkamalla, Ritesh Rathore, Ponnandai Sadasivan Somasundar
BACKGROUND: Lymph node involvement (LNI) is an important prognostic factor in colon cancer. But, variations in LNI among different age groups are less known. Adequate lymph node evaluation (LNE) requires assessment of ≥12 nodes. In our previous study, using Surveillance, Epidemiology and End Results (SEER) data, we demonstrated that older patients are less likely to have LNI (Khan et al. 2014). Our current study validates those findings using National Cancer Data Base (NCDB). METHODS: NCDB was queried for patients diagnosed with stages I-III colon adenocarcinoma from 2004 to 2008 who underwent surgical resections...
November 23, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29197038/barbed-versus-traditional-suture-for-enterotomy-closure-after-laparoscopic-right-colectomy-with-intracorporeal-mechanical-anastomosis-a-case-control-study
#20
Francesco Feroci, Iacopo Giani, Maddalena Baraghini, Luca Romoli, Tiku Zalla, Roberto Quattromani, Stefano Cantafio, Marco Scatizzi
Our aim was to establish the safety and efficacy of barbed suture for enterotomy closure after laparoscopic right colectomy with intracorporeal anastomosis. This study included 47 patients who underwent laparoscopic right hemicolectomy with intracorporeal mechanical anastomosis and barbed suture enterotomy closure (barbed suture closure-BSC) for adenocarcinoma (with the exception of T4 lesions and metastasis), compared with 47 matched patients who underwent laparoscopic right hemicolectomy with intracorporeal mechanical anastomosis and conventional suture enterotomy closure (conventional suture closure-CSC) during the same period...
December 1, 2017: Updates in Surgery
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