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Ho-Su Lee, Suk-Kyun Yang, Myunghee Hong, Seulgi Jung, Byoung Mok Kim, Jung Won Moon, Sang Hyoung Park, Byong Duk Ye, Seak Hee Oh, Kyung Mo Kim, Yong Sik Yoon, Chang Sik Yu, Jiwon Baek, Cue Hyunkyu Lee, Buhm Han, Jianjun Liu, Talin Haritunians, Dermot P B McGovern, Kyuyoung Song
Background and Aims: The genetic contribution to the prognosis of ulcerative colitis (UC) is poorly understood, and most currently known susceptibility loci are not associated with prognosis. To identify genetic variants influencing the prognosis of UC, we performed an Immunochip-based study using an extreme phenotype approach. Methods: Based on the finding that the only association Pdiscovery-meta < 1 × 10-4 was located in the human leukocyte antigen (HLA), we focused our analyses on the HLA region...
June 13, 2018: Journal of Crohn's & Colitis
Diana C Ford, Mary C Schroeder, Dilek Ince, Erika J Ernst
PURPOSE: The cost-effectiveness of initial treatment strategies for mild-to-moderate Clostridium difficile infection (CDI) in hospitalized patients was evaluated. METHODS: Decision-analytic models were constructed to compare initial treatment with metronidazole, vancomycin, and fidaxomicin. The primary model included 1 recurrence, and the secondary model included up to 3 recurrences. Model variables were extracted from published literature with costs based on a healthcare system perspective...
June 14, 2018: American Journal of Health-system Pharmacy: AJHP
Kazuaki Shibuya, Shigenori Homma, Tadashi Yoshida, Yosuke Ohno, Nobuki Ichikawa, Hideki Kawamura, Teppei Imamoto, Yoshihiro Matsuno, Akinobu Taketomi
The development of colorectal cancer in long-standing Crohn's disease (CD) patients has become a major complication. Therapeutic guidelines for CD-associated cancer (CDAC) have already been established in Western countries; however, specific guidelines are not currently available in Japan. Surveillance of the residual intestine for cancer screening is important for long-standing CD patients. The present case report describes the occurrence of rectal carcinoma in a patient with a 25-year history of CD. A 37-year-old male with a 17-year history of CD underwent semi-emergent subtotal colectomy and ileostomy for bowel obstruction secondary to the transverse colon stenosis, and multiple severe stenosis and inflammation...
July 2018: Molecular and Clinical Oncology
António Bernardes, Catarina Melo, Sandra Ferraz
INTRODUCTION: Postoperative duodenal-cutaneous fistula represents a rare and very complex problem. In most cases operative management becomes necessary, but only after local and systemic stabilization and sepsis control. CASE PRESENTATION: A 39-year-old man was admitted for surgical management of laparostomy and pyloro-duodenostomy of the first (DI) and second (DII) duodenal segments with one year of evolution, as a complication of several surgical interventions...
June 4, 2018: International Journal of Surgery Case Reports
Danuta Plewka, Andrzej Plewka, Adam Miskiewicz, Michał Morek, Edyta Bogunia
Background: It has been proved that nuclear factor-kappa B (NF-κB) is activated in all cells, promotes proliferation of cells, regulates the immunological and inflammatory response, and contribute to the pathogenesis of many conditions, including cancer. Many studies pointed to constitutive activation of NF-κB in cells of certain malignant tumors. Objective: The aim of the study was to analyze the role of nuclear growth factor κB as colon cancer marker and prognostic factor...
April 2018: Journal of Cancer Research and Therapeutics
Kaitlin G Whaley, Michael J Rosen
Acute severe ulcerative colitis is a medical emergency that requires prompt recognition, evaluation, and intervention. Patients require hospital admission with laboratory, radiographic, and endoscopic evaluation with initiation of corticosteroid treatment. Despite early intervention, many patients require salvage medical therapy, with some progressing to colectomy. Here we review important concepts and recent advances in the evaluation and medical management of adult and pediatric patients with acute severe ulcerative colitis...
June 7, 2018: Inflammatory Bowel Diseases
Manjri Raval, Matthew C Choy, Peter De Cruz
Ulcerative colitis (UC) is a chronic inflammatory bowel disease with an age of onset that affects young people during the peak of their reproductive years. Management of flares of disease during pregnancy can be complex and there are few case reports of pregnant women with acute severe ulcerative colitis (ASUC). We present the case of a 31-year-old pregnant woman who at 16 weeks gestation developed ASUC in the context of primary non-response to infliximab therapy. She subsequently underwent an emergency laparoscopic colectomy after failing to respond to hydrocortisone and cyclosporine salvage therapy...
June 8, 2018: BMJ Case Reports
P J Trivedi, J Reece, R W Laing, E Slaney, R Cooney, B K Gunson, S K Kamarajah, T Pinkney, F Thompson, P Muiesan, A Schlegel, G M Hirschfield, T Iqbal, J Ferguson
BACKGROUND: Liver transplantation is the only life-extending intervention for primary sclerosing cholangitis (PSC). Given the co-existence with colitis, patients may also require colectomy; a factor potentially conferring improved post-transplant outcomes. AIM: To determine the impact of restorative surgery via ileal pouch-anal anastomosis (IPAA) vs retaining an end ileostomy on liver-related outcomes post-transplantation. METHODS: Graft survival was evaluated across a prospectively accrued transplant database, stratified according to colectomy status and type...
June 8, 2018: Alimentary Pharmacology & Therapeutics
Antonio Sciuto, Giovanni Merola, Giovanni D De Palma, Maurizio Sodo, Felice Pirozzi, Umberto M Bracale, Umberto Bracale
Every colorectal surgeon during his or her career is faced with anastomotic leakage (AL); one of the most dreaded complications following any type of gastrointestinal anastomosis due to increased risk of morbidity, mortality, overall impact on functional and oncologic outcome and drainage on hospital resources. In order to understand and give an overview of the AL risk factors in laparoscopic colorectal surgery, we carried out a careful review of the existing literature on this topic and found several different definitions of AL which leads us to believe that the lack of a consensual, standard definition can partly explain the considerable variations in reported rates of AL in clinical studies...
June 7, 2018: World Journal of Gastroenterology: WJG
Amy L Lightner, Scott R Kelley, David W Larson
INTRODUCTION: An IPAA is the preferred operative approach for restoration of intestinal continuity in patients with ulcerative colitis and familial adenomatous polyposis. As minimally invasive approaches have become more widely adopted, their use in IPAA has also become increasingly commonplace. Laparoscopy has the same limitations during the proctectomy portion as seen in operations for rectal cancer, including dissection in the mid-to-lower rectum attributed to angles created by bony confines of the deep pelvis and lack of visibility when constructing the anastomosis...
July 2018: Diseases of the Colon and Rectum
Kristen A Ban, Julia R Berian, Jason B Liu, Clifford Y Ko, Liane S Feldman, Julie K M Thacker
BACKGROUND: Implementation of enhanced recovery protocols in colectomy reduces length of stay and morbidity, but it remains unknown whether benefits vary by clinical diagnosis. OBJECTIVE: Outcomes after colectomy in the setting of enhanced recovery protocols were compared for 3 diagnoses: 1) neoplasm, 2) diverticulitis, and 3) IBD. DESIGN: This was a retrospective registry-based cohort study. SETTINGS: Novel enhanced recovery variables were released in the American College of Surgeons National Surgical Quality Improvement Program in 2014...
July 2018: Diseases of the Colon and Rectum
Volkan Ozben, Cansu de Muijnck, Eren Esen, Erman Aytac, Bilgi Baca, Tayfun Karahasanoglu, Ismail Hamzaoglu
INTRODUCTION: Laparoscopic complete mesocolic excision (CME) for transverse colon cancer is technically challenging. Robotic technology has been developed to reduce technical limitations of laparoscopy. Yet, no data are available on the role of robotic approach for CME of transverse colon cancer. The aim of this study is to evaluate the feasibility and short-term outcomes of robotic CME in this subset of colon cancer. METHODS: A retrospective review of a prospectively maintained database of 29 consecutive patients undergoing robotic CME for transverse colon adenocarcinoma between December 2014 and December 2017 was performed...
June 7, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Meara Dean, Herman Kessler, Emre Gorgun
BACKGROUND: The incidence of diverticulitis is increasing among young patients (≤ 50 years), as are rates of recurrent disease. There is ongoing controversy regarding the best management strategy for this patient group. Guidelines have changed from elective colectomy after a single episode to a more individualized approach no longer based on patient age. This study investigated the clinical presentation and surgical outcomes of young patients undergoing surgery for diverticulitis over two time periods...
June 5, 2018: Surgical Endoscopy
Shinji Kishi, Hiroyuki Monma, Hiroshige Hori, Shoichi Kinugasa, Masayo Fujimoto, Takeshi Nakamura
BACKGROUND Giant cell tumor of soft tissue (GCT-ST) is a rare disease generally generated from superficial tissue. We report an extremely rare case of giant cell tumor of soft tissue arising from retroperitoneal tissue. CASE REPORT A 78-year-old man visited our medical center with the chief complaint of fatigue and weight loss for 1 month. He had a hard and immobilized mass without pain in the left upper quadrant. Contrast-enhanced CT showed a huge tumor (22×20×16 cm) in the retroperitoneal space, and it invaded into the stomach, colon, pancreas, spleen, and left kidney...
June 5, 2018: American Journal of Case Reports
Laura Darmaun, Estelle Aubry, Sophie Lejeune, Helene Sudour-Bonnange
We report the case of a 15-year-old female patient suffering from progressive anorexia, weight loss and recurrent abdominal pain, initially diagnosed as anorexia nervosa. She eventually presented with severe malnutrition and acute bowel obstruction, revealing a mass of the transverse colon. A well-differentiated Lieberkühn adenocarcinoma was established by histology. The patient underwent transverse and right colectomy and was treated with adjuvant chemotherapy. Colorectal cancer (CRC) is predominantly a disease of older adults and is extremely rare in children and adolescents...
June 4, 2018: BMJ Case Reports
Ira L Leeds, Joseph K Canner, Faiz Gani, Patrick M Meyers, Elliott R Haut, Jonathan E Efron, Fabian M Johnston
OBJECTIVE: The purpose of this study was to evaluate the impact of optimization of preoperative comorbidities by nonsurgical clinicians on short-term postoperative outcomes. SUMMARY BACKGROUND DATA: Preoperative comorbidities can have substantial effects on operative risk and outcomes. The modifiability of these comorbidity-associated surgical risks remains poorly understood. METHODS: We identified patients with a major comorbidity (eg, diabetes, heart failure) undergoing an elective colectomy in a multipayer national administrative database (2010-2014)...
June 1, 2018: Annals of Surgery
Elise Chia-Hui Tan, Ming-Chin Yang, Chien-Chih Chen
OBJECTIVE: Laparoscopy is a safe and effective treatment for colon cancer. However, its effects on short- and long-term health outcomes and medical utilization are not fully elucidated. The study aimed to compare short- and long-term utilization and health outcomes of colon cancer patients who underwent either laparoscopic or open surgery in a population-based cohort. METHODS: This study was conducted by linking data from Taiwan Cancer Registry, National Health Insurance claims, and Death Registry...
June 4, 2018: Current Medical Research and Opinion
Alexandre Gherardi, Stéphane Roze, Johan Kuijvenhoven, Ola Ghatnekar, Yum Lina Yip Sonderegger
AIMS: Budesonide with multi-matrix technology (MMX) is an oral corticosteroid, shown to have high topical activity against ulcerative colitis (UC) while maintaining low systemic bioavailability with few adverse events. The aim of this study was to evaluate the cost-effectiveness of budesonide MMX versus commonly-used corticosteroids, in the second-line treatment of active mild-to-moderate UC in the Netherlands. MATERIALS AND METHODS: An 8-state Markov model with an 8-week cycle length captured remission, four distinct therapy stages, hospitalization, possible colectomy and mortality...
June 1, 2018: Journal of Medical Economics
Dan Turner, Frank M Ruemmele, Esther Orlanski-Meyer, Anne M Griffiths, Javier Martin de Carpi, Jiri Bronsky, Gabor Veres, Marina Aloi, Caterina Strisciuglio, Christian P Braegger, Amit Assa, Claudio Romano, Séamus Hussey, Michael Stanton, Mikko Pakarinen, Lissy de Ridder, Konstantinos Katsanos, Nick Croft, Victor Navas-López, David C Wilson, Sally Lawrence, Richard K Russell
BACKGROUND: The contemporary management of ambulatory ulcerative colitis (UC) continues to be challenging with ∼20% of children needing a colectomy within childhood years. We thus aimed to standardize daily treatment of paediatric UC and inflammatory bowel diseases (IBD)-unclassified through detailed recommendations and practice points. METHODS: These guidelines are a joint effort of the European Crohn's and Colitis Organization (ECCO) and the Paediatric IBD Porto group of European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)...
May 30, 2018: Journal of Pediatric Gastroenterology and Nutrition
Riccardo Conventi, Giorgio Pellis, Giandomenico Arzu, John Bosco Nsubuga, Roberta Gelmini
INTRODUCTION: This is a retrospective analysis of patients operated for typhoid perforation, aiming to analyze epidemiology, clinical-diagnostic and therapeutic aspects, mortality and prognosis. METHODS: 47 patients were operated at Matany Hospital from 2010 to 2016. We examined clinical files to collect data. Microbiological and isthological examinations were unavailable, so etiology was deducted operatively. RESULTS: Median age: 17.85 years, 61...
2018: Annali Italiani di Chirurgia
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