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A Onder, C Benlice, J Church, H Kessler, E Gorgun
BACKGROUND: In the current study, we aimed to compare peri- and postoperative 30-day outcomes of patients undergoing laparoscopic versus open total colectomy with ileorectal anastomosis in a case-matched design using data procedure-targeted database. METHODS: Patients who underwent elective total colectomy with ileorectal anastomosis in 2012 and 2013 were identified from the American College of Surgeons National Surgical Quality Improvement Program database. Patients were divided into two groups according to the type of surgical approach (laparoscopic and open)...
October 25, 2016: Techniques in Coloproctology
J Kirchgesner, M Lemaitre, A Rudnichi, A Racine, M Zureik, F Carbonnel, R Dray-Spira
BACKGROUND: Management of inflammatory bowel disease (IBD) has evolved in the last decade. AIM: To assess IBD therapeutic management, including treatment withdrawal and early treatment use in the current era of anti-TNF agents (anti-TNFs). METHODS: All patients affiliated to the French national health insurance diagnosed with IBD were included from 2009 to 2013 and followed up until 31 December 2014. Medication uses, treatment sequences after introduction of thiopurine or anti-TNF monotherapies or both (combination therapy), surgical procedures and hospitalisations were assessed...
October 26, 2016: Alimentary Pharmacology & Therapeutics
Candace L Beilman, Nguyen Xuan Thanh, Victoria Ung, Christopher Ma, Karen Wong, Karen I Kroeker, Thomas Lee, Haili Wang, Arto Ohinmaa, Phil Jacobs, Brendan P Halloran, Richard N Fedorak
Background. Adalimumab is effective for the maintenance of remission in patients with moderate-to-severe ulcerative colitis (UC). Currently, biologic therapies are used in cases where patients fail conventional medical therapies. If biologic therapies are not available, patients often choose to remain in an unwell state rather than undergo colectomy. Objective. The aim of the study was to evaluate the cost-effectiveness of adalimumab in patients with UC where adalimumab was readily available compared to not available...
2016: Canadian Journal of Gastroenterology & Hepatology
Kyle G Cologne, Sean Byers, David R Rosen, Grace S Hwang, Adrian E Ortega, Glenn T Ault, Sang W Lee
A prospectively maintained database of 415 patients undergoing colectomy was evaluated. We performed a logistic regression analysis to identify factors associated with 1) length of stay (LOS) of 2 days or less and 2) LOS of 10 days or more. Investigated variables included demographics, American Society of Anesthesiology (ASA) score, diagnosis, operative procedure, approach and time, transfusion requirements, and occurrence of any complications. Factors associated with a LOS of two days or less included ASA [odds ratio (OR): 0...
October 2016: American Surgeon
Ahmed Dehal, Sunal Patel, Hanna Park, Patrick Nguyen, Robert Yuhan, Joseph Ruan
Robotic colorectal surgery was first performed at our institution in January 2014. The objective of this study is to present our initial experience with robotic colorectal surgery. This is a retrospective review of the prospectively collected data of all patients who underwent robotic colorectal surgery from January 2014 to April 2015. Baseline, perioperative, and postoperative data were obtained for analysis. A total of 101 patients with a mean age of 56 and a body mass index of 31 underwent robotic colorectal surgery between January 2014 and April 2015...
October 2016: American Surgeon
Dhouha Bacha, Abir Chaabane, Fatma Khanche, Saloua Néchi, Hassen Touinsi, Emna Chelbi
Adrenal hemangioma is an uncommon benign vascular tumor that is often discovered incidentally. It has never been reported in association with familial adenomatous polyposis. We report a case of a 60-year old man with a history of familial adenomatous polyposis, in whom a huge retroperitoneal cyst of 18x17 cm was discovered during routine radiologic evaluation. Because of the impossibility of ruling out the presence of malignancy, surgical cystectomy was performed, associated to a scheduled total colectomy. Pathological examination revealed that the cyst corresponded to an adrenal cavernous hemangioma...
August 8, 2016: Clinics and Practice
Laura Gilardi, Manuela Vadrucci
Isolated splenic metastases from solid malignancies are very rare. We report the case of a 58-year-old woman with isolated metachronous splenic metastasis from colon cancer detected 18 months after colectomy. F-FDG PET/CT allowed its recognition and guided the therapeutic approach toward surgery.
October 21, 2016: Clinical Nuclear Medicine
Valentine Nfonsam, Hassan Aziz, Viraj Pandit, Mazhar Khalil, Jana Jandova, Bellal Joseph
INTRODUCTION: Optimization of surgical outcomes after colectomy continues to be actively studied, but most studies group right-sided and left-sided colectomies together. The aim of our study was to determine whether the complication rate differs between right-sided and left-sided colectomies for cancer. METHODS: We identified patients who underwent laparoscopic colectomy for colon cancer between 2005 and 2010 in the American College of Surgeons National Surgical Quality Improvement Program database and stratified cases by right and left side...
2016: Cancer Treatment Communications
Paul H Sugarbaker
BACKGROUND: Mucinous appendiceal neoplasms (MAN) with peritoneal dissemination is treated as a standard of care using cytoreductive surgery and hyperthermic perioperative chemotherapy. The extent of the resection of peritoneal surfaces and visceral structures is generally well defined. Exception to this consensus regarding structures to be removed are the right colon and adjacent ileocolic lymph nodes. METHODS: From a prospectively maintained database, all patients with a histologic diagnosis of peritoneal mucinous carcinoma (PMCA) who underwent complete cytoreductive surgery were assessed for the presence versus absence of adenocarcinoma in lymph nodes within the appendiceal mesentery and/or in the lymph nodes of the ileocolic group...
October 21, 2016: Annals of Surgical Oncology
Masato Yamadera, Hideki Ueno, Hirotoshi Kobayashi, Tsuyoshi Konishi, Fumio Ishida, Tatsuro Yamaguchi, Takao Hinoi, Yasuhiro Inoue, Yukihide Kanemitsu, Naohiro Tomita, Hideyuki Ishida, Kenichi Sugihara
PURPOSE: We conducted this study to clarify the current clinical practice of prophylactic colectomy for patients with familial adenomatous polyposis (FAP) in Japan. METHODS: This retrospective multi-center cohort study involved 23 specialized institutions for colorectal disease in Japan. We analyzed the records of 147 patients who underwent prophylactic surgical treatment between 2000 and 2012. Patients were divided into Group 1 (2000-2006) and Group 2 (2007-2012) based on their date of surgery...
October 21, 2016: Surgery Today
Qingbin Wu, Chengwu Jin, Tao Hu, Mingtian Wei, Ziqiang Wang
AIM: To compare intracorporeal anastomosis (IA) and extracorporeal anastomosis (EA) in laparoscopic right colectomy (LRC) in terms of intraoperative and postoperative outcomes. METHODS: A systematic literature search with no limits was performed in PubMed and Embase. The last search was performed on April 9, 2016. The outcomes of interests included intraoperative outcomes (operative time, blood loss, length of incision, conversion, lymph nodes harvested, and intraoperative complications) and postoperative outcomes (time to first flatus, time to first defecation, time to liquid diet, length of hospital stay, postoperative complications, mortality, ileus, anastomotic leakage, anastomotic bleeding, wound infection, hernia, and intra-abdominal abscess)...
October 21, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Cigdem Benlice, Erman Aytac, Meagan Costedio, Hermann Kessler, Maher A Abbas, Feza H Remzi, Emre Gorgun
BACKGROUND: This study aimed to compare perioperative outcomes of patients undergoing robotic, laparoscopic, and open colectomy using a procedure-targeted database. METHODS: Retrospective review of patients undergoing elective colectomy in 2013 was conducted using the procedure-targeted database of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). Robotic, laparoscopic, and open groups were matched (1:1:1) based on age, gender, body mass index, surgical procedure, diagnosis and ASA classification...
October 21, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Tae Jun Kim, Eun Ran Kim, Sung Noh Hong, Young-Ho Kim, Jung Wook Huh, Yoon Ah Park, Yong Beom Cho, Seong Hyeon Yun, Hee Cheol Kim, Woo Yong Lee, Kiyoun Kim, Kyunga Kim, Dong Kyung Chang
BACKGROUND: The survival benefit of extensive colectomy is controversial in Lynch syndrome, and risk factors for metachronous colorectal cancer (CRC) after segmental colectomy are unclear. OBJECTIVE: The aim of this study was to investigate the survival outcome and risk of metachronous CRC after surgery in Lynch syndrome patients diagnosed with their first CRC. METHODS: Overall, 106 patients with Lynch syndrome who underwent surgery for CRC were included in the study...
October 20, 2016: Annals of Surgical Oncology
Robert Hunt Dunlap, Ryan Martinez
Kayexalate is an ion exchange resin that is commonly used to acutely treat patients with hyperkalemia. Bowel ulceration and necrosis is a rare and uncommonly recognized complication of kayexalate administration. More often, concomitant administration with sorbitol is reported to damage the bowel; however, there are reports of kayexalate administration causing bowel necrosis without sorbitol. We present a case of a critically ill patient who underwent total colectomy for colonic necrosis secondary to oral kayexalate administration that was not recognized until late in the pathologic process...
October 7, 2016: Journal of Surgical Case Reports
Fernando Velayos, Priya Kathpalia, Emily Finlayson
This review chronicles the evolution of dysplasia detection and management in IBD since 1925, the year the first case report of colitis-related colorectal cancer was published. We have grouped advances in colorectal cancer research, endoscopic techniques, surgery, and technology into 4 unequally timed eras, before colonoscopy, early era of colonoscopy, new century, and 2017 and beyond. We conclude that colorectal cancer prevention and dysplasia management for patients with IBD has changed over these periods, from somewhat hopeless to hopeful...
October 17, 2016: Gastroenterology
Ara Ko, Lia Aquino, Nicolas Melo, Rodrigo F Alban
BACKGROUND: The relationship between failure-to-rescue (FTR) after colectomy is not well understood, particularly in teaching institutions. We sought to examine this relationship using a large national database. METHODS: Patients undergoing colectomy from 2010 to 2012 were identified in the Nationwide Inpatient Sample database. FTR events were defined as deaths following deep vein thrombosis or pulmonary embolism, sepsis, gastrointestinal bleed, acute myocardial infarction, acute kidney injury, pneumonia, respiratory failure, shock...
September 30, 2016: American Journal of Surgery
Lauren Beswick, Bei Ye, Daniel R van Langenberg
INTRODUCTION: Concurrent cytomegalovirus (CMV) in inflammatory bowel disease-related colitis is an important yet complex clinical scenario associated with high rates of colectomy and other morbidity. This review aimed to examine the literature to produce a comprehensive diagnostic and treatment algorithm for the management of CMV in patients with colitis. METHODS: A systematic literature review was conducted via PubMed/Medline databases until August 31, 2015, using multiple keywords in English language and where original data only presented...
October 18, 2016: Inflammatory Bowel Diseases
Jevon R Puckett, John W Pickering, Suetonia C Palmer, John L McCall, Michal T Kluger, Janak De Zoysa, Zoltan H Endre, Mattias Soop
OBJECTIVE: To determine whether a low perioperative minimum urine output target is safe and fluid sparing when compared with the standard target. BACKGROUND: A minimum hourly urine output of 0.5 mL/kg is a key target guiding perioperative fluid therapy. Few data support this standard practice, which may contribute to perioperative fluid overloading. METHODS: We randomized patients without significant risk factors for acute kidney injury undergoing elective colectomy to a minimum urine output target of 0...
October 19, 2016: Annals of Surgery
Carlos Walter Sobrado, Lucas Faraco Sobrado
Introduction: Acute severe colitis is a potentially lethal medical emergency and, even today, its treatment remains a challenge for clinicians and surgeons. Intravenous corticoid therapy, which was introduced into the therapeutic arsenal in the 1950s, continues to be the first-line treatment and, for patients who are refractory to this, the rescue therapy may consist of clinical measures or emergency colectomy. Objective: To evaluate the indications for and results from drug rescue therapy (cyclosporine, infliximab and tacrolimus), and to suggest a practical guide for clinical approaches...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Varun K Phadke, Rachel J Friedman-Moraco, Brian C Quigley, Alton B Farris, J P Norvell
BACKGROUND: Herpesvirus infections often complicate the clinical course of patients with inflammatory bowel disease; however, invasive disease due to herpes simplex virus is distinctly uncommon. METHODS: We present a case of herpes simplex virus colitis and hepatitis, review all the previously published cases of herpes simplex virus colitis, and discuss common clinical features and outcomes. We also discuss the epidemiology, clinical manifestations, diagnosis, and management of herpes simplex virus infections, focusing specifically on patients with inflammatory bowel disease...
October 2016: Medicine (Baltimore)
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