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Colorectal obstruction

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https://www.readbyqxmd.com/read/29342445/case-report-of-an-uncommon-case-of-drain-site-hernia-after-colorectal-surgery
#1
M Manigrasso, P Anoldo, F Milone, G D De Palma, M Milone
BACKGROUND: trocar site herniation is a rare but potentially serious complication of laparoscopic surgery. Data about drain site hernia after laparoscopic surgery is scarce and anecdotal. CASE PRESENTATION: we report an uncommon case of drain site hernia in a man undergone laparoscopic left colectomy for a colonic adenocarcinoma who developed small bowel herniation in a 10 mm port site, in which a 24 FR drain was inserted leaving a real free space of 2 mm. DISCUSSION: laparoscopic approach has gained widespread acceptance in each surgical fields because of the perceived better postoperative outcomes in terms of less pain, faster recovery, and lower risk of incisional hernia...
January 9, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29325357/-impact-of-primary-tumor-site-on-the-prognosis-in-different-stage-colorectal-cancer-patients-after-radical-resection
#2
J Han, X Zhang, A D Zhang, X L Zhou, L Feng, J Y Wang, G Y Wang
Objective: To analyze the effect to the prognosis of tumor site on the patients of colorectal cancer after curative resection with different stage. Methods: Clinicopathological and follow-up data of 2 097 colorectal carcinoma cases undergoing resection at Fourth Hospital of Hebei Medical University from January 2008 to March 2015 were retrospectively analyzed. There were 421 patients in left-sided colorectal cancer (LCC) group (including carcinoma in cecum, ascending colon , hepatic flexure, and transvers colon) , 386 in right-sided colorectal cancer (RCC) group (including carcinoma in splenic flexure, descending colon and sigmoid colon) and 1 290 in rectal cancer (RECC) group...
January 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29319557/posterior-compartment-surgery-provides-no-differential-benefit-for-defecatory-symptoms-before-or-after-concomitant-mesh-augmented-apical-suspension
#3
Divya Arunachalam, Douglass S Hale, Michael H Heit
OBJECTIVES: The aim of this study was to determine the value of posterior compartment surgery during concomitant mesh-augmented apical suspension by comparing obstructed defecatory symptoms after laparoscopic sacrocolpopexy (LSC) with LSC with posterior repair (LSC + PR) and laparoscopic sacrocolpoperineopexy (LSCP) procedures. METHODS: This was a retrospective cohort study of women who underwent LSC, LSC + PR, and LSCP between July 2007 and July 2016 at a tertiary referral center in Indianapolis, Ind...
January 9, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29300257/ultrasound-indicators-of-rectal-support-defect-in-women-with-obstructive-defecatory-symptoms
#4
Ghazaleh Rostaminia, Pouya Javadian, Charbel Awad, S Abbas Shobeiri
OBJECTIVE: The anatomic and physiologic pathophysiology of obstructive defecatory symptoms is complex and poorly understood. As a consequence, there is no one surgical method that can achieve overall superiority. We aimed to investigate rectal architectural change in women with obstructive defecatory symptoms using three-dimensional pelvic floor ultrasound. METHODS: This retrospective cohort study included 65 women who were referred to our urogynecology clinic because of varied pelvic floor disorders between January 2013 and January 2014...
January 3, 2018: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/29280117/-long-term-efficacy-of-stapled-transanal-rectal-resection-for-obstructed-defecation-syndrome
#5
Yonghong Yu, Bin Zhang, Jianhua Ding, Guangzuan Zhuo, Guowei Ni, Jun Zhu, Ke Zhao
OBJECTIVE: To evaluate the long-term efficacy of stapled transanal rectal resection (STARR) in treating obstructed defecation syndrome(ODS). METHODS: Clinical data of 95 female patients with ODS undergoing STARR at Department of Colorectal Surgery, Rocket Army General Hospital from February 2010 to August 2012 were analyzed retrospectively. The Cleveland constipation scoring system (CSS), Longo ODS scoring system and severe symptoms score(SSS) were used to evaluate the degree and intensity of clinical symptoms...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29280111/-choice-of-surgical-procedures-and-control-of-surgical-risks-in-chronic-constipation
#6
Jinke Sui, Wei Zhang
Surgery, as one of the methods for the treatment of chronic constipation, is the final choice after the failure of non-surgical treatment with its specific particularity. The history of surgical treatment of chronic constipation is complex and tortuous. How to select operation among many kinds of surgery, and control risk is difficult for clinician. The choice of surgical procedure depends mainly on the patient's conditions, the objective examination basis and the experience of physician teams. Based on the previous reports and the team's experience, this paper discusses the choice of surgical treatment for the following types of chronic constipation: (1) Slow transit constipation: subtotal colorectal resection plus ileorectal anastomosis or ascending colon rectum anastomosis is widely used at present in the domestic, and its efficacy is quite good...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29280109/-interpretation-of-chinese-guidelines-for-the-diagnosis-and-treatment-of-constipation-surgery-2017
#7
Baohua Liu
The Chinese Society of Coloproctology (CSCP) released the updated "guidelines for the diagnosis and treatment of constipation surgery" in 2017. The major amendments include the following aspects: (1) According to defecation reflex involving parts of the classification, the cause of constipation is divided into three parts, including colorectal factors, internal and external colorectal factors. The new division is more rational, easy to make clear the location and the possible pathogenesis. (2) Constipation is divided into slow transit constipation, outlet obstructive constipation and mixed constipation...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29246174/changes-of-liver-hemodynamic-and-elastography-parameters-in-patients-with-colorectal-liver-metastases-receiving-preoperative-chemotherapy-a-note-of-caution
#8
Amalia Pelegrina, Josep Martí, Rosa Miquel, Joana Ferrer, Virginia Hernández-Gea, Alba Diaz, Cristina Nadal, Juan Carlos García-Valdecasas, Josep Fuster
BACKGROUND: New systemic chemotherapy agents have improved prognosis in patients with colorectal liver metastases (CLM), but some of them damage the liver parenchyma and ultimately increase postoperative morbidity and mortality after liver resection. The aims of our study were to determine the degree of hemodynamic and pathological liver injury in CLM patients receiving preoperative chemotherapy and to identify an association between these injuries and postoperative complications after liver resection...
December 16, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29235008/oncological-assessment-of-stent-placement-for-obstructive-colorectal-cancer-from-circulating-cell-free-dna-and-circulating-tumor-dna-dynamics
#9
Goro Takahashi, Takeshi Yamada, Takuma Iwai, Kohki Takeda, Michihiro Koizumi, Seiichi Shinji, Eiji Uchida
BACKGROUND: The self-expanding metallic stent (SEMS) provides effective decompression for patients with malignant large bowel obstruction (MLBO); however, mechanical damage to malignant cells from insertion may negatively affect prognosis, similar to surgical manipulation, and its oncological safety is unclear. We examined mechanical damage from SEMS placement using circulating cell-free DNA (cfDNA) and circulating tumor DNA (ctDNA). METHODS: Between 1 November 2014 and 30 June 2017, 35 MLBO patients were analyzed, comprising 25 SEMS patients and 10 transanal decompression tube (TDT) patients (control)...
December 12, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29233486/cetuximab-combined-with-induction-oxaliplatin-and-capecitabine-followed-by-neoadjuvant-chemoradiation-for-locally-advanced-rectal-cancer-swog-0713
#10
Cynthia Gail Leichman, Shannon L McDonough, Stephen R Smalley, Kevin G Billingsley, Heinz-Josef Lenz, Matthew A Beldner, Aram F Hezel, Mario R Velasco, Katherine A Guthrie, Charles D Blanke, Howard S Hochster
BACKGROUND: Neoadjuvant chemoradiation (NCRT) is standard treatment for locally advanced rectal cancer. Pathologic complete response (pCR) has associated with improved survival. In modern phase III trials of NCRT, pCR ranges from 10% to 20%. Cetuximab improves response in KRAS (KRAS proto-oncogene) wild type (wt) metastatic colorectal cancer. S0713 was designed to assess improvement in pCR with additional use of cetuximab with induction chemotherapy and NCRT for locally advanced, KRAS-wt rectal cancer...
October 24, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29233454/does-radiotherapy-prior-to-surgery-improve-long-term-prognosis-in-pediatric-colorectal-cancer-in-lower-and-upper-middle-income-countries-with-limited-resources-our-experience-and-literature-review
#11
Yacoob Omar Carrim, Luvo Gaxa, Francisca van der Schyff, Nndweleni Meshack Bida, Fareed Omar, Zarina Lockhat
Colorectal carcinoma in children and adolescents is extremely rare, with an annual incidence <0.3 cases per million, most frequently reported in the second decade of life. It accounts for severe morbidity and poor prognosis owing to the low index of suspicion, delayed diagnosis, advanced stage at presentation and the aggressive tumor nature. Patients present with abdominal pain, vomiting, constipation, abdominal distension, rectal tenesmus, iron-deficiency anemia, change in bowel habit and weight loss...
December 2017: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/29225684/colon-cancer-presenting-as-pseudo-obstruction-during-pregnancy-a-case-report
#12
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/29215479/major-abdominal-and-perianal-surgery-in-crohn-s-disease-long-term-follow-up-of-australian-patients-with-crohn-s-disease
#13
MULTICENTER STUDY
James W T Toh, Nelson Wang, Christopher J Young, Matthew J F X Rickard, Anil Keshava, Peter Stewart, Viraj Kariyawasam, Rupert Leong
BACKGROUND: Most patients with Crohn's disease still require surgery despite significant advances in medical therapy, surveillance, and management strategies. OBJECTIVE: The purpose of this study was to assess surgical strategies and outcomes in Crohn's disease, including surgical recurrence and emergency surgery. DESIGN: This was a multicenter, retrospective review of a prospectively collected database. SETTINGS: A specialist-referred cohort of patients with Crohn's disease between 1970 and 2009 was studied...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29215476/clinical-outcomes-of-self-expandable-metal-stents-for-malignant-rectal-obstruction
#14
Hyun Jung Lee, Sung Pil Hong, Jae Hee Cheon, Tae Il Kim, Won Ho Kim, Soo Jung Park
BACKGROUND: Self-expandable metal stents are widely used to treat malignant colorectal obstruction. However, data on clinical outcomes of stent placement for rectal obstruction specifically are lacking. OBJECTIVE: We aimed to investigate the clinical outcomes of self-expandable metal stents in malignant rectal obstruction in comparison with those in left colonic obstruction and to identify factors associated with clinical failure and complication. DESIGN: This was a retrospective study...
January 2018: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29209981/the-effect-of-frailty-index-on-early-outcomes-after-combined-colorectal-and-liver-resections
#15
Sophia Y Chen, Miloslawa Stem, Marcelo Cerullo, Susan L Gearhart, Bashar Safar, Sandy H Fang, Matthew J Weiss, Jin He, Jonathan E Efron
BACKGROUND: Although previous studies have examined frailty as a potential predictor of adverse surgical outcomes, little is reported on its application. We sought to assess the impact of the 5-item modified frailty index (mFI) on morbidity in patients undergoing combined colorectal and liver resections. METHODS: Adult patients who underwent combined colorectal and liver resections were identified using the ACS-NSQIP database (2005-2015). The 5-item mFI consists of history of chronic obstructive pulmonary disease, congestive heart failure, hypertension, diabetes, and partial/total dependence...
December 5, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29197851/deadly-combination-clostridium-septicum-and-colorectal-malignancy
#16
Carolyn Cullinane, Helen Earley, Shona Tormey
Gas gangrene is a life-threatening, necrotising soft tissue infection. Colorectal malignancy-associated Clostridiumsepticum is a rare cause of gas gangrene. This case outlines an initial presentation of colonic malignancy as gas gangrene from C.septicum infection.A 69-year-old man presented with abdominal pain, vomiting and constipation. Abdominal X-ray revealed dilated small bowel loops. Lactate was elevated. A diagnosis of small bowel obstruction was made. Subsequent CT revealed caecal thickening and subcutaneous emphysema overlying the left flank...
December 2, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29197194/the-role-of-self-expandable-metallic-stents-as-bridge-to-surgery-for-the-treatment-of-acute-malignant-colorectal-obstruction-our-experience
#17
Gianpasquale Gallo, Giuseppe Sammarco, Alessandro Paolo Chiriatti, Ferdinando Calabria, Rosario Sacco
INTRODUCTION: Despite the widespread use of screening programs, the colorectal cancer occurs in 7-29% of cases with a bowel obstruction, needing an immediate decompression treatment by emergency surgery; unfortunately, the emergency surgery is characterized by high morbidity and mortality rates. The endoscopic placement of self-expandable metallic stents can be a useful alternative, allowing to decompress the acute obstruction in a short time, in order to correct dehydration, electrolytic imbalance and to improve the overall clinical conditions prior to adequately plan the intervention of elective surgery...
2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/29181070/investigation-of-clinicopathological-parameters-in-emergency-colorectal-cancer-surgery-a-study-of-67-patients
#18
Amir Talebreza, Emad Yahaghi, Ehsan Bolvardi, Babak Masoumi, Mehran Bahramian, Ebrahim Khodaverdi Darian, Koorosh Ahmadi
Introduction: The aim of the present study was to establish, having adjusted for case mix, the size of the differences in postoperative mortality and 5-year survival between patients presenting as an emergency with evidence of obstruction and perforation and the association of clinicopathological factors with mortality (bivariate analyses). Material and methods: The study included 67 patients who presented with colorectal cancer (CRC) between 2009 and 2013 in Iran...
October 2017: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29164050/colorectal-stenting-for-obstruction-due-to-retrorectal-tumor-in-a-patient-unsuitable-for-surgery
#19
Veysel Ersan, Ramazan Kutlu, Ceyhun Erdem, Servet Karagul, Cuneyt Kayaalp
Fund of knowledge on palliative treatment of unresectable retrorectal tumors is scare. Here, we reported a non-surgical treatment of a huge retrorectal malignant tumor in an aged and debilitated patient complicated with colorectal obstruction. An 86-year-old male with severe comorbidities was admitted with acute colorectal obstruction owing to an untreated retrorectal malign epithelial tumor. There was a lobulated retrorectal mass, 20 cm × 15 cm at largest size, extending to the superior iliac bifurcation level, caused an obstruction of the rectal lumen...
September 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/29153075/is-whole-colon-investigation-by-colonoscopy-computerised-tomography-colonography-or-barium-enema-necessary-for-all-patients-with-colorectal-cancer-symptoms-and-for-which-patients-would-flexible-sigmoidoscopy-suffice-a-retrospective-cohort-study
#20
Wendy Atkin, Kate Wooldrage, Urvi Shah, Kate Skinner, Jeremy P Brown, Willie Hamilton, Ines Kralj-Hans, Michael R Thompson, Karen G Flashman, Steve Halligan, Siwan Thomas-Gibson, Margaret Vance, Amanda J Cross
BACKGROUND: For patients referred to hospital with suspected colorectal cancer (CRC), it is current standard clinical practice to conduct an examination of the whole colon and rectum. However, studies have shown that an examination of the distal colorectum using flexible sigmoidoscopy (FS) can be a safe and clinically effective investigation for some patients. These findings require validation in a multicentre study. OBJECTIVES: To investigate the links between patient symptoms at presentation and CRC risk by subsite, and to provide evidence of whether or not FS is an effective alternative to whole-colon investigation (WCI) in patients whose symptoms do not suggest proximal or obstructive disease...
November 2017: Health Technology Assessment: HTA
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