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Anals of Surgery

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https://www.readbyqxmd.com/read/28529624/anal-adenocarcinoma-requires-prophylactic-inguinal-nodal-treatment-results-from-a-single-chinese-institution
#1
Zhen Su, Zhan-Wen Guo, Yan-Ping Mao, Jie Tang, Xiao-Wen Lan, Fang-Yun Xie, Qun Li
BACKGROUND: Literature pertaining to prophylactic inguinal nodal treatment for anal adenocarcinoma in China is scarce. METHODS: In this retrospective study, we analyzed 126 patients from 1965 to 2015. Among these, 67 patients received surgery only, 18 patients received chemoradiotherapy only, 27 patients received a combination of both, and the remaining 14 patients received palliative treatment. RESULTS: The median follow up period was 30 months...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28527628/multidisciplinary-clinics-for-colorectal-cancer-care-reduces-treatment-time
#2
Vanessa N Kozak, Alok A Khorana, Sudha Amarnath, Katherine E Glass, Matthew F Kalady
INTRODUCTION: Management of locally advanced and metastatic colorectal cancer (CRC) requires the expertise of multiple specialists. Multidisciplinary clinics (MDCs) are a working model designed to facilitate delivery of coordinated care. The present study evaluated the effects of MDC on the time to treatment (TTT). PATIENTS AND METHODS: Patients with CRC or locally advanced anal cancer who were evaluated at a single-institution MDC from January 2014 to October 2015 were identified from an institutional registry...
April 19, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/28526917/do-we-know-the-outcome-predictors-for-cauda-equine-syndrome-ces-a-retrospective-single-center-analysis-of-60-patients-with-ces-with-a-suggestion-for-a-new-score-to-measure-severity-of-symptoms
#3
Alexander König, Lisa Amelung, Marco Danne, Ullrich Meier, Johannes Lemcke
OBJECTIVE: Despite the awareness and familiarity of almost every medical professional with the cauda equine compression syndrome (CES), risk factors for a poor prognosis of the disease remain elusive. Even the relationship between subsequent outcome and the time elapsed from the time of appearance of symptoms to surgery taking place remain obscure. The aim of our study, therefore, was to analyze a relatively large population of our own patients studied consecutively, to identify outcome predictors for CES and to propose a clinical score for CES symptoms (Berlin CES score)...
May 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28514887/transanal-inspection-and-management-of-low-colorectal-anastomosis-performed-with-a-new-technique-the-ticrant-study
#4
Francesco Crafa, Sebastian Smolarek, Giulia Missori, Mostafa Shalaby, Silvia Quareisma, Adele Noviello, Diletta Cassini, Pasquale Ascenzi, Luana Franceschilli, Paolo Delrio, Giannandrea Baldazzi, Ucchino Giampiero, Jacques Megevand, Giovanni Maria Romano, Pierpaolo Sileri
BACKGROUND: Anastomotic leakage is one of the most serious complications after rectal cancer surgery. METHOD: A prospective multicenter interventional study to assess a newly described technique of creating the colorectal and coloanal anastomosis. The primary outcome was to access the safety and efficacy of this technique in the reduction of anastomotic leak. RESULT: Fifty-three patients with rectal cancer who underwent low or ultra-low anterior resection were included in the study...
May 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28514300/increasing-efficacy-and-reducing-side-effects-in-treatment-of-chronic-anal-fissures-a-study-of-topical-diazepam-therapy
#5
Minh Tuan H Hang, Betsy E Smith, Carson Keck, Ali Keshavarzian, Shahriar Sedghi
This is a single institution nonexperimental study intended to analyze the therapeutic efficacy of topical diazepam in treating symptoms of chronic anal fissures.Anal fissures are a common cause of anal pain. Conventional treatments include nonsteroidal anti-inflammatory drugs, topical creams, such as nitroglycerin and nifedipine, and surgery. However, these treatments are usually suboptimally efficacious or have deterring side effects.Patients at an outpatient community center with a diagnosis of a chronic anal fissure were prescribed either topical 2% (n = 19) or 4% (n = 18) diazepam cream between January 2013 and February 2015...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28504930/extracorporeal-stimulation-of-sacral-nerve-roots-for-observation-of-pelvic-autonomic-nerve-integrity-description-of-a-novel-methodological-setup
#6
Tomasz Moszkowski, Daniel Kauff, Celine Wegner, Roman Ruff, Karin Somerlik-Fuchs, Thilo Krueger, Piotr Augustyniak, Klaus-Peter Hoffmann, Werner Kneist
INTRODUCTION: Neurophysiologic monitoring can improve autonomic nerve sparing during critical phases of rectal cancer surgery. OBJECTIVES: To develop a system for extracorporeal stimulation of sacral nerve roots. METHODS: Dedicated software controlled a ten-electrode stimulation array by switching between different electrode configurations and current levels. A built-in impedance and current level measurement assessed the effectiveness of current injection...
May 12, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28503516/transanal-minimally-invasive-surgery-for-treating-patients-with-regressed-rectal-cancer-after-preoperative-chemoradiotherapy
#7
Byoung Chul Lee, Seonok Oh, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim
PURPOSE: Although the standard treatment for patients with locally advanced rectal cancer managed by preoperative chemoradiotherapy (CRT) is a radical resection, local excisions are used in highly-selective cases. Recently, transanal minimally-invasive surgery (TAMIS) has emerged as a feasible technique for local excision of midrectal lesions. We assess the feasibility of using TAMIS to treat patients with locally advanced rectal cancer who showed good response to CRT. METHODS: From October 2010 to June 2013, 35 consecutive patients with rectal cancer managed by using preoperative CRT underwent TAMIS...
April 2017: Annals of Coloproctology
https://www.readbyqxmd.com/read/28497757/safety-and-tolerability-of-veliparib-combined-with-capecitabine-plus-radiotherapy-in-patients-with-locally-advanced-rectal-cancer-a-phase-1b-study
#8
Brian G Czito, Dustin A Deming, Gayle S Jameson, Mary F Mulcahy, Houman Vaghefi, Matthew W Dudley, Kyle D Holen, Angela DeLuca, Rajendar K Mittapalli, Wijith Munasinghe, Lei He, John R Zalcberg, Samuel Y Ngan, Philip Komarnitsky, Michael Michael
BACKGROUND: Further optimisation of present standard chemoradiation is needed in patients with locally advanced rectal cancer. Veliparib, an oral poly(ADP-ribose) polymerase inhibitor, has been shown to enhance the antitumour activity of chemotherapy and radiotherapy in preclinical models. We aimed to establish the maximum tolerated dose and establish the recommended phase 2 dose of veliparib combined with neoadjuvant capecitabine and radiotherapy. METHODS: This phase 1b, open-label, multicentre, dose-escalation study was done at six hospitals (one in Australia and five in the USA)...
June 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28497402/impact-of-resection-versus-no-resection-of-the-primary-tumor-on-survival-in-patients-with-colorectal-cancer-and-synchronous-unresectable-metastases-protocol-for-a-randomized-multicenter-study-cr4
#9
Sebastiano Biondo, Ricardo Frago, Esther Kreisler, Eloy Espin-Basany
PURPOSE: The purpose of this study was to determine whether patients diagnosed with colorectal cancer and synchronous unresectable metastases (stage IV) can benefit from resection of the primary tumor in terms of an improvement in cancer-specific survival. METHODS: Stage IV colorectal cancer patients are eligible for inclusion in a randomized multicenter study carried out in 18 hospitals throughout Spain. Exclusion criteria are rectal tumors below 12 cm from the anal verge or locally advanced tumors, multiple bone or central nervous system metastases, and history of another primary cancer...
May 11, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28494458/improvement-of-anal-function-by-adipose-derived-stem-cell-sheets
#10
Yusuke Inoue, Fumihiko Fujita, Izumi Yamaguchi, Hiroko Kinoe, Daisuke Kawahara, Yusuke Sakai, Tamotsu Kuroki, Susumu Eguchi
AIM: One of the most troublesome complications of anal preserving surgery is anal sphincter dysfunction. The aim of this study was to evaluate functional recovery after implantation of adipose-derived stem cell (ADSC) sheets, novel biotechnology, for an anal sphincter resection animal model. METHODS: Eighteen female Sprague-Dawley rats underwent removal of the nearest half of the internal and external anal sphincter muscle. Nine rats received transplantation with ADSC sheets to the resected area while the remaining rats received no transplantation...
May 12, 2017: Digestive Surgery
https://www.readbyqxmd.com/read/28493393/final-results-of-a-european-multi-centre-prospective-observational-study-of-permacol-%C3%A2-collagen-paste-injection-for-the-treatment-of-anal-fistula
#11
Pasquale Giordano, Pierpaolo Sileri, Steen Buntzen, Angelo Stuto, Joseph Nunoo-Mensah, Leonardo Lenisa, Baljit Singh, Ole Thorlacius-Ussing, Ben Griffiths, Dorin Ziyaie
AIM: Permacol(™) collagen paste (Permacol(™) paste) is an acellular cross-linked porcine dermal collagen matrix suspension for use in soft tissue repair. The use of Permacol(™) paste in the filling of anorectal fistula tract is a new sphincter-preserving method for fistula repair. The MASERATI100 study was a prospective, observational clinical study with the objective to assess the efficacy of Permacol(™) collagen paste for anal fistula repair in 100 patients. METHOD: Patients (N=100) with anal fistula were treated at ten European surgical sites with a sphincter-preserving technique using Permacol(™) paste...
May 11, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28493146/laparoscopic-proximal-gastrectomy-with-oblique-jejunogastrostomy
#12
Kimitaka Tanaka, Yuma Ebihara, Yo Kurashima, Yoshitsugu Nakanishi, Toshimichi Asano, Takehiro Noji, Soichi Murakami, Toru Nakamura, Takahiro Tsuchikawa, Keisuke Okamura, Toshiaki Shichinohe, Satoshi Hirano
BACKGROUND: Proximal early gastric cancer is a good indication for totally laparoscopic proximal gastrectomy (TLPG) with double-tract reconstruction (DTR). However, when most of the dietary intake passes through the escape route of the jejunum, the functional benefits of proximal gastrectomy might be similar to those after total gastrectomy. Our DTR procedure was improved for easy passage through the remnant stomach. The purposes of this study were to present a novel technique for intracorporeal DTR using linear staplers after TLPG and to investigate surgical outcomes...
May 10, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28489253/randomized-clinical-trial-comparing-collagen-plug-and-advancement-flap-for-trans-sphincteric-anal-fistula
#13
J Bondi, J Avdagic, U Karlbom, O Hallböök, D Kalman, J Šaltytė Benth, N Naimy, T Øresland
BACKGROUND: The role of a collagen plug for treating anal fistula is not well established. A randomized prospective multicentre non-inferiority study of surgical treatment of trans-sphincteric cryptogenic fistulas was undertaken, comparing the anal fistula plug with the mucosal advancement flap with regard to fistula recurrence rate and functional outcome. METHODS: Patients with an anal fistula were evaluated for eligibility in three centres, and randomized to either mucosal advancement flap surgery or collagen plug, with clinical follow-up at 3 and 12 months...
May 10, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28488729/randomized-clinical-trial-of-biodegradeable-intraluminal-sheath-to-prevent-anastomotic-leak-after-stapled-colorectal-anastomosis
#14
I S Bakker, A N Morks, H O Ten Cate Hoedemaker, J G M Burgerhof, H G Leuvenink, J B van Praagh, R J Ploeg, K Havenga
BACKGROUND: Anastomotic leakage is a potential major complication after colorectal surgery. The C-seal was developed to help reduce the clinical leakage rate. It is an intraluminal sheath that is stapled proximal to a colorectal anastomosis, covering it intraluminally and thus preventing intestinal leakage in case of anastomotic dehiscence. The C-seal trial was initiated to evaluate the efficacy of the C-seal in reducing anastomotic leakage in stapled colorectal anastomoses. METHODS: This RCT was performed in 41 hospitals in the Netherlands, Germany, France, Hungary and Spain...
May 10, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28488380/addition-of-oxaliplatin-to-neoadjuvant-radiochemotherapy-in-mri-defined-t3-t4-or-n-rectal-cancer-a-randomized-clinical-trial
#15
Peiman Haddad, Monir Miraie, Farshid Farhan, Mohammad-Sadegh Fazeli, Afsaneh Alikhassi, Afsaneh Maddah-Safaei, Mahdi Aghili, Bita Kalaghchi, Mohammad Babaei
BACKGROUND: Clinical trials investigating the effects of addition of oxaliplatin to neoadjuvant radiochemotherapy in locally advanced rectal cancers (LARCs) have brought controversial results for pathologic complete response as an endpoint. This randomized clinical trial investigated downstaging as a short-term surrogate for progression-free survival (PFS). METHODS: Patients with magnetic resonance imaging (MRI) defined T3, T4 or N+ histologically proven adenocarcinoma of rectum within 15 cm from anal verge were randomly assigned to receive 50-50...
May 10, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28486255/intestinal-barrier-disruption-in-ileal-pouchitis-after-ileal-pouch-anal-anastomosis-in-a-rat-model
#16
Kai-Yu Li, Jian-Lin Wang, Yan-Yan Xu, Sen-Yang Gao, Ying-Ying Zhang, An-Qi He, Gang Liu
BACKGROUND: Pouchitis occurs in approximately 50% of patients with ulcerative colitis after ileal pouch-anal anastomosis (IPAA) but the pathogenesis remains unclear. We used a rat model of dextran sulfate sodium (DSS)-induced ileal pouchitis to examine whether intestinal barrier disruption plays a role in the development and progression of the disease. METHODS: Rats were randomly divided into DSS (underwent IPAA and administered 5% DSS orally), IPAA (underwent IPAA), and Sham groups (underwent switch abdominal surgery)...
May 5, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28485994/copious-irrigation-versus-suction-alone-during-laparoscopic-appendectomy-for-complicated-appendicitis-in-adults
#17
Fengbo Sun, He Wang, Fengjuan Zhang, Xinming Zhang, Zhiyuan Xing, Shenglin Zhang, Haifeng Zhang, Ye Wang
OBJECTIVE: The objective of this study was to determine whether copious irrigation of peritoneal cavity during laparoscopic appendectomy for complicated appendicitis effectively reduces the incidence of postoperative complications and improves the postoperative recovery in adults compared with suction alone. METHODS: In this prospective randomized trial, adult patients with complicated appendicitis were randomized to "irrigation and suction"(IS) group or "suction only"(SO) group...
May 9, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/28485190/complications-and-morbidity-associated-with-loop-ileostomies-in-patients-with-ulcerative-colitis
#18
J Park, B Gessler, M Block, E Angenete
BACKGROUND AND AIMS: Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting. MATERIAL AND METHODS: Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively...
May 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28481858/selected-techniques-of-anal-fistula-surgery-from-antiquity-through-the-early-20th-century-illustrated
#19
Adrian E Ortega, Alan Gesek, Megan Linnebur, Kyle G Cologne
This article highlights surgical approaches to the surgical treatment of anal fistula from antiquity to the early 20th century. Primary translations and other authoritative commentaries on the subject are included. Selected surgical techniques have been reconstructed and illustrated in contemporary interpreted images.
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28481854/paradoxical-impact-of-ileal-pouch-anal-anastomosis-on-male-and-female-fertility-in-patients-with-ulcerative-colitis
#20
Frederik R Pachler, Søren B Brandsborg, Søren Laurberg
BACKGROUND: Birth rates in males with ulcerative colitis and ileal pouch-anal anastomosis have not been studied. OBJECTIVE: This study aimed to estimate birth rates in males and females with ulcerative colitis and study the impact of ileal pouch-anal anastomosis. DESIGN: This was a retrospective registry-based cohort study that was performed over a 30-year period. SETTINGS: Records for parenting a child from the same period were cross-linked with patient records, and birth rates were calculated using 15 through 49 years as age limits...
June 2017: Diseases of the Colon and Rectum
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