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Anals of Surgery

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https://www.readbyqxmd.com/read/29234923/non-inferiority-multicenter-prospective-randomized-controlled-study-of-rectal-cancer-t2-t3s-superficial-n0-m0-undergoing-neoadjuvant-treatment-and-local-excision-tem-vs-total-mesorectal-excision-tme
#1
X Serra-Aracil, C Pericay, T Golda, L Mora, E Targarona, S Delgado, A Reina, F Vallribera, J M Enriquez-Navascues, S Serra-Pla, J C Garcia-Pacheco
PURPOSE: The standard treatment of rectal adenocarcinoma is total mesorectal excision (TME), in many cases requires a temporary or permanent stoma. TME is associated with high morbidity and genitourinary alterations. Transanal endoscopic microsurgery (TEM) allows access to tumors up to 20 cm from the anal verge, achieves minimal postoperative morbidity and mortality rates, and does not require an ostomy. The treatment of T2, N0, and M0 cancers remains controversial. Preoperative chemoradiotherapy (CRT) in association with TEM reduces local recurrence and increases survival...
December 12, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29232533/laparoscopic-abdominal-transanal-proctocolectomy-with-coloanal-anastomosis-is-a-good-surgical-option-in-selective-patients-with-low-lying-rectal-cancer-a-retrospective-analysis-based-on-a-single-surgeon-s-experience
#2
Bong-Hyeon Kye, Jun-Gi Kim, Hyeon-Min Cho, Hyung-Jin Kim, Chung-Soo Chun
PURPOSE: We intended to identify the oncological outcome for rectal cancer over the past 20 years and whether or not sphincter-preserving surgery is an appropriate approach for low-lying rectal cancer. MATERIALS AND METHODS: The oncological outcomes from a total of 418 patients who electively underwent rectal cancer surgery for a lesion located within 8 cm of the anal verge by a single colorectal surgeon were reviewed retrospectively. RESULTS: Of 418 patients, 175 patients underwent low anterior resection (LAR), 172 laparoscopic abdominal transanal proctocolectomy with coloanal anastomosis (LATA), and 71 abdominoperineal resection (APR)...
December 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29229485/the-position-of-the-anal-dimple-in-newborns-and-infants-with-anorectal-malformations-and-its-correlation-with-the-normal-anal-position
#3
Jigar N Patel, Amit Kumar, Partap Singh Yadav, Rajiv Chadha, Vikram Datta, Subhasis Roy Choudhury
BACKGROUND/PURPOSE: The anal position index (API) defines the normal anal position as the ratio of fourchette-anal distance to fourchette-coccyx distance for females and the scrotum-anal distance to scrotum-coccyx distance for males. In this study, measurement of the API in newborns and infants with anorectal malformations (ARM), using the center of the midline anal dimple (AD) to represent the center of the proposed neoanus, was performed to assess whether or not the AD was located in a significantly abnormal position as correlated with the normal anal position...
November 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29224507/three-anastomotic-techniques-following-laparoscopic-rectal-cancer-resection-our-experience-in-155-patients
#4
Mahtab Zanguie, Abbas Abdollahi, Roham Salek, Ali Jangjoo, Mehdi Jabbari Nooghabi, Hosein Shabahang, Hamed Golmohammadzadeh
PURPOSE: This study aimed to assess the impact of 3 anastomotic techniques after laparoscopic rectal cancer resection. METHODS: In a cross-sectional study, the data of 155 patients who underwent surgery for rectal cancer were retrieved. An anastomosis was created between the left colon and anal canal with 3 different methods: coloanal anastomosis with protective ileostomy (group A), coloanal anastomosis without ostomy (group B), and delayed coloanal anastomosis (group C)...
December 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/29208550/transabdominal-salvage-surgery-after-pouch-failure-in-a-tertiary-center-a-case-matched-study
#5
Matteo Rottoli, Carlo Vallicelli, Paolo Gionchetti, Fernando Rizzello, Luca Boschi, Gilberto Poggioli
BACKGROUND: Salvage surgery after failure of ileal pouch-anal anastomosis (IPAA) could be offered to selected patients. However, the results vary widely in different centers. AIMS: To assess the outcomes of salvage surgery by comparison with a control group matched for confounding variables. METHODS: From a prospective database of 1286 IPAA, patients undergoing transabdominal salvage surgery were compared for perioperative and functional outcomes and quality of life (QOL) to a 1:3 control group of primary IPAA cases...
November 26, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/29203973/long-term-functional-and-oncological-outcomes-following-intersphincteric-resection-for-low-rectal-cancers
#6
Sivakumar Mahalingam, Ramakrishnan Ayloor Seshadri, Surendran Veeraiah
Surgery for low rectal cancer often involves a permanent stoma. Intersphincteric resection (ISR) with colo-anal anastomosis is a valuable sphincter sparing surgical procedure that avoids the need for permanent stoma in patients with low rectal cancer. The aim of this study was to analyze the long-term functional and oncological outcomes following ISR. This was a retrospective analysis of patients with low rectal cancer who underwent ISR with colo-anal anastomosis in our institution between 2007 and 2015. All patients had a diversion stoma...
December 2017: Indian Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29194531/conservative-surgery-versus-colorectal-resection-in-deep-endometriosis-infiltrating-the-rectum-a-randomized-trial
#7
Horace Roman, Michael Bubenheim, Emmanuel Huet, Valérie Bridoux, Chrysoula Zacharopoulou, Emile Daraï, Pierre Collinet, Jean-Jacques Tuech
STUDY QUESTION: Is there a difference in functional outcome between conservative versus radical rectal surgery in patients with large deep endometriosis infiltrating the rectum 2 years postoperatively? SUMMARY ANSWER: No evidence was found that functional outcomes differed when conservative surgery was compared to radical rectal surgery for deeply invasive endometriosis involving the bowel. WHAT IS KNOWN ALREADY: Adopting a conservative approach to the surgical management of deep endometriosis infiltrating the rectum, by employing shaving or disc excision, appears to yield improved digestive functional outcomes...
November 29, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29190183/a-long-term-follow-up-of-a-new-surgery-method-laparoscope-assisted-heart-shaped-anastomosis-for-hirschsprung-s-disease
#8
Chunlei Jiao, Donghai Yu, Dandan Li, Guo Wang, Jiexiong Feng
BACKGROUND: Laparoscopic surgery is widely used in the treatment of Hirschsprung's disease (HD). However, constipation and soiling are still the main long-term complications. A new type of anastomosis, which is characterized by a heart-shaped colorectal anastomosis after splitting the posterior rectum wall to 0.5 cm above the dentate line, has been improved by our medical center. The purpose of this study was to determine the long-term effects of laparoscope-assisted heart-shaped anastomosis (LHSA) and to compare it with a more generally applied approach, the laparoscope-assisted Soave procedure (LSP)...
November 30, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29182899/five-year-experience-of-the-treatment-of-squamous-cell-carcinoma-of-the-anus
#9
C A Leo, C Santorelli, J D Hodgkinson, O Bidovaneta, F Baldelli, F Cantarella, E Cavazzoni
OBJECTIVES: The best treatment of early stage anal squamous cell carcinoma (SCC) is under debated. Wide local excision (WLE) may be considered adequate for stage 1 anal margin cancer. This study demonstrates our experience in treatment of patients with SCC over 5 years. PATIENTS AND METHODS: We conducted a retrospective study of patients who had undergone anal screening or anal cancer surveillance between October 2010 and 2015 in our department. Each patient underwent anal Pap test, HPV test PCR HPV DNA and cytology by Thin Prep...
July 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29180206/ropivacaine-wound-infiltration-a-fast-track-approach-in-patients-undergoing-thoracotomy-surgery
#10
Zhuqing Rao, Haoming Zhou, Xiongxiong Pan, Jing Chen, Yuting Wang, Zhongyun Wang, Zhengnian Ding
BACKGROUND: Postoperative pain impairs enhanced recovery in patients after various surgeries. Local use of ropivacaine has become an effective strategy for postoperative pain management. The aim of this study was to assess the effectiveness and safety of wound infiltration with ropivacaine for postoperative analgesia as a fast-track approach in patients undergoing thoracotomy surgery. MATERIALS AND METHODS: Forty adult patients with esophageal cancer scheduled for selective thoracotomy surgery were enrolled in this double-blind, randomized, controlled study...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29178097/-association-of-early-diarrhea-and-fecal-volume-with-anastomotic-leakage-after-low-anterior-resection-of-rectal-cancer
#11
Caijin Zhou, Wenting Ou, Feipeng Xu, Lin Lin, Qingwen Xu
OBJECTIVE: To evaluate the association of early diarrhea and fecal volume with anastomotic leakage after low anterior resection (LAR) of rectal cancer. METHODS: Clinical data of 541 patients with rectal cancer undergoing LAR at The Affiliated Hospital of Guangdong Medical College between January 2007 and January 2017 were analyzed retrospectively. Early postoperative diarrhea was defined as at least one occurrence of more than 50 ml watery stool or at least four times defecation per day within 7 days after surgery...
November 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29173830/the-lived-experiences-of-patients-with-post-operative-rectal-cancer-who-suffer-from-altered-bowel-function-a-phenomenological-study
#12
Ling-Chun Lu, Xuan-Yi Huang, Chien-Chih Chen
PURPOSE: Altered bowel function is a common consequence of anal sphincter-saving surgery in rectal cancer patients, and bowel symptoms influence patients' daily life and psychosocial status. Patients have inadequate professional support because care specialists fail do fully appreciate the impact of the patients' symptoms. In-depth exploration of the individual's experience is essential to improve the quality of patient care. The purpose of this study was to explore the lived experiences of post-operative rectal cancer patients with altered bowel function...
December 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/29173260/transanal-minimally-invasive-surgery-for-benign-large-rectal-polyps-and-early-malignant-rectal-cancers-experience-and-outcomes-from-the-first-canadian-centre-to-adopt-the-technique
#13
Antonio Caycedo-Marulanda, Henry Y Jiang, Erica L Kohtakangas
BACKGROUND: Transanal minimally invasive surgery (TAMIS) has emerged as a relatively new technique in treating early cancer and benign lesion of the rectum. The technique is likely to be widely adopted, surpassing other comparable techniques owing to its simple setup and cost-effectiveness. We assessed the outcomes of TAMIS at our centre. METHODS: We retrospectively reviewed prospectively collected data on 50 patients who underwent TAMIS for benign, malignant T1 or T2 cancers that were unfit for radical surgery over a 4-year period...
December 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/29164476/diverticular-colitis-with-progression-to-ulcerative-colitis-after-sigmoidectomy
#14
Atsuyo Ikeda, Tsunekazu Mizushima, Yutaro Egashira, Hidekazu Takahashi, Norikatsu Miyoshi, Naotsugu Haraguchi, Taishi Hata, Chu Matsuda, Yuichiro Doki, Masaki Mori
Diverticular colitis is chronic inflammation of the colon where diverticula are present. The endoscopic and histopathological findings of this disease are sometimes similar to those of ulcerative colitis, and several reports describe cases of diverticular colitis that progressed to typical ulcerative colitis. A 77-year-old woman with intramesenteric penetration of the sigmoid diverticulum underwent low anterior resection. One month later, the patient experienced anastomotic leakage, and transverse colostomy was performed...
November 21, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29158365/phase-ii-trial-using-a-combination-of-oxaliplatin-capecitabine-and-celecoxib-with-concurrent-radiation-for-newly-diagnosed-resectable-rectal-cancer
#15
Emilio P Araujo-Mino, Yehuda Z Patt, Cristina Murray-Krezan, Joshua A Hanson, Pranshu Bansal, Ben J Liem, Ashwani Rajput, M Houman Fekrazad, Glenory Heywood, Fa Chyi Lee
LESSONS LEARNED: Colorectal cancers exhibit a high level of cyclooxygenase-2 (COX-2) expression with strong preclinical rationale for improved clinical outcomes with COX-2 inhibition. Celecoxib is a COX-2 inhibitor and we have shown that it can be safely combined with capecitabine and oxaliplatin as part of neoadjuvant treatment with radiation therapy (RT) in rectal cancer.There was a significant improvement in skin toxicity with this combination as compared with historical data. Considering the field has moved on to single-agent capecitabine, we believe future trials with capecitabine and celecoxib hold potential...
November 20, 2017: Oncologist
https://www.readbyqxmd.com/read/29147895/routine-virtual-ileostomy-following-restorative-proctocolectomy-for-familial-adenomatous-polyposis
#16
Peter C Ambe, Hubert Zirngibl, Gabriela Möslein
BACKGROUND: Anastomotic leakage (AL) is the most feared complication in colorectal surgery. A diverting ileostomy is routinely used to prevent or reduce morbidity and mortality following AL. However, a diverting ileostomy cannot prevent AL. Besides, diverting ileostomy might be associated with relevant complications. Herein, we introduce the virtual ileostomy as an alternative to diverting ileostomy in patients undergoing restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) for familial adenomatous polyposis (FAP)...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29146073/robotic-assisted-transanal-polypectomies-is-there-any-indication
#17
Marcos Gómez Ruiz, Carmen Cagigas Fernández, Joaquín Alonso Martín, Lidia Cristobal Poch, Carlos Manuel Palazuelos, Francisco Javier Barredo Cañibano, Manuel Gómez Fleitas, Julio Castillo Diego
OBJECTIVES: Robotic assisted transanal polipectomy may have advantages compared with the conventional transanal minimally invasive surgery technique. We evaluate the safety, feasibility and advantages of this technique. METHODS: Between February 2014 and October 2015, 9patients underwent robotic transanal polypectomy. We performed a retrospective study in which we analyse prospectively collected data regarding patient and tumor characteristics, perioperative outcomes, pathological report, morbidity and mortality...
November 13, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29146001/what-happens-after-a-failed-lift-for-anal-fistula
#18
Moriah Wright, Alan Thorson, Garnet Blatchford, Maniamparampil Shashidharan, Jennifer Beaty, Noelle Bertelson, Piyush Aggrawal, Lindsay Taylor, Charles A Ternent
BACKGROUND: Ligation of the intersphincteric fistula tract (LIFT) was developed to treat transsphincteric anal fistulas. The aftermath of a failed LIFT has not been well documented. METHODS: Retrospective chart review of LIFT procedure for transsphincteric anal fistula between March 2012 and September 2016. RESULTS: 53 patients with LIFT procedure were identified, 20 (37.7%) had persistent fistula with median followup of 4 months. Following LIFT, recurrence of fistula was transsphincteric (75%) or intersphincteric (25%) (p = NS)...
December 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/29136732/-prognosis-factors-for-the-perineal-incision-complications-after-abdominoperineal-resection-for-low-rectal-cancer
#19
S Luo, J W Liang, H T Zhou, W Pei, Z X Zhou, Q Liu, X S Wang
Objective: To evaluate the prognosis factors affecting perineal incision complications after abdominoperineal resection (APR) for the low rectal cancer. Methods: This was a retrospective analysis of 151 consecutive patients with low rectal cancer undergoing APR between January and December 2013 at Department of Colorectal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The patients were comprised of 95 males and 56 females. The mean age of the patients was (57...
November 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/29130971/can-the-ki-67-labeling-index-in-biopsy-specimens-predict-the-world-health-organization-grade-of-rectal-neuroendocrine-tumors
#20
Shinya Sugimoto, Kinichi Hotta, Tadakazu Shimoda, Kenichiro Imai, Sayo Ito, Yuichiro Yamaguchi, Kohei Takizawa, Naomi Kakushima, Masaki Tanaka, Noboru Kawata, Masao Yoshida, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Hiroyuki Ono
BACKGROUND: Being grade 2 is a known risk factor for metastasis in rectal neuroendocrine tumors (R-NETs). We aimed to identify the efficacy of the Ki-67 labeling index (LI) in endoscopic biopsy specimens to predict the World Health Organization (WHO) grade of R-NETs. METHODS: A total of 59 patients with 60 R-NETs (43 WHO grade 1 and 17 WHO grade 2), treated between October 2002 and December 2014, were retrospectively evaluated. The patients included in the study underwent biopsies followed by endoscopic submucosal resection with a ligation device, trans-anal full-thickness surgical resection, or radical surgery with lymph node dissection...
October 31, 2017: Digestive Diseases
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