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Anals of Surgery

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https://www.readbyqxmd.com/read/28812104/-laparoscopic-proctocolectomy-technique-restorative-proctocolectomy-with-ileal-pouch-anal-anastomosis-in-ulcerative-colitis-video-article
#1
REVIEW
B Jansen-Winkeln, O Lyros, A Lachky, N Teich, I Gockel
Laparoscopic restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) constitutes a curative treatment option for therapy-refractory ulcerative colitis. A two-stage procedure with loop ileostomy at the time of IPAA is the most frequent variant of surgery. The aim of the procedure is the complete removal of the colon and rectum with simultaneous restoration of gastrointestinal continuity and preservation of continence functions. Long-term quality of life following laparoscopic proctocolectomy with IPAA is good and comparable with a healthy reference population...
August 15, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28797517/gynecologic-anatomic-abnormalities-following-anorectal-malformations-repair
#2
Alejandra Vilanova-Sanchez, Carlos A Reck, Kate A McCracken, Victoria A Lane, Alessandra C Gasior, Richard J Wood, Marc A Levitt, Geri D Hewitt
BACKGROUND/AIM: Patients may present with gynecologic concerns after previous posterior sagittal anorectoplasty (PSARP) for repair of an anorectal malformation (ARM). Common findings include an inadequate or shortened perineal body, as well as introital stenosis, retained vaginal septum, and remnant rectovestibular fistula. An inadequate or shortened perineal body may impact fecal continence, sexual function and recommendations regarding obstetrical mode of delivery. We describe our experience with female patients referred to our center for evaluation of their previously repaired ARM, with a specific focus on perineal body anatomy and concomitant gynecologic abnormalities...
July 24, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28796730/squamous-cancers-of-the-rectum-demonstrate-poorer-survival-and-increased-need-for-salvage-surgery-compared-with-squamous-cancers-of-the-anus
#3
Audrey S Kulaylat, Christopher S Hollenbeak, David B Stewart
BACKGROUND: Squamous cell cancers of the anus are rare GI malignancies for which neoadjuvant chemoradiation is the first-line treatment for nonmetastatic disease. Squamous cancers of the rectum are far less common, and it is unclear to what degree chemoradiotherapy improves their outcomes. OBJECTIVE: The purpose of this study was to compare stage-specific survival for anal and rectal squamous cancers stratified by treatment approach. DESIGN: This was a retrospective cohort study...
September 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28795245/a-systematic-review-and-meta-analysis-of-the-treatment-of-anal-fissure
#4
REVIEW
R L Nelson, D Manuel, C Gumienny, B Spencer, K Patel, K Schmitt, D Castillo, A Bravo, A Yeboah-Sampong
BACKGROUND: Anal fissure has a very large number of treatment options. The choice is difficult. In an effort to assist in that, choice presented here is a systematic review and meta-analysis of all published treatments for anal fissure that have been studied in randomized controlled trials. METHODS: Randomized trials were sought in the Cochrane Controlled Trials Register, Medline, EMBASE and the trials registry sites clinicaltrials.gov and who/int/ictrp/search/en...
August 9, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28778099/predictive-clinical-model-of-tumor-response-after-chemoradiation-in-rectal-cancer
#5
Marisa D Santos, Cristina Silva, Anabela Rocha, Carlos Nogueira, Fernando Castro-Poças, António Araujo, Eduarda Matos, Carina Pereira, Rui Medeiros, Carlos Lopes
Survival improvement in rectal cancer treated with neoadjuvant chemoradiotherapy (nCRT) is achieved only if pathological response occurs. Mandard tumor regression grade (TRG) proved to be a valid system to measure nCRT response. The ability to predict tumor response before treatment may significantly have impact the selection of patients for nCRT in rectal cancer. The aim is to identify potential predictive pretreatment factors for Mandard response and build a clinical predictive model design. 167 patients with locally advanced rectal cancer were treated with nCRT and curative surgery...
July 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28767804/partial-stapled-hemorrhoidopexy-clinical-aspects-and-impact-on-anorectal-physiology
#6
Marllus Braga Soares, Marcos Bettini Pitombo, Francisco Lopes Paulo, Paulo Cezar de Castro, Júlia Resende Schlinz, Annibal Amorim, Karin Guterres Lohmann Hamada
Objective: to evaluate the impact of partial stapled hemorrhoidopexy on anorectal physiology, the complications related to this surgical technique, pain, postoperative bleeding and recurrence of hemorrhoidal disease one year after surgery. Methods: this is a prospective, descriptive study in consecutive patients with mixed or internal hemorrhoidal disease, the internal component being classified as grade III or IV, undergoing partial stapled hemorrhoidopexy. Results: we studied 17 patients, 82% of them with internal hemorrhoids grade III and 18% grade IV...
May 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28766076/multicenter-analysis-of-risk-factors-for-anastomotic-leakage-after-middle-and-low-rectal-cancer-resection-without-diverting-stoma-a-retrospective-study-of-319-consecutive-patients
#7
Wei Zhang, Zheng Lou, Qizhi Liu, Ronggui Meng, Haifeng Gong, Liqiang Hao, Peng Liu, Ge Sun, Jun Ma, Wei Zhang
PURPOSE: The purpose of this study was to evaluate the risk factors for anastomotic leakage (AL) after anterior resection for middle and low rectal cancer in order to help surgeons to decide which patients could benefit from a diverting stoma. METHODS: Data on 319 patients having a middle and low rectal cancer resection with anastomosis between May 2011 and October 2015 from two hospitals were included in the study. The analysis included the following variables: patient-related variables (gender, age, diabetes mellitus, ASA score, preoperative radiochemotherapy, body mass index, blood hemoglobin, and serum albumin level), tumor-related variables (K-ras status, distance of tumor from the anal verge, histopathologic grade, pathological T stage, pathological N stage, pathological M stage, TNM stage, and tumor size), and surgery-related variables (laparoscopic or open surgery, blood loss, and operative time)...
August 2, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28745796/safety-and-efficacy-evaluation-of-laparoscopy-in-colorectal-cancer-with-liver-metastasis
#8
M-F Ye, G-G Xu, J-F Gu, Q-L Zhou, F-Q Lin, K-L Tao, F Tao
OBJECTIVE: To study the safety and efficacy of simultaneous completion of colorectal cancer resection and liver metastasis resection by total laparoscopy. PATIENTS AND METHODS: In the observation group, 40 patients with colorectal cancer combined with liver metastasis (CRCLM) were selected to receive total laparoscopic surgery. At the same time, 40 cases were selected for laparoscopic resection of colorectal cancer and hepatic resection as control group. RESULTS: The outcomes of the two methods in the treatment of CRCLM were compared...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28745699/-sacral-resection-in-surgical-treatment-of-locally-advanced-primary-and-recurrent-rectal-and-anal-cancer-short-term-outcomes
#9
P V Tsarkov, S K Efetov, L V Sidorova, I A Tulina
AIM: To assess safety of rectum removal with distal sacral resection. MATERIAL AND METHODS: The short-term results of surgical treatment of primary and recurrent locally advanced rectal and anal cancer with sacral fixation have been analyzed. 32 patients underwent combined operations with sacral resection at the level of S2-S5. In 12 patients only one point of tumor fixation (F1) was revealed, 10 patients had two points of fixation (F2), three patients had three fixation points (F3) and in 7 cases the tumor was fixed to four points (F4) of fixation to different pelvic structures...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28742696/transanal-versus-transabdominal-minimally-invasive-completion-proctectomy-with-ileal-pouch-anal-anastomosis-in-ulcerative-colitis-a-comparative-study
#10
Anthony de Buck van Overstraeten, Anders Mark-Christensen, Karin A Wasmann, Vivian P Bastiaenen, Christianne J Buskens, Albert M Wolthuis, Koen Vanbrabant, André D'hoore, Willem A Bemelman, Anders Tottrup, Pieter J Tanis
OBJECTIVE: This study aims to compare surgical outcome of transanal ileal pouch-anal anastomosis (ta-IPAA) with transabdominal minimal invasive approach in ulcerative colitis (UC), using the comprehensive complication index (CCI). BACKGROUND: Recent evolutions in rectal cancer surgery led to transanal dissection of the rectum resulting in a better exposure of the distal rectum and presumed better outcome. The same approach was introduced for patients with UC, resulting in decreased invasiveness...
July 24, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28737964/laparoscopic-duhamel-procedure-with-ex-anal-rectal-transection-for-right-sided-hirschsprung-s-disease
#11
Xi Zhang, Li Yang, Shao-Tao Tang, Guo-Qing Cao, Shuai Li, Meng Jiang, Meng Xiong, De-Hua Yang, Xiao-Pan Chang, Kang Li, Ya-Zhen Ma
BACKGROUND: Increased defecation frequency and soiling are common complications of surgery for right-sided Hirschsprung's disease (HD). Though the laparoscopic Duhamel procedure is a favorable option in right-sided HD, the conventional laparoscopic technique is time consuming and has complications that are associated with the reservoir. In this study, we described a modified laparoscopic Duhamel technique with ex-anal rectal transection combined with the Deloyer's procedure for right-sided HD...
July 24, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28736635/immunotherapy-in-gastrointestinal-cancers
#12
REVIEW
Patrick Grierson, Kian-Huat Lim, Manik Amin
Gastrointestinal (GI) cancers such as gastric, esophageal, pancreas, hepatobiliary, colorectal and anal cancers are a major cause of cancer related mortality worldwide. Traditional treatment options such as chemotherapy, surgery, radiation therapy, monoclonal antibodies and anti-angiogenic agents have been the backbone of treatment of GI cancers in various stages. Current cancer research is moving forward to incorporate immunotherapies in the treatment of GI cancers either as single agent or in combination with current available treatment modalities...
June 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28735411/risk-factors-associated-with-postoperative-recurrence-and-repeat-surgery-in-japanese-patients-with-crohn-s-disease
#13
Jun Kusaka, Hisashi Shiga, Masatake Kuroha, Tomoya Kimura, Yoichi Kakuta, Katsuya Endo, Yoshitaka Kinouchi, Tooru Shimosegawa
PURPOSE: To avoid frequent surgery in patients with Crohn's disease, it is important to identify the risk factors for postoperative recurrence or repeat surgery. However, there have so far been few studies on this topic from Asian countries. In addition, the recent development of anti-tumor necrosis factor (TNF) therapy may have changed the risk factors. We aimed to identify the factors associated with postoperative recurrence and repeat surgery. METHODS: The postoperative courses of 168 patients were reviewed...
July 22, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28733534/low-dose-of-dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-cesarean-surgery-provides-better-intraoperative-somato-visceral-sensory-block-characteristcs-and-postoperative-analgesia
#14
Yong-Hong Bi, Xiao-Guang Cui, Rui-Qin Zhang, Chun-Yu Song, Yan-Zhuo Zhang
OBJECT: In this study, we aimed to investigate the beneficial effects of dexmedetomidine on somato-visceral sensory block characteristcs, postoperative analgesia and stress response of intrathecal bupivacaine administration in women undergoing cesarean section, and to find out which dose is better. METHODS: Sixty parturients with the American Society of Anesthesiologists (ASA) physical status I or II were anesthetized with intrathecal bupivacaine(10mg) alone or in combination with dexmedetomidine (3 μg and 5 μg) to undergo cesarean section...
June 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28729224/robotic-placement-of-fenix-continence-restoration-system-in-a-patient-with-previous-radiation-to-the-pelvis-a-case-report
#15
Mariana Espinal, Christopher C DeStephano, Paulami Guha, Shilpa P Gajarawala, Anita H Chen, Paul D Pettit
Fecal incontinence (FI) is a disabling problem affecting women. Conservative treatment includes dietary modification, antimotility agents, and pelvic floor physical therapy. If conservative medical management is unsuccessful, surgical intervention may be required. Surgical options include rectal sphincteroplasty, bulking agent injection, radiofrequency anal sphincter remodeling procedure and sacral nerve stimulation (SNS) therapy. Recently, a new therapy for FI, the FENIX Continence Restoration System has become available...
July 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28726144/anastomotic-stricture-after-ultralow-anterior-resection-or-intersphincteric-resection-for-very-low-lying-rectal-cancer
#16
Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Hyeong Rok Kim
BACKGROUND: Anastomotic stricture following colorectal cancer surgery is not a rare complication, but proper management of anastomotic stricture located close to the anal verge is uncertain. This study aimed to investigate risk factors and management strategies for anastomotic stricture after ultralow anterior resection (ULAR). METHODS: We retrospectively reviewed a database of patients with rectal cancer who underwent surgery between January 2007 and June 2015, and included patients with an anastomosis within 4 cm from the anal verge...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28724187/nasogastric-tube-as-abdominal-pressure-sensor-in-urodynamics-proof-of-concept-of-a-novel-approach
#17
Sundaramoorthy VijayGanapathy, Vilvapathy Senguttuvan Karthikeyan, Ashwin Mallya, Ali Poonawala, Ramaiah Keshavamurthy
AIMS: The standard sensor for abdominal pressure (Pabd) measurement in urodynamics (UD) is a rectal sensor. In patients where the rectum is not available due to prior surgery or when external anal sphincter (EAS) tone is poor, rectal sensor may slip, making Pabd recording unreliable. Vaginal Pabd measurement and wireless vaginal sensors have been tried. We present our preliminary series of a novel nasogastric tube (NG) sensor for Pabd measurement. METHODS: We identified patients undergoing UD with a NG Pabd sensor from a prospectively maintained UD database of a tertiary care urological center between July 2013 and December 2016...
July 19, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28723770/initial-application-of-transanal-endoscopic-microsurgery-for-high-risk-lower-rectal-gastrointestinal-stromal-tumor-after-imatinib-mesylate-neoadjuvant-chemotherapy-a-case-report
#18
Qiaofei Liu, Guangxi Zhong, Weixun Zhou, Guole Lin
RATIONALE: The lower rectal gastrointestinal stromal tumor (GIST) is a rare entity and warrants special attentions because of the considerations of preserving of anal and urinal functions. Neoadjuvant therapy with imatinib mesylate (IM) has achieved great success in GIST, which potentially extends the applications of function-preserving minimally invasive surgical procedures. Transanal endoscopic microsurgery (TEM) is a well-developed minimally invasive technique for benign tumors in lower rectum...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723750/sphincter-preserving-surgery-for-low-middle-rectal-cancer-can-we-predict-feasibility-with-high-resolution-magnetic-resonance-imaging
#19
Hai-Bin Zhu, Lin Wang, Zi-Yu Li, Xiao-Ting Li, Xiao-Yan Zhang, Ying-Shi Sun
The study proposed to evaluate the feasibility of predicting sphincter-sparing surgery (SSS) preoperatively in low-middle rectal cancer by using magnetic resonance (MR).The study included both retrospective and prospective design. In the retrospective design, the distance from lower edge of tumor to upper margin of the internal sphincter (Dis1) and distance to anal verge (Dis2) were measured on MR, the distance to anal verge recorded by colonoscopy (Dis3) and digital rectal examination (Dis4) were also obtained...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28722085/-anatomical-planes-and-landmarks-of-transanal-total-mesorectal-excision-for-rectal-cancer-and-prophylaxis-of-intraoperative-complications
#20
Zhanlong Shen, Yingjiang Ye, Shan Wang
Total mesorectal excision (TME) is a mile-stone procedure in the history of rectal cancer surgery, but the exposure of surgical field of distal rectum is usually poor in patients with male, obese and narrow pelvis, which may lead to tumor residue and relative complications. Recently, a new technique called transanal TME (taTME) is considered to solve the above problems, but most medical centers are still in the learning curve of this procedure. Therefore, anatomical planes and landmarks of taTME for rectal cancer and prophylaxis of intraoperative complications are induced in this paper, which includes posterior plane: angle of anus and distal mesorectum and bleeding of mesorectum; rectosacral fascia and presacral bleeding; lateral and posterior-lateral plane: posterior branches of pelvic plexus and damage of anal function; anterior plane: vessel branches of neurovascular bundle and bleeding...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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