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Colon colorectal anal

Lily S Cheng, Allan M Goldstein
Constipation is a common childhood problem, but an anatomic or physiologic cause is identified in fewer than 5% of children. By definition, idiopathic constipation is a diagnosis of exclusion. Careful clinical evaluation and thoughtful use of imaging and other testing can help exclude specific causes of constipation and guide therapy. Medical management with laxatives is effective for the majority of constipated children. For those patients unresponsive to medications, however, several surgical options can be employed, including anal procedures, antegrade colonic enemas, colorectal resection, and intestinal diversion...
March 2018: Clinics in Colon and Rectal Surgery
Fabio Rondelli, Roberto Santinelli, Paolo Stella, Walter Bugiantella, Graziano Ceccarelli, Ruben Carlo Balzarotti, Michele De Rosa, Nicola Avenia
BACKGROUND: Colorectal cancer is the fourth most diffuse cause of death in the world and local recurrence is associated with a reduced long-term life expectancy, with a reduced quality of life. Rectal washout at the anastomosis site leads to a statistically significant reduction of local recurrences. METHODS: We developed the idea of a new laparoscopic stapler with an integrated washout system that could decontaminate the rectal stump before resection, without the need to enlarge the standard surgical incision or even to distort the incision site, closing the rectal stump just below the inferior part of the cancer, and then proceeding with the resection and stapling of the distal part of the tumor...
February 1, 2018: Surgical Innovation
N Jewel Samadder, Scott K Kuwada, Kenneth M Boucher, Kathryn Byrne, Priyanka Kanth, Wade Samowitz, David Jones, Sean V Tavtigian, Michelle Westover, Therese Berry, Kory Jasperson, Lisa Pappas, Laurel Smith, Danielle Sample, Randall W Burt, Deborah W Neklason
Importance: Patients with familial adenomatous polyposis (FAP) are at markedly increased risk for colorectal polyps and cancer. A combination of sulindac and erlotinib led to a 71% reduction in duodenal polyp burden in a phase 2 trial. Objective: To evaluate effect of sulindac and erlotinib on colorectal adenoma regression in patients with FAP. Design, Setting, and Participants: Prespecified secondary analysis for colorectal adenoma regression was carried out using data from a double-blind, randomized, placebo-controlled trial, enrolling 92 patients with FAP, conducted from July 2010 to June 2014 in Salt Lake City, Utah...
February 8, 2018: JAMA Oncology
Keishi Hakoda, Masanori Yoshimitsu, Manabu Emi, Yuya Hirai, Atsushi Kamigaichi, Manato Osawa, Norimasa Kuraoka, Toshiaki Komo, Norifumi Tsubokawa, Ichiko Yamakita, Masashi Miguchi, Yoshiro Aoki, Akira Nakashima, Mikihiro Kano, Koichi Oishi, Toshihiko Kohashi, Mayumi Kaneko, Mahito Funakoshi, Jun Hihara, Hidenori Mukaida, Naoki Hirabayashi
Anal metastasis of colorectal cancer is rare, and no standardized effective therapeutic strategy exists. We report a case of abdominoperineal resection for anal metastasis of rectal cancer. A 65-year-old man underwent laparoscopic low anterior resection for rectal cancer in August 2013. Histopathological examination revealed a moderately differentiated adenocarcinoma( tub2, pSS, ly3, v2, pN1, H0, P0, M0, Stage III a, Cur A). In February 2015, he complained of anal discomfort, and tumor markers were elevated...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Jing Sun, Sen Zhang, Minhua Zheng
Clinical investigation in minimally invasive gastrointestinal surgery has been developed by leaps and bounds in 2017. Standardizations of port placement, surgical approaches, lymphadenectomy, reconstruction, total laparoscopic surgery, incision-free technique, 3D laparoscope, as well as robotic surgeries, have been established. In the treatment for gastric cancer, the first-hand data of the laparoscopic technique for advanced gastric cancer will be released soon. Therefore, the research hotspots have been moved forward to lymphadenectomy, resection range, and reconstruction in laparoscopic advanced gastric cancer surgery...
January 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
James G Glasser, James M Nottingham, Martin Durkin, Michael E Haney, Sean Christensen, Riley Stroman, Tyler Hammett
Background: The role of surgery in treating children with functional constipation (FC) is controversial, because of the efficacy of bowel management programs. This case series is comprised of failures: 43 children, spanning 25 years' practice, who had megarectosigmoid (MRS) and unremitting constipation. Purpose: To determine whether these children were helped by surgery, and to contribute to formulating a standard of care for children with megarectum (MR) and/or redundancy of the sigmoid colon (MS) who fail medical management...
February 2018: Annals of Medicine and Surgery
Albert Grinshpun, Naama Halpern, Roy Zvi Granit, Ayala Hubert, Tamar Hamburger, Yael Laitman, Einat Shacham-Shmueli, Yehudit Peerless, Eitan Friedman, Tamar Peretz
Mutations in the BRCA1/2 genes were recently shown to be associated with an increased risk for colorectal cancer. We characterized the largest cohort available of BRCA1/2 mutation carriers with colorectal cancer. We analyzed 32 patients with lower gastrointestinal cancers and germline BRCA1/2 mutations from two large academic hospital registries; 91% of patients were of Ashkenazi ancestry, 78% were women, and 62.5% were carriers of BRCA1 gene mutations. A high percentage of colorectal tumors (34.5%) had a mucinous histology and were located atypically in the left colon...
January 10, 2018: European Journal of Human Genetics: EJHG
Ioanna Delladetsima, Stratigoula Sakellariou, Olivier Govaere, Elpida Poulaki, Evangelos Felekouras, Dina Tiniakos
AIMS: Hepatic progenitor cells (HPCs) are activated in various liver diseases, but their role in the carcinomatous environment remains unknown. We aimed to identify the possible presence and topography of HPCs in liver metastases. METHODS AND RESULTS: We examined 14 liver resection specimens for colorectal adenocarcinoma (n = 13) and anal squamous cell carcinoma (n = 1) metastases. Immunohistochemical markers of colonic origin (keratin 20 and CDX2) and squamous cell origin (p63), HPC [keratin 19 (K19) and CD56] and stem cell (CD44) markers, and the biliary marker keratin 7 (K7), which may also highlight HPCs, were applied on routinely processed tissue sections...
December 8, 2017: Histopathology
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
Tajana Filipec Kanizaj, Maja Mijic
Most common hepatobiliary manifestation of inflammatory bowel disease (IBD) are primary sclerosing cholangitis (PSC) and autoimmune hepatitis, ranking them as the main cause of liver transplantation (LT) in IBD setting. Course of pre-existing IBD after LT differs depending on many transplant related factors. Potential risk factors related to IBD deterioration after LT are tacrolimus-based immunosuppressive regimens, active IBD and cessation of 5-aminosalicylates at the time of LT. About 30% patients experience improvement of IBD after LT, while approximately the same percentage of patients worsens...
May 14, 2017: World Journal of Gastroenterology: WJG
Georgios I Panagiotakis, Alexandros G Andreou, Ioannis E Petrakis, Maria Tzardi, Maria Daskalogiannaki, Georgios E Chalkiadakis
Lipomas of the sigmoid colon are rare entities. The present case describes a 27-year-old Caucasian woman who underwent a laparoscopic sigmoidectomy following the detection of a giant lipoma. The young patient was referred to the Emergency Department of the University Hospital of Heraklion (Crete, Greece) in May 2013 after experiencing intermittent abdominal cramping during defecation, and altering episodes of diarrhea and constipation. In addition, the patient described the protrusion of a solid tissue mass shaped like a 'champagne bottle cork' from the anus following defecation...
March 2017: Oncology Letters
Asad Jehangir, Brian H Le, Oluwaseun Shogbesan
Colonic angiosarcoma is a rare malignancy representing only 0.0012% of all colorectal malignancies. Due to its non-specific symptoms, diagnosis is often delayed. However, because of the aggressive nature of this malignancy, it is important to keep it in the differential diagnosis of rectal bleeding, pelvic discomfort, chronic diarrhea, and weight loss in patients with risk factors. We present a case of angiosarcoma of the colon in a 74-year-old female with a remote history of chemo-radiation for anal squamous cell carcinoma (ASCC)...
March 26, 2017: Curēus
Daniel Hancu, James Williams, Faris Kubba, Abhay Chopada
A 67-year-old man with a slow-growing, asymptomatic perianal lesion was presented to the colorectal clinic. Physical examination and radiological investigation were suggestive of an externally prolapsing colonic polyp. However, intraoperative findings of a cystic lesion containing a thick brown substance questioned the initial diagnosis. After complete surgical resection of the encapsulated lesion, histological examination revealed a tailgut cyst (cystic hamartoma). These uncommon lesions originate from an embryological remnant of the hindgut...
April 24, 2017: BMJ Case Reports
Anne F Peery, Nicholas J Shaheen, Katherine S Cools, Todd H Baron, Mark Koruda, Joseph A Galanko, Ian S Grimm
BACKGROUND AND AIMS: Despite evidence that most nonmalignant colorectal polyps can be managed endoscopically, a substantial proportion of patients with a nonmalignant colorectal polyp are still sent to surgery. Risks associated with this surgery are not well characterized. We describe 30-day postoperative morbidity and mortality and explore risk factors for adverse events in patients undergoing surgical resection for nonmalignant colorectal polyps. METHODS: We analyzed data collected prospectively as part of the National Surgical Quality Improvement Program...
April 10, 2017: Gastrointestinal Endoscopy
Chloé Coton, Léon Maggiori, Diane Mège, Clotilde Naudot, Justine Prost À la Denise, Yves Panis
Background and Aims: The extent of lymph node harvesting during surgery for colorectal neoplasm [dysplasia and/or cancer] complicating inflammatory bowel disease [IBD] is a matter of debate. This study aimed to assess the risk of invasive rectal cancer in patients undergoing ileal pouch-anal anastomosis [IPAA] for colonic neoplasm complicating IBD, and thus to clarify whether a systematic total mesorectal excision [TME] should be systematically performed, or not, in those patients. Methods: From 1998 to 2015, all patients who underwent IPAA for colorectal neoplasm complicating IBD were included...
August 1, 2017: Journal of Crohn's & Colitis
Mohamad Abdelaziz, Motaz Sayed
Laterally spreading tumors (LSTs) are generally defined as superficial lesions ≥10 mm in diameter that typically extend laterally rather than vertically along the colonic wall. Such lesions are now increasingly reported because of increased awareness and the introduction of chromo and magnifying colonoscopy. Although the clinicopathological characteristics and the efficacy of endoscopic management of LSTs have been defined in Japanese cohorts, reports from the Middle East are lacking where surgical resection is the mainstay of treatment...
January 2017: Middle East Journal of Digestive Diseases
Ilufredo Y Tantoy, Anand Dhruva, Janine Cataldo, Alan Venook, Bruce A Cooper, Steven M Paul, Jon D Levine, Yvette P Conley, Frances Cartwright, Kathryn Lee, Fay Wright, Christine Miaskowski
BACKGROUND: Approximately 28% of patients with gastrointestinal (GI) cancers will receive targeted therapy (TT) because of the associated increases in survival. Only four studies have examined the symptom experience of these patients. To date, no studies have evaluated for differences in symptom occurrence, severity, and distress between patients who received chemotherapy (CTX) alone (n=304) or CTX with TT (n=93). METHODS: Patients completed self-report questionnaires, approximately one week after they received CTX...
February 2017: Journal of Gastrointestinal Oncology
Carol Huibregtse, Marija Bjegovich-Weidman, James L Weese
143 Background: Managing physicians (medical oncologist, radiation oncologist, surgeons) have a responsibility to clinically stage patients prior to the initiation of cancer treatment. Clinical staging not only directs the treatment plan, but identifies appropriate clinical trials and estimates prognosis. We sought to determine whether engagement of managing physicians would result in increased clinical staging for various types of cancer. METHODS: Baseline data on clinical staging for breast, colorectal (colon, rectal, anal, rectosigmoid junction)*, thoracic (lung esophageal)†, genitourinary (prostate, penis, testes)‡, and pancreatic primary cancers were obtained...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
François Cauchy, Solafah Abdalla, Christophe Penna, Benjamin Angliviel, Benoit Lambert, Bruno Costaglioli, Antoine Brouquet, Stéphane Benoist
PURPOSE: The aim of this prospective study was to assess the influence of morphological characteristics of anastomotic doughnuts on the risk of anastomotic leakage (AL) after double-stapled colorectal anastomosis. METHODS: This single-center prospective study enrolled all patients undergoing double-stapled colorectal anastomosis between December 2012 and December 2015. Maximal diameter and minimal and maximal heights and widths of both colonic and rectal doughnuts were measured by surgeons in the operating room...
May 2017: International Journal of Colorectal Disease
Emanuele Asti, Andrea Lovece, Luigi Bonavina
BACKGROUND AND AIMS: Laparoscopic resection is a well-established approach for colorectal cancer surgery. In patients with rectal cancer treated by neoadjuvant chemoradiotherapy, it may be difficult to identify a clear safety margin for endostapling and subsequent anastomosis. We designed an innovative technical approach to assist colorectal anastomosis in these patients. TECHNIQUE: A four-trocar laparoscopic approach is used. After exploration of the abdominal cavity, the left colic flexure is completely mobilized...
June 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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