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Surgery and ibd

S Renshaw, I L Silva, A Hotouras, S D Wexner, J Murphy, C Bhan
The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulcerative Colitis"). Two investigators screened abstracts for eligibility. All English language full-text articles were reviewed for specified outcomes. Data were presented in a summarised and aggregate form, since the lack of higher-level evidence studies precluded meta-analysis...
March 15, 2018: Techniques in Coloproctology
Nan Lan, Bo Shen
Background: Current treatment modalities for anastomotic stricture in Crohn's disease (CD) include endoscopic balloon dilation (EBD) and surgery. We recently published a case series of inflammatory bowel disease patients treated with the novel endoscopic stricturotomy (ES). The aim of this case-control study was to compare the efficacy and safety of ES versus conventional EBD in the treatment of anastomotic strictures in CD patients. Methods: All eligible patients with CD anastomotic stricture who were treated with ES or EBD were included...
March 12, 2018: Inflammatory Bowel Diseases
Jildou Hoekstra, Aafke H C van Roon, Frank C Bekkering, Antonie J P van Tilburg, Rachel L West
INTRODUCTION: The aim of this study was to evaluate information provided on pregnancy, personal decision making, disease course, and outcome of pregnancy from a patient's perspective in a population of patients with inflammatory bowel disease (IBD) attending two general hospitals. PATIENTS AND METHODS: A questionnaire was sent to all female patients with IBD in two general hospitals in the Netherlands. The questionnaire comprised four sections: (i) demographic data and medication use (ii) details on previous pregnancies and reasons for not becoming pregnant, (iii) outcome of pregnancies before IBD diagnosis, and (iv) outcome of pregnancies after IBD diagnosis...
March 14, 2018: European Journal of Gastroenterology & Hepatology
Christopher John Kiely, Paul Pavli, Claire Louise O'Brien
Studies of the human intestinal microbiome in patients with inflammatory bowel disease (IBD) consistently show that there are differences (an abnormal or unbalanced microbiome, "dysbiosis") when compared to healthy subjects. We sought to describe changes in the microbiome in individual patients over time, and determine the clinical factors that are associated with significant alteration. Forty-two mucosal biopsies were collected from 20 patients that were spaced an average of 2.4 years apart. These were analysed using bacterial 16S rRNA gene high-throughput sequencing methods...
March 15, 2018: Gut Microbes
Kristy L Rialon, Eileen Crowley, Natashia M Seemann, Aleixo Muise, Jacob C Langer
PURPOSE: The timing of J-pouch surgery following colectomy for children with very early-onset colitis is controversial, with some advocating early reconstruction and others delaying reconstruction because of fear that the colitis may be owing to Crohn's disease (CD). We sought to determine the long-term incidence of CD in this population and whether there may be clinical features that predict the risk of CD. METHODS: Children with noninfectious colitis diagnosed prior to age 10, who underwent subtotal colectomy and ileostomy from 2000 to 2015, were reviewed...
February 8, 2018: Journal of Pediatric Surgery
Joseph Basile, James F Kenny, Boris Khodorkovsky, Elias Youssef, Brahim Ardolic, Jerel Chacko, Barry Hahn
INTRODUCTION: Computed tomography (CT) of the abdomen and pelvis using only intravenous contrast has been shown to have a high degree of accuracy in evaluating abdominal pain. The aim of this study was to determine the effect on time to completion of study, time to radiologist read, and length of stay in the emergency department (ED) of implementing a protocol that stopped the routine use of oral contrast for CT of the abdomen and pelvis. METHODS: This was a single-center, retrospective cohort study...
March 6, 2018: Clinical Imaging
Ole Haagen Nielsen, Lars Rejnmark, Alan C Moss
Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, is a chronic and unpredictable characterized by alternating periods of remission interspersed with relapses. In recent years accumulating support for an immunomodulating effect of vitamin D on both the innate and adaptive immune system has been presented. Through the vitamin D receptor, the active form of vitamin D, 1,25(OH)2D, induces antimicrobial peptide secretion, decrease dendritic cell activity, and promotes Th2 and regulatory T cell development and activity...
February 24, 2018: Journal of Crohn's & Colitis
Antonio Rispo, Nicola Imperatore, Anna Testa, Luigi Bucci, Gaetano Luglio, Giovanni Domenico De Palma, Matilde Rea, Olga Maria Nardone, Nicola Caporaso, Fabiana Castiglione
Background: In the management of Crohn's Disease (CD) patients, having a simple score combining clinical, endoscopic and imaging features to predict the risk of surgery could help to tailor treatment more effectively. AIMS: to prospectively evaluate the one-year risk factors for surgery in refractory/severe CD and to generate a risk matrix for predicting the probability of surgery at one year. Methods: CD patients needing a disease re-assessment at our tertiary IBD centre underwent clinical, laboratory, endoscopy and bowel sonography (BS) examinations within one week...
March 8, 2018: Journal of Crohn's & Colitis
Blaise Hamel, May Wu, Elizabeth O Hamel, Dorsey M Bass, K T Park
Background: Severe colitis flare from ulcerative colitis (UC) or Crohn's disease (CD) may be refractory to corticosteroids and antitumour necrosis factor (TNF) agents resulting in high colectomy rates. We aimed to describe the utility of tacrolimus to prevent colectomy during second-line vedolizumab initiation after corticosteroid and anti-TNF treatment failure in paediatric severe colitis. Methods: A retrospective cohort analysis was performed between 1 October 2014 and 31 October 2016 at a single tertiary care centre...
2018: BMJ Open Gastroenterology
P F Vollebregt, A A van Bodegraven, T M L Markus-de Kwaadsteniet, D van der Horst, R J F Felt-Bersma
BACKGROUND: Patient reported outcomes regarding perianal disease and faecal incontinence in the community-based inflammatory bowel disease population are poorly described. AIMS: To determine the impacts of perianal disease and faecal incontinence on quality of life and employment in inflammatory bowel disease patients. METHODS: For this cross-sectional study, a comprehensive survey was sent out to members of the Dutch National Crohn's and Colitis patient organisation...
March 9, 2018: Alimentary Pharmacology & Therapeutics
Katarzyna Szpilewska, Jan Juzwiszyn, Zofia Bolanowska, Zofia Bolanowska, Magdalena Milan, Mariusz Chabowski, Dariusz Janczak
INTRODUCTION: The main reason of the emergence of enteric stoma is colorectal cancer. Enteric stoma is a serious health, as well as life problem. In Poland, there are about 6,000 stoma surgeries yearly. It changes the functioning of patients, restricts their daily activity and influences their quality of life significantly. Therefore, in the modern treatment process, all spheres of human life and its surroundings are considered. The evaluation of the quality of life and the level of acceptance of the disease enables us to identify the regions in which patients require attention and help, as well as places to which health promotion among patients with a stoma should be directed...
February 28, 2018: Polski Przeglad Chirurgiczny
H Ooms, H U De Schepper, T G Moreels
BACKGROUND AND STUDY AIMS: Small bowel ulceration poses a limited, but difficult differential diagnosis. The most common causes are Crohn's disease (CD), NSAID-associated enteritis, lymphoma, cytomegaly virus infection and tuberculosis. A less known and relatively novel differential diagnosis is cryptogenic multifocal ulcerative stenosing enteritis (CMUSE). PATIENTS AND METHODS: ive patients referred for balloon-assisted enteroscopy for various reasons showed endoscopic features of CMUSE...
July 2017: Acta Gastro-enterologica Belgica
R Ungaro, R Fausel, H L Chang, S Chang, L A Chen, A Nakad, A El Nawar, I Prytz Berset, J Axelrad, G Lawlor, A Atreja, L Roque Ramos, J Torres, J-F Colombel
BACKGROUND: Case series suggest a possible association between bariatric surgery and incident IBD. AIM: The aim of this study was to evaluate the association between bariatric surgery and new-onset IBD. METHODS: We first conducted a multi-institutional case series of patients with a history of IBD and bariatric surgery. We next conducted a matched case-control study using medical and pharmacy claims from 2008 to 2012 in a US national database from Source Healthcare Analytics LLC...
March 7, 2018: Alimentary Pharmacology & Therapeutics
Stefano Scaringi, Annamaria Di Bella, Luca Boni, Francesco Giudici, Carmela Di Martino, Daniela Zambonin, Ferdinando Ficari
BACKGROUND AND AIMS: Surgical management of Crohn's colitis represents one of the most complex situations in colorectal surgery. Segmental colectomy (SC) and total abdominal colectomy with ileorectal anastomosis (TAC-IRA) are the most common procedures, but there are few available data on their long-term outcome. The aim of the present study was to analyze the long-term outcome of patients who underwent segmental colectomy for Crohn's colitis, with regard to the risk for total abdominal colectomy...
March 6, 2018: International Journal of Colorectal Disease
Lei Lian, Emmanuel Obusez, Erick M Remer, Manoj Monga, Bo Shen
Background: Enlarged prostate is often noticed in patients with ileal pouch-anal anastomosis (IPAA) in our clinical practice. The aims were to identify the factors associated with enlarged prostate and to investigate its clinical implications. Methods: IPAA patients with available prostate imaging after IPAA were included. Prostate length and width were measured in the axial plane and height in coronal plane. Prostate volume was calculated with the formula (length × width × height) × π/6...
February 2018: Gastroenterology Research
Amy L Lightner, Kellie L Mathis, Chung Sang Tse, John H Pemberton, Bo Shen, Gursimran Kochlar, Amandeep Singh, Parambir S Dulai, Samuel Eisenstein, William J Sandborn, Lisa Parry, Sarah Stringfield, David Hudesman, Feza Remzi, Edward V Loftus
Background: Vedolizumab is now widely available for the treatment of moderate to severe ulcerative colitis (UC) and Crohn's disease (CD). We sought to quantify the rates of postoperative complications with preoperative vedolizumab compared with anti-tumor necrosis factor (anti-TNF) therapy. Methods: A multicenter retrospective review of adult inflammatory bowel disease (IBD) patients who underwent an abdominal operation between May 20, 2014, and December 31, 2015, was performed...
March 2, 2018: Inflammatory Bowel Diseases
B Lo, M K Vester-Andersen, I Vind, M Prosberg, M Dubinsky, C A Siegel, F Bendtsen, J Burisch
Background and Aim: Crohn's disease [CD] is a progressive inflammatory bowel disease that can lead to complications such as strictures or penetrating disease, and ultimately surgery. Few population-based studies have investigated the predictors for disease progression and surgery in CD according to the Montreal classification. We aimed to identify clinical predictors associated with complicated CD in a Danish population-based inception cohort during the biologic era. Methods: All incident patients with CD in a well-defined Copenhagen area, between 2003 and 2004, were followed prospectively until 2011...
February 28, 2018: Journal of Crohn's & Colitis
Ashish Malhotra, Parkpoom Phatharacharukul, Charat Thongprayoon
BACKGROUND: Repeat hospitalizations in veterans with inflammatory bowel disease (IBD) are understudied. The early readmission rate and potentially modifiable risk-factors for 90-day readmission in veterans with IBD were studied to avert avoidable readmissions. METHODS: A retrospective cohort study was conducted using the data from veterans who were admitted to the Minneapolis VA Medical Center (MVMC) between January 1, 2007, and December 31, 2013, for an IBD-related problem...
February 8, 2018: Military Medical Research
Basavaraj Kerur, Jason T Machan, Jason M Shapiro, Carolina S Cerezo, James Markowitz, David R Mack, Anne M Griffiths, Anthony R Otley, Marian D Pfefferkorn, Joel R Rosh, David J Keljo, Brendan Boyle, Maria Oliva-Hemker, Marsha H Kay, Shehzad A Saeed, Andrew B Grossman, Boris Sudel, Michael D Kappelman, Marc Schaefer, Gitit Tomer, Athos Bousvaros, Trudy Lerer, Jeffrey S Hyams, Neal S LeLeiko
BACKGROUND & AIMS: Up to 30% of patients with Crohn's disease (CD) require surgery within the first 5 years from diagnosis. We investigated the recent risk of bowel surgery in an inception cohort of pediatric patients with CD and whether early use of biologics (tumor necrosis factor antagonists) alters later disease course. METHODS: We collected data from the Pediatric Inflammatory Bowel Disease Collaborative Research Group registry on 1442 children (16 years old or younger) diagnosed with CD from January 2002 through December 2014...
February 24, 2018: Clinical Gastroenterology and Hepatology
Dóra Antal-Uram, László Harsányi, Dóra Perczel-Forintos
Inflammatory bowel disease (Crohn's disease and colitis ulcerosa) is a chronic, long-term condition that causes chronic inflammation in the digestive tract, and shows an increasing incidence and prevalence worldwide. Changes in disease activity over time affect psychological distress which increases the risk of exacerbations. Beside somatic symptoms (such as abdominal pain, diarrhoea and weight loss), psychiatric comorbidity (in particular major depression, anxiety, social phobia) is common in patients with Crohn's disease...
March 2018: Orvosi Hetilap
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