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IBD surgery

Fernando Velayos, Priya Kathpalia, Emily Finlayson
This review chronicles the evolution of dysplasia detection and management in IBD since 1925, the year the first case report of colitis-related colorectal cancer was published. We have grouped advances in colorectal cancer research, endoscopic techniques, surgery, and technology into 4 unequally timed eras, before colonoscopy, early era of colonoscopy, new century, and 2017 and beyond. We conclude that colorectal cancer prevention and dysplasia management for patients with IBD has changed over these periods, from somewhat hopeless to hopeful...
October 17, 2016: Gastroenterology
Rachelle N Damle, Julie M Flahive, Jennifer S Davids, Justin A Maykel, Paul R Sturrock, Karim Alavi
BACKGROUND: Racial disparities in outcomes are well described among surgical patients. OBJECTIVE: The purpose of this work was to identify any racial disparities in the receipt of a minimally invasive approach for colorectal surgery. DESIGN: Adults undergoing colorectal surgery were studied using the University HealthSystem Consortium. Univariate and multivariable analyses were used to identify predictors for the receipt of a minimally invasive approach...
November 2016: Diseases of the Colon and Rectum
Jordan Axelrad, Anuja Kriplani, Umut Ozbek, Noam Harpaz, Jean-Frederic Colombel, Steven Itzkowitz, Randall F Holcombe, Celina Ang
BACKGROUND: Inflammatory bowel disease (IBD), comprising Crohn disease and ulcerative colitis, is a risk factor for colorectal cancer (CRC). Chemotherapy toxicity may exacerbate IBD symptoms and vice versa, but data are limited. We evaluated chemotherapy tolerance and oncologic outcomes in patients with CRC with and without IBD. PATIENTS AND METHODS: Medical records of patients with CRC with and without IBD treated between 2008 and 2013 were reviewed. Where possible, patients were matched by age, sex, stage, and diagnosis year...
September 20, 2016: Clinical Colorectal Cancer
Walter Fries, Anna Viola, Natalia Manetti, Iris Frankovic, Daniela Pugliese, Rita Monterubbianesi, Giuseppe Scalisi, Annalisa Aratari, Laura Cantoro, Maria Cappello, Leonardo Samperi, Simone Saibeni, Giovanni Casella, Giammarco Mocci, Matilde Rea, Federica Furfaro, Antonella Contaldo, Andrea Magarotto, Francesca Calella, Francesco Manguso, Gaetano Inserra, Antonino C Privitera, Mariabeatrice Principi, Fabiana Castiglione, Flavio Caprioli, Sandro Ardizzone, Silvio Danese, Claudio Papi, Fabrizio Bossa, Anna Kohn, Alessandro Armuzzi, Renata D'Incà, Vito Annese, Angela Alibrandi, Stefanos Bonovas, Gionata Fiorino
BACKGROUND: Late-onset UC represents an important issue for the near future, but its outcomes and relative therapeutic strategies are yet poorly studied. AIM: To better define the natural history of late-onset ulcerative colitis. METHODS: In a multicenter retrospective study, we investigated the disease presentation and course in the first 3 years in 1091 UC patients divided into 3 age-groups: diagnosis ≥65years, 40-64 years, and <40years...
September 21, 2016: Digestive and Liver Disease
Juan Paredes Méndez, Guillermo Otoya Moreno, Ana Lucía Mestanza Rivas Plata, Luis Lazo Molina, Katia Acuña Ordoñez, José Luis Arenas Gamio, Eduardo Huamán Egoavil, Fabián Juliao Baños
OBJECTIVE: To identify sociodemographic, clinical, and endoscopic characteristics in patients with inflammatory bowel disease (IBD). MATERIALS AND METHODS: The study period was from January 2004 to December 2014. The final diagnosis was determined by clinical gastroenterologists experienced in the diagnosis and management of IBD, based on internationally accepted diagnostic criteria. RESULTS: 105 patients with IBD were studied, 77% with ulcerative colitis (UC) and 23% with Crohn's disease (CD)...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Dr Dharmendra Kanoriya, Dr A R Pradeep, Dr Vibhuti Garg, Dr Sandeep Singhal
BACKGROUND: Different materials have been instigated for renewal of lost supporting periodontal structures and tested for furcation defects treatment. Platelet-rich fibrin (PRF) is a pool of growth promoting factors and cytokines which promotes bone regeneration and maturation of soft tissue. Alendronate (ALN), an influential member of bisphosphonate group is known to enhance osteoblastogenesis and inhibits osteoclastic bone resorption, thus promoting tissue regeneration. This randomized trial was done to assess the effectiveness of PRF and 1% ALN gel combination in mandibular degree II furcation defects treatment in comparison to PRF and access therapy alone...
October 7, 2016: Journal of Periodontology
E Zittan, Grace W Ma, N Wong-Chong, R Milgrom, R S McLeod, M Silverberg, Z Cohen
BACKGROUND: We aimed to summarize the outcomes of ulcerative colitis (UC) patients receiving an ileal pouch-anal anastamosis (IPAA) over an 11-year period at a high-volume Canadian inflammatory bowel disease (IBD) center. METHODS: A retrospective chart review was performed for subjects with UC who underwent IPAA between 2002 and 2013. Patient charts were reviewed for demographic data, clinical characteristics, preoperative medical treatment, and surgical outcomes...
October 4, 2016: International Journal of Colorectal Disease
Peter A Najjar, Arin L Madenci, Cheryl K Zogg, Eric B Schneider, Christian A Dankers, Marc T Pimentel, Amrita S Chabria, Joel E Goldberg, Gaurav Sharma, Gregory Piazza, Ronald Bleday, Dennis P Orgill, Allen Kachalia
BACKGROUND: Prophylactic anticoagulation is routinely used in the inpatient setting; however, the risk of VTE remains elevated after discharge. Extensive evidence and clinical guidelines suggest post-discharge VTE prophylaxis is critical in at-risk populations but it remains severely underutilized in practice. STUDY DESIGN: We performed a single institution retrospective, non-randomized, pre- and post-intervention analysis of a systematic post-discharge pharmacological prophylaxis program against the primary outcome, post-discharge symptomatic VTE...
September 27, 2016: Journal of the American College of Surgeons
Malgorzata Krzystek-Korpacka, Sabina Gorska, Dorota Diakowska, Bartosz Kapturkiewicz, Magdalena Podkowik, Andrzej Gamian, Iwona Bednarz-Misa
Midkine is a multifunctional cytokine and growth factor displaying proinflammatory and pro-tumorigenic activity. Its association with bowel diseases has not been fully elucidated. Our purpose was to delineate midkine expression pattern by RT-qPCR in inflamed/cancerous bowel (n=208) and whole blood (n=150) in colorectal cancer (CRC), Crohn's disease (CD), and ulcerative colitis (UC) and to evaluate midkine dynamics in early postoperative period following colorectal surgery. The expression of midkine was significantly up-regulated in stage III CRC and independently associated with lymph node metastasis...
September 28, 2016: Cytokine
Gautam Ray
There is rising incidence and prevalence of inflammatory bowel disease (IBD) in India topping the Southeast Asian (SEA) countries. The common genes implicated in disease pathogenesis in the West are not causal in Indian patients and the role of "hygiene hypothesis" is unclear. There appears to be a North-South divide with more ulcerative colitis (UC) in north and Crohn's disease (CD) in south India. IBD in second generation Indian migrants to the West takes the early onset and more severe form of the West whereas it retains the nature of its country of origin in migrants to SEA countries...
September 28, 2016: World Journal of Gastroenterology: WJG
Erika Lehtola, Johanna Haapamäki, Martti A Färkkilä
BACKGROUND: Biological medications, particularly TNF-α inhibitors, are used increasingly for active inflammatory bowel disease (IBD). Even though they are superior to many older medications in achieving remission and mucosal healing, primary nonresponse and loss of response remain significant problems, and a remarkable proportion of patients still need surgery at some point. OBJECTIVE: To study the outcome of IBD patients treated with TNF-α inhibitors, either infliximab or adalimumab, with a two-year follow-up...
December 2016: Scandinavian Journal of Gastroenterology
J Greene, G M O'Kane, D N Carney, E Aherne, G C O'Toole
Patients with inflammatory bowel disease (IBD) have an increased risk of developing malignancy. The use of immunosuppressive therapies and tumour necrosis factor (TNF) inhibitors in these patients may provide a further risk for the development of malignancy. We report the clinical and pathological findings of a high grade osteosarcoma in a patient with Crohns disease receiving TNF inhibitor therapy. In this case, a 32-year old female presented with a painful right knee after receiving maintenance adalimumab for Crohns disease for a period of six years...
2016: Irish Medical Journal
Ganglei Liu, Xianrui Wu, Yi Li, Yuanyi Rui, Luca Stocchi, Feza H Remzi, Bo Shen
BACKGROUND: There are no published studies on the impact of visceral adipose tissue (VAT) change on outcomes of restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA). The aim of this historic cohort study was to evaluate the impact of excessive VAT gain on the outcomes of inflammatory bowel disease (IBD) patients with IPAA. METHODS: We evaluated all eligible patients with at least two sequential CT scans after pouch construction from our prospectively maintained Pouchitis Registry between 2002 and 2014...
September 25, 2016: Gastroenterology Report
Julajak Limsrivilai, Ryan W Stidham, Shail M Govani, Akbar K Waljee, Wen Huang, Peter D R Higgins
BACKGROUND & AIMS: A subset of patients with inflammatory bowel diseases (IBD) have continuously active inflammation, leading to a high number of complications and high direct healthcare costs (diagnostic tests, medications, and surgeries) and indirect costs (reduced employment and productivity and fewer opportunities for activities). Identifying these high-risk patients and providing effective interventions could produce better outcomes and reduce costs. We used prior year data to create IBD risk models to predict IBD-related hospitalizations, emergency department visits, and high treatment charges (>$30,000/year) in the subsequent year...
September 16, 2016: Clinical Gastroenterology and Hepatology
Edward L Barnes, Alison Goldin, Rachel W Winter, Emily Collins, Bonnie Cao, Madeline Carrellas, Anne Marie Crowell, Joshua R Korzenik
BACKGROUND: The benefits of combination therapy with infliximab and azathioprine have been demonstrated in clinical trials of patients with ulcerative colitis (UC) and Crohn's disease (CD). Concerns remain regarding the ideal duration and benefits of adding therapies in a sequential manner. AIMS: We aim to compare long-term outcomes among patients with inflammatory bowel disease (IBD) treated with sequentially added combination therapy or monotherapy strategies ...
November 2016: Digestive Diseases and Sciences
Domenico Corica, Claudio Romano
The incidence of inflammatory bowel disease (IBD) has increased steadily worldwide, both in adult and in children; approximately 25% of IBD patients are diagnosed before the age of 18. The natural history of IBD is usually more severe in children than in adults, and can be associated with linear growth impairment, delayed puberty onset, reduced bone mass index, malnutrition, and the need for surgery. Biological therapies, especially blocking tumor necrosis factor-α (TNFα), have radically modified the treatment strategies and disease course of IBD in children...
September 15, 2016: Journal of Clinical Gastroenterology
Quinton M Hatch, Rubina Ratnaparkhi, Alison Althans, Michael Keating, Ruel Neupane, Madhuri Nishtala, Eric K Johnson, Scott R Steele
BACKGROUND: The impact of modern medical management of inflammatory bowel disease (IBD) on surgical necessity and outcomes remains unclear. We hypothesized that surgery rates have decreased while outcomes have worsened due to operating on "sicker" patients since the introduction of biologic medications. METHODS: The Nationwide Inpatient Sample and ICD-9-CM codes were used to identify inpatient admissions for Crohn's disease and ulcerative colitis. Trends in IBD nutrition, surgeries, and postoperative complications were determined...
September 15, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Anders Rönnblom, Tommy Holmström, Urban Karlbom, Hans Tanghöj, Mari Thörn, Daniel Sjöberg
OBJECTIVE: The aim of the study was to describe the medical treatment, change in phenotype, need for surgery and IBD-associated mortality during the first 5 years after diagnosis. MATERIAL AND METHODS: Patients diagnosed with Crohn's disease including all age groups in the Uppsala healthcare region in the middle of Sweden 2005-2009 were included in the study. Medical notes were scrutinised and patients contacted. Out of 269 patients, 260 (96.3%) could be followed for 5 full years or until death...
September 15, 2016: Scandinavian Journal of Gastroenterology
Nicholas Horton, Xianrui Wu, Jessica Philpott, Ari Garber, Jean-Paul Achkar, Aaron Brzezinski, Bret A Lashner, Bo Shen
BACKGROUND: Inflammatory bowel diseases (IBDs) are considered immune-mediated disorders with dysregulated innate and adaptive immunities. Secondary immunogloblin deficiency can occur in IBD and its impact on the disease course of IBD is not clear. AIMS: We sought to determine associations between low IgG/G1 levels and poor clinical outcomes in IBD patients. METHODS: This historic cohort study was performed on IBD patients with obtained IgG/IgG1 levels...
November 2016: Digestive Diseases and Sciences
Iago Rodríguez-Lago, Olga Merino, Óscar Nantes, Carmen Muñoz, Urko Aguirre, José Luis Cabriada
BACKGROUND AND AIMS: Inflammatory bowel disease is a chronic disorder of the gastrointestinal tract. Tacrolimus is a calcineurin inhibitor used in the prophylaxis of rejection after a solid organ transplant. There is some evidence for its use in inflammatory bowel disease, although there is a lack of information about the patients who will benefit the most with this drug and the prognostic factors for a favorable response. MATERIAL AND METHODS: We performed a multicentric retrospective study evaluating all the patients who have received tacrolimus in the last 10 years as a treatment for IBD in our area...
September 2016: Revista Española de Enfermedades Digestivas
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