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https://www.readbyqxmd.com/read/28289834/the-impact-of-anastomotic-leakage-on-anal-function-following-intersphincteric-resection
#1
Mitsuru Yokota, Masaaki Ito, Yuji Nishizawa, Akihiro Kobayashi, Norio Saito
BACKGROUND: Data regarding anastomotic leakage (AL) following intersphincteric resection (ISR) are lacking. We aimed to evaluate the effect of AL on anal function in a retrospective review of patients who developed AL following ISR. METHODS: We evaluated 341 consecutive patients who underwent ISR between 2000 and 2012. Patients were classified into three groups: anastomotic dehiscence (AD), major AL (Clavien-Dindo grade III+), or control (<grade III or no AL)...
March 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28281474/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#2
Morten Holt Thomsen, Henrik Ovesen, Jens Ravn Eriksen
INTRODUCTION: Incomplete specimens resulting in residual mesorectum in the patient and an increased risk of local recurrence remains a problem. We have introduced transanal-total mesorectal excision (Ta-TME) in our department to potentially overcome this problem due to more direct access to the lower pelvis in patients undergoing TME for rectal cancer and this article presents our initial experience with the new procedure. MATERIALS AND METHODS: Patients with a T1-T3 mid or low rectal cancer eligible for TME or intersphincteric abdominoperineal excision were selected for a combined transanal and transabdominal laparoscopic resection...
April 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28271331/five-years-of-experience-with-the-filac%C3%A2-laser-for-fistula-in-ano-management-long-term-follow-up-from-a-single-institution
#3
A Wilhelm, A Fiebig, M Krawczak
BACKGROUND: There are limited data available concerning endofistular therapies for fistula-in-ano, with our group reporting the first preliminary outcomes of the use of the radial fibre Fistula laser Closing (FiLaC ™) device. METHODS: The aim of this study was to assess a cohort of anal fistulae managed with laser ablation plus definitive flap closure of the internal fistula opening over a long-term follow-up. Factors governing primary healing success and secondary healing success (i...
March 7, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28271064/ligation-of-intersphincteric-fistula-tract-is-suitable-for-recurrent-anal-fistulas-from-follow-up-of-16-months
#4
Yansong Xu, Weizhong Tang
Since 2007, ligation of the intersphincteric fistula tract (LIFT) for the management of anal fistula was all introduced with initial success and excitement. It remains controversial which surgical procedure is suitable for transsphincteric fistula, especially to complex anal fistula. This retrospective study was designed to evaluate the results in patients with recurrent anal fistula by LIFT. A retrospective study of 55 complex fistula patients who underwent LIFT procedure in a single medical center was analyzed...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28259693/transanal-opening-of-intersphincteric-space-tropis-a-new-procedure-to-treat-high-complex-anal-fistula
#5
Pankaj Garg
BACKGROUND: The sepsis in intersphincteric space has important role in pathogenesis of most complex fistula-in-ano. This sepsis is like a small abscess in a closed space. This closed space needs to be drained adequately and then kept open for the fistula-in-ano to heal properly. The aim was to lay open and drain the intersphincteric space through internal opening via transanal approach. This has been tried in submucosal and intersphincteric rectal abscesses but has never been tried in complex fistula-in-ano...
March 1, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28251361/german-s3-guidelines-anal-abscess-and-fistula-second-revised-version
#6
Andreas Ommer, Alexander Herold, Eugen Berg, Alois Fürst, Stefan Post, Reinhard Ruppert, Thomas Schiedeck, Oliver Schwandner, Bernhard Strittmatter
BACKGROUND: The incidence of anal abscess and fistula is relatively high, and the condition is most common in young men. METHODS: This is a revised version of the German S3 guidelines first published in 2011. It is based on a systematic review of pertinent literature. RESULTS: Cryptoglandular abscesses and fistulas usually originate in the proctodeal glands of the intersphincteric space. Classification depends on their relation to the anal sphincter...
March 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28133302/-two-cases-of-locally-recurrent-rectal-cancer-after-intersphincteric-resection-that-were-controlled-with-a-combination-of-chemoradiotherapy-and-abdominoperineal-resection
#7
Yasuhiro Komatsu, Hitoshi Idani, Kazutaka Takahashi, Naoki Mimura, Toshihiro Ogawa, Soichiro Miyake, Michihiro Ishida, Daisuke Satoh, Yasuhiro Choda, Daisuke Sumitani, Masao Harano, Hiroyoshi Matsukawa, Yasutomo Ojima, Shigehiro Shiozaki, Masazumi Okajima
We report 2 cases of locally recurrent rectal cancer after intersphincteric resection(ISR)that were controlled with a combination of chemoradiotherapy and abdominoperineal resection(APR). In Case 1, we performed preoperative chemoradiotherapy( TS-1 plus RT 45 Gy)and APR for the local recurrence of ISR. On pathology, viable neoplastic cells were noted. In Case 2, we performed preoperative chemotherapy(Bmab plus mFOLFOX6)and APR for the local recurrence of ISR. On pathology, no viable neoplastic cells were noted...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28091845/comparison-of-the-clinical-results-of-abdominoperanal-intersphincteric-resection-and-abdominoperineal-resection-for-lower-rectal-cancer
#8
Shunsuke Tsukamoto, Yukihide Kanemitsu, Dai Shida, Hiroki Ochiai, Junichi Mazaki
BACKGROUND: The aim of this study was to compare the oncologic results of abdominoperanal intersphincteric resection (ISR) and abdominoperineal resection (APR). METHODS: Between 2003 and 2014, 277 consecutive patients with stage I-III low rectal cancer located within 5 cm from the anal verge underwent curative ISR and APR. A retrospective comparison of these two procedures was performed. RESULTS: Overall, 128 patients underwent ISR and 149 underwent APR...
January 16, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28054134/ultrasonographic-evidence-of-gatekeeper%C3%A2-prosthesis-migration-in-patients-treated-for-faecal-incontinence-a-case-series
#9
F de la Portilla, M L Reyes-Díaz, M V Maestre, R M Jiménez-Rodríguez, A M García-Cabrera, J M Vázquez-Monchul, J M Díaz-Pavón, F C Padillo-Ruiz
BACKGROUND: Faecal incontinence (FI) is both a medical and social problem, with an underestimated incidence. For patients with internal anal sphincter damage, implantation of biomaterial in the anal canal is a recognised treatment option. One such material, Gatekeeper™, has previously shown promising short- and medium-term results without any major complications, including displacement. The main aim of the present study is to assess the degree to which displacement of Gatekeeper prostheses may occur and to determine whether this is associated with patient outcomes...
January 4, 2017: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28006721/wide-local-excision-for-anal-gist-a-case-report-and-review-of-literature
#10
Mohamed Azzaza, Houssem Ammar, Nihed Abdessayed, Rahul Gupta, Mohamed Said Nakhli, Amine Chhaider, Nafis Abdennaceur, Ali Ben Ali
INTRODUCTION: Gastrointestinal stromal tumors (GIST) are tumors of mesenchymal origin commonly detected in stomach and small bowel. GIST arising primarily from the anal canal is extremely rare. Due to the malignant potential, these tumors are treated with radical surgery like abdominoperineal resection. But with the advent of imatinib therapy and a better understanding of the tumor biology, some cases have been successfully treated with wide local excision. PRESENTATION OF CASE: We describe a case of a 70-year-old lady presenting with a 2cm mass in the anal canal...
December 2, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28000657/combined-laparoscopic-and-transanal-total-mesorectal-excision-for-rectal-cancer-initial-experience-and-early-results
#11
Morten Holt Thomsen, Henrik Ovesen, Jens Ravn Eriksen
INTRODUCTION: Incomplete specimens resulting in residual mesorectum in the patient and an increased risk of local recurrence remains a problem. We have introduced transanal-total mesorectal excision (Ta-TME) in our department to potentially overcome this problem due to more direct access to the lower pelvis in patients undergoing TME for rectal cancer and this article presents our initial experience with the new procedure. MATERIALS AND METHODS: Patients with a T1-T3 mid or low rectal cancer eligible for TME or intersphincteric abdominoperineal excision were selected for a combined transanal and transabdominal laparoscopic resection...
December 21, 2016: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27990592/combined-notes-total-mesorectal-excision-and-single-incision-laparoscopy-principles-for-conservative-proctectomy-a-single-centre-study
#12
H Meillat, C de Chaisemartin, F Poizat, E Bories, R Fara, J R Delpero, B Lelong
BACKGROUND: Surgery for low rectal cancer remains a challenge when a standard laparoscopic approach is used. Transanal endoscopic total mesorectal excision (TME) has been shown to be feasible and to be associated with a low conversion rate. Combining the transanal and transabdominal single-port approaches (with an abdominal single port implanted in the future stoma and extraction site) could allow TME with minimal wound trauma, low morbidity, and faster recovery. The aim of the current study was to assess the short- and mid-term results of this technique...
January 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27981492/sphincter-preserving-surgery-for-low-rectal-cancer-do-we-overshoot-the-mark
#13
Johannes Klose, Ignazio Tarantino, Yakup Kulu, Thomas Bruckner, Stefan Trefz, Thomas Schmidt, Martin Schneider, Thilo Hackert, Markus W Büchler, Alexis Ulrich
PURPOSE: Intersphincteric resection (ISR) is an alternative to abdominoperineal resection (APR) for a selected subset of patients with low rectal cancer, combining equivalent oncological outcome and sphincter preservation. However, functional results are heterogeneous and often imperfect. The aim of the present investigation was to determine the long-term functional results and quality of life after ISR. METHODS: One hundred forty-three consecutive patients who underwent surgery for low rectal cancer were analysed...
December 15, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27943527/three-dimensional-endoanal-ultrasound-is-accurate-and-reproducible-in-determining-type-and-height-of-anal-fistulae
#14
M Kołodziejczak, G A Santoro, A Obcowska, Z Lorenc, M Mańczak, I Sudoł-Szopińska
AIM: Surgical treatment of high anal fistulae is associated with potential risk of faecal incontinence and recurrence. The primary aim of this study was to determine the accuracy of three-dimensional endoanal ultrasound (3D-EAUS) in the assessment of height and type of anal fistulae, compared to the intraoperative findings (gold standard). The secondary aim was to evaluate the inter-observer reproducibility of 3D-EAUS. METHODS: The study design was a prospective analysis of retrospective data...
December 10, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/27934790/abdomino-endoscopic-perineal-excision-of-the-rectum-for-benign-and-malignant-pathology-technique-considerations-for-true-transperineal-verus-transanal-total-mesorectal-excision-endoscopic-proctectomy
#15
Hazar Al Furajii, Niall Kennedy, Ronan A Cahill
PURPOSE: Transanal minimally invasive surgery using single port instrumentation is now well described for the performance of total mesorectal excision with restorative colorectal/anal anastomosis most-often in conjunction with transabdominal multiport assistance. While non-restorative abdomino-endoscopic perineal excision of the anorectum is conceptually similar, it has been less detailed in the literature. METHODS: Consecutive patients undergoing non-restorative ano-proctectomy including a transperineal endoscopic component were analysed...
January 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/27885389/mri-features-of-perianal-fistulas-is-there-a-difference-between-crohn-s-and-non-crohn-s-patients
#16
Irai S Oliveira, Aoife Kilcoyne, Melissa C Price, Mukesh Harisinghani
PURPOSE: Though perianal fistulas are commonly seen in patients with Crohn's disease, they can also be seen in patients without inflammatory bowel disease. The purpose of this study was to evaluate MR imaging differences of perianal fistulas in patients with and without Crohn's disease. METHODS: Our retrospective search from January 2012 to December 2015 of the Radiology database for perianal fistula yielded 207 patients. Only patients with dedicated MR fistula protocol studies were included, whereas patients with previous anal surgery or anastomosis, anorectal tumors, and equivocal findings that could not be definitely assessed as a fistula were excluded...
November 24, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27878621/clinical-and-functional-results-of-laparoscopic-intersphincteric-resection-for-ultralow-rectal-cancer-is-there-a-distinction-between-the-three-types-of-hand-sewn-colo-anal-anastomosis
#17
Bin Zhang, Ke Zhao, Quanlong Liu, Shuhui Yin, Guangzuan Zhuo, Yujuan Zhao, Jun Zhu, Jianhua Ding
PURPOSE: The purpose of this study is to compare the clinical and functional outcomes of three types of hand-sewn colo-anal anastomosis (CAA) after laparoscopic intersphincteric resection (Lap-ISR) for patients with ultralow rectal cancer. METHODS: A total of 79 consecutive patients treated by Lap-ISR for low-lying rectal cancer in an academic medical center from June 2011 to February 2016. According to the distal tumor margin and individualized anal length, the patients underwent three types of hand-sewn CAA including partial-ISR, subtotal-ISR, and total-ISR...
November 23, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27878618/effective-and-long-term-outcome-following-ligation-of-the-intersphincteric-fistula-tract-lift-for-transsphincteric-fistula
#18
Hong-Jin Chen, Gui-Dong Sun, Ping Zhu, Zai-Long Zhou, Yu-Gen Chen, Bo-Lin Yang
OBJECTIVE: The purpose of this study was to evaluate the efficacy and long-term outcome of the ligation of the intersphincteric fistula tract (LIFT) procedure for transsphincteric fistula-in-ano. METHODS: A total of 43 patients that were treated with LIFT procedure and had a follow-up time of more than 1 year were included. RESULTS: The median age was 37.18 years, and 32 (74.4%) of the patients were male. The median follow-up time was 26...
November 23, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/27856106/surgical-management-of-colorectal-cancer-for-the-aging-population-a-survey-by-the-japanese-society-for-cancer-of-colon-and-rectum
#19
Hiroshi Matsuoka, Kotaro Maeda, Tsunekazu Hanai, Harunobu Sato, Koji Masumori, Yosikazu Koide, Hidetoshi Katsuno, Tomoyoshi Endo, Miho Shiota, Kenichi Sugihara
OBJECTIVE: The treatment policy of colorectal cancer in elderly patients is controversial due to a lack of specific guidelines. To clarify the present management of colorectal cancer for aged patients, a questionnaire survey was conducted by the Japanese Society for Cancer of the Colon and Rectum. METHODS: Questionnaire forms were sent to the 430 member institutions of the Japanese Society for Cancer of the Colon and Rectum. RESULTS: The response rate of the surgical department to the questionnaire was 39%...
November 14, 2016: Asian Journal of Surgery
https://www.readbyqxmd.com/read/27761895/patient-centered-outcomes-to-decide-treatment-strategy-for-patients-with-low-rectal-cancer
#20
Michitaka Honda, Takashi Akiyoshi, Hisashi Noma, Atsushi Ogura, Toshiya Nagasaki, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Yosuke Fukunaga, Masashi Ueno
BACKGROUND: For patients with low-lying rectal cancer, the feasibility of anus-preserving surgery in combination with neoadjuvant chemoradiotherapy (NACRT) has been not well established from the perspective of patient-centered outcomes. METHODS: We investigated 278 patients with low-lying rectal adenocarcinoma from 2005 to 2012. We compared their symptoms and QOL scores of patients who underwent anus-preserving surgery with (n = 88) and without (n = 143) NACRT according to the Wexner scale, EORTC QLQ C-30, CR29, and the modified fecal incontinence quality life scale (mFIQL)...
October 2016: Journal of Surgical Oncology
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