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22 papers 0 to 25 followers
Karen N Zaghiyan, Harry C Sax, Emily Miraflor, David Cossman, Willis Wagner, James Mirocha, Bruce Gewertz, Phillip Fleshner
OBJECTIVE: To identify the optimal timing of perioperative chemical thromboprophylaxis (CTP) and incidence of occult preoperative deep vein thrombosis (OP-DVT) in patients undergoing major colorectal surgery. BACKGROUND: There is limited Level 1 data regarding the optimal timing of CTP in major colorectal surgery and the incidence of OP-DVT remains unclear. Both issues influence the occurrence of venous thromboembolism (VTE) and may impact Medicare reimbursement because of penalties for hospital-acquired conditions...
October 2016: Annals of Surgery
Henk-Thijs Brandsma, Birgitta M E Hansson, Theo J Aufenacker, Dick van Geldere, Felix M V Lammeren, Chander Mahabier, Peter Makai, Pascal Steenvoorde, Tammo S de Vries Reilingh, Marinus J Wiezer, Johannes H W de Wilt, Robert P Bleichrodt, Camiel Rosman
OBJECTIVE: The aim of this study was to investigate the incidence of parastomal hernias (PSHs) after end-colostomy formation using a polypropylene mesh in a randomized controlled trial versus conventional colostomy formation. BACKGROUND: A PSH is the most frequent complication after stoma formation. Symptoms may range from mild abdominal pain to life-threatening obstruction and strangulation. The treatment of a PSH is notoriously difficult and recurrences up to 20% have been reported despite the use of mesh...
July 29, 2016: Annals of Surgery
Brian D Nicholson, Bethany Shinkins, David Mant
CLINICAL QUESTION: What is the trade-off between sensitivity and specificity at specific carcinoembryonic antigen (CEA) thresholds for detecting recurrent colorectal cancer? BOTTOM LINE: To detect colorectal cancer recurrence, the sensitivity of CEA ranges from 68% for a threshold of 10 µg/L to 82% for a threshold of 2.5 µg/L and the specificity ranges from 97% for a threshold of 10 µg/L to 80% for a threshold of 2.5 µg/L.
September 27, 2016: JAMA: the Journal of the American Medical Association
Mathieu Uzzan, Jacques Cosnes, Aurélien Amiot, Jean-Marc Gornet, Philippe Seksik, Eddy Cotte, Emmanuel Tiret, Yves Panis, Xavier Treton
OBJECTIVES: To determine the cumulative incidence and the prognostic factors of ileorectal anastomosis (IRA) failure after colectomy for ulcerative colitis (UC). BACKGROUND: Although ileal pouch-anal anastomosis is recommended after colectomy for UC, IRA is still performed. METHODS: This was a multicenter retrospective cohort study, which included patients with IRA for UC performed between 1960 and 2014. IRA failure was defined as secondary proctectomy and/or rectal cancer occurrence...
September 21, 2016: Annals of Surgery
Julie Navez, Christophe Remue, Daniel Leonard, Radu Bachmann, Alex Kartheuser, Catherine Hubert, Laurent Coubeau, Mina Komuta, Marc Van den Eynde, Francis Zech, Nicolas Jabbour
BACKGROUND: Chemotherapeutic advances have enabled successful cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) expansion in treating metastatic colorectal cancer. OBJECTIVES: The aims of this study were to evaluate the safety of combining liver surgery (LS) with HIPEC and CRS (which remains controversial) and its impact on overall survival (OS) rates. METHODS: From 2007 to 2015, a total of 77 patients underwent CRS/HIPEC for peritoneal carcinomatosis (PC) of colorectal cancer...
September 19, 2016: Annals of Surgical Oncology
Quentin Denost, Philippe Rouanet, Jean-Luc Faucheron, Yves Panis, Bernard Meunier, Eddy Cotte, Guillaume Meurette, Sylvain Kirzin, Charles Sabbagh, Jèrôme Loriau, Stèphane Benoist, Christophe Mariette, Igor Sielezneff, Bernard Lelong, François Mauvais, Benoit Romain, Marie-Line Barussaud, Christine Germain, Marie-Quitterie Picat, Eric Rullier, Christophe Laurent
OBJECTIVE: To assess the effect of pelvic drainage after rectal surgery for cancer. BACKGROUND: Pelvic sepsis is one of the major complications after rectal excision for rectal cancer. Although many studies have confirmed infectiveness of drainage after colectomy, there is still a controversy after rectal surgery. METHODS: This multicenter randomized trial with 2 parallel arms (drain vs no drain) was performed between 2011 and 2014. Primary endpoint was postoperative pelvic sepsis within 30 postoperative days, including anastomotic leakage, pelvic abscess, and peritonitis...
September 14, 2016: Annals of Surgery
Christopher T Aquina, Neil Blumberg, Adan Z Becerra, Francis P Boscoe, Maria J Schymura, Katia Noyes, John R T Monson, Fergal J Fleming
OBJECTIVE: To investigate the potential additive effects of blood transfusion and sepsis on colon cancer disease-specific survival, cardiovascular disease-specific survival, and overall survival after colon cancer surgery. BACKGROUND: Perioperative blood transfusions are associated with infectious complications and increased risk of cancer recurrence through systemic inflammatory effects. Furthermore, recent studies have suggested an association among sepsis, subsequent systemic inflammation, and adverse cardiovascular outcomes...
September 14, 2016: Annals of Surgery
Frederick H Koh, Ker-Kan Tan
BACKGROUND: Laparoscopic extended right hemicolectomy is regarded as one of the more difficult procedures in colorectal surgery due to the complexity of the dissection around the pancreatic neck to identify the origin of the middle colic artery.1 Proper identification and ligation of the middle colic artery at its origin is paramount to achieve complete mesocolic excision.2 (,) 3 We describe our technique of middle colic vessels dissection in a laparoscopic extended right hemicolectomy...
August 22, 2016: Annals of Surgical Oncology
Laura Q Mortensen, Jakob Burcharth, Kristoffer Andresen, Hans-Christian Pommergaard, Jacob Rosenberg
OBJECTIVE: To investigate the association between diverticulitis and colon cancer in a large, nationwide cohort study. BACKGROUND: Diverticulitis is a common disease, especially in the Western world. Previous articles have investigated the association between diverticulitis and colon cancer with inconclusive results. METHODS: We conducted a population-based cohort study based on longitudinal Danish national registers with data from the period 1995 to 2012...
May 17, 2016: Annals of Surgery
Ida S Frøysnes, Stein G Larsen, Milan Spasojevic, Svein Dueland, Kjersti Flatmark
BACKGROUND AND OBJECTIVES: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) can offer long-term survival to patients with resectable peritoneal metastasis (PM) from colorectal cancer (CRC), a condition with otherwise dismal prognosis. This study describes short- and long-term outcome in a national patient cohort and aims to identify prognostic factors. METHODS: All patients treated with CRS-HIPEC for non-appendiceal PM-CRC in Norway 2004-2013 were included (n = 119), and outcome and potential prognostic factors were examined using survival- and ROC-curve analysis...
August 2016: Journal of Surgical Oncology
Kostan W Reisinger, Dirk H S M Schellekens, Joanna W A M Bosmans, Bas Boonen, Karel W E Hulsewé, Prapto Sastrowijoto, Joep P M Derikx, Joep Grootjans, Martijn Poeze
OBJECTIVE: To study the effects of COX-2 on colonic surgical wound healing. BACKGROUND: Cyclooxygenase-2 (COX-2) is a key enzyme in gastrointestinal homeostasis. COX-2 inhibitors have been associated with colonic anastomotic leakage. METHODS: Wildtype, COX-2 knockout and COX-2 heterozygous mice were subjected to a model of colonic anastomotic leakage, and were treated with vehicle, diclofenac, or prostaglandin E2 (PGE2), the most important COX-2 product in the intestine...
April 8, 2016: Annals of Surgery
N Jewel Samadder, Deborah W Neklason, Kenneth M Boucher, Kathryn R Byrne, Priyanka Kanth, Wade Samowitz, David Jones, Sean V Tavtigian, Michelle W Done, Therese Berry, Kory Jasperson, Lisa Pappas, Laurel Smith, Danielle Sample, Rian Davis, Matthew K Topham, Patrick Lynch, Elena Strait, Wendy McKinnon, Randall W Burt, Scott K Kuwada
IMPORTANCE: Patients with familial adenomatous polyposis (FAP) are at markedly increased risk for duodenal polyps and cancer. Surgical and endoscopic management of duodenal neoplasia is difficult and chemoprevention has not been successful. OBJECTIVE: To evaluate the effect of a combination of sulindac and erlotinib on duodenal adenoma regression in patients with FAP. DESIGN, SETTING, AND PARTICIPANTS: Double-blind, randomized, placebo-controlled trial, enrolling 92 participants with FAP, conducted from July 2010 through June 2014 at Huntsman Cancer Institute in Salt Lake City, Utah...
March 22, 2016: JAMA: the Journal of the American Medical Association
Jihye Yun, Edouard Mullarky, Changyuan Lu, Kaitlyn N Bosch, Adam Kavalier, Keith Rivera, Jatin Roper, Iok In Christine Chio, Eugenia G Giannopoulou, Carlo Rago, Ashlesha Muley, John M Asara, Jihye Paik, Olivier Elemento, Zhengming Chen, Darryl J Pappin, Lukas E Dow, Nickolas Papadopoulos, Steven S Gross, Lewis C Cantley
More than half of human colorectal cancers (CRCs) carry either KRAS or BRAF mutations and are often refractory to approved targeted therapies. We found that cultured human CRC cells harboring KRAS or BRAF mutations are selectively killed when exposed to high levels of vitamin C. This effect is due to increased uptake of the oxidized form of vitamin C, dehydroascorbate (DHA), via the GLUT1 glucose transporter. Increased DHA uptake causes oxidative stress as intracellular DHA is reduced to vitamin C, depleting glutathione...
December 11, 2015: Science
Ravi Pokala Kiran, Alice C A Murray, Cody Chiuzan, David Estrada, Kenneth Forde
OBJECTIVES: To clarify whether bowel preparation use or its individual components [mechanical bowel preparation (MBP)/oral antibiotics] impact specific outcomes after colorectal surgery. METHODS: National Surgical Quality Improvement Program-targeted colectomy data initiated in 2012 capture information on the use/type of bowel preparation and colorectal-specific complications. For patients undergoing elective colorectal resection, the impact of preoperative MBP and antibiotics (MBP+/ABX+), MBP alone (MBP+/ABX-), and no bowel preparation (no-prep) on outcomes, particularly anastomotic leak, surgical site infection (SSI), and ileus, were evaluated using unadjusted/adjusted logistic regression analysis...
September 2015: Annals of Surgery
D Peter O'Leary, Noel Lynch, Cillian Clancy, Desmond C Winter, Eddie Myers
IMPORTANCE: This Delphi study provides consensus related to many aspects of acute diverticulitis and identifies other areas in need of research. OBJECTIVE: To generate an international, expert-based, consensus statement to address controversies in the management of acute diverticulitis. DESIGN, SETTING, AND PARTICIPANTS: This study was conducted using the Delphi technique from April 3 through October 21, 2014. A survey website was used and a panel of acute diverticulitis experts was formed via the snowball method...
September 2015: JAMA Surgery
John E Scarborough, Christopher R Mantyh, Zhifei Sun, John Migaly
OBJECTIVE: To determine the association between preoperative bowel preparation and 30-day outcomes after elective colorectal resection. METHODS: Patients from the 2012 Colectomy-Targeted American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database who underwent elective colorectal resection were included for analysis and assigned to 1 of 4 groups based on the type of preoperative preparation they received [combined mechanical and oral antibiotic preparation (OAP), mechanical preparation only, OAP only, or no preoperative bowel preparation]...
August 2015: Annals of Surgery
Marwan G Fakih
Substantial improvements have been made in the management of metastatic colorectal cancer over the last two decades. The overall survival of patients diagnosed with unresectable metastatic colorectal cancer has increased from approximately 1 year during the era of fluoropyrimidine monotherapy to more than 30 months with the integration of multiple cytotoxic agents and targeted therapies. More effective therapeutic combinations have increased the rate of curative-intent surgical resections, resulting in median survival in this subgroup that exceed 5 years...
June 1, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Melanie S Morris, Laura A Graham, Daniel I Chu, Jamie A Cannon, Mary T Hawn
OBJECTIVE: To determine the relationship between oral antibiotic bowel preparation (OABP) and surgical site infection (SSI) rates in a national colectomy cohort. BACKGROUND: OABP for elective colorectal surgery has fallen out of favor. Large cohort studies show that OABP is associated with a 50% reduction in SSI after colectomy. METHODS: A retrospective analysis of the National Surgical Quality Improvement Program colectomy cohort from 2011 to 2012 was performed to examine the association between use of OABP and outcomes of SSI, length of stay (LOS), and readmission after elective colectomy...
June 2015: Annals of Surgery
Timo W Hakkarainen, Scott R Steele, Amir Bastaworous, E Patchen Dellinger, Ellen Farrokhi, Farhood Farjah, Michael Florence, Scott Helton, Marc Horton, Michael Pietro, Thomas K Varghese, David R Flum
IMPORTANCE: Nonsteroidal anti-inflammatory drugs (NSAIDs) have many physiologic effects and are being used more commonly to treat postoperative pain, but recent small studies have suggested that NSAIDs may impair anastomotic healing in the gastrointestinal tract. OBJECTIVE: To evaluate the relationship between postoperative NSAID administration and anastomotic complications. DESIGN, SETTING, AND PARTICIPANTS: Retrospective cohort study of 13,082 patients undergoing bariatric or colorectal surgery at 47 hospitals in Washington State from January 1, 2006, through December 31, 2010, using data from the Surgical Care and Outcomes Assessment Program linked to the Washington State Comprehensive Abstract Reporting System...
March 1, 2015: JAMA Surgery
Cheryl Lau, Edward Phillips, Catherine Bresee, Phillip Fleshner
OBJECTIVE: Compare the feasibility and patient tolerance to either a clear fluid (CF) or low residue diet (LRD) started on postoperative day (POD) 1 after elective colorectal surgery. BACKGROUND: Diet advancement after surgery traditionally starts gradually with liquids, on the basis of fears that early solid intake may increase nausea, vomiting, and overall complications. A randomized controlled trial comparing LRD and CF on POD 1 was performed. METHODS: 111 elective colorectal surgery patients were randomized to CF (n = 57) or LRD (n = 54)...
October 2014: Annals of Surgery
2016-10-06 12:17:25
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