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Metrics Used to Quantify Fecal Incontinence and Constipation
Clin Colon Rectal Surg 2021; 34: 005-014 DOI: 10.1055/s-0040-1714245While fecal incontinence and constipation can be measured through physiological testing, the subjective experience of severity and impact on health-related quality of life lead to both being most effectively captured through patient-reported measures. Patient-reported measures of severity and impact help to determine baseline symptoms, guide clinical decision making, and compare various treatments. Here, we take pause to review the psychometric qualities that make effective instruments, and discuss some of the most commonly used instruments along with the ...
Source: Clinics in Colon and Rectal Surgery - January 28, 2021 Category: Surgery Authors: Hunt, Cameron W. Cavallaro, Paul M. Bordeianou, Liliana G. Tags: Review Article Source Type: research

Pathophysiology and Epidemiology of Diverticular Disease
Clin Colon Rectal Surg DOI: 10.1055/s-0040-1716698Diverticular disease exists on a spectrum, ranging from asymptomatic diverticulosis to complicated diverticulitis. Incidence of diverticulitis in western nations has increased in recent years, although the factors that influence the progression from diverticulosis to diverticulitis are unknown. Geographic/environmental influences, lifestyle variables, and microbiota of the gastrointestinal tract are some of the factors implicated in diverticular disease. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals:...
Source: Clinics in Colon and Rectal Surgery - December 8, 2020 Category: Surgery Authors: Talutis, Stephanie D. Kuhnen, F Angela H. Tags: Review article Source Type: research

Pelvic Floor Disorders
Clin Colon Rectal Surg DOI: 10.1055/s-0040-1714244 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - November 4, 2020 Category: Surgery Authors: Vogler, Sarah A. Tags: Preface Source Type: research

Surgical Management of Recurrent Uncomplicated Diverticulitis
Clin Colon Rectal Surg DOI: 10.1055/s-0040-1716700Sigmoid diverticulitis represents a most common gastroenterological diagnosis in the western world. There has been a significant change in the management of recurrent uncomplicated diverticulitis in the last 10 to 15 years. The absolute number of previous episodes is not used as criteria to recommend surgery anymore. Young age is no longer considered to be an indication for more aggressive surgical treatment. It is accepted that subsequent episodes of diverticulitis are not significantly worse than the first episode. Laparoscopic surgery is now the standard of care for elec...
Source: Clinics in Colon and Rectal Surgery - November 2, 2020 Category: Surgery Authors: Rai, Vinay Mishra, Nitin Tags: Review Article Source Type: research

Nonoperative Management for T2 Low Rectal Cancer: A Western Approach
Clin Colon Rectal Surg 2020; 33: 366-371 DOI: 10.1055/s-0040-1714241The possibility of organ preservation in early rectal cancer has gained popularity during recent years. Patients with early tumor stage and low risk for local recurrence do not usually require neoadjuvant chemoradiation for oncological reasons. However, these patients may be considered for chemoradiation exclusively for the purpose of achieving a complete clinical response and avoid total mesorectal excision. In addition, cT2 tumors may be more likely to develop complete response to neoadjuvant therapy and may constitute ideal candidates for organ-preservi...
Source: Clinics in Colon and Rectal Surgery - November 2, 2020 Category: Surgery Authors: Fernandez, Laura Melina S ão Julião, Guilherme Pagin Vailati, Bruna Borba Habr-Gama, Angelita Perez, Rodrigo Oliva Tags: Review Article Source Type: research

ISR for T1-2 Low Rectal Cancer: A Japanese Approach
Clin Colon Rectal Surg 2020; 33: 361-365 DOI: 10.1055/s-0040-1714240The evolution over the past 20 years of anal preservation in rectal cancer surgery has been truly remarkable. Intersphincteric resection (ISR) reported by Schiessel in 1994 in Australia has been shown to enable anal preservation even for cancers quite close to the anus. In Japan, ISR via the detachment of the anal canal between the internal and external sphincters and excision of the internal sphincter first began to be practiced in the latter half of 1990. A multicenter Phase II trial of ISR in Japan suggested that 70% of the cases had relatively good fun...
Source: Clinics in Colon and Rectal Surgery - November 2, 2020 Category: Surgery Authors: Ito, Masaaki Tags: Review Article Source Type: research

CME versus D3 Dissection for Colon Cancer
Clin Colon Rectal Surg 2020; 33: 344-348 DOI: 10.1055/s-0040-1714237Over the past 30 years, rectal cancer surgery has been standardized by total mesorectal excision. More recently, some have suggested that colon cancer surgery should be standardized by complete mesocolic excision (CME) with central vascular ligation (CVL), especially in Western countries. Surgeons undertaking CME with CVL report optimal outcomes. Sharp dissection within the embryological plane and high vascular ligation at the vessel origin are essential. In Japan, a similar concept, D3 dissection, has been adopted for decades. Although both surgical proce...
Source: Clinics in Colon and Rectal Surgery - November 2, 2020 Category: Surgery Authors: Kobayashi, Hirotoshi West, Nicholas P. Tags: Review Article Source Type: research

Tsuyoshi Konishi, MD, PhD
Clin Colon Rectal Surg 2020; 33: 325-326 DOI: 10.1055/s-0040-1714233 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - November 2, 2020 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to the Guest Editor Source Type: research

Sarah A. Vogler, MD, MBA, FACS, FASCRS
Clin Colon Rectal Surg DOI: 10.1055/s-0040-1714243 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - October 30, 2020 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to the Guest Editor Source Type: research

Complicated Diverticular Disease
Clin Colon Rectal Surg DOI: 10.1055/s-0040-1716701The modern management of colonic diverticular disease involves grouping patients into uncomplicated or complicated diverticulitis, after which the correct treatment paradigm is instituted. Recent controversies suggest overlap in management strategies between these two groups. While most reports still support surgical intervention for the treatment of complicated diverticular disease, more data are forthcoming suggesting complicated diverticulitis does not merit surgical resection in all scenarios. Given the significant risk for complication in surgery for diverticulitis, ca...
Source: Clinics in Colon and Rectal Surgery - October 21, 2020 Category: Surgery Authors: Coakley, Kathleen M. Davis, Bradley R. Kasten, Kevin R. Tags: Review Article Source Type: research

Cytoreductive Surgery Combined with Hyperthermic Intraperitoneal Chemotherapy for Peritoneal Metastasis from Colorectal Cancer
Clin Colon Rectal Surg DOI: 10.1055/s-0040-1714242Peritoneal metastasis from colorectal cancer (PM-CRC) is used to be considered a systemic and fatal condition; however, it has been growingly accepted that PM-CRC can still be local disease rather than systemic disease as analogous to liver or lung metastasis.Cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is now considered an optimal treatment for PM-CRC with accumulating evidence. There is a good reason that CRS + HIPEC, widely accepted as a standard of care for pseudomyxoma peritonei (PMP), could be a viable option for PM-C...
Source: Clinics in Colon and Rectal Surgery - September 21, 2020 Category: Surgery Authors: Yano, Hideaki Tags: Review Article Source Type: research

Neoadjuvant (chemo)radiotherapy and Lateral Node Dissection: Is It Mutually Exclusive?
Clin Colon Rectal Surg DOI: 10.1055/s-0040-1714239The importance of total mesorectal excision (TME) has been the global standard of care in patients with rectal cancer. However, there is no universal strategy for lateral lymph nodes (LLN). The treatment of the lateral compartment remains controversial and has gone to the opposite directions between Eastern and Western countries in the past decades. In the East, mainly Japan, surgeons consider LLN metastases as regional disease and have performed TME with lateral lymph node dissection (LLND) without neoadjuvant (chemo)radiotherapy ([C]RT) in patients with clinical Stage II/...
Source: Clinics in Colon and Rectal Surgery - September 21, 2020 Category: Surgery Authors: Ogura, Atsushi van Oostendorp, Stefan Kusters, Miranda Tags: Review Article Source Type: research

Rectovaginal Fistulas Secondary to Obstetrical Injury
Clin Colon Rectal Surg DOI: 10.1055/s-0040-1714284Rectovaginal fistula (RVF), defined as any abnormal connection between the rectum and the vagina, is a complex and debilitating condition. RVF can occur for a variety of reasons, but frequently develops following obstetric injury. Patients with suspected RVF require thorough evaluation, including history and physical examination, imaging, and objective evaluation of the anal sphincter complex. Prior to attempting repair, sepsis must be controlled and the tract allowed to mature over a period of 3 to 6 months. All repair techniques involve reestablishing a healthy, well-vasc...
Source: Clinics in Colon and Rectal Surgery - September 21, 2020 Category: Surgery Authors: Dawes, Aaron J. Jensen, Christine C. Tags: Review Article Source Type: research

Venkatesh Munikrishnan, MRCS(Ed), FRCS(Ed), CCT(UK), Manish Chand, MBBS, BSc, FRCS, FASCRS, MBA, PhD
Clin Colon Rectal Surg 2020; 33: 243-244 DOI: 10.1055/s-0040-1715122 Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - September 20, 2020 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to the Guest Editors Source Type: research

Multivisceral Resection of Advanced Pelvic Tumors: From Planning to Implementation
Clin Colon Rectal Surg 2020; 33: 268-278 DOI: 10.1055/s-0040-1713744Pelvic exenteration involves radical multivisceral resection for locally advanced and recurrent pelvic tumors. Advances in tumor staging, oncological therapies, preoperative patient optimization, surgical techniques, and critical care medicine have permitted the safe expansion of pelvic exenterative surgery at specialist units. It is now understood that in carefully selected patients, 5-year survival can exceed 60% following pelvic exenteration, and that very low mortality figures and an optimum postexenteration quality of life are possible. In the present...
Source: Clinics in Colon and Rectal Surgery - September 17, 2020 Category: Surgery Authors: Mirnezami, R. Mirnezami, A. Tags: Review Article Source Type: research