Applying Enhanced Recovery Pathways to Unique Patient Populations
Clinics in Colon and Rectal Surgery 2019; 32: 134-137 DOI: 10.1055/s-0038-1676479Enhanced Recovery after Surgery (ERAS) pathways have become popular in colorectal surgery due to their associated decrease in length of stay (LOS), complications, and readmission rate. However, it is unclear if these pathways are safe, feasible, or effective in unique patient populations such as elderly patients, urgent/emergent surgeries, patients with specific comorbidities, inflammatory bowel disease, or pediatric patients. Enhanced recovery pathways appear safe in elderly patients, associated with decreased complications, though with sligh...
Source: Clinics in Colon and Rectal Surgery - February 28, 2019 Category: Surgery Authors: Lee, Grace C. Hodin, Richard A. Tags: Review Article Source Type: research

Enhanced Recovery after Surgery for Colorectal Surgery: A Review of the Economic Implications
Clinics in Colon and Rectal Surgery 2019; 32: 129-133 DOI: 10.1055/s-0038-1676478Enhanced Recovery After Surgery (ERAS) programs are transdisciplinary, evidence-based perioperative protocols that aim to standardize best practices and increase the value of delivered healthcare. Quality improvement programs such as ERAS for colorectal surgery have been linked to a reduction in rates of hospital-acquired infections (HAIs) including surgical site infection as well as a reduction in overall length of stay. Importantly, to achieve these results, hospitals must commit to fostering transdisciplinary collaboration across surgery, a...
Source: Clinics in Colon and Rectal Surgery - February 28, 2019 Category: Surgery Authors: Stone, Alexander B. Grant, Michael C. Wu, Christopher L. Wick, Elizabeth C. Tags: Review Article Source Type: research

Pain Management in Enhanced Recovery after Surgery (ERAS) Protocols
Clinics in Colon and Rectal Surgery 2019; 32: 121-128 DOI: 10.1055/s-0038-1676477Pain control is an integral part of Enhanced Recovery after Surgery (ERAS) protocols for colorectal surgery. While opioid therapy remains the mainstay of therapy for postsurgical pain, opioids have undesired side effects including delayed recovery of bowel function, respiratory depression, and postoperative nausea and vomiting. A variety of nonopioid systemic medical therapies as well as regional and neuraxial techniques have been described as improving pain control while reducing opioid use. Multimodal and preemptive analgesia as part of an E...
Source: Clinics in Colon and Rectal Surgery - February 28, 2019 Category: Surgery Authors: Simpson, J. Creswell Bao, Xiaodong Agarwala, Aalok Tags: Review Article Source Type: research

Perioperative Fluid Management in the Enhanced Recovery after Surgery (ERAS) Pathway
Clinics in Colon and Rectal Surgery 2019; 32: 114-120 DOI: 10.1055/s-0038-1676476Fluid management is an essential component of the Enhanced Recovery after Surgery (ERAS) pathway. Optimal management begins in the preoperative period and continues through the intraoperative and postoperative phases. In this review, we outline current evidence-based practices for fluid management through each phase of the perioperative period. Preoperatively, patients should be encouraged to hydrate until 2 hours prior to the induction of anesthesia with a carbohydrate-containing clear liquid. When mechanical bowel preparation is necessary, w...
Source: Clinics in Colon and Rectal Surgery - February 28, 2019 Category: Surgery Authors: Zhu, Alyssa Cheng-Cheng Agarwala, Aalok Bao, Xiaodong Tags: Review Article Source Type: research

Does Implementation of Enhanced Recovery after Surgery (ERAS) Protocols in Colorectal Surgery Improve Patient Outcomes?
Clinics in Colon and Rectal Surgery 2019; 32: 109-113 DOI: 10.1055/s-0038-1676475Enhanced Recovery after Surgery (ERAS) protocols are multimodal perioperative care pathways designed to accelerate recovery by minimizing the physiologic stress of a surgical procedure. Benefits of ERAS implementation in colorectal surgery include reduced length of stay and decreased complications without an increase in readmissions. Though there is evidence associating individual ERAS protocol elements (e.g., preoperative carbohydrate loading, judicious perioperative fluid administration, and early initiation of postoperative nutrition) with ...
Source: Clinics in Colon and Rectal Surgery - February 28, 2019 Category: Surgery Authors: Ban, Kristen A. Berian, Julia R. Ko, Clifford Y. Tags: Review Article Source Type: research

Implementation of an ERAS Pathway in Colorectal Surgery
This article presents the specific components of an ERAS protocol implemented at the authors' institution. In particular, details of both surgical and anesthetic ERAS pathways are provided with explanation of all aspects of preoperative, perioperative, and postoperative care. Evidence supporting inclusion of various aspects within the ERAS protocol is briefly reviewed. The ERAS protocol described has significantly benefitted postoperative outcomes in colorectal patients and can be employed at other institutions wishing to develop an ERAS pathway for colorectal patients. A checklist is provided for clinicians to easily refe...
Source: Clinics in Colon and Rectal Surgery - February 28, 2019 Category: Surgery Authors: Cavallaro, Paul Bordeianou, Liliana Tags: Review Article Source Type: research

Contemporary Opportunity for Prehabilitation as Part of an Enhanced Recovery after Surgery Pathway in Colorectal Surgery
Clinics in Colon and Rectal Surgery 2019; 32: 095-101 DOI: 10.1055/s-0038-1676473The implementation of upfront, preoperative habilitation (“prehabilitation”), as opposed to postoperative habilitation (rehabilitation), provides a unique opportunity to optimize surgical outcomes, while ensuring that patients receive necessary conditioning that may otherwise be significantly delayed by postoperative complications. In this review, opportunities to design, implement, monitor, and evaluate a surgical prehabilitation program in colorectal surgery are discussed, and broken down to include emotional, physical, and nutri...
Source: Clinics in Colon and Rectal Surgery - February 28, 2019 Category: Surgery Authors: Ven Fong, Zhi Chang, David C. Lillemoe, Keith D. Nipp, Ryan D. Tanabe, Kenneth K. Qadan, Motaz Tags: Review Article Source Type: research

Enhanced Recovery after Surgery (ERAS) for Colorectal Surgery
Clinics in Colon and Rectal Surgery 2019; 32: 093-094 DOI: 10.1055/s-0038-1676471 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 - February 28, 2019 Category: Surgery Authors: Kunitake, Hiroko Tags: Preface Source Type: research

Hiroko Kunitake, MD, MPH
Clinics in Colon and Rectal Surgery 2019; 32: 091-092 DOI: 10.1055/s-0038-1676472 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 - February 28, 2019 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to the Guest Editor Source Type: research

Electronic Health Record –Based Registries: Clinical Research Using Registries in Colon and Rectal Surgery
Clinics in Colon and Rectal Surgery 2019; 32: 082-090 DOI: 10.1055/s-0038-1673358Electronic health records (EHRs) or electronic medical records (EMRs) contain a vast amount of clinical data that can be useful for multiple purposes including research. Disease registries are collections of data in predefined formats for population management, research, and other purposes. There are differences between EHRs and registries in the data structure, data standards, and protocols. Proprietary EHR systems use different coding systems and data standards, which are usually kept secret. For EHR data to flow seamlessly into registries, ...
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Carlson, Jacob Laryea, Jonathan Tags: Review Article Source Type: research

Enhanced Recovery After Surgery Interactive Audit System: 10 Years' Experience with an International Web-Based Clinical and Research Perioperative Care Database
Clinics in Colon and Rectal Surgery 2019; 32: 075-081 DOI: 10.1055/s-0038-1673357The Enhanced Recovery After Surgery (ERAS) is a managed care program that has shown the ability to reduce complications following elective colorectal surgery. In 2006, the ERAS® Society developed the ERAS® Interactive Audit System (EIAS), which has allowed centers in over 20 countries to enter perioperative patient data to benchmark against international practice within the audit system and act as a stimulus for quality improvement. The de-identified patient data are coded in SQL (a relational database), stored on secure servers, and d...
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Currie, Andrew Soop, Mattias Demartines, Nicolas Fearon, Kenneth Kennedy, Robin Ljungqvist, Olle Tags: Review Article Source Type: research

Review of Colorectal Studies Using the National Cancer Database
Clinics in Colon and Rectal Surgery 2019; 32: 069-074 DOI: 10.1055/s-0038-1673356The National Cancer Database (NCDB) is a large clinical oncology database developed with data collected from Commission on Cancer (CoC)-accredited facilities. The CoC is managed under the American College of Surgeons, and is a multidisciplinary team that maintains standards in cancer care delivery in health care settings. This database has been used in multiple cancer-focused studies and reports on cancer diagnosis, hospital-level, and patient-related demographics. The focus of this review is to explore and discuss the use of NCDB in colorecta...
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Kelley, Katherine A. Tsikitis, V. Liana Tags: Review Article Source Type: research

Surveillance, Epidemiology, and End Results (SEER) and SEER-Medicare Databases: Use in Clinical Research for Improving Colorectal Cancer Outcomes
Clinics in Colon and Rectal Surgery 2019; 32: 061-068 DOI: 10.1055/s-0038-1673355The Surveillance, Epidemiology, and End Results (SEER) program is a clinical database, funded by the National Cancer Institute (NCI), which was created to collect cancer incidence, prevalence, and survival data from U.S. cancer registries. By capturing approximately 30% of the U.S. population, it serves as a powerful resource for researchers focused on understanding the natural history of colorectal cancer and improvement in patient care. The linked SEER-Medicare database is a robust database allowing investigators to perform studies focusing ...
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Daly, Meghan C. Paquette, Ian M. Tags: Review Article Source Type: research

Truven Health Analytics MarketScan Databases for Clinical Research in Colon and Rectal Surgery
Clinics in Colon and Rectal Surgery 2019; 32: 054-060 DOI: 10.1055/s-0038-1673354The MarketScan databases are a family of administrative claims databases that contain data on inpatient and outpatient claims, outpatient prescription claims, clinical utilization records, and healthcare expenditures. The three main databases available for use are each composed of a convenience sample for one of the following patient populations: (1) patients with employer-based health insurance from contributing employers, (2) Medicare beneficiaries who possess supplemental insurance paid by their employers, and (3) patients with Medicaid in ...
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Kulaylat, Audrey S. Schaefer, Eric W. Messaris, Evangelos Hollenbeak, Christopher S. Tags: Review Article Source Type: research

Using the National Surgical Quality Improvement Project (NSQIP) to Perform Clinical Research in Colon and Rectal Surgery
Clinics in Colon and Rectal Surgery 2019; 32: 041-053 DOI: 10.1055/s-0038-1673353The American College of Surgeons' National Surgical Quality Improvement Project (ACS-NSQIP) is probably the most well-known surgical database in North American and worldwide. This clinical database was first proposed by Dr. Clifford Ko, a colorectal surgeon, to the ACS, and NSQIP first started collecting data ca. 2005 with the intent of comparing hospitals (benchmarking) and for hospital-level quality improvement projects. Since then, its popularity has grown from just a few participating hospitals in the United States to more than 708 partici...
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Eisenstein, Samuel Stringfield, Sarah Holubar, Stefan D. Tags: Review Article Source Type: research

Clinical Research Using the National Inpatient Sample: A Brief Review of Colorectal Studies Utilizing the NIS Database
Clinics in Colon and Rectal Surgery 2019; 32: 033-040 DOI: 10.1055/s-0038-1673352The National Inpatient Sample (NIS) is the largest collection of longitudinal hospital care data in the United States and is sponsored by the Agency for Healthcare Research and Quality. The data are collected from state organizations, hospital associations, private organizations, and the federal government. This database has been used in more than 400 disease-focused studies to examine health care utilization, access, charges, quality, and outcomes of care. The database has been maintained since 1988, making it one of the oldest on hospital da...
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Kelley, Katherine A. Tsikitis, V. Liana Tags: Review Article Source Type: research

Surgical Care and Outcomes Assessment Program (SCOAP): A Nuanced, Flexible Platform for Colorectal Surgical Research
Clinics in Colon and Rectal Surgery 2019; 32: 025-032 DOI: 10.1055/s-0038-1673351The Surgical Care and Outcomes Assessment Program (SCOAP) is a surgeon-led quality improvement (QI) initiative developed in Washington State to track and reduce variability in surgical care. It has developed into a collaboration of over two-thirds of the hospitals in the state, who share data and receive regular benchmarking reports. Data are abstracted at each site by trained abstractors. While there has some overlap with other national QI databases, the data captured by SCOAP has clinical nuances that make it pragmatic for studying surgical ...
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Simianu, Vlad V. Kumar, Anjali S. Tags: Review Article Source Type: research

Statewide Clinic Registries: The Michigan Surgical Quality Collaborative
This article will describe the organizational structure of the MSQC, the contributions the registry has made to quality improvement in colorectal surgery, and how future work will align to improve the reliability of improvement-relevant registry data. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Nikolian, Vahagn C. Regenbogen, Scott E. Tags: Review Article Source Type: research

Use of the Rochester Epidemiology Project for Clinical Research in Colon and Rectal Surgery
Clinics in Colon and Rectal Surgery 2019; 32: 008-015 DOI: 10.1055/s-0038-1673349The Rochester Epidemiology Project (REP), a longitudinal population-based database, is the largest epidemiologic database in the world. Originally established at Mayo Clinic in Rochester, Minnesota, the REP has been instrumental in defining the natural history of disease states and the impact of treatment in a well-defined population. In the United States, the REP has made important contributions to the colon and rectal literature, largely because healthcare is fragmented with no unique identifier to longitudinally follow-up with a patient thr...
Source: Clinics in Colon and Rectal Surgery - January 8, 2019 Category: Surgery Authors: Lightner, Amy L. Cima, Robert Tags: Review Article Source Type: research

Dedication
Clinics in Colon and Rectal Surgery 2019; 32: 007-007 DOI: 10.1055/s-0038-1673348 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 - January 8, 2019 Category: Surgery Authors: Holubar, Stefan D. Tags: Dedication Source Type: research

Introduction to Big Data in Colorectal Surgery
Clinics in Colon and Rectal Surgery 2019; 32: 005-006 DOI: 10.1055/s-0038-1673347 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 - January 8, 2019 Category: Surgery Authors: Etzioni, David A. Tags: Preface Source Type: research

Big Data in Colorectal Surgery
Clinics in Colon and Rectal Surgery 2019; 32: 003-004 DOI: 10.1055/s-0038-1673346 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 - January 8, 2019 Category: Surgery Authors: Holubar, Stefan D. Tags: Introduction Source Type: research

Stefan D. Holubar, MD, MS, FACS, FASCRS
Clinics in Colon and Rectal Surgery 2019; 32: 001-002 DOI: 10.1055/s-0038-1673345 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 - January 8, 2019 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to Guest Editor Source Type: research

Fia Yi, MD, FACS, FASCRS, LtCol
Clinics in Colon and Rectal Surgery 2018; 31: 317-318 DOI: 10.1055/s-0038-1668099 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 3, 2018 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to Guest Editor Source Type: research

Basic Science, Epidemiology, and Screening for Anal Intraepithelial Neoplasia and Its Relationship to Anal Squamous Cell Cancer
This article will discuss the epidemiology of ASCC and its association with HPV and the life cycle of the HPV, and the molecular changes that lead to clearance, productive infection, latency, and persistence. The immunology of HPV infection will discuss natural immunity, humoral and cellular immunity, and how the HPV virus evades and interferes with these mechanisms. We will also discuss high-risk factors for developing AIN in high-risk patient populations with relation to infections (HIV, HPV, and chlamydia infections), prolonged immunocompromised people, and sexual behavior and tobacco abuse. We will also discuss the pre...
Source: Clinics in Colon and Rectal Surgery - November 2, 2018 Category: Surgery Authors: Davis, Kurt G. Orangio, Guy R. Tags: Review Article Source Type: research

Multidisciplinary Approach to the Management and Treatment of Anal Dysplasia
Clinics in Colon and Rectal Surgery 2018; 31: 361-367 DOI: 10.1055/s-0038-1668106The incidence of anal intraepithelial neoplasia (AIN) has been increasing over the years. AIN acts as a precursor lesion for anal squamous cell cancer. Factors leading to progression of AIN into malignancy are complex and involve grade of the lesion, human papillomavirus and HIV coinfection, as well as patient-related risk factors such as immunocompromised state and men who have sex with men. The multifaced aspects of this disease make its management challenging, as it involves several disciplines including pathology, primary care, infectious ...
Source: Clinics in Colon and Rectal Surgery - November 2, 2018 Category: Surgery Authors: Douaiher, Jeffrey Langenfeld, Sean J. Tags: Review Article Source Type: research

So Now My Patient Has Squamous Cell Cancer: Diagnosis, Staging, and Treatment of Squamous Cell Carcinoma of the Anal Canal and Anal Margin
Clinics in Colon and Rectal Surgery 2018; 31: 353-360 DOI: 10.1055/s-0038-1668105Squamous cell carcinomas of the anal canal and the anal margin are rare malignancies that are increasing in incidence. Patients with these tumors often experience delayed treatment due to delay in diagnosis or misdiagnosis of the condition. Distinguishing between anal canal and anal margin tumors has implications for staging and treatment. Chemoradiation therapy is the mainstay of treatment for anal canal squamous cell, with abdominoperineal resection reserved for salvage treatment in cases of persistent or recurrent disease. Early anal margin...
Source: Clinics in Colon and Rectal Surgery - November 2, 2018 Category: Surgery Authors: Kin, Cindy Tags: Review Article Source Type: research

Anal Intraepithelial Neoplasia and Squamous Cell Cancer of the Anus
Clinics in Colon and Rectal Surgery 2018; 31: 347-352 DOI: 10.1055/s-0038-1668104Anal intraepithelial neoplasia (AIN) is the premalignant condition of the anal squamous tissue. It is associated with the human papilloma virus and is considered the transition prior to the invasive anal squamous cell carcinoma. It is typically asymptomatic and can be either an incidental finding after anorectal surgery or identified when high-risk patient populations are screened. Once AIN is diagnosed, the optimal management remains controversial, partly because the natural history of the disease is unclear. Surgical management of the diseas...
Source: Clinics in Colon and Rectal Surgery - November 2, 2018 Category: Surgery Authors: Hoedema, Rebecca E. Tags: Review Article Source Type: research

History of High-Resolution Anoscopy
Clinics in Colon and Rectal Surgery 2018; 31: 336-346 DOI: 10.1055/s-0038-1668103High-resolution anoscopy (HRA) is a form of low-resolution anal microscopy currently utilized in the screening and management of anal squamous dysplasia. No randomized controlled trials, national or international guidelines exist on the use of HRA for this purpose. Much of our understanding of this entity has been adapted from the literature on cervical squamous dysplasia, including the technique of HRA itself. Epidemiologic evidence has shown that the prevalence and incidence of anal dysplasia is highest in HIV-positive populations. The histo...
Source: Clinics in Colon and Rectal Surgery - November 2, 2018 Category: Surgery Authors: Cho, S. David Groves, Emily Lao, Victoria V. Tags: Review Article Source Type: research

Anal Intraepithelial Neoplasia from a Pathologists Point of View
Clinics in Colon and Rectal Surgery 2018; 31: 328-335 DOI: 10.1055/s-0038-1668102Anal squamous cell carcinoma is a relatively rare diagnosis, but its incidence has continued to rise. Anal squamous cell carcinoma and its precursor lesion, anal intraepithelial neoplasia (AIN), are human papillomavirus (HPV)-associated squamous neoplasias. High-risk HPV subtypes cause cellular proliferation in the anal transformation zone mucosa leading to similar dysplastic changes as seen in the cervix. Unified cytologic and histologic classification systems have emerged for all HPV-associated squamous lesions of the lower anogenital tract ...
Source: Clinics in Colon and Rectal Surgery - November 2, 2018 Category: Surgery Authors: Lyons, Keegan M. Butler, Samantha L. Tags: Review Article Source Type: research

Vaccinations for Anal Squamous Cancer: Current and Emerging Therapies
Clinics in Colon and Rectal Surgery 2018; 31: 321-327 DOI: 10.1055/s-0038-1668101Human papillomavirus (HPV) infection is responsible for 4.3% of the global cancer burden. Since 2006, current HPV vaccines have reduced the prevalence of the virus in adolescent girls, reduced the prevalence of genital warts, and been proven to reduce the progression of anal intraepithelial neoplasia in men. Herein, we review the epidemiology, virology, and immunology behind the prophylactic HPV vaccines and current recommendations for its use. We also review future immune therapies being trialed for use against HPV-related cancers including a...
Source: Clinics in Colon and Rectal Surgery - November 2, 2018 Category: Surgery Authors: Berry, John Glasgow, Sean C. Tags: Review Article Source Type: research

Anal Intraepithelial Neoplasia and Squamous Cell Cancer of the Anus: Past, Present, and Future
Clinics in Colon and Rectal Surgery 2018; 31: 319-320 DOI: 10.1055/s-0038-1668100 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, 2018 Category: Surgery Authors: Yi, Fia Tags: Preface Source Type: research

Colorectal Lymphoma: A Review
This article will review the current understanding of the different histologic subtypes of primary colorectal lymphoma and propose management algorithms. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - September 4, 2018 Category: Surgery Authors: Gay, Nathan D. Chen, Andy Okada, Craig Y. Tags: Review Article Source Type: research

Small Bowel and Colorectal Carcinoids
Clinics in Colon and Rectal Surgery 2018; 31: 301-308 DOI: 10.1055/s-0038-1642054Neuroendocrine tumors, or carcinoid tumors, of both the midgut and hindgut are quite rare, but their incidence is increasing. Surgery is the treatment of choice in patients who can tolerate an operation and have operable disease. Options for the treatment of metastatic disease include cytoreductive surgery, somatostatin analogues, interferon α, local liver therapies (hepatic arterial embolization, ablation), chemotherapy, Peptide-Receptor Radionucleotide Radiotherapy, angiogenesis inhibitors, and mammalian target of rapamycin inhibitors....
Source: Clinics in Colon and Rectal Surgery - September 4, 2018 Category: Surgery Authors: Byrne, Raphael M. Pommier, Rodney F. Tags: Review Article Source Type: research

Gastrointestinal Stromal Tumors of the Distal Gastrointestinal Tract
Clinics in Colon and Rectal Surgery 2018; 31: 295-300 DOI: 10.1055/s-0038-1642053Gastrointestinal stromal tumors (GISTs) are rare in occurrence, but comprise the most common mesenchymal tumors of the gastrointestinal tract and affect between 15 and 20 individuals per million per year. Due to recent advancements in molecular classification of these tumors, medical therapy has provided improved outcomes to a historically surgically managed disease. This review article briefly discusses the molecular characteristics, medical and surgical therapies, and future of GIST management. [...] Thieme Medical Publishers 333 Seventh Ave...
Source: Clinics in Colon and Rectal Surgery - September 4, 2018 Category: Surgery Authors: Kelley, Katherine A. Byrne, Raphael Lu, Kim C. Tags: Review Article Source Type: research

The Role of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for Appendiceal Tumors and Colorectal Adenocarcinomas
Clinics in Colon and Rectal Surgery 2018; 31: 288-294 DOI: 10.1055/s-0038-1642052Peritoneal surface disease (PSD) has historically been used interchangeably with the term peritoneal carcinomatosis (PC) and has a dismal natural history. A variety of malignant pathologies, including colorectal and appendiceal primary tumors, can disseminate throughout the peritoneal cavity, leading to bowel obstruction and death. In general, peritoneal spread from high-grade appendiceal and colorectal primaries has the potential of hepatic and distant spread and best classified as PC. Low-grade appendiceal tumors are better categorized as PS...
Source: Clinics in Colon and Rectal Surgery - September 4, 2018 Category: Surgery Authors: Kuncewitch, Michael Levine, Edward A. Shen, Perry Votanopoulos, Konstantinos I. Tags: Review Article Source Type: research

Appendiceal Neoplasms
Clinics in Colon and Rectal Surgery 2018; 31: 278-287 DOI: 10.1055/s-0038-1642051Appendiceal neoplasms are identified in 0.9 to 1.4% of appendiceal specimens, and the incidence is increasing. It has long been professed that neuroendocrine tumors (formerly carcinoids) are the most common neoplastic process of the appendix; recent data, however, has suggested a shift in epidemiology. Our intent is to distill the complex into an algorithm, and, in doing so, enable the surgeon to seamlessly maneuver through operative decisions, treatment strategies, and patient counseling. The algorithm for evaluation and treatment is complex,...
Source: Clinics in Colon and Rectal Surgery - September 4, 2018 Category: Surgery Authors: Hatch, Quinton M. Gilbert, Erin W. Tags: Review Article Source Type: research

Small Bowel Adenocarcinoma
Clinics in Colon and Rectal Surgery 2018; 31: 267-277 DOI: 10.1055/s-0038-1660482Small bowel adenocarcinoma is a clinically and anatomically distinct gastrointestinal cancer that lacks prospective data to support its optimal management. Patients with inflammatory bowel disease and inherited conditions that cause gastrointestinal polyps are at especially high risk. Due to a lack of effective surveillance programs resulting in missed or delayed diagnoses only when symptoms develop, this disease is generally discovered at an advanced stage. Surgical resection is the only treatment modality with a chance of cure. Currently acc...
Source: Clinics in Colon and Rectal Surgery - September 4, 2018 Category: Surgery Authors: Chen, Emerson Y. Vaccaro, Gina M. Tags: Review Article Source Type: research

“Miscellaneous” Tumors of the Small Bowel and Colon and Rectum
Clinics in Colon and Rectal Surgery 2018; 31: 265-266 DOI: 10.1055/s-0038-1642050 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 4, 2018 Category: Surgery Authors: Tsikitis, V. Liana Tags: Preface Source Type: research

Vassiliki “Liana” Tsikitis, MD, MCR, FACS, FASCRS
Clinics in Colon and Rectal Surgery 2018; 31: 263-264 DOI: 10.1055/s-0038-1642049 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 4, 2018 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to Guest Editor Source Type: research

Uncommon Diverticular Disease
This article describes the epidemiology, pathogenesis, diagnosis, and treatment of three rare variants of diverticular disease: cecal and right-sided colonic diverticula, giant colonic diverticula, and small bowel diverticula. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Mohanty, Sanjay Webb, Shawn P. Tags: Review Article Source Type: research

Evaluation of Quality of Life and Surgical Outcomes for Treatment of Diverticular Disease
Clinics in Colon and Rectal Surgery 2018; 31: 251-257 DOI: 10.1055/s-0037-1607969The prevalence of diverticular disease in the Western and industrialized nations has increased over the last century, and our understanding of this disease and its management continues to evolve. In this article, we review the literature regarding the postoperative quality of life (QOL) and functional outcomes following surgical management of diverticulitis, including information regarding bowel function, recurrence of symptoms, and other postoperative sequelae. While objective parameters, such as attacks of diverticulitis, complications, and ...
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Lin, Mayin Raman, Shankar R. Tags: Review Article Source Type: research

Management of Diverticular Bleeding: Evaluation, Stabilization, Intervention, and Recurrence of Bleeding and Indications for Resection after Control of Bleeding
Clinics in Colon and Rectal Surgery 2018; 31: 243-250 DOI: 10.1055/s-0037-1607963Diverticular bleeding is the most common cause of lower gastrointestinal bleeding with nearly 200,000 admissions in the United States annually. Less than 5% of patients with diverticulosis present with diverticular bleeding and present usually as painless, intermittent, and large volume of lower gastrointestinal bleeding. Management algorithm for patients presenting with diverticular bleeding includes resuscitation followed by diagnostic evaluation. Colonoscopy is the recommended first-line investigation and helps in identifying the stigmata o...
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Mohammed Ilyas, Mohammed Iyoob Szilagy, Eric J. Tags: Review Article Source Type: research

Surgical Management of Diverticular Disease in the Elective Setting
Clinics in Colon and Rectal Surgery 2018; 31: 236-242 DOI: 10.1055/s-0037-1607962Diverticulosis is a common condition that has increased in prevalence in industrialized countries over the past century. Estimates of developing diverticular disease in the United states range from 5% by 40 years of age up, to over 80% by age 80. It is estimated that approximately 20% of patients with diverticulosis develop diverticulitis over the course of their lifetime. Diverticular disease can be divided into simple and chronic diverticulitis with various sub categories. There are various instances and circumstances where elective resectio...
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Neale, Jeffrey A. Tags: Review Article Source Type: research

Current Options for the Emergency Management of Diverticular Disease and Options to Reduce the Need for Colostomy
This article reviews the current options and recommendations for the emergency management of acute diverticulitis, including the spectrum of antibiotics, percutaneous drainage, laparoscopic lavage, and surgical options for resection with the restoration of bowel continuity. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Theodoropoulos, Dimitra Tags: Review Article Source Type: research

Management of Diverticular Disease in the Setting of Other Colorectal Pathology: Data on Simultaneous Issues in Segmental Colitis, Inflammatory Bowel Disease, Cancer, and Complications
Clinics in Colon and Rectal Surgery 2018; 31: 226-228 DOI: 10.1055/s-0037-1607468Diverticulosis of the colon is a very common anatomical condition. In the Western world, it affects more than 70% of over 65 years old population and represents the fifth most important gastrointestinal disease in terms of health care costs in Western countries. The diagnosis of diverticular disease and diverticulitis can be challenging. Often, there is overlap with other colonic pathologies, such as segmental colitis, ischemia, inflammatory bowel disease, cancer, or infectious colitis. Management of diverticular disease in these settings migh...
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Ghalyaie, Nasrin Tags: Review Article Source Type: research

Considerations and Changes in the Evaluation, Management, and Outcomes in the Management of Diverticular Disease: The Diagnosis, Pathology, and Treatment of Diverticular Colitis
Clinics in Colon and Rectal Surgery 2018; 31: 221-225 DOI: 10.1055/s-0037-1607467Diverticular colitis, also known as segmental colitis associated with diverticulosis, is a colonic inflammatory disorder on the spectrum of inflammatory bowel disease (IBD). The disease consists of macroscopic and microscopic inflammation affecting inter-diverticular mucosa, sparing peri-diverticular mucosa, with inflammation confined to the descending and sigmoid colon. The disease likely arises from the altered immune response of an individual, genetically susceptible to the IBD spectrum of diseases. Patients with segmental colitis associate...
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Kucejko, Robert J. Poggio, Juan L. Tags: Review Article Source Type: research

Current Status of the Radiologic Assessment of Diverticular Disease
Clinics in Colon and Rectal Surgery 2018; 31: 217-220 DOI: 10.1055/s-0037-1607466Radiologic assessment plays a vital role in the management of diverticulitis. It not only helps in the diagnosis, but also helps to guide the management. As technology has progressed, different modalities have offered insight into the treatment of this disease process. Through various trials and studies, certain modalities stand above the rest in terms of sensitivity and specificity. Computed tomography (CT) imaging has also proved to help us guide the management through a grading system. Newer studies show us the advantages of other modalitie...
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Kandagatla, Pridvi G. Stefanou, Amalia J. Tags: Review Article Source Type: research

Medical Management of Diverticular Disease
This article reviews the current literature supporting the non-surgical options for treatment in acute uncomplicated diverticulitis, complicated diverticulitis, and options for prevention of recurrent diverticulitis. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Knott, Liam Reickert, Craig A. Tags: Review Article Source Type: research

Epidemiology and Pathophysiology of Diverticular Disease
Clinics in Colon and Rectal Surgery 2018; 31: 209-213 DOI: 10.1055/s-0037-1607464Colonic diverticular disease is a common health care issue which has historically been attributed to western countries and older age population. Recent studies have shown a rise in incidence among developing countries that have adopted western diets as well as rise in prevalence among younger patients. In this article, the authors discuss the incidence, epidemiology, and pathophysiology of colonic diverticular disease. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents&nbs...
Source: Clinics in Colon and Rectal Surgery - June 22, 2018 Category: Surgery Authors: Munie, Semeret T. Nalamati, Surya P. M. Tags: Review Article Source Type: research