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Current Trends in Vaccine Development for Hereditary Colorectal Cancer Syndromes
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770383The coming of age for cancer treatment has experienced exponential growth in the last decade with the addition of immunotherapy as the fourth pillar to the fundamentals of cancer treatment—chemotherapy, surgery, and radiation—taking oncology to an astounding new frontier. In this time, rapid developments in computational biology coupled with immunology have led to the exploration of priming the host immune system through vaccination to prevent and treat certain subsets of cancer such as melanoma and hereditary colorectal cancer. By targeting the immune system through tu...
Source: Clinics in Colon and Rectal Surgery - July 31, 2023 Category: Surgery Authors: Bowen, Charles M. Sinha, Krishna M. Vilar, Eduardo Tags: Review Article Source Type: research

Hereditary Colorectal Cancer Syndromes Registry: What, How, and Why?
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770733Caring for patients with colorectal cancer inherited cancer syndromes is complex, and it requires a well-thought integration process between a multidisciplinary team, an accessible database, and a registry coordinator. This requires an aligned vision between the administrative business team and the clinical team.Although we can manage most of the cancers that those patients develop according to oncologic guidance, the future risk of patients and their families might add emotional and psychological burdens on them in the absence of a well-qualified and trained team where bal...
Source: Clinics in Colon and Rectal Surgery - July 31, 2023 Category: Surgery Authors: Abbass, Mohammad Ali Poylin, Vitaliy Strong, Scott Tags: Review Article Source Type: research

Management of Desmoid Disease in Familial Adenomatous Polyposis
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770731Desmoid disease, though technically a benign condition, is nevertheless a leading cause of morbidity and mortality in patients with familial adenomatous polyposis (FAP). Desmoid disease impacts approximately 30% of FAP patients, with several known risk factors. It runs the gamut in terms of severity—ranging from small, slow-growing asymptomatic lesions to large, focally destructive, life-threatening masses. Desmoids usually occur following surgery, and several patient risk factors have been established, including female sex, family history of desmoid disease, 3′ APC mut...
Source: Clinics in Colon and Rectal Surgery - July 25, 2023 Category: Surgery Authors: Sommovilla, Joshua Shepard, Dale Liska, David Tags: Review Article Source Type: research

Precision Medicine in the Era of Genetic Testing: Microsatellite Instability Evolved
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770385The recognized importance of microsatellite instability (MSI) in cancer has evolved considerably in the past 30 years. From its beginnings as a molecular predictor for Lynch syndrome, MSI first transitioned to a universal screening test in all colorectal and endometrial cancers, substantially increasing the identification of patients with Lynch syndrome among cancer patients. More recently, MSI has been shown to be a powerful biomarker of response to immune checkpoint blockade therapy across a diversity of tumor types, and in 2017 was granted Food and Drug Administration ap...
Source: Clinics in Colon and Rectal Surgery - July 25, 2023 Category: Surgery Authors: Ioffe, Dina McSweeny, Michelle Hall, Michael J. Tags: Review Article Source Type: research

Joshua D. Sommovilla, MD, and Emre Gorgun, MD
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770707 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - July 25, 2023 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to the Guest Editors Source Type: research

Mohammad Ali Abbass, MD, MPH
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770378 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - July 22, 2023 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to the Guest Editor Source Type: research

Combined Endoscopy –Laparoscopy Surgery: When and How to Utilize This Tool
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770945Combined endoscopic and laparoscopic surgery (CELS) has been used to resect colon polyps since the 1990s. These colon-sparing techniques, however, have not yet been widely adopted. With the evolution of technology in both diagnosing and treating colon cancer, colorectal surgeons should strive for a diverse and complete armamentarium through which they can best serve their patients. In this article, we hope to provide clarity on CELS by discussing three topics: (1) the history and fruition of CELS; (2) the techniques involved in CELS; and (3) the utility of CELS within diffe...
Source: Clinics in Colon and Rectal Surgery - July 21, 2023 Category: Surgery Authors: Wlodarczyk, Jordan Gupta, Abhinav Lee, Sang W. Tags: Review Article Source Type: research

Assessment and Techniques for Endoscopic Closure
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770944Endoscopic closure is an essential technique to perform safe advanced endoscopy. Without appropriate closure of a defect, patients can experience spillage of fecal contents into the peritoneal cavity resulting in abdominal sepsis. The essential components to performing endoscopic closure are assessing the defect appropriately and choosing the correct closure technique. Assessing the defect involves five separate elements: timing, size, depth, shape, blood flow, and location in the colon or rectum. Understanding how each of these elements contributes toward a successful clos...
Source: Clinics in Colon and Rectal Surgery - July 19, 2023 Category: Surgery Authors: Siddharthan, Ragavan Marcello, Peter Tags: Review Article Source Type: research

Shared Decision-Making, Sphincter Preservation, and Rectal Cancer Treatment: Identifying and Executing What Matters Most to Patients
This article reviews these data in the context of shared decision-making approaches in an effort to better inform patients deliberating treatment options for rectal cancer. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Clinics in Colon and Rectal Surgery)
Source: Clinics in Colon and Rectal Surgery - July 19, 2023 Category: Surgery Authors: Ivatury, Srinivas Joga Suwanabol, Pasithorn A. Roo, Ana C. De Tags: Review Article Source Type: research

The Evolution of Genetic Testing from Focused Testing to Panel Testing and from Patient Focused to Population Testing: Are We There Yet?
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770381The field of cancer genetics has evolved significantly over the past 30 years. Genetic testing has become less expensive and more comprehensive which has changed practice patterns. It is no longer necessary to restrict testing to those with the highest likelihood of testing positive. In addition, we have learned that the criteria developed to determine who has the highest likelihood of testing positive are neither sensitive nor specific. As a result, the field is moving from testing only the highest risk patients identified based on testing criteria to testing all cancer pa...
Source: Clinics in Colon and Rectal Surgery - July 19, 2023 Category: Surgery Authors: Gima, Lauren Solomon, Ilana Hampel, Heather Tags: Review Article Source Type: research

Chemoprevention in Inherited Colorectal Cancer Syndromes
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770384Cancer prevention in hereditary gastrointestinal predisposition syndromes relies primarily on intensive screening (e.g., colonoscopy) or prophylactic surgery (e.g., colectomy). The use of chemopreventive agents as an adjunct to these measures has long been studied both in the general population and in hereditary cancer patients, in whom the risk of malignancy, and therefore the potential risk reduction, is considerably greater. However, to date only few compounds have been found to be effective, safe, and tolerable for widespread use. Furthermore, many of the studies involv...
Source: Clinics in Colon and Rectal Surgery - July 19, 2023 Category: Surgery Authors: Gilad, Ophir Muller, Charles Kupfer, Sonia S. Tags: Review Article Source Type: research

The Role of Intraoperative Radiotherapy Treatment of Locally Advanced Rectal Cancer
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770718Intraoperative radiation therapy (IORT) has been used in the treatment of locally advanced and recurrent rectal cancers for the last several decades. Given the heterogeneity of patients treated and different indications for use and dosing at different institutions, it has been difficult to discern if IORT adds any appreciable benefit to standard of care therapies. Herein, the rationale for IORT in rectal cancer is discussed along with the most modern and best available data in 2023. IORT is likely indicated in patients with locally advanced and locally recurrent rectal canc...
Source: Clinics in Colon and Rectal Surgery - July 19, 2023 Category: Surgery Authors: Amarnath, Sudha R. Tags: Review Article Source Type: research

Dual Channel Endoscopic Mucosal Resection
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770943Endoscopic mucosal resection (EMR) is the recommended technique for colon polypectomy for nonpedunculated lesions that are >20 mm in size not requiring excision. Dual-channel EMR (DC-EMR) uses an endoscope with two working channels to facilitate easier submucosal injection, snare resection, and clip closure of polypectomy defects. There is also promising early literature indicating that this endoscopic modality can reduce the overall learning curve present for single-channel colonoscopy EMR. This chapter will describe the steps and techniques required to perform DC-EMR...
Source: Clinics in Colon and Rectal Surgery - July 17, 2023 Category: Surgery Authors: Saraidaridis, Julia T. Gaetani, Racquel S. Marcello, Peter W. Tags: Review Article Source Type: research

Endoscopic Assessment of Colorectal Polyps
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770940Colorectal cancer is the third most common cancer among men and the second among women. In the United States alone, there are 150,000 cases diagnosed each year. Colonoscopy remains the best method for identifying, evaluating, and intervening on patients with precancerous lesions. Multiple guidelines and techniques are available to assist the endoscopist with accurate diagnosis of these lesions. These include the Paris, Narrow-Band Imaging (NBI) International Colorectal Endoscopic (NICE), Japan NBI Expert Team (JNET), Kudo, Hiroshima, and Shudo classifications which utilize ...
Source: Clinics in Colon and Rectal Surgery - July 17, 2023 Category: Surgery Authors: Pettis, Jaron Paruch, Jennifer Tags: Review Article Source Type: research

Endoscopic Colorectal Stenting: Lessons Learned from a Two-Decade Journey
Clin Colon Rectal Surg DOI: 10.1055/s-0043-1770946Endoscopic colorectal stenting has gained momentum over the last two decades as a viable alternative to surgical intervention in a subgroup of patients with colorectal disease. Stenting can be used as a temporizing bridge to surgical intervention or as a definitive treatment measure. Patient selection and the technical expertise of the endoscopist are of paramount importance to optimize the clinical outcome. Technical skills in therapeutic endoscopy and the choice of proper equipment including the consumables are required for the conduct of a safe and successful procedure. ...
Source: Clinics in Colon and Rectal Surgery - July 17, 2023 Category: Surgery Authors: Oner, Muharrem Abbas, Maher A. Tags: Review Article Source Type: research