Diverticular Disease
Clinics in Colon and Rectal Surgery 2018; 31: 207-208 DOI: 10.1055/s-0037-1607463 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 - June 22, 2018 Category: Surgery Authors: Reickert, Craig A. Tags: Preface Source Type: research

Craig A. Reickert, MD, FACS, FASCRS
Clinics in Colon and Rectal Surgery 2018; 31: 205-206 DOI: 10.1055/s-0037-1607462 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 - June 22, 2018 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to Guest Editor Source Type: research

Translational Research in Familial Colorectal Cancer Syndromes
This article will summarize many of the updates to both the familiar and perhaps less familiar syndromes that can lead to inherited or early-onset colorectal cancer. [...] 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 - May 1, 2018 Category: Surgery Authors: Ford, Molly M. Tags: Review Article Source Type: research

Updates on Translational Research on Prevention of Polyps and Colorectal Cancer
Clinics in Colon and Rectal Surgery 2018; 31: 153-160 DOI: 10.1055/s-0037-1602235Morbidity and mortality from colorectal cancer (CRC) can be effectively reduced through early detection and prevention. To date, strategies for managing CRC risk have focused primarily on secondary prevention, through screening asymptomatic individuals for colorectal neoplasia. In the United States, implementation of screening among individuals age ≥50 has led to not only decreased CRC-related mortality but also reduced CRC incidence through colonoscopic removal of precancerous polyps. In contrast to screening's endpoint of early detection,...
Source: Clinics in Colon and Rectal Surgery - May 1, 2018 Category: Surgery Authors: Stoffel, Elena M. Tags: Review Article Source Type: research

Emerging Systemic Therapies for Colorectal Cancer
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602238Despite advances over the past 20 years in colorectal cancer (CRC) screening, diagnosis, and treatment, survival outcomes remain suboptimal. Five-year survival for patients with locally advanced CRC is 69%; 5-year survival drops to 12% for patients with metastatic disease. Novel, effective systemic therapies are needed to improve long-term outcomes. In this review, we describe currently available systemic therapies for the treatment of locally advanced and metastatic CRC and discuss emerging therapies, including encouraging advances in identifying novel targete...
Source: Clinics in Colon and Rectal Surgery - April 1, 2018 Category: Surgery Authors: Veenstra, Christine M. Krauss, John C. Tags: Review Article Source Type: research

Colorectal Cancer in Inflammatory Bowel Disease
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602237Patients with inflammatory bowel disease (IBD) are at significantly increased risk of colorectal cancer (CRC), principally resulting from the pro-neoplastic effects of chronic intestinal inflammation. Epidemiologic studies continue to highlight the increased risk of CRC in IBD. However, the incidence has declined over the past 30 years, attributed to both successful CRC-surveillance programs and improved control of mucosal inflammation. Risk factors that further increase the risk of IBD-related CRC include disease duration, extent and severity, the presence of ...
Source: Clinics in Colon and Rectal Surgery - April 1, 2018 Category: Surgery Authors: Stidham, Ryan W. Higgins, Peter D.R. Tags: Review Article Source Type: research

Development of Preclinical Models to Understand and Treat Colorectal Cancer
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602240The establishment and validation of preclinical models that faithfully recapitulate the pathogenesis and treatment response of human colorectal cancer (CRC) is critical to expedient therapeutic advances in the clinical management of this disease. Integral to the application of precision medicine for patients diagnosed with metastatic CRC is the need to understand the molecular determinants of response for a given therapy. Preclinical models of CRC have proven invaluable in answering many of our basic questions relating to the molecular aberrations that drive co...
Source: Clinics in Colon and Rectal Surgery - April 1, 2018 Category: Surgery Authors: Sebolt-Leopold, Judith S. Tags: Review Article Source Type: research

Update on Sporadic Colorectal Cancer Genetics
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602234Our understanding of the genetics of colorectal cancer has changed dramatically over recent years. Colorectal cancer can be classified in multiple different ways. Along with the advent of whole-exome sequencing, we have gained an understanding of the scale of the genetic changes found in sporadic colorectal cancer. We now know that there are multiple pathways that are commonly involved in the evolution of colorectal cancer including Wnt/β-catenin, RAS, EGFR, and PIK3 kinase. Another recent leap in our understanding of colorectal cancer genetics is the reco...
Source: Clinics in Colon and Rectal Surgery - April 1, 2018 Category: Surgery Authors: Hardiman, Karin M. Tags: Review Article Source Type: research

The Role of the Gut Microbiome in Colorectal Cancer
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602239There is increasing evidence that the gut microbiome, which consists of trillions of microbes representing over 1,000 species of bacteria with over 3 million genes, significantly impacts intestinal health and disease. The gut microbiota not only is capable of promoting intestinal homeostasis and antitumor responses but can also contribute to chronic dysregulated inflammation as well as have genotoxic effects that lead to carcinogenesis. Whether the gut microbiota maintains health or promotes colon cancer may ultimately depend on the composition of the gut micro...
Source: Clinics in Colon and Rectal Surgery - April 1, 2018 Category: Surgery Authors: Chen, Grace Y. Tags: Review Article Source Type: research

Translational Research in Colorectal Cancer
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1617415 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 - April 1, 2018 Category: Surgery Authors: Hardiman, Karin M. Tags: Preface Source Type: research

Karin M. Hardiman, MD, PhD
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602233 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 - April 1, 2018 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to Guest Editor Source Type: research

Current Approaches to Pediatric Polyposis Syndromes
Clinics in Colon and Rectal Surgery 2018; 31: 132-142 DOI: 10.1055/s-0037-1609029Colorectal adenomatous polyposis syndromes encompass a diverse group of disorders with varying modes of inheritance and penetrance. Children may present with overt disease or within screening programs for families at high risk. We provide an overview of the array of pediatric polyposis syndromes, current screening recommendations, and surgical indications and technical considerations. Optimal disease management for these pediatric patients is still evolving and has implications for screening, surveillance, pediatric surgical management, and tr...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: Fahy, Aodhnait S. Moir, Christopher R. Tags: Review Article Source Type: research

Enteric Duplication
Clinics in Colon and Rectal Surgery 2018; 31: 127-131 DOI: 10.1055/s-0037-1609028Enteric duplications have been described throughout the entire gastrointestinal tract. The usual perinatal presentation is an abdominal mass. Duplications associated with the foregut have associated respiratory symptoms, whereas duplications in the midgut and hindgut can present with obstructive symptoms, perforation, nausea, emesis, hemorrhage, or be asymptomatic, and identified as an incidental finding. These are differentiated from other cystic lesions by the presence of a normal gastrointestinal mucosal epithelium. Enteric duplications are...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: Jeziorczak, Paul M. Warner, Brad W. Tags: Review Article Source Type: research

Meconium Ileus
This article discusses the various ways cystic fibrosis can affect the gastrointestinal tract. Both the operative and nonoperative management of complicated and uncomplicated meconium ileus are discussed in the neonatal period as well as long-term issues, such as distal intestinal obstructive syndrome, fibrosing colonopathy, and rectal prolapse, all of which may be seen in older children and adults. [...] 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 - February 25, 2018 Category: Surgery Authors: Waldhausen, John H.T. Richards, Morgan Tags: Review Article Source Type: research

Anorectal Complaints: Hemorrhoids, Fissures, Abscesses, Fistulae
Clinics in Colon and Rectal Surgery 2018; 31: 117-120 DOI: 10.1055/s-0037-1609026Anorectal complaints are not uncommon in pediatric care, but the etiology and management can differ significantly from adults. Age is an important factor when considering etiology and management, distinguishing between infants, children, and adolescents. For all ages, malignancy is rarely a consideration, but a thorough examination of infants and children typically requires deep sedation or general anesthesia. Very little primary literature or evidence exists to guide care; so there are many opportunities for careful study to enhance our under...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: Jamshidi, Ramin Tags: Review Article Source Type: research

Pediatric Rectal Prolapse
Clinics in Colon and Rectal Surgery 2018; 31: 108-116 DOI: 10.1055/s-0037-1609025Rectal prolapse is a common and self-limiting condition in infancy and early childhood. Most cases respond to conservative management. Patients younger than 4 years with an associated condition have a better prognosis. Patients older than 4 years require surgery more often than younger children. Multiple operative and procedural approaches to rectal prolapse exist with variable recurrence rates and without a clearly superior operation. These include sclerotherapy, Thiersch's anal cerclage, Ekehorn's rectopexy, laparoscopic suture rectopexy, an...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: Rentea, Rebecca M. St Peter, Shawn D. Tags: Review Article Source Type: research

Chronic Intestinal Pseudo-obstruction
Clinics in Colon and Rectal Surgery 2018; 31: 099-107 DOI: 10.1055/s-0037-1609024Chronic intestinal pseudo-obstruction (CIP) is defined by either continuous or intermittent symptoms of bowel obstruction in the absence of fixed lumen excluding lesion. CIP includes a heterogeneous group of disorders which result either from diseases affecting the enteric neurons and smooth muscle lining or those involving the autonomic innervation of the bowel. Symptoms associated with CIP are nonspecific, which can sometimes contribute to the delay in recognizing the condition and making the correct diagnosis. The diagnostic workup should i...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: El-Chammas, Khalil Sood, Manu R. Tags: Review Article Source Type: research

Surgical Management of Idiopathic Constipation in Pediatric Patients
Clinics in Colon and Rectal Surgery 2018; 31: 089-098 DOI: 10.1055/s-0037-1609023Constipation is a common childhood problem, but an anatomic or physiologic cause is identified in fewer than 5% of children. By definition, idiopathic constipation is a diagnosis of exclusion. Careful clinical evaluation and thoughtful use of imaging and other testing can help exclude specific causes of constipation and guide therapy. Medical management with laxatives is effective for the majority of constipated children. For those patients unresponsive to medications, however, several surgical options can be employed, including anal procedure...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: Cheng, Lily S. Goldstein, Allan M. Tags: Review Article Source Type: research

Pediatric Crohn's Disease
Clinics in Colon and Rectal Surgery 2018; 31: 080-088 DOI: 10.1055/s-0037-1609022The incidence of Crohn's disease in the pediatric population is increasing. While pediatric patients with Crohn's disease exhibit many of the characteristics of older patients, there are important differences in the clinical presentation and course of disease that can impact the clinical decisions made during treatment. The majority of children are diagnosed in the early teen years, but subgroups of very early onset and infantile Crohn's present much earlier and have a unique clinical course. Treatment paradigms follow the traditional laddered...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: von Allmen, Daniel Tags: Review Article Source Type: research

Medical and Surgical Management of Pediatric Ulcerative Colitis
Clinics in Colon and Rectal Surgery 2018; 31: 071-079 DOI: 10.1055/s-0037-1609021Inflammatory bowel disease (IBD) describes a spectrum of idiopathic, lifelong, and progressive intestinal inflammatory conditions that includes Crohn's disease, ulcerative colitis, and indeterminate colitis. A worldwide increase in the incidence of IBD has been observed. In comparison to adults, IBD occurring during childhood and adolescence has several unique clinical characteristics and surgical management issues. In this article, we provide an overview contrasting these important differences. [...] Thieme Medical Publishers 333 Seventh Aven...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: Cabrera, Jos é M. Sato, Thomas T. Tags: Review Article Source Type: research

Anorectal Malformations
Clinics in Colon and Rectal Surgery 2018; 31: 061-070 DOI: 10.1055/s-0037-1609020Anorectal malformation are common congenital problems occurring in 1 in 5,000 births and have a spectrum of anatomical presentations, requiring individualized treatments for the newborn, sophisticated approaches to the definitive reconstruction, and management of long-term treatments and outcomes. Associated anomalies related to the cardiac, renal, gynecologic, orthopedic, spinal, and sacral systems impact care and prognosis. Long-term results are good provided there is an accurate anatomical reconstruction and a focus on maximizing of functio...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: Wood, Richard J. Levitt, Marc A. Tags: Review Article Source Type: research

Hirschsprung Disease beyond Infancy
Clinics in Colon and Rectal Surgery 2018; 31: 051-060 DOI: 10.1055/s-0037-1604034Hirschsprung disease (HD) is a common cause of neonatal intestinal obstruction in which a variable segment of the distal intestinal tract lacks the normal enteric nervous system elements. Affected individuals present with varying degrees of obstructive symptoms, but today most patients are diagnosed within the first several months of life owing to the well-recognized symptoms and the ease of making the diagnosis by way of the bedside suction rectal biopsy. Thus, for the adult general or colorectal surgeon, the vast majority of patients who pre...
Source: Clinics in Colon and Rectal Surgery - February 25, 2018 Category: Surgery Authors: Calkins, Casey M. Tags: Review Article Source Type: research

Pediatric and Congenital Colorectal Diseases in the Adult Patient
Clinics in Colon and Rectal Surgery 2018; 31: 049-050 DOI: 10.1055/s-0037-1604047 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 25, 2018 Category: Surgery Authors: Gourlay, David M. Tags: Preface Source Type: research

David M. Gourlay, MD, FACS, FAAP
Clinics in Colon and Rectal Surgery 2018; 31: 047-048 DOI: 10.1055/s-0037-1604046 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 25, 2018 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to Guest Editor Source Type: research

Sean C. Glasgow, MD, FACS, FASCRS
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602172 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 - December 20, 2017 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to the Guest Editor Source Type: research

Colon Trauma: Evidence-Based Practices
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602175Colon injury is not uncommon and occurs in about a half of patients with penetrating hollow viscus injuries. Despite major advances in the operative management of penetrating colon wounds, there remains discussion regarding the appropriate treatment of destructive colon injuries, with a significant amount of scientific evidence supporting segmental resection with primary anastomosis in most patients without comorbidities or large transfusion requirement. Although literature is sparse concerning the management of blunt colon injuries, some studies have shown ope...
Source: Clinics in Colon and Rectal Surgery - December 19, 2017 Category: Surgery Authors: Yamamoto, Ryo Logue, Alicia J. Muir, Mark T. Tags: Review Article Source Type: research

Historical Perspectives on Colorectal Trauma Management
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602174The authors discuss the history and evolution of management of traumatic wounds to the colon and rectum, summarizing early management parallel with the history of armed conflict followed by the increase in research and management interest by civilian centers in the post-Vietnam era. They explore the strong opinions of the early thought-leaders such as DeBakey and Ogilvie, detailing factors that may have impacted their views. The current literature on optimal management of both colon and rectal trauma is reviewed, including the contentious debate over which pati...
Source: Clinics in Colon and Rectal Surgery - December 19, 2017 Category: Surgery Authors: Tyler, Joshua A. Welling, David R. Tags: Review Article Source Type: research

Colonoscopic Perforations
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602179Colonoscopy is the gold standard for colon cancer screening. It has led to a decrease in the incidence of colorectal cancer mortality. Colon perforation is a feared complication of this procedure with high morbidity and substantial mortality. Due to the high volume of colonoscopies performed, the absolute number of colonoscopic perforations is relatively high. It leads to a substantial cost to the patient and the health system. Understanding the mechanisms and the risk factors may help in preventing perforation. Traditionally, a laparotomy with creation of a st...
Source: Clinics in Colon and Rectal Surgery - December 19, 2017 Category: Surgery Authors: Rai, Vinay Mishra, Nitin Tags: Review Article Source Type: research

Anal and Perineal Injuries
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602176With increased use of explosive devices in warfare, anal trauma is often seen coupled with more complex pelviperineal injury. While the associated mortality is high, casualties that survive are often left with disabling fecal incontinence from damage to the anosphincteric complex. After resolution of the acute insult, the initial evaluation mandates a thorough physical exam, including endoscopic evaluation with rigid proctoscopy and flexible sigmoidoscopy, as well as adjunctive testing, specifically anal manometry and endoanal ultrasound. First-line therapy fav...
Source: Clinics in Colon and Rectal Surgery - December 19, 2017 Category: Surgery Authors: Jeganathan, Arjun N. Cannon, Jeremy W. Bleier, Joshua I. S. Tags: Review Article Source Type: research

Rectal Trauma: Evidence-Based Practices
This article will serve to review the anatomy and types of injuries associated with rectal trauma. A treatment algorithm will also be presented based on our current literature review. We will also address controversial points and attempt to give our opinion in an effort to provide an update on an age-old problem. [...] 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 - December 19, 2017 Category: Surgery Authors: Clemens, Michael S. Peace, Kaitlin M. Yi, Fia Tags: Review Article Source Type: research

Management of Destructive Colon Injuries after Damage Control Surgery
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602178After the World War II, fecal diversion became the standard of care for colon injuries, although medical, logistic, and technical advancements have challenged this approach. Damage control surgery serves to temporize immediately life-threatening conditions, and definitive management of destructive colon injuries is delayed until after appropriate resuscitation. The bowel can be left in discontinuity for up to 3 days before edema ensues, but the optimal repair window remains within 12 to 48 hours. Delayed anastomosis performed at the take-back operation or stoma...
Source: Clinics in Colon and Rectal Surgery - December 19, 2017 Category: Surgery Authors: Chamieh, Jad Prakash, Priya Symons, William J. Tags: Review Article Source Type: research

The Evolution of Damage Control in Concept and Practice
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602177Damage control surgery (DCS) began as an adjunct approach to hemorrhage control, seeking to facilitate the body's innate clotting ability when direct repair or ligation was impossible, but it has since become a valuable instrument for a broader collection of critically ill surgical patients in whom metabolic dysfunction is the more immediate threat to life than imminent exsanguination. Modern damage control is a strategy that combines the principles of DCS with those of damage control resuscitation. When used correctly, damage control may improve survival in pr...
Source: Clinics in Colon and Rectal Surgery - December 19, 2017 Category: Surgery Authors: Beldowicz, Brian C. Tags: Review Article Source Type: research

Editorial
Clinics in Colon and Rectal Surgery DOI: 10.1055/s-0037-1602173 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 - December 19, 2017 Category: Surgery Authors: Glasgow, Sean C. Tags: Editorial Source Type: research

Locally Advanced Disease and Pelvic Exenterations
Clinics in Colon and Rectal Surgery 2017; 30: 404-414 DOI: 10.1055/s-0037-1606118Advanced primary and recurrent colorectal cancer can be successfully treated by experienced, dedicated centers delivering good outcomes with low mortality and morbidity. Development and implementation of a comprehensive referral pathway is to be encouraged. Multidisciplinary team management is essential in the management of this complex group of patients and is associated with significantly more complete preoperative evaluation and more accurate provision of patient information, as well as improved access to the most appropriate individualized...
Source: Clinics in Colon and Rectal Surgery - December 1, 2017 Category: Surgery Authors: Kontovounisios, Christos Tekkis, Paris Tags: Review Article Source Type: research

Molecular Biology: Are We Getting Any Closer to Providing Clinically Useful Information?
Clinics in Colon and Rectal Surgery 2017; 30: 415-422 DOI: 10.1055/s-0037-1606373Advances in molecular biology and biomarker research have significantly impacted our understanding and treatment of multiple solid malignancies. In rectal cancer, where neoadjuvant chemoradiation is widely used for locally advanced disease, most efforts have focused on the identification of predictors of response in an attempt to appropriately select patients for multimodality therapy. A variety of biomarkers have been studied, including genetic mutations, chromosomal copy number alterations, and single as well as multigene expression patterns...
Source: Clinics in Colon and Rectal Surgery - November 27, 2017 Category: Surgery Authors: Karagkounis, Georgios Kalady, Matthew F. Tags: Review Article Source Type: research

Organ-Preserving Strategies for the Management of Near-Complete Responses in Rectal Cancer after Neoadjuvant Chemoradiation
Clinics in Colon and Rectal Surgery 2017; 30: 395-403 DOI: 10.1055/s-0037-1606117In recent years, organ preservation has been considered a feasible alternative to total mesorectal excision for patients with locally advanced rectal cancer with a clinical complete response to neoadjuvant therapy. However, the degree of tumor response to neoadjuvant therapy is variable. A fraction of the patients who did not achieve a complete response had grossly visible tumors. These patients, with clearly incomplete clinical response, need a total mesorectal excision. In addition, some patients with a significant tumor response still have ...
Source: Clinics in Colon and Rectal Surgery - November 27, 2017 Category: Surgery Authors: Lynn, Patricio B. Strombom, Paul Garcia-Aguilar, Julio Tags: Review Article Source Type: research

Management of the Complete Clinical Response
Clinics in Colon and Rectal Surgery 2017; 30: 387-394 DOI: 10.1055/s-0037-1606116Organ preservation is considered in the management of selected patients with rectal cancer. Complete clinical response observed after neoadjuvant chemoradiation for rectal cancer is one of these cases. Patients who present complete clinical response are candidates to the watch-and-wait approach, when radical surgery is not immediately performed and is offered only to patients in the event of a local relapse. These patients are included in a strict follow-up, and up of 70% of them will never be operated during the follow-up. This strategy is as...
Source: Clinics in Colon and Rectal Surgery - November 27, 2017 Category: Surgery Authors: Habr-Gama, Angelita S ão Julião, Guilherme Pagin Vailati, Bruna Borba Castro, Ivana Raffaele, Debora Tags: Review Article Source Type: research

Neoadjuvant Strategies: Locally Advanced Rectal Cancer
This article principally concentrates on the current neoadjuvant treatment for locally advanced rectal cancer and the prognostic outcomes of such therapy, including a discussion on the historical perspective. [...] 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 - November 27, 2017 Category: Surgery Authors: Ahmed, Shahab Eng, Cathy Tags: Review Article Source Type: research

Neoadjuvant Treatment Strategies: Advanced Radiation Alternatives
This article will examine selected controversies, including novel chemoradiation regimens, duration of radiation (short vs. long course), and radiation techniques such as intensity-modulated radiation therapy (IMRT). [...] 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 - November 27, 2017 Category: Surgery Authors: Minsky, Bruce D. Tags: Review Article Source Type: research

Intersphincteric Resection Pushing the Envelope for Sphincter Preservation
This article will discuss the best indications, technical aspects, functional, and oncological outcomes of intersphicteric resection in the management of rectal cancer. [...] 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 - November 27, 2017 Category: Surgery Authors: Denost, Quentin Rullier, Eric Tags: Review Article Source Type: research

Abdominoperineal Excision: Technical Challenges in Optimal Surgical and Oncological Outcomes after Abdominoperineal Excision for Rectal Cancer
This article discusses the technical aspects and results from this approach. [...] 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 - November 27, 2017 Category: Surgery Authors: Holm, Torbj örn Tags: Review Article Source Type: research

Is There Any Reason to Still Consider Lateral Lymph Node Dissection in Rectal Cancer? Rationale and Technique
Clinics in Colon and Rectal Surgery 2017; 30: 346-356 DOI: 10.1055/s-0037-1606112Nodal dissemination in locally advanced rectal cancer occurs mainly in two directions: upward and lateral. Lateral node involvement has been demonstrated; however, lateral lymph node dissection (LLND) is not routinely performed in Western countries and the focus is more on neoadjuvant treatment regimens. The main reasons for this are the high morbidity associated with the operation and the uncertain oncological benefit. There is, however, recent evidence that in selected cases, neoadjuvant treatment combined with total mesorectal excision only...
Source: Clinics in Colon and Rectal Surgery - November 27, 2017 Category: Surgery Authors: Kusters, Miranda Uehara, Keisuke Velde, Cornelis J. H. van de Moriya, Yoshihiro Tags: Review Article Source Type: research

Transanal Total Mesorectal Excision: Why, When, and How
Clinics in Colon and Rectal Surgery 2017; 30: 339-345 DOI: 10.1055/s-0037-1606111Transanal total mesorectal excision (taTME) has evolved over the past decade fueled by advances in minimally invasive surgery. The technique aims to overcome the constraints posed by a narrow rigid pelvis and poor TME visualization that are encountered during “top-down” rectal surgery. A more accurate pelvic dissection should subsequently result in safer oncological resections and better preservation of pelvic autonomic nerves. taTME is an advanced complex technique that requires dedicated training and experience in TME surgery. In...
Source: Clinics in Colon and Rectal Surgery - November 27, 2017 Category: Surgery Authors: Penna, Marta Cunningham, Christopher Hompes, Roel Tags: Review Article Source Type: research

Is There Any Reason Not to Perform Standard Laparoscopic Total Mesorectal Excision?
Clinics in Colon and Rectal Surgery 2017; 30: 333-338 DOI: 10.1055/s-0037-1606110The curative treatment of locally advanced rectal cancer is currently based on chemoradiotherapy and total mesorectal excision (TME). Laparoscopy has developed considerably because of obvious clinical benefits such as reduced pain and shorter hospital stay. Recently, several prospective randomized clinical trials with long-term follow-up have showed that laparoscopy is noninferior to laparotomy with the same oncologic outcomes in terms of survival and local control rate. However, laparoscopic TME remains a challenging procedure requiring a hig...
Source: Clinics in Colon and Rectal Surgery - November 27, 2017 Category: Surgery Authors: Lakkis, Zaher Panis, Yves Tags: Review Article Source Type: research

The Perfect Total Mesorectal Excision Obviates the Need for Anything Else in the Management of Most Rectal Cancers
This article discusses the local control of primary rectal cancer and its locoregional spread in the light of modern advances. In recent years, the use of neoadjuvant chemoradiation has spread widely. However, its true benefit is not always balanced with its morbidities. Often total mesorectal excision (TME) is the best option. We will discuss the indications for immediate surgery for chemoradiation in advance and the importance of a delay in the management plan. To understand this selection, it is mandatory to know the true extent of tissue at risk for tumor dissemination and spread. Considering that TME may be enough for...
Source: Clinics in Colon and Rectal Surgery - November 27, 2017 Category: Surgery Authors: Heald, Richard John Santiago, Ines Pares, Oriol Carvalho, Carlos Figueiredo, Nuno Tags: Review Article Source Type: research

Local Excision and Endoscopic Resections for Early Rectal Cancer
Clinics in Colon and Rectal Surgery 2017; 30: 313-323 DOI: 10.1055/s-0037-1606108Radical surgery is considered as the standard treatment for rectal cancer. Transanal local excision has been considered an interesting alternative for the management of selected patients with rectal cancers for many decades. Different approaches had been considered for local excision, from endoscopic submucosal dissection to resections using platforms, such as transanal endoscopic microsurgery or transanal minimally invasive surgery. Identifying the ideal candidate for this approach is crucial, as a local failure after local excision is associ...
Source: Clinics in Colon and Rectal Surgery - November 27, 2017 Category: Surgery Authors: S ão Julião, Guilherme Pagin Celentano, Juan Pablo Alexandre, Flavia Andrea Vailati, Bruna Borba Tags: Review Article Source Type: research

How Should Imaging Direct/Orient Management of Rectal Cancer?
Clinics in Colon and Rectal Surgery 2017; 30: 297-312 DOI: 10.1055/s-0037-1606107Modern rectal cancer management is dependent on preoperative staging, and radiological assessment is a crucial part of this process. Imaging must provide sufficient information to guide preoperative decision-making that is reliable and reproducible. Different methods have been used for local staging; however, magnetic resonance imaging (MRI) has shown to be the most reliable tool for this purpose. MRI offers prognostic information about the patients and guides the decision between neoadjuvant treatment and total mesorectal excision alone. Also...
Source: Clinics in Colon and Rectal Surgery - November 27, 2017 Category: Surgery Authors: Bhoday, Jemma Balyasnikova, Svetlana Wale, Anita Brown, Gina Tags: Review Article Source Type: research

New Horizons in Rectal Cancer Management in Colon and Rectal Surgery
Clinics in Colon and Rectal Surgery 2017; 30: 295-296 DOI: 10.1055/s-0037-1606106 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 27, 2017 Category: Surgery Authors: Madoff, Robert D. Tags: Foreword Source Type: research

New Horizons in Rectal Cancer Management
Clinics in Colon and Rectal Surgery 2017; 30: 293-294 DOI: 10.1055/s-0037-1606105 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 27, 2017 Category: Surgery Authors: Perez, Rodrigo Oliva Tags: Preface Source Type: research

Rodrigo Oliva Perez, MD, PhD
Clinics in Colon and Rectal Surgery 2017; 30: 291-292 DOI: 10.1055/s-0037-1606104 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 27, 2017 Category: Surgery Authors: Steele, Scott R. Tags: Introduction to Guest Editor Source Type: research