Biologic versus Synthetic Mesh Reinforcement: What are the Pros and Cons?
Clinics in Colon and Rectal Surgery 2014; 27: 140-148DOI: 10.1055/s-0034-1394155Preserving patients' native tissues has posed many challenges for surgeons. Increased life expectancy is leading to a proportionately older surgical population with weaker tissues. The growing population of morbidly obese patients in addition to those with multiple comorbidities which influence the native strength and perfusion of tissues compounds the surgeon's challenge. Certainly, there is a rising demand for materials to replace or augment a patient's native tissue when it has been compromised. Over time, the number of products available ha...
Source: Clinics in Colon and Rectal Surgery - November 10, 2014 Category: Surgery Authors: FitzGerald, James F.Kumar, Anjali S. Source Type: research

Biomaterials: So Many Choices, So Little Time. What Are the Differences?
Clinics in Colon and Rectal Surgery 2014; 27: 134-139DOI: 10.1055/s-0034-1394087The use of biologic mesh has increased greatly in recent years in response to the need for a solution in managing contaminated hernias. Multiple different meshes are commercially available, and are derived from a variety of sources, including human dermis as well as animal sources. For a mesh to be effective, it must be resistant to infection, have adequate tensile strength for hernia repair, and be well tolerated by the host. To achieve this end, biologic meshes go through an intense processing that varies from one product to the next. In this...
Source: Clinics in Colon and Rectal Surgery - November 10, 2014 Category: Surgery Authors: Hunter, John D.Cannon, Jamie A. Source Type: research

A Primer on Wound Healing in Colorectal Surgery in the Age of Bioprosthetic Materials
Clinics in Colon and Rectal Surgery 2014; 27: 125-133DOI: 10.1055/s-0034-1394086Wound healing is a complex, dynamic process that is vital for closure of cutaneous injuries, restoration of abdominal wall integrity after laparotomy closure, and to prevent anastomotic dehiscence after bowel surgery. Derangements in healing have been described in multiple processes including diabetes mellitus, corticosteroid use, irradiation for malignancy, and inflammatory bowel disease. A thorough understanding of the process of healing is necessary for clinical decision making and knowledge of the current state of the science may lead futur...
Source: Clinics in Colon and Rectal Surgery - November 10, 2014 Category: Surgery Authors: Lundy, Jonathan B. Source Type: research

Continuing Medical Education
Clinics in Colon and Rectal Surgery 2014; 27: C1-C8DOI: 10.1055/s-0034-1395441Thieme 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 10, 2014 Category: Surgery Source Type: research

Novel Treatment Options for Fecal Incontinence
Clinics in Colon and Rectal Surgery 2014; 27: 116-120DOI: 10.1055/s-0034-1387800Fecal incontinence (FI) is a devastating condition affecting a substantial portion of the population. The etiologies of FI are wide ranging, as are the treatment options. When conservative measures fail, often surgical intervention is required. As in any area where a wide range of treatment options exist, there is no one perfect solution. Fortunately, novel treatment options for FI are becoming available, namely, posterior tibial nerve stimulation, magnetic anal sphincter, stem cell transplant, pyloric transplantation, and acupuncture.[...]Thie...
Source: Clinics in Colon and Rectal Surgery - September 24, 2014 Category: Surgery Authors: Barker, AdamHurley, Jefferson Source Type: research

Bowel Management in Spinal Cord Injury Patients
Clinics in Colon and Rectal Surgery 2014; 27: 113-115DOI: 10.1055/s-0034-1383904Spinal cord injuries are common in the United States, affecting approximately 12,000 people per year. Most of these patients lack normal bowel function. The pattern of dysfunction varies with the spinal level involved. Most patients use a bowel management program, and elements of successful programs are discussed. Surgical treatment, when indicated, could include sacral nerve stimulation, Malone antegrade continence enema, and colostomy.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table ...
Source: Clinics in Colon and Rectal Surgery - September 24, 2014 Category: Surgery Authors: Hughes, Matthew Source Type: research

Obstetrics and Fecal Incontinence
Clinics in Colon and Rectal Surgery 2014; 27: 110-112DOI: 10.1055/s-0034-1383903Anal incontinence (AI) can be a debilitating condition for women following vaginal delivery. Operative vaginal delivery and anal sphincter laceration are important risk factors for the development of postpartum AI. Obtaining a comprehensive delivery history, along with a thorough physical examination of the perineum, vagina and rectum may aid the clinician in the diagnosis of an anal sphincter defect. Sonographic imaging can also assist in identifying sphincter defects. The treatment of AI may include a combination of dietary modification, medi...
Source: Clinics in Colon and Rectal Surgery - September 24, 2014 Category: Surgery Authors: Chin, Kathleen Source Type: research

Surgical Management for Fecal Incontinence
This article is devoted to the various surgical options for fecal incontinence including the history, technical details, and studies demonstrating the complication and success rate.[...]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 24, 2014 Category: Surgery Authors: Anandam, Joselin L. Source Type: research

Pelvic Floor Rehabilitation in the Treatment of Fecal Incontinence
Clinics in Colon and Rectal Surgery 2014; 27: 99-105DOI: 10.1055/s-0034-1384662Fecal incontinence (FI) is a prevalent problem that can drastically affect quality of life. Pelvic floor rehabilitation is an important first-line treatment for patients with FI, and many published case reports and a small number of randomized controlled trials (RCTs) provide limited evidence for its efficacy. Pelvic floor rehabilitation approaches to the treatment of FI include pelvic floor muscle training, biofeedback, and volumetric training with rectal balloon catheters. Various forms of external electrical stimulation have also been describ...
Source: Clinics in Colon and Rectal Surgery - September 24, 2014 Category: Surgery Authors: Scott, Kelly M. Source Type: research

Medical Management of Fecal Incontinence in Challenging Populations: A Review
Clinics in Colon and Rectal Surgery 2014; 27: 91-98DOI: 10.1055/s-0034-1384661Fecal incontinence (FI) is a common and growing problem in the United States. Although there are multiple emerging novel interventions for the treatment of FI, the mainstay of initial therapy remains medical management. In this article, we review the available literature on the medical management of FI, with a special focus on patients with multiple sclerosis, diabetes mellitus, and the elderly.[...]Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals:Table of contents  |  Abstract&...
Source: Clinics in Colon and Rectal Surgery - September 24, 2014 Category: Surgery Authors: Lee, DavidArora, Gaurav Source Type: research

Diagnostic Testing for Fecal Incontinence
Clinics in Colon and Rectal Surgery 2014; 27: 85-90DOI: 10.1055/s-0034-1383901Many tests are available to assist in the diagnosis and management of fecal incontinence. Imaging studies such as endoanal ultrasonography and defecography provide an anatomic and functional picture of the anal canal which can be useful, especially in the setting of planned sphincter repair. Physiologic tests including anal manometry and anal acoustic reflexometry provide objective data regarding functional values of the anal canal. The value of this information is of some debate; however, as we learn more about these methods, they may prove usef...
Source: Clinics in Colon and Rectal Surgery - September 24, 2014 Category: Surgery Authors: Olson, Craig H. Source Type: research

Fecal Incontinence
Clinics in Colon and Rectal Surgery 2014; 27: 83-84DOI: 10.1055/s-0034-1383900Thieme 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 24, 2014 Category: Surgery Authors: Downs, J. Marcus Tags: Preface Source Type: research

J. Marcus Downs, MD
Clinics in Colon and Rectal Surgery 2014; 27: 81-82DOI: 10.1055/s-0034-1383905Thieme 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 24, 2014 Category: Surgery Authors: Beck, David E. Tags: Introduction to Guest Editor Source Type: research

Developing a Career in Colorectal Research
Clinics in Colon and Rectal Surgery 2014; 27: 041-042DOI: 10.1055/s-0034-1376165Thieme 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 9, 2014 Category: Surgery Authors: Yoo, Jim Tags: Preface Source Type: research

James Yoo, MD, FACS, FASCRS
Clinics in Colon and Rectal Surgery 2014; 27: 039-040DOI: 10.1055/s-0034-1376166Thieme 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 9, 2014 Category: Surgery Authors: Beck, David E. Tags: Introduction to the Guest Editor Source Type: research

Building an Academic Colorectal Division
Clinics in Colon and Rectal Surgery 2014; 27: 075-080DOI: 10.1055/s-0034-1376173Colon and rectal surgery is fully justified as a valid subspecialty within academic university health centers, but such formal recognition at the organizational level is not the norm. Creating a colon and rectal division within a greater department of surgery requires an unfailing commitment to academic concepts while promulgating the improvements that come in patient care, research, and teaching from a specialty service perspective. The creation of divisional identity then opens the door for a strategic process that will grow the division even...
Source: Clinics in Colon and Rectal Surgery - June 9, 2014 Category: Surgery Authors: Koltun, Walter A. Source Type: research

Work–Life Balance: History, Costs, and Budgeting for Balance
Clinics in Colon and Rectal Surgery 2014; 27: 071-074DOI: 10.1055/s-0034-1376172The concept and difficulties of work–life balance are not unique to surgeons, but professional responsibilities make maintaining a work–life balance difficult. Consequences of being exclusively career focused include burn out, physical, and mental ailments. In addition, physician burn out may hinder optimal patient care and incur significant costs on health care in general. Assessing current uses of time, allocating goals catered to an individual surgeon, and continual self-assessment may help balance time, and ideally will help pre...
Source: Clinics in Colon and Rectal Surgery - June 9, 2014 Category: Surgery Authors: Raja, SivaStein, Sharon L. Source Type: research

Establishing a Successful Clinical Research Program
This article covers the critical factors and the important components of a successful CR program. The first and most important step is to build a dedicated research team to overcome time constraints and enable a surgical practice to make CR a priority. With the research team in place, the next step is to create a program on the basis of an original idea and new clinical hypotheses. This often comes from personal experience supported by a review of the available evidence. Randomized controlled (clinical) trials are the most stringent way of determining whether a cause–effect relationship exists between the interventio...
Source: Clinics in Colon and Rectal Surgery - June 9, 2014 Category: Surgery Authors: Scoglio, DanieleFichera, Alessandro Source Type: research

Establishing a Successful Basic Science Research Program in Colon and Rectal Surgery
Clinics in Colon and Rectal Surgery 2014; 27: 058-064DOI: 10.1055/s-0034-1376170Although at first glance, the surgeon-scientist appears to be a rare breed in today's clinical revenue-driven world, with careful planning and mentorship this is still a vibrant career path. If one is considering this avenue, it is important to seize even small opportunities to pursue laboratory work during training—summers in college and medical school, rotation blocks, and dedicated time in the middle of residency. Publications and small grants during these times will lay the ground work for future success. When considering a faculty po...
Source: Clinics in Colon and Rectal Surgery - June 9, 2014 Category: Surgery Authors: Leeds, IraWick, Elizabeth C. Source Type: research

Academic Colorectal Surgery Job Search
This article describes some strategies to approach the academic colorectal job search and provides insight into deciding a career focus, exploring relevant positions, weighing specific factors, and negotiating your first offer.[...]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 9, 2014 Category: Surgery Authors: Kalady, Matthew F. Source Type: research

Developing a Research Skill Set
Clinics in Colon and Rectal Surgery 2014; 27: 048-054DOI: 10.1055/s-0034-1376168The recent decades have witnessed a significant expansion in the diversity of career paths within academic surgery. Although the skills for providing exemplary surgical care and for maintaining a strong work ethic are the foundations of an academic surgeon, deliberate career planning and organized acquisition of research skills contribute to the success of an academic career. In this article, we identify a set of core academic skills and propose a framework for acquiring them. We also describe specific career paths within academic surgery and p...
Source: Clinics in Colon and Rectal Surgery - June 9, 2014 Category: Surgery Authors: You, Y. NancyBednarski, Brian Source Type: research

Overview: Getting Involved in Research as a Busy Practicing Surgeon
This article will provide insight into the steps to consider along the way as you work to establish your successful research program.[...]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 9, 2014 Category: Surgery Authors: Kennedy, Gregory D. Source Type: research

Continuing Medical Education
Clinics in Colon and Rectal Surgery 2014; 27: C1-C8DOI: 10.1055/s-0034-1376174Thieme 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 9, 2014 Category: Surgery Source Type: research