Developing Opioid Prescription Guidelines After Anorectal Surgery: Do Patient-Reported Outcomes and Risk Factors Influence Consumption?
BACKGROUND:
Opioids prescribed to address postoperative pain drive opioid-related deaths in the United States. Prescribing guidelines have been developed for many general surgical procedures, which have decreased opioid prescription and consumption. The literature on opioids after anorectal surgery is lacking.
OBJECTIVE:
We analyzed our data on opioid prescription and consumption to create opioid-prescribing guidelines for anorectal procedures.
DESIGN:
We designed a prospectively collected postoperative survey given to consecutive patients undergoing anorectal surgery by colorectal surgeons.
SETTINGS: ...
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Original Contributions: Anorectal Source Type: research
Topical Versus Oral Metronidazole After Excisional Hemorrhoidectomy: A Double-Blind Randomized Controlled Trial
CONCLUSION:
Postoperative oral and topical metronidazole provide similar analgesia after excisional hemorrhoidectomy. The route should depend on patient preference, with topical administration potentially benefiting from improved antimicrobial stewardship and having less effect on the gut microbiome. See Video Abstract at http:/links.lww.com/DCR/B853.
METRONIDAZOL TÓPICO VERSUS ORAL DESPUÉS DE UNA HEMORROIDECTOMÍA POR ESCISIÓN: UN ENSAYO CONTROLADO ALEATORIO DOBLE CIEGO
ANTECEDENTES:
Se ha demostrado que tanto el metronidazol tópico como el oral reducen el dolor después de una hemorroidectomía por esci...
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Original Contributions: Anorectal Source Type: research
IPAA Is More “Desmoidogenic” Than Ileorectal Anastomosis in Familial Adenomatous Polyposis
This study aimed to investigate the surgical risk factors for desmoid formation.
DESIGN:
This was a retrospective, single-center, registry-based cohort study.
SETTINGS:
This study was conducted at a single academic institution with a prospectively maintained hereditary colorectal cancer database between 1995 and 2015.
PATIENTS:
All patients with familial polyposis (total 345) who underwent either proctocolectomy with a pouch or colectomy with an ileorectal anastomosis during the study period and met inclusion criteria were selected.
MAIN OUTCOME MEASURES:
The development of symptomatic abdominal...
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Original Contributions: Benign Source Type: research
Stoma-less IPAA Is Not Associated With Increased Anastomotic Leak Rate or Long-term Pouch Failure in Patients With Ulcerative Colitis
CONCLUSIONS:
The results of this study suggest that the omission of a diverting ileostomy is feasible in select patients undergoing IPAA. Stoma-less IPAA does not have a statistically significant higher risk of anastomotic leak or pouch failure when compared to IPAA with diverting loop ileostomy in properly selected patients. Diverting loop ileostomies have their own risks, which partially offset their perceived safety. See Video Abstract at http://links.lww.com/DCR/B891.
LA ANASTOMÓSIS DE RESERVORIO ILEAL AL ANO SIN ESTOMA NO ESTÁ ASOCIADO CON UN AUMENTO EN LA TASA DE FUGA ANASTOMÓTICA O DISFUNCIÓN DE LA BOLSA ...
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Original Contributions: Inflammatory Bowel Disease Source Type: research
Multicenter Study of Drain Fluid Amylase as a Biomarker for the Detection of Anastomotic Leakage After Ileal Pouch Surgery Without a Diverting Ileostomy
This study aimed to assess drain fluid amylase as a biomarker of anastomotic leak after ileal pouch surgery and without a diverting ileostomy.
DESIGN:
This was a multicenter prospective observational cohort study.
SETTINGS:
The study was conducted at 4 tertiary hospitals in Queensland, Australia.
PATIENTS:
This study included elective patients undergoing restorative proctectomy and ileal pouch surgery.
INTERVENTIONS:
Measurement of rectal tube amylase and drain fluid amylase.
MAIN OUTCOME MEASURES:
The primary measure was observation of increased drain fluid amylase on the day of anastomo...
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Original Contributions: Inflammatory Bowel Disease Source Type: research
Clinical Implication of Perineural and Lymphovascular Invasion in Rectal Cancer Patients Who Underwent Surgery After Preoperative Chemoradiotherapy
This study assessed the prognostic value of lymphovascular and perineural invasion in rectal cancer patients who received preoperative chemoradiotherapy followed by curative resection.
DESIGN:
This is a retrospective analysis.
SETTING:
This study was performed at a tertiary cancer center.
PATIENTS:
Rectal cancer patients who underwent curative resection after preoperative chemoradiotherapy between January 2000 and December 2010.
MAIN OUTCOME MEASURES:
The primary outcomes were disease-free survival and overall survival. The survival rates were estimated using Kaplan-Meier analysis, and group com...
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
A Comparison of Perineal Myocutaneous Flaps Following Abdominoperineal Excision of the Rectum for Anorectal Pathology
This study was conducted at a large, tertiary referral institution.
PATIENTS:
Following Institutional Review Board approval, prospectively maintained clinical and financial databases were interrogated and cross-referenced for patients undergoing proctectomy or abdominoperineal resection with flap reconstruction from 2007 to 2018. Patients with primary gynecological or urological pathology were excluded.
MAIN OUTCOME MEASURES:
The primary outcome was flap complication rate. Secondary outcomes included perineal hernia rate, donor site complications, emergency department consult after discharge, readmission 0.9)...
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
Transanal Endoscopic Microsurgery Versus Total Mesorectal Excision in ypT0-1 Rectal Cancer After Preoperative Radiochemotherapy: Postoperative Morbidity, Functional Results, and Long-term Oncologic Outcome
This study aimed to evaluate postoperative short-term morbidity, functional outcome, and oncologic long-term outcome in patients with rectal cancer treated with local excision by transanal endoscopic microsurgery or radical surgery and to determine who achieved a complete or major pathological response (ypT0-1) after neoadjuvant treatment.
DESIGN:
This was a retrospective study.
SETTING:
The study was conducted at a single center.
PATIENTS:
Patients who had received neoadjuvant treatment by local excision with a major or complete pathological response at histological examination (transanal endoscopic m...
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Original Contributions: Colorectal Cancer Source Type: research
Expert Commentary on the Incidental Goblet Cell Adenocarcinoma
No abstract available (Source: Diseases of the Colon and Rectum)
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Commentaries and Educational Content: Resident’s Corner Source Type: research
The Incidental Goblet Cell Adenocarcinoma
No abstract available (Source: Diseases of the Colon and Rectum)
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Commentaries and Educational Content: Resident’s Corner Source Type: research
The European Society of Coloproctology Collecting Opinions on Sustainable Surgery Study
No abstract available (Source: Diseases of the Colon and Rectum)
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Commentaries and Educational Content: Viewpoint Source Type: research
Being Academic
No abstract available (Source: Diseases of the Colon and Rectum)
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Commentaries and Educational Content: On Being ... Source Type: research
Providing Value to Patients: Operating Outside the Bubble
No abstract available (Source: Diseases of the Colon and Rectum)
Source: Diseases of the Colon and Rectum - October 14, 2022 Category: Gastroenterology Tags: Commentaries and Educational Content: Editorial Source Type: research
Colon and Rectal Surgery Regional Society Meetings
No abstract available (Source: Diseases of the Colon and Rectum)
Source: Diseases of the Colon and Rectum - September 23, 2022 Category: Gastroenterology Tags: Colon and Rectal Surgery Regional Society Meetings Source Type: research
Announcements
No abstract available (Source: Diseases of the Colon and Rectum)
Source: Diseases of the Colon and Rectum - September 23, 2022 Category: Gastroenterology Tags: Announcements Source Type: research
