Implementation of an Enhanced Recovery After Surgery program in elective colorectal surgery: a prospective cohort study
ConclusionsERAS protocol and laparoscopic surgery decreased LOS without increasing 30 days readmission rate. Severe CDC increased LOS and readmissions.ResumoObjetivoAvaliar os resultados de um protocolo de recuperação aprimorada após a cirurgia (enhanced recovery after surgery [ERAS]) em cirurgia colorretal eletiva em comparação com a coorte histórica deste hospital, que recebeu o tratamento padrão, em termos de hospitalização, taxa de readmissão de 30 dias e graus 3 a 5 na escala de complicações cirúrgicas de Clavien-Dindo (CCD).MetodologiaOs dados foram coletados de pacientes consecutivos em dois períodos d...
Source: Journal of Coloproctology - June 26, 2019 Category: Gastroenterology Source Type: research
Perianal Paget's disease
We report a case of extramammary Paget's disease in the perianal region that initially presented as an irregular, circumferential, scaling lesion with eczematous eruptions. Immunology and immunohistochemistry confirmed the diagnosis. Although surgery is the standard treatment, the patient opted for pelvic radiotherapy associated with radiosensitizing chemotherapy.ResumoA doença de Paget acomete mais comumente a mama. Os focos extramamários são raros e os locais mais habitualmente acometidos são vulva, ânus, região perianal e axila. A patologia envolve a evolução da doença para adenocarcinoma invasivo ou neoplasias...
Source: Journal of Coloproctology - June 26, 2019 Category: Gastroenterology Source Type: research
Rectal carcinoma with synchronous liver metastases
ConclusionComplete resection of liver metastases is considered the major condition for a potential survival outcome in these patients. Management of these patients should include a multidisciplinary team with consideration of each individual specificities. Prospective randomized trials are needed to elucidate the optimal treatment strategy.ResumoIntroduçãoO câncer colorretal está entre as neoplasias mais prevalentes no mundo, apresentando a uma taxa de mortalidade relativamente alta. Ele corresponde a 20% a 30% de todos os casos de câncer colorretal; 25% dos casos apresentam doença metastática síncrona. Este estudo...
Source: Journal of Coloproctology - June 24, 2019 Category: Gastroenterology Source Type: research
The significance of retroflexion technique in the right colon on adenoma detection rates during colonoscopy
ConclusionColonoscopy with right-sided retroflexion after forward-view examination significantly increases the detection of adenomas compared with standard forward-view examination with a high success rate and small risk of adverse events.ResumoAntecedentes e objetivoOs adenomas do cólon direito podem não ser diagnosticados, apresentando uma elevada taxa de não detecção de adenoma, especialmente quando estão localizados atrás das pregas haustrais e flexões anatômicas. O objetivo deste estudo foi comparar, no cólon direito, a técnica de visualização retroflexionada com a técnica de visualização frontal quant...
Source: Journal of Coloproctology - June 22, 2019 Category: Gastroenterology Source Type: research
Management of rectal prolapse (Guda Bhramsa) through Kshara Karma (chemical cauterisation) – a case study
Publication date: Available online 17 June 2019Source: Journal of ColoproctologyAuthor(s): Madan Bhandari, Basavaraj Chanda, Prasanna N. Rao, B.J. Gopikrishna, K.R. SahanasheelaAbstractRectal Prolapse is a condition where the rectum protrudes beyond the anus. The explanation of this condition can be traced back to ancient Ayurveda text like Susruta Samhita, Ebers Pappyrus of 1500 B.C., etc. The exact cause of rectal prolapse is unclear but it is predominant on female gender and on people having constipation, previous anorectal surgeries etc. Both patial and complete varieties of rectal prolapse are extremely debilitating b...
Source: Journal of Coloproctology - June 19, 2019 Category: Gastroenterology Source Type: research
Other causes of intestinal obstruction actino-mycetoma – a case report and literature review
ConclusionIn low income countries, intestinal actinomycosis should be considered in the differential diagnosis of abdominal masses and chronic inflammatory processes, patient prognosis with proper management is excellent.ResumoIntroduçãoA actinomicose é uma doença infecciosa rara que acomete órgãos abdominais, simula doença oncológica e dificilmente causa de obstrução intestinal.SintomasPaciente do sexo masculino, 43 anos, com quadro de dor abdominal esquerda por dois meses, associado ao surgimento de massa e perda de peso de 8 kg, sem febre ou alterações dos hábitos intestinais.IntervençõesColonoscopia...
Source: Journal of Coloproctology - June 7, 2019 Category: Gastroenterology Source Type: research
Tumour sidedness and clinicopathological features of resected colon cancer in rural population of Northern Pakistan: single institutional analysis
ConclusionOur study is the first report of colon cancer in a rural population in north-Pakistan. An earlier onset of tumours (44–50 years) was observed in comparison with global data.ResumoObjetivoCaracterísticas clínico-patológicas e moleculares distintas foram observadas em tumores de cólon no lado direito ou esquerdo. O presente estudo teve como objetivo caracterizar o câncer de cólon e sua lateralidade em uma população rural norte-paquistanesa diagnosticada com câncer de cólon nesta instituição.MétodosO estudo incluiu 70 pacientes que foram submetidos a quimioterapia adjuvante no Instituto Bannu de Medic...
Source: Journal of Coloproctology - June 4, 2019 Category: Gastroenterology Source Type: research
Laparoscopic versus robotic approach in rectal cancer
Publication date: Available online 1 June 2019Source: Journal of ColoproctologyAuthor(s): Marcus Valadão, Rodrigo Otavio Araujo, Eduardo Linhares, José Paulo de JesusAbstractThe treatment of rectal cancer is complex and responsible for sequelae due to the various therapeutic modalities, especially the surgical resection. The advent of minimally invasive surgery provided a faster postoperative recovery and a lower complication rate when compared to conventional surgery. The implementation of laparoscopic approach in rectal cancer was responsible for these better results, but the limitations of this method added to the dev...
Source: Journal of Coloproctology - June 2, 2019 Category: Gastroenterology Source Type: research
Evaluation of polypropylene and polyglactin sutures in primary sphincteroplasty for the treatment of anal fistula in rats
ConclusionThere was no persistence of the fistula in any of the treated animals; there was no difference in the distance between the muscle fibers between the groups subjected to primary sphincteroplasty with polypropylene or polyglactin, or between these groups and the one treated only by fistulotomy. There was greater fibrosis in animals treated with primary sphincteroplasty with polyglactin.ResumoRacionalA fistulotomia seguida de esfincteroplastia primária é uma das opções terapêuticas nas fístulas transesfincterianas, porém, não se sabe ao certo qual fio poderia apresentar melhor resultado.ObjetivoComparar os f...
Source: Journal of Coloproctology - June 1, 2019 Category: Gastroenterology Source Type: research
Anal position index; can it predict pelvic organ disorders in adults?
DiscussionAnal position index can be a prognostic factor to predict chronic constipation and pelvic floor anatomy disturbance in adults as well as pediatrics.ResumoIntroduçãoO índice de posição anal é calculado com uma fórmula simples, usada para determinar a posição exata do ânus no períneo. Atualmente, esse índice é usado apenas em neonatos e bebês. O deslocamento anterior do ânus é uma causa comum de constipação crônica. No presente estudo, avaliou-se a associação entre o índice de posição anal e as características dos pacientes, constipação crônica, prolapso uterino, prolapso do reto e núme...
Source: Journal of Coloproctology - June 1, 2019 Category: Gastroenterology Source Type: research
Jejunal stromal tumor and neurofibromatosis
This study aimed to report a case of gastrointestinal stromal tumor in the jejunal region in a patient with type 1 neurofibromatosis, followed-up for two years, who underwent laparoscopic segmental enterectomy and diagnosis determined by histopathology and immunohistochemistry. The diagnosis of small intestine gastrointestinal stromal tumor is challenging because of its low incidence, nonspecific symptoms, relative inaccessibility of the small intestine to conventional endoscopic examination, broad spectrum of radiological appearances, and the fact that the nature of the mass is difficult to determine with imaging examinat...
Source: Journal of Coloproctology - June 1, 2019 Category: Gastroenterology Source Type: research
Visceral obesity is not correlated with lymph node metastases nor Colorectal cancer survival
ConclusionIn this study, no significant association was observed between visceral obesity and the number of metastatic lymph node, nor with survival at 5 and 10 years.ResumoIntroduçãoA presença de metastização ganglionar no câncer colorretal é determinante como fator de prognóstico e para planear o tratamento. A relação entre a presença de gordura visceral e o prognóstico não está totalmente documentada na literatura. Assim, pretende-se avaliar a existência de relação entre obesidade visceral e a presença de metástases ganglionares e o prognóstico de doentes com câncer colorretal.Materiais e métodosCo...
Source: Journal of Coloproctology - May 30, 2019 Category: Gastroenterology Source Type: research
Congenital abnormalities and anatomical variations of the vermiform appendix and mesoappendix
ConclusionThis review sought to present and discuss the anatomical variations and congenital abnormalities of the vermiform appendix and mesoappendix reported in recent years, and their associations with acute appendicitis and other associated pathologies, contributing to aid in clinical diagnosis and surgical interventions in patients with suspected acute appendicitis.ResumoObjetivoO objetivo desta revisão foi apresentar e discutir as variações anatômicas e anomalias congênitas do apêndice vermiforme e mesoapêndice relatados nos últimos anos e suas associações com apendicite aguda e outras patologias associadas....
Source: Journal of Coloproctology - May 29, 2019 Category: Gastroenterology Source Type: research
Endoscopic stent in malignant colonic obstruction: the risk of tumor seeding
Discussion and conclusionObservational studies and clinical trials show discrepant results. Metal stents are increasingly accepted in palliative care but are not yet recommended as a bridge to curative surgery. Treatment should be individualized, according to surgical risk and the probability of endoscopic complications.ResumoIntroduçãoA oclusão intestinal aguda maligna é tradicionalmente considerada uma emergência cirúrgica. Com o desenvolvimento das técnicas endoscópicas surgiram os stents metálicos que asseguram a patência do cólon em doentes não candidatos a cirurgia e, mais recentemente, como uma medida te...
Source: Journal of Coloproctology - May 29, 2019 Category: Gastroenterology Source Type: research
Visceral obesity is not correlated with lymph node metastases nor CRC survival
ConclusionIn this study, no significant association was observed between visceral obesity and the number of metastatic lymph node, nor with survival at 5 and 10 years.ResumoIntroduçãoA presença de metastização ganglionar no câncer colorretal é determinante como fator de prognóstico e para planear o tratamento. A relação entre a presença de gordura visceral e o prognóstico não está totalmente documentada na literatura. Assim, pretende-se avaliar a existência de relação entre obesidade visceral e a presença de metástases ganglionares e o prognóstico de doentes com câncer colorretal.Materiais e métodosCo...
Source: Journal of Coloproctology - May 26, 2019 Category: Gastroenterology Source Type: research
