Prophylactic HIPEC in high-risk colorectal cancer: do we really need a randomized clinical trial to prove a “logical” hypothesis?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 18, 2021 Category: Surgery Source Type: research

Fascial space priority approach for laparoscopic en bloc extended right hemicolectomy with pancreaticoduodenectomy for locally advanced colon cancer
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 17, 2021 Category: Surgery Source Type: research

Virtual laparoscopic imaging for performing central vascular ligation through laparoscopic surgery for transverse colon cancer
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 16, 2021 Category: Surgery Source Type: research

Management of cryptoglandular fistula-in-ano among gastrointestinal surgeons in the Netherlands
ConclusionsDutch gastrointestinal surgeons use various techniques in the management of FIA. Novel promising techniques should be investigated adequately in sufficient large trials to increase consensus. A core outcome measurement and a prospective international database would help in comparing results. Until then, treatment should be adjusted to the individual patient, governed by fistula characteristics and patient choice. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 15, 2021 Category: Surgery Source Type: research

Laparoscopic ventral mesh rectopexy performed with ArtiSential ®: a video vignette
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 15, 2021 Category: Surgery Source Type: research

Delta-shaped overlap anastomosis in laparoscopic colectomy with mechanical closure of the enterotomy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 9, 2021 Category: Surgery Source Type: research

D-pouch: a modified ileal J-pouch for patients with ulcerative colitis and familial adenomatous polyposis
ConclusionsThe D-pouch construction is safe and feasible for patients with UC and FAP with good functional outcome over the medium term and the potential to reduce the risk of pouch  leaks. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 7, 2021 Category: Surgery Source Type: research

Prospective study of urinary function and analysis of risk factors after rectal cancer surgery
ConclusionsOur study showed worsening urinary dysfunction after rectal cancer surgery in 26.4% of the patients. However, there were no statistically significant differences in mean IPSS scores at the three assessment times (preoperatively, 6  months, 12 months). ASA class, surgical difficulty, and anastomotic leakage may predict postoperative deterioration. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 2, 2021 Category: Surgery Source Type: research

The management of adult appendicitis during the COVID-19 pandemic: an interim analysis of a UK cohort study
This study describes the impact of the first weeks of the pandemic on the management of AA in the United Kingdom (UK).MethodsPatients 18  years or older, diagnosed clinically and/or radiologically with AA were eligible for inclusion in this prospective, multicentre cohort study. Data was collected from 23rd March 2020 (beginning of the UK Government lockdown) to 1st May 2020 and included: patient demographics, COVID status; initial management (operative and conservative); length of stay; and 30-day complications. Analysis was performed on the first 500 cases with 30-day follow-up.ResultsThe patient cohort consisted of...
Source: Techniques in Coloproctology - April 1, 2021 Category: Surgery Source Type: research

How to make operating anoscopes from large syringes
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 1, 2021 Category: Surgery Source Type: research

Impact of a defunctioning ileostomy and time to stoma closure on bowel function after low anterior resection for rectal cancer: a systematic review and meta-analysis
AbstractBackgroundImpaired bowel function after low anterior resection (LAR) for rectal cancer is a frequent problem with a major impact on quality of life. The aim of this study was to assess the impact of a defunctioning ileostomy, and time to ileostomy closure on bowel function after LAR for rectal cancer.MethodsWe performed a systematic review based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Comprehensive literature searches were conducted using PubMed, Embase and Cochrane databases for articles published from 1989 up to August 2019. Analysis was performed using Review...
Source: Techniques in Coloproctology - April 1, 2021 Category: Surgery Source Type: research

T2-weighted, apparent diffusion coefficient and 18 F-FDG PET histogram analysis of rectal cancer after preoperative chemoradiotherapy
ConclusionsHistogram analysis of SUV values is a predictor of TRG in LARC. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 1, 2021 Category: Surgery Source Type: research

Sampling reflex: a relic from the past or a useful parameter for the future?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 31, 2021 Category: Surgery Source Type: research

Fecobionics assessment of the effect of position on defecatory efficacy in normal subjects
AbstractBackgroundDefecation is a complex process and up to 25% of the population suffer from symptoms of defecatory dysfunction. For functional testing, diagnostics, and therapy of anorectal disorders, it is important to know the optimal defecation position. is The aim of this study was to evaluate defecation pressure patterns in side lying, seated and squatting defecation positions in normal subjects using a simulated stool device called Fecobionics.MethodsThe Fecobionics expulsion parameters were assessed in an interventional study design conducted from May 29 to December 9 2019. Subjects were invited to participate in ...
Source: Techniques in Coloproctology - March 29, 2021 Category: Surgery Source Type: research

Ileal neoappendicostomy for antegrade colonic enema (ACE) in the treatment of fecal incontinence and chronic constipation: a systematic review
ConclusionsTaking into consideration that studies of INA were few and of poorly quality; ACE via an INA had a positive impact on bowel function and quality of life. Stoma-related complications and postoperative complications remain a concern. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 25, 2021 Category: Surgery Source Type: research

Partial stapled hemorrhoidopexy for second-degree symptomatic hemorrhoidal prolapse
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 25, 2021 Category: Surgery Source Type: research

How do Swiss surgeons perform fluorescence angiography in colorectal surgery?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 24, 2021 Category: Surgery Source Type: research

Laparoscopic right and transverse colectomy for fulminant colitis during pregnancy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 24, 2021 Category: Surgery Source Type: research

Fecal microbiota transplantation for Crohn ’s disease: a systematic review and meta-analysis
AbstractBackgroundCrohn ’s disease (CD) is a chronic idiopathic inflammatory intestinal disorder associated with fecal dysbiosis. Fecal microbiota transplantation (FMT) is an emerging treatment approach for CD. But its efficacy and safety remain controversial. We performed a systematic review and meta-analysis to evaluat e the efficacy and safety of FMT in CD patients.MethodsElectronic databases were searched for studies that reported efficacy and/or safety of FMT for CD. Clinical remission was established as the primary outcome. Secondary outcome was clinical response. Odds ratios with 95% confidence intervals (CIs)...
Source: Techniques in Coloproctology - March 23, 2021 Category: Surgery Source Type: research

Negative pressure-assisted endoscopic pilonidal sinus treatment
ConclusionsNPA EPSiT is a simple method for improving postoperative wound management, facilitating a quicker recovery and possibly improving overall patient satisfaction. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 23, 2021 Category: Surgery Source Type: research

Comment on “Currently available and experimental dyes for intraoperative near-infrared fluorescence imaging of the ureters: a systematic review”
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 21, 2021 Category: Surgery Source Type: research

Levator ani and puborectalis muscle rupture: diagnosis and repair for perineal instability
ConclusionsDiagnosis of levator ani and puborectalis muscle rupture requires careful history taking, clinical examination, endoanal and perineal ultrasound. Surgical repair improved anal continence as well as sexual function in all patients. Transvaginal levator ani repair seems to be well tolerated with good short-term results. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 20, 2021 Category: Surgery Source Type: research

A mapping review of sacrococcygeal pilonidal sinus disease
ConclusionsThis mapping review summarises eight decades of research on the management of pilonidal sinus. Further research is needed to identify front-running interventions, understand variation in practice and patient values, and to prioritise future research. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 16, 2021 Category: Surgery Source Type: research

SICCR web-educational colorectal meeting “Hemorrhoids and fissures”: Congress report
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 9, 2021 Category: Surgery Source Type: research

Rubber band ligation versus haemorrhoidectomy for the treatment of grade II –III haemorrhoids: a systematic review and meta-analysis of randomised controlled trials
ConclusionsHaemorrhoidectomy seems to provide better symptom control but at the cost of more pain and complications. However, due to the poor quality of the studies analysed/it is not possible to determine which of the two procedures provides the best treatment for grade II –III haemorrhoids. Further studies focusing on clearly defined outcome measurements taking patients perspective and economic impact into consideration are required. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 8, 2021 Category: Surgery Source Type: research

Laparoscopic ileocecal-sparing right hemicolectomy (LISH) for cancers of the hepatic flexure or proximal transverse colon: a video vignette
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 8, 2021 Category: Surgery Source Type: research

Is sterile exposure in perianal procedures necessary? A single-institution experience and results from a national survey
ConclusionsThis study suggests that it is safe to perform perianal surgery in a non-sterile setting with regard to the SSI and reintervention rate. Adjustment of the current practice will contribute to a reduction in healthcare expenses. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 4, 2021 Category: Surgery Source Type: research

Trends in emergent diverticular disease management: a nationwide cohort study from 2009 to 2018
ConclusionsAlthough admissions for emergent diverticular disease have increased during the study period, the rate of surgical treatment has decreased, suggesting an evolution toward more conservative management of this pathology. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 3, 2021 Category: Surgery Source Type: research

Laparoscopic lateral pelvic lymph node dissection combined with removal of the internal iliac vessels in rectal cancer: how to standardize this surgical procedure
ConclusionRecognizing the pelvic anatomical points illustrated in the present study contributes to the surgical safety of LLND combined with removal of the internal iliac vessels. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 2, 2021 Category: Surgery Source Type: research

Radiographic guidance for Turnbull –Weakley blowhole colostomy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 1, 2021 Category: Surgery Source Type: research

Successful use of a pedicled anterolateral thigh flap for reconstruction of an abdominal wound and peristomal dehiscence
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 1, 2021 Category: Surgery Source Type: research

A prospective study of  health related quality of life, bowel and sexual function after TaTME and conventional laparoscopic TME for mid and low rectal cancer
AbstractBackgroundThe aim of our study was to evaluate short  -term (3 months) and medium-term (12 months) postoperative effects on health related quality of life (HRQoL), bowel and sexual function after transanal total mesorectal excision (TaTME)  in comparison with conventional laparoscopic total mesorectal excision (TME).MethodsA prospective  study was conducted on consecutive patients who had conventional laparoscopic TME and TaTME at our institution from November 2014 to December 2018.We evaluated HRQoL and bowel function using validated scales including the European Organization for Research ...
Source: Techniques in Coloproctology - March 1, 2021 Category: Surgery Source Type: research

Obstructed defecation syndrome associated with paradoxical puborectalis contraction: osteopathic treatment versus anal biofeedback. Results of a pilot study
ConclusionsOsteopathy is a promising treatment for dyssynergic defecation, and it can be associated with biofeedback. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 27, 2021 Category: Surgery Source Type: research

Abstracts presented at the 14th European Colorectal Congress (#ECCStGallen), 29.11.2020 –2.12.2020, St.Gallen, Switzerland
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 22, 2021 Category: Surgery Source Type: research

Oncological outcomes and stoma-free survival following TaTME, a prospective cohort study
ConclusionsA local recurrence rate of 5.7% supports the oncological safety of TaTME for rectal cancer. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 19, 2021 Category: Surgery Source Type: research

A systematic review of the quality of reporting of interventions in the surgical treatment of Crohn ’s anal fistula: an assessment using the TIDiER and Blencowe frameworks
ConclusionsThis study demonstrates that reporting on technical aspects of interventions for Crohn ’s anal fistula is poor. Surgeons should aim to improve reporting to allow accurate reproduction of techniques both in clinical practice and in clinical trials. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 18, 2021 Category: Surgery Source Type: research

Cold snare EMR of a flat lesion in the right colon of a high-risk patient
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 17, 2021 Category: Surgery Source Type: research

Long-term clinical outcomes of total mesorectal excision and selective lateral pelvic lymph node dissection for advanced low rectal cancer: a comparative study of a robotic versus laparoscopic approach
ConclusionsRobotic TME with LPND is safe and feasible. In particular, it is associated with lower urinary retention. Robotic TME with LPND might yield a similar local recurrence rate and 5-year disease-free survival, but favorable long-term overall survival as compared to the laparoscopic approach. However, considering the retrospective nature and both major variables of TME and LPND involved together, this should be cautiously interpreted. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 16, 2021 Category: Surgery Source Type: research

Author ’s reply to “The nerve of blaming the curve”
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 16, 2021 Category: Surgery Source Type: research

Sampling reflex: pathogenic role in functional defecation disorder
ConclusionThe sampling reflex is impaired in patients with FDD. This finding provides an important insight into the pathogenesis of obstructed functional defecation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 15, 2021 Category: Surgery Source Type: research

Outcomes of radiofrequency ablation for anal high-grade squamous intraepithelial lesions
ConclusionsIn this study, targeted plus circumferential RFA had a 58.3% efficacy rate for the treatment of anal HSIL in immunocompromised patients, achieving 100% eradication after adding electrocautery ablation. No metachronous lesions were detected. Patients presented relatively mild symptoms after the procedure, no changes in anorectal anatomy or function, and some improvements in their sexual function. These results seem promising in light of the high recurrence reported after HSIL treatment. Larger studies are needed to validate our results. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 15, 2021 Category: Surgery Source Type: research

Long-term results of dynamic graciloplasty for severe fecal incontinence
ConclusionThe efficacy of dynamic graciloplasty is conserved in 55% of patients after a mean follow-up of 11  years. This procedure needs to be kept in the surgical armamentarium for persistent and severe fecal incontinence after previous surgical interventions or in the presence of large perineal defects, before the ultimate step of permanent stoma. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 15, 2021 Category: Surgery Source Type: research

Robot-assisted surgery with Senhance robotic system for colon cancer: our original single-incision plus 2-port procedure and a review of the literature
ConclusionsSILS+2-S is a safe and feasible approach for patients with colon cancer. Further studies are needed to validate the advantages of SILS+2-S and to evaluate the long-term oncological outcomes. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 15, 2021 Category: Surgery Source Type: research

Comments on a systematic review assessing the outcomes of stapled hemorrhoidopexy versus open hemorrhoidectomy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 15, 2021 Category: Surgery Source Type: research

Big data papers and COVID-19: a “false friend” for academic surgeons
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 15, 2021 Category: Surgery Source Type: research

Mediterranean Society of Coloproctology Web Masterclass
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 15, 2021 Category: Surgery Source Type: research

Indications and oncological outcomes of selective dissection for clinically suspected lateral lymph node metastasis in patients with rectal cancer based on pretreatment imaging
AbstractBackgroundThe aim of this study was to identify the indications and oncological outcomes of selective lateral lymph node dissection (sLLND) in rectal cancer patients.MethodsA retrospective study was conducted on consecutive patients with rectal cancer who had standard total mesorectal excision and sLLND at our institution. Clinicopathological characteristics and oncological outcomes were analyzed. We performed subgroup analysis and multivariate analysis based on patients with or without preoperative chemoradiotherapy to identify the related risk factors.ResultsA total of 77 consecutive patients with TME and sLLND w...
Source: Techniques in Coloproctology - February 14, 2021 Category: Surgery Source Type: research

High-resolution anoscopy, is there a benefit in proceeding directly to the operating room?
AbstractBackgroundThe development of high-resolution anoscopy (HRA) has advanced our ability to detect anal dysplasia. Historically, HRA is performed in a clinical setting and subsequent ablation is performed in the clinical setting or operating room. The aim of this study was to determine the most effective venue for the performance of HRA.MethodsFollowing institutional review board (IRB) approval, the correlation between anal cytology and HRA performed in the clinic versus in the operating room was evaluated. Data were extracted from our IRB-approved prospective HRA database over the time period of 2013 –2017.Resul...
Source: Techniques in Coloproctology - February 10, 2021 Category: Surgery Source Type: research

Surgical steps for right laparoscopic D3 lymphadenectomy in a patient with a giant duodenal diverticulum
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 5, 2021 Category: Surgery Source Type: research

Longstanding ‘outlet challenge’
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 1, 2021 Category: Surgery Source Type: research