Treatment of anal fistula with FiLaC ®: results of a 10-year experience with 175 patients
ConclusionsLonger follow-up confirms the efficacy of FiLaC® in the treatment of complex anal fistulas. Its use and implementation should be encouraged. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 19, 2021 Category: Surgery Source Type: research

Mesenteric closure with polymer-ligating clips after right colectomy with complete mesocolic excision for cancer  and mesentery-based ileocolic resection for Crohn’s disease
We describe a simple technique for the closure of the mesentery after surgi cal resection using polymer-ligating clips. This novel technique seems to minimize the time, effort and risk inherent to the procedure, even after large mesenteric excisions. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 15, 2021 Category: Surgery Source Type: research

A comparative multicentre study evaluating gluteal turnover flap for wound closure after abdominoperineal resection for rectal cancer
ConclusionsThe uncomplicated perineal wound-healing rate after the gluteal turnover flap and primary closure after APR is similar, and no chronic perineal sinus or perineal hernia occurred after flap closure. Future studies have to confirm potential benefits of the gluteal turnover flap. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 14, 2021 Category: Surgery Source Type: research

Quantitative FIT stratification is superior to NICE referral criteria NG12 in a high-risk colorectal cancer population
This study aims to compare the diagnostic value of clinical features and faecal immunochemical test (FIT) results to identify those at a higher risk of CRC, thereby facilitating effective triage of patients.MethodsWe undertook a review of all patients referred for investigation of CRC at our centre between September 2016 and June 2018. Patients were identified using a prospectively recorded local database. We performed a logistic regression analysis of factors associated with a diagnosis of CRC.ResultsOne-thousand-and-seven-hundred-eighty-four patients with FIT results were included in the study. Change in bowel habit (CIB...
Source: Techniques in Coloproctology - July 14, 2021 Category: Surgery Source Type: research

Successful TAMIS in an elderly patient with a large rectal adenoma
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 10, 2021 Category: Surgery Source Type: research

Robotic transanal total mesorectal excision combined with intersphincteric resection for ultra-low rectal cancer
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 8, 2021 Category: Surgery Source Type: research

Laparoscopic modified complete mesocolic excision for right-sided colon cancer
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 5, 2021 Category: Surgery Source Type: research

Envisioning the future of colorectal surgery: preclinical assessment and detailed description of an endoluminal robotic system (ColubrisMX ELS)
ConclusionsELS was successful in performing the tasks of partial-thickness disc excision and closure in a preclinical evaluation. Further study is necessary to determine its clinical applicability. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 5, 2021 Category: Surgery Source Type: research

An unexpected complication in grade III internal hemorrhoids following treatment with cap-assisted endoscopic sclerotherapy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 3, 2021 Category: Surgery Source Type: research

Adherence to transanal irrigation in older adults: first-year assessment
ConclusionsAdherence to transanal irrigation during the first year in older adults remains close to that in the adult general population. Predictive factors of adherence remain unclear. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 29, 2021 Category: Surgery Source Type: research

Video demonstration of the ColubrisMX ELS robotic system for local excision and suture closure in a preclinical model
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 29, 2021 Category: Surgery Source Type: research

Author ’s reply to commentary on “The role of MRI pelvimetry in predicting technical difficulty and outcomes of open and minimally invasive total mesorectal excision: a systematic review”
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 28, 2021 Category: Surgery Source Type: research

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of pilonidal disease
AbstractPilonidal disease (PD) is a relatively common, benign but challenging condition of the natal cleft. This consensus statement was drawn up by a panel of surgeons, identified by the Italian Society of Colorectal Surgery (SICCR) as having a “special interest” in PD, with the aim of recommending the best therapeutic options according to currently available scientific evidence. A three-step modified-Delphi process was adopted, implying: (1) choice of the panelists; (2) development of a discussion outline and of target issues; and (3) a detailed systematic review of the current literature. The agreement/disag...
Source: Techniques in Coloproctology - June 27, 2021 Category: Surgery Source Type: research

Implementation of an Enhanced Recovery After Surgery (ERAS) protocol for acute complicated and uncomplicated appendicitis
AbstractBackgroundEnhanced Recovery After Surgery (ERAS) protocols are well-documented logistic programs in elective surgery but it is still uncertain whether ERAS can benefit emergency patients, because of significant challenges facing its application to emergency surgery.The aim of this study was to evaluate the implementation of an ERAS protocol for patients with acute appendicitis (AA), both complicated and uncomplicated.MethodsA prospective observational study was performed at two university hospitals in Spain, between January 2012 and December 2019. Inclusion criteria were patients with diagnosis of AA, undergoing ap...
Source: Techniques in Coloproctology - June 26, 2021 Category: Surgery Source Type: research

The impact of transanal local excision of early rectal cancer on completion rectal resection without neoadjuvant chemoradiotherapy: a systematic review
ConclusionsThe data are incomplete and of low quality. There was a tendency towards an increased risk of APR and poor specimen quality. It is necessary to improve the accuracy of preoperative staging of malignant rectal tumors in patients scheduled for TAE. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 25, 2021 Category: Surgery Source Type: research

Commentary on: “Does caffeine enhance bowel recovery after elective colorectal resection? A prospective double-blinded randomized clinical trial” Tech Coloproctol. 2021 Apr 26. doi: 10.1007/s10151-021-02450-7
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 25, 2021 Category: Surgery Source Type: research

The levator ani muscle repair: a call to action
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 23, 2021 Category: Surgery Source Type: research

Initial experience with a suprapubic single-port robotic right hemicolectomy in patients with colon cancer
ConclusionsSpRHC is safe and feasible. However, further comparative studies are needed to assess whether this procedure can provide patients with significant benefits compared with multiport robotic surgery. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 22, 2021 Category: Surgery Source Type: research

Are novel knot-free setons also trouble-free?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 22, 2021 Category: Surgery Source Type: research

Large-diameter cap for fast-track forceps scissor-based endoscopic submucosal dissection
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 20, 2021 Category: Surgery Source Type: research

Laparoscopic low anterior resection using new articulating instruments
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 17, 2021 Category: Surgery Source Type: research

The angle of the anal fistula track and the distance between the internal opening and the anorectal junction: two further useful parameters in MRI?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 17, 2021 Category: Surgery Source Type: research

Correction to: Consensus Definitions and Interpretation Templates for Fluoroscopic Imaging of Defecatory Pelvic Floor Disorders
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 15, 2021 Category: Surgery Source Type: research

Can end-to-end anastomosis reduce the risks of anastomotic leak compared to side-to-end anastomosis? A comparative study of 518 consecutive patients undergoing laparoscopic total mesorectal excision for low- or mid-rectal cancer
ConclusionsETE seems to be associated with a significantly lower rate of AL and higher rate of spontaneous healing after chronic AL than STE. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 13, 2021 Category: Surgery Source Type: research

Right hemicolectomy with complete mesocolic excision is safe, leads to an increased lymph node yield and to increased survival: results of a systematic review and meta-analysis
ConclusionsRight hemicolectomy with CME is not inferior to traditional surgery in terms of safety and has a greater lymph node yield when compared with traditional surgery. Moreover, right-sided CME is associated with better overall and disease-free survival. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 12, 2021 Category: Surgery Source Type: research

Local excision and treatment of early node-negative anal squamous cell carcinomas in a highly HIV prevalent population
ConclusionsWe recommend that local excision be considered the sole treatment for stage 1 node-negative tumours that have clear margins and advantageous histology regardless of HIV status. However, PLWH who have local excision alone must have access to an expert long-term surveillance programme after treatment to identify late recurrences. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 12, 2021 Category: Surgery Source Type: research

A minimally invasive approach to pilonidal disease with endoscopic pilonidal sinus treatment (EPSiT): a single-center case series with long-term results
ConclusionsIn our experience, EPSiT is safe, well accepted. and associated with a low level of postoperative pain, short hospitalization, short time off work, as well as optimal cosmetic results. Its failure rate is similar to that of excisional surgery. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 10, 2021 Category: Surgery Source Type: research

Usefulness of internal organ retractors in making sutureless delta-shaped intracorporeal anastomosis during laparoscopic colectomy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 9, 2021 Category: Surgery Source Type: research

What is the best method of rectovaginal fistula repair? A 25-year single-center experience
ConclusionsLocal procedures such as mucosal flap or primary closure and sphincteroplasty are associated with a high success rate should be considered in patients with low-lying, simple RVF. Abdominal resections with and without proximal diversions and ileostomy takedown have a relatively high success rate in selected patients. The low success rate of fibrin glue and fistula plugs demonstrates their low efficacy in RVF; thus, these procedures should be avoided in the treatment algorithm. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 8, 2021 Category: Surgery Source Type: research

Nebulized Glubran 2 in patients at high risk of bleeding after Milligan –Morgan hemorrhoidectomy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 7, 2021 Category: Surgery Source Type: research

The use of ultrasound in central vascular ligation during laparoscopic right-sided colon cancer surgery: technical notes
ConclusionIOUS is a safe, feasible, and reproducible technique that can assist in detecting the branching of the SMA and SMV during CME with CVL in laparoscopic right-sided colon cancer surgery, regardless of individual conditions. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 6, 2021 Category: Surgery Source Type: research

Reply to: Robotic-assisted transanal total mesorectal excision for rectal cancer: more questions than answers
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 5, 2021 Category: Surgery Source Type: research

Benefits of flavonoid and metronidazole use after excisional hemorrhoidectomy: a randomized double-blind clinical trial
AbstractBackgroundExcisional hemorrhoidectomy remains the most effective treatment for a significant group of patients with hemorrhoids, despite the potential for postoperative pain. The purpose of this study was to evaluate the effects of flavonoid and metronidazole use in the postoperative period on patients undergoing excisional hemorrhoidectomy.MethodsA double-blind randomized clinical study was performed. Sixty-eight patients underwent excisional hemorrhoidectomy and were randomized into 4 groups of 17 patients each to receive double-placebo (G1), metronidazole plus placebo (G2), flavonoids plus placebo (G3) or metron...
Source: Techniques in Coloproctology - May 31, 2021 Category: Surgery Source Type: research

An initial experience with a novel technique of single-port robotic resection for rectal cancer
ConclusionsOur initial experience suggests that SP robotic rectal resection is safe and feasible. Further clinical trials comparing SP and multiport robotic rectal resection should be conducted to verify the superior aspects of this new system. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 29, 2021 Category: Surgery Source Type: research

A step-by-step approach to endorectal proctopexy (ERPP): how we do it
AbstractThere are many surgical treatments aimed at correcting internal mucosal prolapse and rectocele associated with obstructed defecation syndrome (ODS). Perineal procedures can be considered as first options in young men in whom an abdominal approach poses risks of sexual dysfunction and in selected women with isolated posterior compartment prolapse who failed conservative treatment. About 20  years ago, we described endorectal proctopexy (ERPP) also known as internal Delorme procedure. The aim of the present study was to describe, with attention to technical details and the aid of a video, the different steps of ...
Source: Techniques in Coloproctology - May 28, 2021 Category: Surgery Source Type: research

Surgical strategy for supralevator abscess in Perianal Crohn ’s disease: emergency surgery and residual complex fistula
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 24, 2021 Category: Surgery Source Type: research

Treatment of anal fistula with FiLaC ® : results of a 10-year experience with 175 patients
ConclusionsLonger follow-up confirms the efficacy of FiLaC® in the treatment of complex anal fistulas. Its use and implementation should be encouraged. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 19, 2021 Category: Surgery Source Type: research

Intracorporeal J-pouch creation after total proctocolectomy assisted by taTME
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 19, 2021 Category: Surgery Source Type: research

Correction to: Author ’s reply to “The nerve of blaming the curve”
A correction to this paper has been published: https://doi.org/10.1007/s10151-021-02454-3 (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 19, 2021 Category: Surgery Source Type: research

Comparison of oncological and functional outcomes and quality of life after transanal or laparoscopic total mesorectal excision for rectal cancer: a systematic review and meta-analysis
ConclusionsTaTME and LaTME have similar long-term oncological and functional outcomes as well as QoL. The only exception is higher LARS scores after TaTME. The current data are based mainly on observational studies and further randomized controlled trials are required. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 17, 2021 Category: Surgery Source Type: research

Transanal endoscopic surgery with a 3D printed device
ConclusionsAn innovative device made with a 3D printer can be used successfully in transanal endoscopic resections of the rectal wall, with spinal anaesthesia and avoiding the need for pneumorectum. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 17, 2021 Category: Surgery Source Type: research

Sign of the times: the Milligan –Morgan era
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 17, 2021 Category: Surgery Source Type: research

Preventive intraperitoneal hyperthermic perfusion chemotherapy for patients with T4 stage colon adenocarcinoma
ConclusionsPreventive HIPEC after radical surgery may decrease peritoneal recurrence and promote disease-free survival for T4 stage colon adenocarcinoma. Large-scale randomized controlled studies are needed to confirm the results of our study. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 16, 2021 Category: Surgery Source Type: research

Fluorescence angiography after vascular ligation to make the ileo-anal pouch reach
AbstractThe two most essential technical aspects of any gastrointestinal anastomosis are adequate perfusion and sufficient reach. For ileal pouch-anal anastomosis (IPAA), a trade-off exists between these two factors, as lengthening manoeuvers to avoid tension may require vascular ligation. In this technical note, we describe two cases in which we used indocyanine green (ICG) fluorescence angiography (FA) to assess perfusion of the pouch after vascular ligation to acquire sufficient reach. In both cases, FA allowed us to distinguish better between an arterial inflow problem and venous congestion than white light assessment....
Source: Techniques in Coloproctology - May 15, 2021 Category: Surgery Source Type: research

Single incision modified Martius flap for rectovaginal fistula
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 15, 2021 Category: Surgery Source Type: research

Securing the surgical field for mobilization of right-sided colon cancer using the duodenum-first multidirectional approach in laparoscopic surgery
AbstractBackgroundThe aim of this study was to compare the short-term outcomes of the duodenum-first multidirectional approach (DMA) in laparoscopic right colectomy with those of the conventional medial approach to assess its safety and feasibility.MethodsThis retrospective study enrolled 120 patients who had laparoscopic surgery for right-sided colon cancer in our institution between April 2013 and December 2019. Fifty-four patients underwent colectomy using the multidirectional approach; among these, 20 underwent the DMA and 34 underwent the caudal-first multidirectional approach (CMA). Sixty-six patients underwent the c...
Source: Techniques in Coloproctology - May 13, 2021 Category: Surgery Source Type: research

The REALISE score: a new statistically validated scoring system to assess the severity of anal fissures
AbstractBackgroundAnal fissure (AF) is a common, painful disease that strongly affects patients ’ quality of life, however, no scoring system to assess the severity of AF is available in the literature. The aim of this study was to set up and validate a reliable scoring system to quantify the severity of AF, to be used in prospective trials comparing the efficacy and the outcomes of surgical or medical treatments.MethodsThe study was conducted on patients with acute or chronic AF and a control group in a tertiary centre for coloproctology in June 2020 –September 2020. Two researchers independently carried out a...
Source: Techniques in Coloproctology - May 13, 2021 Category: Surgery Source Type: research

Non-dynamic graciloplasty is an effective treatment for patients with passive fecal incontinence
ConclusionNon-dynamic graciloplasty is an effective treatment for passive fecal incontinence. Differentiation based on subtypes of fecal incontinence might be important for a pattern-specific approach to treatment. More research is necessary to determine the right indications for more invasive treatments of fecal incontinence. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 12, 2021 Category: Surgery Source Type: research

An emergency Altemeier procedure for necrosis of full-thickness rectal prolapse
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 11, 2021 Category: Surgery Source Type: research

Heterogeneity in outcome selection, definition and measurement in studies assessing the treatment of cryptoglandular anal fistula: findings from a systematic review
ConclusionsThere is substantial heterogeneity in outcomes, definitions, and measurement instruments reported in interventional studies for cryptoglandular anal fistula. This emphasises the need for standardised outcome reporting and measurement. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 8, 2021 Category: Surgery Source Type: research