Surgical techniques in the management of rectal cancer: a modified Delphi method by colorectal surgeons in Australia and New Zealand
ConclusionsAll surgical techniques for rectal cancer dissection have a role and may be considered appropriate. Some techniques have advantages over others in certain clinical situations, and the best outcomes may be achieved by considering all options before applying an individualised approach to each clinical situation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 22, 2019 Category: Surgery Source Type: research

3D printed model-based simulation of laparoscopic surgery for descending colon cancer with a concomitant abdominal aortic aneurysm
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 22, 2019 Category: Surgery Source Type: research

Fluoroscopic-guided laparoscopic ileocolic resection with retrieval of retained (PillCam ® ) wireless capsule endoscope
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 22, 2019 Category: Surgery Source Type: research

Innovative appliance for colostomy patients: an interventional prospective pilot study
ConclusionsIn the short term this new device has provided an increased control over bowel emptying at no risk in half of the trial population suggesting that an alternative approach to bag wearing is achievable. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 21, 2019 Category: Surgery Source Type: research

Delayed presentation of rectourethral fistula following TaTME (transanal total mesorectal excision)
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 21, 2019 Category: Surgery Source Type: research

Reply to ‘comment on colopexy in sigmoid volvulus recurrence’
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 21, 2019 Category: Surgery Source Type: research

Near-infrared fluorescence angiography for intra-operative assessment of pedicled omentoplasty for filling of a pelvic cavity: a pilot study
ConclusionsFA of a pedicled omentoplasty allows a real-time assessment of omental perfusion and leads to change in management in 80% of the cases in this pilot study. These findings support the conduct of larger studies to determine the impact on patient outcome in this setting. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 21, 2019 Category: Surgery Source Type: research

The value of force and torque measurements in transanal total mesorectal excision (TaTME)
ConclusionsForces and torque measured at the entrance port, and the tissue interaction force signatures provide detailed insight into instrument handling, instrument loading, and tissue handling during purse-string suturing in a TaTME training setup. This newly developed training setup for single-port laparoscopy that enables objective feedback has the potential to enhance surgical training in TaTME. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 20, 2019 Category: Surgery Source Type: research

Is it the surgeon or the technology performing the operation?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 20, 2019 Category: Surgery Source Type: research

Novel approach for hepatic flexure mobilization with infracolic, suprapancreatic, medial-to-lateral approach
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 20, 2019 Category: Surgery Source Type: research

Feasibility of a subcutaneous gluteal turnover flap without donor site scar for perineal closure after abdominoperineal resection for rectal cancer
ConclusionsThe GT-flap for routine perineal wound closure after APR seems feasible with limited additional theatre time, but success seems to depend on correct planning of the width of the flap. The potential for reducing perineal morbidity should be evaluated in a randomised controlled trial. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 20, 2019 Category: Surgery Source Type: research

SICCR Abruzzo –Lazio–Molise tripartite regional meeting: “Reality and concrete perspectives in daily coloproctology: surgical techniques and patient management”
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 13, 2019 Category: Surgery Source Type: research

Radiofrequency ablation for the treatment of haemorrhoidal disease: a minimally invasive and effective treatment modality
AbstractBackgroundHaemorrhoidal disease (HD) is a common colorectal condition that often requires surgical treatment. Less invasive procedures are usually more acceptable to patients. The aim of this study was to report the outcome of a novel and minimally invasive technique employing a radiofrequency ablation (RFA) energy (Rafaelo®) to treat HD.MethodsA total number of 27 patients who had RFA for the treatment of HD were recruited to this study. The procedure was performed under deep sedation and local anaesthesia. Patients ’ demographics; haemorrhoid severity score (HSS); quality of life; pain and satisfaction ...
Source: Techniques in Coloproctology - August 9, 2019 Category: Surgery Source Type: research

Diverticular disease epidemiology: acute hospitalisations are growing fastest in young men
AbstractBackgroundOlder age has long been linked to risk of diverticulitis, but the epidemiology is seldom described for a national population. The aim of this study was to investigate age- and gender differences in incidence, temporal trends, lifetime risk and prevalence related to acute diverticulitis hospitalisations in New Zealand.MethodsRecords of all hospitalisations with diverticulitis the primary diagnosis were obtained from the Ministry of Health for the period 2000 –2015. The first acute diverticulitis admission recorded for an individual was taken as an incident event; all others were classified as recurre...
Source: Techniques in Coloproctology - August 8, 2019 Category: Surgery Source Type: research

Long-term outcomes of biological mesh repair following extra levator abdominoperineal excision of  the rectum: an observational study of 100 patients
ConclusionsThis study demonstrates that pelvic floor reconstruction using biological mesh following ELAPER is both safe and effective as a long-term solution, with low major complication rates. Symptomatic perineal herniation is rare following mesh reconstruction, but may develop sub clinically and be detectable on cross-sectional imaging. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 7, 2019 Category: Surgery Source Type: research

Individual participant data pooled-analysis of risk factors for recurrence after neoadjuvant radiotherapy and transanal local excision of rectal cancer: the PARTTLE study
ConclusionsLocal excision should be offered with caution after neoadjuvant chemoradiotherapy to selected patients with rectal cancers, who achieved a good response to neoadjuvant chemoradiotherapy. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 6, 2019 Category: Surgery Source Type: research

The anatomy of Trans-Obturator Posterior Anal Sling (TOPAS) and dynamics of potential mechanism of action
ConclusionsThe transobturator posterior anal sling travels mostly in the avascular area of the ischiorectal fossa and posterior to the puborectalis muscle as intended. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 3, 2019 Category: Surgery Source Type: research

Contemporary surgical practice in the management of anal fistula: results from an international survey
ConclusionsProfound technical variations exist in surgical management of AF, making it difficult to reproduce and compare treatment outcomes among different centers. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 31, 2019 Category: Surgery Source Type: research

Endoscopic full-thickness resection (EFTR) in the lower gastrointestinal tract
ConclusionsEFTR yields excellent resection rates for benign recurrent adenomas with non-lifting sign, advanced histopathological findings or submucosal lesions when the procedure is performed in experienced hands and for the correct indication. Thus, surgery can be avoided in many cases. For all lesions the risk of R1 resection goes up with the size of the lesion and careful patient selection is mandatory. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 31, 2019 Category: Surgery Source Type: research

Correction to: Gracilis muscle transposition for treatment of recurrent anovaginal, rectovaginal, rectourethral, and pouch –vaginal fistulas in patients with inflammatory bowel disease
The article Gracilis muscle transposition for treatment (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 26, 2019 Category: Surgery Source Type: research

Mesalamine (5-ASA) for the prevention of recurrent diverticulitis (Review)
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 25, 2019 Category: Surgery Source Type: research

Comments on ‘Gastroscope guidewire volvulus tube decompression’
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 25, 2019 Category: Surgery Source Type: research

Use of three-dimensional virtual images for planning surgery of complex anal fistulas: a new technology available via smartphone
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 24, 2019 Category: Surgery Source Type: research

Hospital management of colonic perforations complicating ambulatory outpatient colonoscopy via over-the-scope clips or surgery: a case series
ConclusionsBased on the characteristics of the five cases and a review of the literature, we suggest a practical approach for undertaking closure of colonic perforations occurring during colonoscopy in the outpatient setting, focusing on clinical criteria to determine eligibility of patients for attempted endoscopic closure and outlining required therapeutic and monitoring steps needed to optimize outcomes. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 23, 2019 Category: Surgery Source Type: research

Effectiveness of endosponge therapy for the management of presacral abscesses following rectal surgery
ConclusionsEndosponge therapy is an effective treatment for the closure of presacral cavities with high success rate and leading to restored gastrointestinal continuity in 73%. However, despite endosponge therapy many patients develop major LARS. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 23, 2019 Category: Surgery Source Type: research

Clinical results of infrared coagulation as a treatment of high-grade anal dysplasia: a systematic review
ConclusionsInfrared coagulation is a safe and effective method for ablation of high-grade anal dysplasia that could help prevent anal cancer. Continued surveillance is recommended due to the risk of recurrence. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 23, 2019 Category: Surgery Source Type: research

Possible effects of height of ligation of the inferior mesenteric vein on venous return of the colorectal anastomosis: the venous trunk theory
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 18, 2019 Category: Surgery Source Type: research

Perianal fistulas and the lift procedure: results, predictive factors for success, and long-term results with subsequent treatment
This study was performed in patients who underwent LIFT between 2013 and 2015 at our institution. Their medical data were retrieved from the electronic patient files. The fistula characteristics were described by physical examination, three-dimensional endoanal ultrasound, and perioperative evaluation. Recurrence rate, postoperative fecal incontinence, and quality of life were assessed with the Patient-Reported Outcome Measurement (PROM). Thirty-two months later, long-term follow-up including subsequent procedures was evaluated.ResultsForty-five patients [17 men, mean age 40  years (range 24–67 years)] were...
Source: Techniques in Coloproctology - July 17, 2019 Category: Surgery Source Type: research

A protocol for skin closure after stoma reversal
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 17, 2019 Category: Surgery Source Type: research

The 118th Annual Scientific Meeting of the American Society of Colon and Rectal Surgeons
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 15, 2019 Category: Surgery Source Type: research

Comment on ‘Colopexy in sigmoid volvulus recurrence’
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 15, 2019 Category: Surgery Source Type: research

A standardized use of intraoperative anastomotic testing in colorectal surgery in the new millennium: is technology taking over? A systematic review and network meta-analysis
ConclusionsThis study suggests that intraoperative testing for  a good blood supply using ICG may reduce the AL rate following colorectal surgery. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2019 Category: Surgery Source Type: research

Laparoscopic total abdominal colectomy as first step of three-stage surgical treatment of ulcerative colitis: a systematic approach
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 9, 2019 Category: Surgery Source Type: research

Mesenchymal stem-cell therapy for perianal fistulas in Crohn ’s disease: a systematic review and meta-analysis
AbstractBackgroundMesenchymal stem-cell (MSC) therapy for perianal fistulas in Crohn ’s disease (CD) remains controversial. We performed this meta-analysis to evaluate the efficacy and safety of MSC therapy for the treatment of perianal fistulas in CD.MethodsElectronic databases were searched for studies that reported efficacy and/or safety of MSC therapy for perianal CD (pCD). We used the metaprop command of the meta package in R and RevMan to assess the efficacy and safety. Subgroup analyses were performed for exploration of heterogeneity regarding all outcomes.ResultsAfter screening, 13 trials were included in our...
Source: Techniques in Coloproctology - July 8, 2019 Category: Surgery Source Type: research

Radio-surgical agreement on the inferior mesenteric artery ligation level in left colon and rectal cancer
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 6, 2019 Category: Surgery Source Type: research

Short-term outcomes of radical excision vs. phenolisation of the sinus tract in primary sacrococcygeal pilonidal sinus disease: a randomized-controlled trial
ConclusionsPit excision with phenolisation of SPSD resulted in a quicker return to normal daily activities, less pain, and quicker wound epithelialization compared to radical excision. Surgeons should consider phenolisation in patients with primary SPSD. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 5, 2019 Category: Surgery Source Type: research

Protection of colorectal anastomosis with an intraluminal bypass device for patients undergoing an elective anterior resection: a pilot study
ConclusionsCG-100 may provide a safe method for fecal diversion over a newly created anastomosis without the complications related to stoma creation and closure. A larger prospective randomized study in patients originally scheduled to receive diverting stoma is needed to confirm these findings. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 5, 2019 Category: Surgery Source Type: research

Enhancing the precision of circular stapled colorectal anastomosis: could powered stapler technology provide the solution?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 5, 2019 Category: Surgery Source Type: research

The laparoscopic medial-to-lateral approach to the splenic flexure
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 5, 2019 Category: Surgery Source Type: research

Cesarean delivery to prevent anal incontinence: a systematic review and meta-analysis
ConclusionsThere are three components of pelvic floor dysfunction that are thought to be caused by VD and hopefully prevented by CD: AI, urinary incontinence and pelvic floor prolapse. Of these, AI was not found to be reliably prevented by CD in this review. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 4, 2019 Category: Surgery Source Type: research

Robotic ventral mesh rectopexy for rectal prolapse: a few years until this becomes the gold standard
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 4, 2019 Category: Surgery Source Type: research

Minimally invasive colorectal cancer procedures in patients with obesity: an interdisciplinary approach
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 4, 2019 Category: Surgery Source Type: research

A prospective pilot study on MRI visibility of iron oxide-impregnated polyvinylidene fluoride mesh after ventral rectopexy
ConclusionsT2 sagittal and T1-weighted flash images provide the best information about the position and integrity of the iron oxide-impregnated PVDF mesh after LVMR or RVMR with a short examination time. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 3, 2019 Category: Surgery Source Type: research

Optimized fistulectomy using the novel FiXcision ® device: a technical feasibility study and evaluation of short term healing rates
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 3, 2019 Category: Surgery Source Type: research

Robotic vs. laparoscopic ventral mesh rectopexy for external rectal prolapse and rectal intussusception: a systematic review
AbstractBackgroundLaparoscopic ventral mesh rectopexy (LVR) is a treatment with promising results in external rectal prolapse, rectal intussusception, and rectocele. Because of the emergence of robotic-assisted surgery and the technical advantage it provides, we examined the potential role and place of robotic surgery in ventral rectopexy.MethodsMEDLINE, PubMed, and other databases were searched, by two independent reviewers, to identify studies comparing robotic to laparoscopic ventral mesh rectopexy. The primary outcome was the rate of unplanned conversion to open. The secondary outcomes were morbidity, length of hospita...
Source: Techniques in Coloproctology - June 28, 2019 Category: Surgery Source Type: research

Practice parameters for the diagnosis and treatment of anal intraepithelial neoplasia (AIN) on behalf of the Italian Society of Colorectal Surgery (SICCR)
AbstractSquamous cell carcinoma (SCC) of the anus is a human papilloma virus (HPV) related malignancy that is preceded by anal intraepithelial neoplasia (AIN) making this cancer, at least theoretically, a preventable disease. In the past 10  years the diagnosis, management and nomenclature of AIN has dramatically changed. Increased life expectancy in human immunodeficiency virus (HIV) positive patients due to highly active antiretroviral therapy (HAART) has caused an increase in the incidence of SCC of the anus. While many experts rec ommend screening and treatment of anal high-grade squamous intraepithelial lesion (H...
Source: Techniques in Coloproctology - June 26, 2019 Category: Surgery Source Type: research

The Kraske procedure: no more indications for benign lesions?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 26, 2019 Category: Surgery Source Type: research

Robotic excision of a colonic neoplasm with ICG as a tumor localizer and colonoscopic assistance
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 26, 2019 Category: Surgery Source Type: research

Why most published meta-analysis findings are false
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 25, 2019 Category: Surgery Source Type: research

The REAL (REctal Anastomotic Leak) score for prediction of anastomotic leak after rectal cancer surgery
AbstractBackgroundAnastomotic leak after rectal cancer surgery is a severe complication associated with poorer oncologic outcome and quality of life. Preoperative assessment of the risk for anastomotic leak is a key component of surgical planning, including the opportunity to create a defunctioning stoma.ObjectiveThe purpose of this study was to identify and quantify the risk factors for anastomotic leak to minimize risk by either not restoring bowel continuity or protecting the anastomosis with a temporary diverting stoma.MethodsPotentially relevant studies were identified from the following databases: PubMed, Embase and ...
Source: Techniques in Coloproctology - June 25, 2019 Category: Surgery Source Type: research