Minimally invasive right colectomy with transrectal natural orifice extraction: could this be the next step forward?
ConclusionsNOSE was associated with acceptable short-term surgical outcomes that were comparable to those of conventional surgery. NOSE results in less postoperative wound pain and a shorter hospital stay than conventional surgery. Larger studies are needed (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 6, 2020 Category: Surgery Source Type: research

Single-port robotic transanal minimally invasive surgery (SPR-TAMIS) approach to local excision of rectal tumors
ConclusionsSPR-TAMIS is a novel, safe, and feasible procedure capable of achieving non-piecemeal resections of low-risk rectal tumors. Further study needs to be conducted to determine complication rates, functional and oncologic outcomes, and ensure the long-term safety profile. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 6, 2020 Category: Surgery Source Type: research

Treatment of thrombosed external hemorrhoids in Russia: an online survey
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 6, 2020 Category: Surgery Source Type: research

The role of MRI pelvimetry in predicting technical difficulty and outcomes of open and minimally invasive total mesorectal excision: a systematic review
ConclusionsBony pelvic measurements may predict surgical difficulty during TME, however, use of different indicators of difficulty limit comparison between studies. Early data suggest MRI soft tissue measurements may predict surgical difficulty and warrants further investigation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 4, 2020 Category: Surgery Source Type: research

The cecal mucus sign underlying appendiceal sessile serrated polyp/adenoma without dysplasia
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 4, 2020 Category: Surgery Source Type: research

Pushing the limits for the treatment of anal canal cancer
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 3, 2020 Category: Surgery Source Type: research

Rectal perforation from a perianal drain repaired with transanal minimally invasive surgery
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 2, 2020 Category: Surgery Source Type: research

More extensive lymphadenectomy in colon cancer; how far are we willing to go for a biomarker?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 16, 2020 Category: Surgery Source Type: research

Goodsall ’s flaw
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 16, 2020 Category: Surgery Source Type: research

Laser haemorrhoidoplasty: is it time to rethink the procedure?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 16, 2020 Category: Surgery Source Type: research

Controversies in CO 2 Insufflation and COVID-19
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 16, 2020 Category: Surgery Source Type: research

Small type O-IIa de novo colon cancer treated with curative endoscopic full-thickness resection (EFTR)
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 16, 2020 Category: Surgery Source Type: research

Anal fistula associated with anal fissure
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 16, 2020 Category: Surgery Source Type: research

Long-term healing after complex anal fistula repair in patients with Crohn ’s disease
ConclusionsRepair of complex anal fistula in CD results in modest healing rates. LIFT independently predicts long-term healing. However, these results must be taken in context, considering differences in patient and fistula characteristics between groups. These results ought to be kept in mind when counseling CD patients with complex anal fistula. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 14, 2020 Category: Surgery Source Type: research

A low incidence of perineal hernia when using a biological mesh after extralevator abdominoperineal excision with or without pelvic exenteration or distal sacral resection in locally advanced rectal cancer patients
ConclusionsClosure of the perineal wound after (EL)APE with a biological mesh is associated with a low incidence of perineal hernia. Wound healing complications in this high-risk group of patients are comparable to those reported in the literature. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 8, 2020 Category: Surgery Source Type: research

The retro-ileal pull-through technique for colorectal and coloanal anastomosis
ConclusionsIn our cohort of patients, a retro-ileal pull-through technique was shown to be a successful approach to achieve a tension-free colorectal or coloanal anastomosis in various scenarios. This technique may prevent performing an ileorectal anastomosis or a permanent colostomy. We believe that this approach should be popularized among colorectal surgeons dealing with complicated colorectal operations. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 6, 2020 Category: Surgery Source Type: research

Acute intestinal ischemia in a patient with COVID-19
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 6, 2020 Category: Surgery Source Type: research

Recurrent psoas abscess secondary to Crohn ’s fistula disease
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 6, 2020 Category: Surgery Source Type: research

Development and validation of a transanal endoscopic rectal purse string simulator
ConclusionsA transanal endoscopic purse string simulator was constructed and preliminary testing has shown variable performance based on prior laparoscopic suturing experience. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 6, 2020 Category: Surgery Source Type: research

Robotic complete mesocolic excision for transverse colon cancer can be performed with a morbidity profile similar to that of conventional  laparoscopic colectomy
AbstractBackgroundIn minimally invasive surgery, complete mesocolic excision (CME) for transverse colon cancer is challenging; thus, non-CME resections are commonly preferred when laparoscopy is used. Robotic technology has been developed to reduce the limitations of laparoscopy. The aim of our study was to evaluate whether robotic CME for transverse colon cancer can be performed with short-term outcomes similar to those of laparoscopic conventional colectomy (CC).MethodsA retrospective review of 118 consecutive patients having robotic CME or laparoscopic CC for transverse colon cancer in two specialized centers between Ma...
Source: Techniques in Coloproctology - June 3, 2020 Category: Surgery Source Type: research

Robotic low anterior resection: how to maximise success in difficult surgery
AbstractMinimally invasive laparoscopic low or ultra-low anterior resection may present as a complex, technically difficult challenge to even the most experienced of colorectal surgeons. This is because, within the narrow confines of the pelvis, there is usually limited visibility, and difficult manoeuvrability of rigid laparoscopic instrumentation with resulting poor access. The utilisation of robotic technology makes sense within the narrow confines of the pelvis. Several studies including recent meta-analyses of randomized controlled trials and propensity-score-matched cohorts have shown reduced rates of conversion to o...
Source: Techniques in Coloproctology - May 11, 2020 Category: Surgery Source Type: research

Colonic perfusion assessment with indocyanine-green fluorescence imaging in anterior resections: a propensity score-matched analysis
ConclusionsThe routine use of ICG FI was associated with a lower anastomotic leakage rate in anterior resections. The reduction in anastomotic leakage rate was mainly seen in TME. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 8, 2020 Category: Surgery Source Type: research

A dark swelling in a hidden place
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 6, 2020 Category: Surgery Source Type: research

The use of Endo-SPONGE ® in rectal anastomotic leaks: a systematic review
ConclusionsEndo-SPONGE® seems to be a useful method of rectal anastomotic leak treatment in selected group of patients; however, the quality of available data is poor and it is impossible to draw a final conclusion. There is unexpected high rate of permanent ileostomy. There is a need for further assessment of this the rapy with well-designed randomised or cohort studies. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 6, 2020 Category: Surgery Source Type: research

A systematic review and meta-analysis of biofeedback therapy for dyssynergic defaecation in adults
ConclusionsBiofeedback therapy is recommended for patients referred to tertiary units with dyssynergic defaecation who fail conservative therapy. Future research should be directed towards identifying validated outcomes and the optimum method for delivering biofeedback therapy. Home biofeedback therapy may improve accessibility and recruitment to future clinical trials. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 5, 2020 Category: Surgery Source Type: research

Techniques for safe laparoscopic anterior resection for complicated diverticular disease
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 4, 2020 Category: Surgery Source Type: research

Retrospective study of the functional and oncological outcomes of conformal sphincter preservation operation in the treatment of very low rectal cancer
ConclusionsFor patients with very low rectal cancers, fecal continence can be preserved with CSPO without compromising oncological results. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 2, 2020 Category: Surgery Source Type: research

Laser treatment for anal fistulas: what are the pitfalls?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 2, 2020 Category: Surgery Source Type: research

The efficacy of sacral neuromodulation in the treatment of low anterior resection syndrome: a systematic review and meta-analysis
AbstractBackgroundSacral neuromodulation (SNM) has become one of the main treatment options in patients with fecal incontinence. The aim of this study was to determine the efficacy of sacral neuromodulation in the treatment of low anterior resection syndrome (LARS).MethodsA systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The search was conducted using the Pubmed, Embase, Ovid, and Cochrane databases, restricted to the English language and to articles published from 2000 to November 2018.ResultsA total of 434 articles on the efficacy of...
Source: Techniques in Coloproctology - April 30, 2020 Category: Surgery Source Type: research

A difficult case of robotic splenic-flexure mobilization, performed by a trainee surgeon with a dual Davinci console
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 27, 2020 Category: Surgery Source Type: research

Laser ablation of fistula tract (LAFT) and complex fistula-in-ano: “the ideal indication” is becoming clearer…
ConclusionsThis study indicates that  complex anoperineal fistulas with a narrow internal orifice can be successfully treated with less than 400 J and are ideal for LAFT. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 24, 2020 Category: Surgery Source Type: research

Para-ileostomy fistula secondary to swallowed dentures
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 23, 2020 Category: Surgery Source Type: research

Cortical processing to anorectal stimuli after rectal resection with and without radiotherapy
AbstractBackgroundBowel dysfunction is common after surgery for rectal cancer, especially when neoadjuvant radiotherapy is used. The role of sensory function in the pathogenesis remains obscure, and the aim of the present study was to characterize the sensory pathways of the brain-gut axis in rectal cancer patients treated with resection  ± radiotherapy compared with healthy volunteers.MethodsSensory evaluation by (neo)rectal distensions was performed and sensory evoked potentials (SEPs) were recorded during rapid balloon distensions of the (neo)rectum and anal canal in resected patients with (n&thinsp...
Source: Techniques in Coloproctology - April 22, 2020 Category: Surgery Source Type: research

Use of a new transanal irrigation device for bowel disorder management by patients familiar with the irrigation technique: a prospective, interventional, multicenter pilot study
ConclusionsIn patients familiar with TAI, using a new medical device incorporating an electric pump was feasible. Levels of patient satisfaction were high, especially with regard to comfort of use and a feeling of security during TAI. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 21, 2020 Category: Surgery Source Type: research

Video-Assisted Anal Fistula Treatment (VAAFT) for complex anorectal fistula: efficacy and risk factors for failure at 3-year follow-up
ConclusionsVAAFT is a highly effective safe procedure for the treatment of anorectal fistula, with a low recurrence rate at 3-year follow-up. However, our study demonstrated that age  ≥ 50 years is a risk factor for failure of VAAFT. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 21, 2020 Category: Surgery Source Type: research

Surgical anterior plane for rectal surgeons: preserving Denonvilliers ’ fascia
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 21, 2020 Category: Surgery Source Type: research

Strictureplasty for Crohn ’s disease of the small bowel in the biologic era: long-term outcomes and risk factors for recurrence
ConclusionsStrictureplasty is associated with optimal long-term outcomes in the biologic era and should be performed when feasible, to reduce the risk of intestinal failure in Crohn ’s disease patients. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 18, 2020 Category: Surgery Source Type: research

Pre-surgery assessment of anal fistula
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 18, 2020 Category: Surgery Source Type: research

Cogito ergo sum
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 18, 2020 Category: Surgery Source Type: research

Magnetic anchor-guided endoscopic submucosal dissection of rectal submucosal tumor in difficult location
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 18, 2020 Category: Surgery Source Type: research

A novel technique of securing a clear surgical space using a silicone disc during transanal total mesorectal excision
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 17, 2020 Category: Surgery Source Type: research

The Italian paradox of flavonoid use for hemorrhoids
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 17, 2020 Category: Surgery Source Type: research

Surgical management of acquired rectourethral fistula: a retrospective analysis of 52 consecutive patients
ConclusionsSurgery ensured healing in 96% of the patients. Radiotherapy led to higher rate of permanent urinary/fecal diversion. Nearly all irradiated patients who had transabdominal repair end up with a definitive stoma. When transperineal repair with gracilis flap interposition was used, the rate of fistula closure approached 90%. A treatment algorithm is proposed. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 16, 2020 Category: Surgery Source Type: research

The 13th European Colorectal Congress (#ECCStGallen), 1 –5 December 2019, St Gallen, Switzerland: Congress Report
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 16, 2020 Category: Surgery Source Type: research

Intracorporeal versus extracorporeal anastomosis in laparoscopic right hemicolectomy: results from the CLIMHET study group
ConclusionsOur results show that IC anastomosis in LRHC is associated with fewer medical complications and shorter hospital stays compared to EC anastomosis. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 14, 2020 Category: Surgery Source Type: research

Italian society of colorectal surgery recommendations for good clinical practice in colorectal surgery during the novel coronavirus pandemic
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 14, 2020 Category: Surgery Source Type: research

Laparoscopic sacrocolpopexy plus ventral rectopexy as combined treatment for multicompartment pelvic organ prolapse
AbstractBackgroundPelvic organ prolapse (POP) is a dynamic disorder that affects the entire pelvic diaphragm. POP may often involve multiple organs. Abdominal sacrocolpopexy is considered the gold standard to treat female anterior and apical prolapse. Abdominal ventral mesh rectopexy has gained increasing acceptance as an effective treatment for rectal prolapse. The aim of the present study was to assess the safety, feasibility and 1-year outcomes of laparoscopic sacrocolpopexy plus ventral rectopexy as a combined treatment of multicompartment POP.MethodsAll female patients at our institution with anterior and apical prola...
Source: Techniques in Coloproctology - April 13, 2020 Category: Surgery Source Type: research

Combined use of a petal flap and V –Y advancement flap for reconstruction of presacral defects following rectal resection
ConclusionsUse of a petal flap and V –Y advancement flap for reconstruction of presacral defects was found to be safe and simple, and should, therefore, be considered in the management of such problems. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 13, 2020 Category: Surgery Source Type: research

Comparison of survival of stage I –III colon cancer by travel distance and hospital volume
AbstractBackgroundPrevious studies have demonstrated improved outcomes at high-volume colorectal surgery centers; however, the benefit for patients who live far from such centers has not been assessed relative to local, low-volume facilities.MethodsThe 2010 –2015 National Cancer Database (NCDB) was queried for patients with stage I–III colon adenocarcinoma undergoing treatment at a single center. A ‘local, low-volume’ cohort was constructed of 12,768 patients in the bottom quartile of travel distance at the bottom quartile of institution surgic al volume and a ‘travel, high-volume’ cohor...
Source: Techniques in Coloproctology - April 12, 2020 Category: Surgery Source Type: research

Abstracts presented at the 13th European Colorectal Congress (#ECCStGallen), 1-5.12.2019, St.Gallen, Switzerland
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - April 11, 2020 Category: Surgery Source Type: research