Trends in hospital admission for acute diverticulitis in Italy from 2008 to 2015
AbstractBackgroundEpidemiological studies in Western countries have documented an increase of hospitalizations for acute diverticulitis (AD) but Italian evidence is scarce. The aim of the present study was to analyse the trend in hospitalization for AD, including in-hospital mortality, in Italy from 2008 to 2015.MethodsThrough the Italian Hospital Information System of the National Health System, we identified diverticulitis of the colon as a discharge diagnosis. Age- and gender-specific rates of hospitalization for AD were assessed.Results174,436 hospitalizations were identified with an increasing rate in 2008 –2015...
Source: Techniques in Coloproctology - September 8, 2018 Category: Surgery Source Type: research

The 15th International Coloproctology Meeting (#IMOC2018) 16 –18 April 2018, Turin, Italy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - September 1, 2018 Category: Surgery Source Type: research

Doppler-guided hemorrhoidal dearterialization with laser (HeLP): a prospective analysis of data from a multicenter trial
AbstractBackgroundDoppler-guided hemorrhoidal laser procedure (HeLP) is a new minimally invasive technique to treat symptomatic hemorrhoids. The aim of this multicenter study was to prospectively assess clinical results and patients ’ satisfaction in patients treated with HeLP.MethodsIndications for HeLP included patients with symptomatic hemorrhoids resistant to medical therapy, with low-grade prolapse. Clinical efficacy was evaluated assessing resolution of symptoms and patient satisfaction. Frequency of bleeding and frequency of acute hemorrhoid-related symptoms were given a score of 0 to 4 (where 4  =&thin...
Source: Techniques in Coloproctology - August 29, 2018 Category: Surgery Source Type: research

Label-free quantitative optical assessment of human colon tissue using spatial frequency domain imaging
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 29, 2018 Category: Surgery Source Type: research

Ureteric identification with indocyanine green fluorescence in laparoscopic redo pouch surgery
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 28, 2018 Category: Surgery Source Type: research

Tips and tricks for rectal dissection during laparoscopic ultra-low anterior resection
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 17, 2018 Category: Surgery Source Type: research

Management of patients with rectal prolapse: the 2017 Dutch guidelines
ConclusionsThese guidelines for clinical practice are useful in the diagnosis and treatment of rectal prolapse. There are many statements requiring a higher level of evidence due to a lack  of studies. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 11, 2018 Category: Surgery Source Type: research

Indocyanine green fluorescence angiography during low anterior resection for low rectal cancer: results of a comparative cohort study
AbstractBackgroundAnastomotic leak (AL) after low anterior resection (LAR) is associated with increased morbidity, mortality, cost and cancer recurrence rates. The aim of this study was to evaluate the impact of fluorescence angiography (FA) on AL following LAR for low rectal cancer.MethodsThis is a single surgeon retrospective cohort study with a historical, consecutively sampled case matched control group. The institution ’s prospectively maintained institutional review board (IRB)-approved database was queried for all patients who underwent a laparoscopic LAR for rectal neoplasia with a colorectal or coloanal anastomosis 
Source: Techniques in Coloproctology - August 10, 2018 Category: Surgery Source Type: research

The 117th Annual Scientific Meeting of the American Society of Colon and Rectal Surgeons
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 10, 2018 Category: Surgery Source Type: research

Preventing incisional hernia: closing the midline laparotomy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 9, 2018 Category: Surgery Source Type: research

Mediterranean Society of Coloproctology meeting report
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 7, 2018 Category: Surgery Source Type: research

Can fluorescence-guided surgery improve radical resection of colorectal cancer? Comments on the FLICC study
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 6, 2018 Category: Surgery Source Type: research

“Top down no-touch” technique in robotic complete mesocolic excision for extended right hemicolectomy with intracorporeal anastomosis
ConclusionsThe top down technique appears to be useful in robotic CME for an extended right hemicolectomy. Early identification of the gastrocolic trunk and middle colic vessels via this technique may prevent inadvertent vascular injury at the mesenteric root of the transverse colon. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 6, 2018 Category: Surgery Source Type: research

Can fluorescence-guided surgery improve radical resection of colorectal cancer? Comments on the FLICC study
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 6, 2018 Category: Surgery Source Type: research

Role of transanal irrigation in the treatment of anterior resection syndrome
AbstractBackgroundTransanal irrigation(TAI) has been reported to be an inexpensive and effective treatment for low anterior resection syndrome(LARS). The aim of the present prospective study was to evaluate the use of TAI in patients with significant LARS symptoms at a single medical center.MethodsPatients who had  low anterior resection for rectal cancer between April 2015 and May 2016 at the Careggi University Hospital were assessed for LARS using the LARS and the Memorial Sloan-Kettering Cancer Center Bowel Function Instrument (MSKCC BFI) questionnaires 30–40 days after  surgery or ileostomy cl...
Source: Techniques in Coloproctology - August 6, 2018 Category: Surgery Source Type: research

Is a low FODMAP diet dangerous?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 6, 2018 Category: Surgery Source Type: research

Offering HeLP to work out the optimum treatment for haemorrhoidal disease
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 1, 2018 Category: Surgery Source Type: research

Ureteric identification with indocyanine green fluorescence in laparoscopic redo pouch surgery
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 1, 2018 Category: Surgery Source Type: research

Neurovascular sparing robotic high anterior resection –technical note and video vignette
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 31, 2018 Category: Surgery Source Type: research

Clinical value of pouchogram prior to ileostomy closure after ileal pouch anal anastomosis
ConclusionsPouchogram has a low sensitivity in identifying anastomotic leak before ileostomy reversal in patients after RPC and only rarely changes management. In our series it identified the diagnosis of anastomotic leak in only 1 patient and gave false reassurance in two others. Complications are more frequently detected by clinical history and formal EUA before ileostomy closure. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 30, 2018 Category: Surgery Source Type: research

Rectal perforation after Doppler-guided hemorrhoidal dearterialization  treated with diverting sigmoidostomy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 30, 2018 Category: Surgery Source Type: research

Tumor thrombosis of the inferior mesenteric vein in a patient with rectal cancer
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 30, 2018 Category: Surgery Source Type: research

Laparoscopic delayed coloanal anastomosis without diverting ileostomy for low rectal cancer surgery: 85 consecutive patients from a single institution
ConclusionsIn our series, laparoscopic total mesorectal excision with delayed coloanal anastomosis was associated with septic complications and oncologic results similar to those reported after total mesorectal excision with conventional anastomosis and ileostomy, nearly one-third of patients experience a poor functional result. A randomized trial comparing these two options for low rectal cancer is under way. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 19, 2018 Category: Surgery Source Type: research

Systematic review of  blood diagnostic markers in colorectal cancer
AbstractThe purpose of this systematic review was to compare the diagnostic ability of blood markers for colorectal cancer (CRC). A systematic review of the literature for diagnostic blood markers for primary human colorectal cancer over the last 5  years was performed. The primary outcome was to assess the diagnostic ability of these markers in diagnosing colorectal cancer. The secondary outcome was to see whether the marker was compared to other markers. The tertiary outcome was to assess diagnostic ability in early versus late CRC, includi ng stage IV disease. We identified 51 studies (29 prospective, 14 retrospect...
Source: Techniques in Coloproctology - July 18, 2018 Category: Surgery Source Type: research

Bilateral versus unilateral botulinum toxin injections for chronic anal fissure: a randomised trial
ConclusionsInjection-related pain was similar in bilateral and unilateral injection groups. Unilateral injection was as effective as bilateral injections in healing and improving fissure pain without any deterioration in continence. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 18, 2018 Category: Surgery Source Type: research

Topical antimicrobial prophylaxis in colorectal surgery for the prevention of surgical wound infection: a systematic review and meta-analysis
ConclusionsEach of these interventions appears to be effective in decreasing SSI, but the number of studies for each is small and the quality of evidence is very low to moderate. Within the various outcomes of GRADE assessment, even a moderate classification suggests that further studies may well have very different results.. No randomized trials exist of combinations of two or more of the above interventions to see if there is a combined effect. Future studies should make sure that the antibiotic used preoperatively is uniform within a study and is consistent with the current guidelines. Deviation from this leads to a sig...
Source: Techniques in Coloproctology - July 17, 2018 Category: Surgery Source Type: research

Perforated sigmoid diverticulitis: Hartmann ’s procedure or resection with primary anastomosis—a systematic review and meta-analysis of randomised control trials
ConclusionsPA and HP appear to be equivalent in terms of most outcomes of interest, except for a lower intra-abdominal abscess risk after PA. The latter finding needs further investigation as it was not reported in any of the individual trials. However, given the limitations of the included RCTs, no firm conclusion can be drawn on which is the best surgical option  in patients with generalised peritonitis due to diverticular perforation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 11, 2018 Category: Surgery Source Type: research

Robotic transanal minimally invasive surgery (TAMIS) for local excision of rectal lesions with the da Vinci Xi (dVXi): technical considerations and video vignette
We describe our RT technique using the dVXi ™ (Intuitive Surgical, Sunnyvale, CA, USA) which we have used to efficiently and completely excise eight cases of rectal lesions which were not endoscopically resectable. We also include a video vignette of the procedure. With the patient in the prone jackknife position, we insert a GelPOINT™ Pa th Transanal Access Platform (Applied Medical, Rancho Santa Margarita, CA, USA) in combination with the dVXi and AirSeal™ insufflation system (Conmed, Niagara. Falls, ON, Canada). Our technique aims to be ergonomically efficient to minimise docking difficulties and to re...
Source: Techniques in Coloproctology - July 10, 2018 Category: Surgery Source Type: research

Management of acute uncomplicated diverticulitis without antibiotics: a systematic review, meta-analysis, and meta-regression of predictors of treatment failure
AbstractBackgroundDiverticulitis is a common complication of diverticular disease of the colon. While complicated diverticulitis often warrants intervention, acute uncomplicated diverticulitis (AUD) is usually managed conservatively. The aim of the present review was to evaluate the efficacy and safety of conservative treatment of AUD without antibiotics compared to standard antibiotic treatment.MethodsA systematic literature review in compliance with PRISMA guidelines was conducted. Electronic databases including PubMed/Medline, Scopus, Embase and Cochrane central register of controlled trials were searched. Studies that ...
Source: Techniques in Coloproctology - July 6, 2018 Category: Surgery Source Type: research

Authors reply: Damage control surgery in patients with generalized peritonitis secondary to perforated diverticulitis —the risk of overtreatment
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 6, 2018 Category: Surgery Source Type: research

Laparoscopic management of sigmoid colon gallstone ileus
We present a video of a laparoscopic cololithotomy for gallstone ileus caused by a gallstone impacted in the sigmoid colon. As a safe and feasible procedure, enterolithotomy appears to be the treatment of choice based on the scientific literature, especial ly in frail patients. However, except in case of an impacted gallstone in a colorectal cancer, colon resection is not mandatory. Further surgery (such as cholecystectomy or colectomy in benign disease such as diverticulosis) may be selectively considered. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 6, 2018 Category: Surgery Source Type: research

‘Hepworth hitch’: parastomal hernia prevention by simple modifications of operative techniques
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 3, 2018 Category: Surgery Source Type: research

Transanal total mesorectal excision (taTME) in a single-surgeon setting: refinements of the technique during the learning phase
ConclusionsThis study confirms the safety and effectiveness of single-surgeon implementation of taTME technique. Technical challenges experienced in this setting were not obstacles for further refinement and to establish a tendency towards better outcomes. Overcoming technical challenges is possible, familiarity with taTME is slow yet progressive, and improvement tends to occur with experience. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 28, 2018 Category: Surgery Source Type: research

Laparoscopic ventral rectopexy in patients with fecal incontinence associated with rectoanal intussusception: prospective evaluation of clinical, physiological and morphological changes
ConclusionsLVR for RAI produced adequate improvement of FI, and successful anatomical correction of RAI was confirmed by postoperative proctography. Postoperative increase in the rectal volume may have a positive effect on continence. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 28, 2018 Category: Surgery Source Type: research

Left colon resection with transrectal specimen extraction: current status
ConclusionsColectomy with TRSE is feasible and seems safe in selected patients. Reported outcomes seem in general similar to conventional laparoscopic colectomy with a possible benefit in postoperative pain and length of hospital stay. Obvious selection bias and lack of high quality trials do not allow firm conclusions to be drawn. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 12, 2018 Category: Surgery Source Type: research

Damage control surgery in patients with generalized peritonitis secondary to perforated diverticulitis: the risk of overtreatment
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 12, 2018 Category: Surgery Source Type: research

PortSmouth TAble Rotation Robotic technique for pan proctocolecotmy using DaVinci Si robotic system; P-STARR technique
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 8, 2018 Category: Surgery Source Type: research

Correction to: Distal Doppler-guided transanal hemorrhoidal dearterialization with mucopexy versus conventional hemorrhoidectomy for grade III and IV hemorrhoids: postoperative morbidity and long-term outcomes
The article “Distal Doppler-guided transanal hemorrhoidal dearterialization with mucopexy versus conventional hemorrhoidectomy for grade III and IV hemorrhoids: postoperative morbidity and long-term outcomes”, written by L. Trenti, S. Biondo, A. Galvez, A. Bravo, J. Cabrera, E. Kreisler, was originally publ ished electronically on the publisher’s internet portal (currently SpringerLink) on [27 April 2017] without open access. With the author(s)’ decision to opt for Open Choice the copyright of the article changed on 7 June, 2018 to © The Author(s) [2018] and the article is forthwith distributed...
Source: Techniques in Coloproctology - June 8, 2018 Category: Surgery Source Type: research

Use of a lighted stent to identify the urethra during transanal abdominoperineal resection
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 7, 2018 Category: Surgery Source Type: research

Is it correct to perform omentoplasty to repair rectovaginal fistulas in oncological patients?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 7, 2018 Category: Surgery Source Type: research

Indications for a  transanal approach in complicated inflammatory bowel disease
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 7, 2018 Category: Surgery Source Type: research

Novel multi-image view for neuromapping meets the needs of the robotic surgeon
ConclusionsThis report demonstrates the technical feasibility of an improved neuromonitoring process during nerve-sparing RTME. Robotic neuromapping can be fully visualized from the surgeon console. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 4, 2018 Category: Surgery Source Type: research

Sequential endoscopic and surgical removal of giant rectal adenomas extending to the dentate line
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 1, 2018 Category: Surgery Source Type: research

What is fast track multimodal management of colorectal cancer surgery in real life?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - June 1, 2018 Category: Surgery Source Type: research

Perioperative hypothermia during colectomy: when do patients get cold?
AbstractBackgroundHypothermia has been associated with an increase in the rate of infectious complications following colectomy. We hypothesized that a substantial fraction of temperature loss in patients undergoing elective colectomy occurs prior to operation.MethodsTemperature data were collected from 105 consecutive patients undergoing elective colectomy at a single institution.ResultsThe study population consisted of 105 patients; 67(64%) male, median age 59  years (range 17–95 years), median body mass index 27 kg/m2 (range 15 –48 kg/m2). Median preoperative temperature was 36.7  &de...
Source: Techniques in Coloproctology - June 1, 2018 Category: Surgery Source Type: research

Direct target NOTES: prospective applications for next generation robotic platforms
ConclusionsA flexible robotic system has the potential to access anatomy along circuitous paths, making it a suitable platform for direct target NOTES. The conceptual operations posed could be considered suitable for next generation robotics once the technology is optimized, and after further preclinical validation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 31, 2018 Category: Surgery Source Type: research

Levator ani syndrome: transperineal botox injections
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 31, 2018 Category: Surgery Source Type: research

Outcomes of endoscopic pilonidal sinus treatment (EPSiT): a systematic review
ConclusionsInitial studies on EPSiT have shown promising results. However, there is a need for a standardised technique and more comparative studies to validate this novel procedure. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - May 31, 2018 Category: Surgery Source Type: research