Posterior high sacral segmental disconnection prior to anterior en bloc exenteration for recurrent rectal cancer
This article describes a novel technique for en bloc resection of locally recurrent rectal cancer that invades the high sacral bone (above S3). The involved segment of the sacrum is mobilised with osteotomes during an initial posterior approach before an anterior abdominal phase where the segment of sacral bone is delivered with the specimen. This allows en bloc resection of the involved sacrum while preserving uninvolved distal and contralateral sacral bone and nerve roots. The goal is to obtain a clear bony margin and offer a chance of cure while improving functional outcomes by maintaining pelvic stability and minimisin...
Source: Techniques in Coloproctology - March 21, 2016 Category: Surgery Source Type: research

The use of the PEN3 e-nose in the screening of colorectal cancer and polyps
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 21, 2016 Category: Surgery Source Type: research

A new stomaplasty ring (Koring™) to prevent parastomal hernia: an observational multicenter Swiss study
Conclusions Koring™ implantation at the time of creating the stoma is safe, easy and only adds minimally operating time. A long-term follow-up as well as a randomized controlled study is needed to evaluate the impact of the Koring™ on PSH prevention. The ease and rapidity with which Koring™ can be implanted may help surgeons to overcome their apprehension of using a preventative device. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 21, 2016 Category: Surgery Source Type: research

Transanal NOTES total mesorectal excision (TME) in patients with rectal cancer: Is anatomy better preserved?
Conclusions Compared to the LAPTME, the NOTESTME seems to be associated with a more frequent intraoperative identification of the sacral nerves. However, the difference in overall quality of the retrieved specimen, although favoring NOTESTME, did not reach statistical significance in this small series. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 18, 2016 Category: Surgery Source Type: research

Stapled hemorrhoidopexy complicated by rectourethral fistula
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 15, 2016 Category: Surgery Source Type: research

EuroSurg-1 study: an opportunity to encourage student-driven surgical research in Italy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 11, 2016 Category: Surgery Source Type: research

To TEM or not to TEM: past, present and probable future perspectives of the transanal endoscopic microsurgery platform
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 8, 2016 Category: Surgery Source Type: research

Preliminary results of video-assisted anal fistula treatment (VAAFT) in children
Conclusions VAAFT proved to be feasible and safe in children. It also proved to be versatile as it could be applied to fistulas of different etiologies. The key to success seems to be an adequate mucosal sleeve. Older children and adolescents benefit most from VAAFT which is a valid alternative to available surgical procedures. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 8, 2016 Category: Surgery Source Type: research

Pure Natural Orifice Transluminal Endoscopic Surgery (NOTES) with a new elongated, curved Transanal Endoscopic Operation (TEO) device for rectosigmoid resection: a survival study in a porcine model
Conclusions Pure transanal rectosigmoid resection is a feasible procedure. The approach via a single transanal access is demanding but viable with the elongated and curved TEO device. The newly developed scope offers an excellent view of the area cephalad to the promontory. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 3, 2016 Category: Surgery Source Type: research

The Italian approach to diverticular perforation complicated by diffuse peritonitis: report of the Annual UCP-SICCR Meeting 2015
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 2, 2016 Category: Surgery Source Type: research

Hiatal hernia, mitral valve prolapse and defecatory disorders: An underlying rectal prolapse?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 29, 2016 Category: Surgery Source Type: research

Sacral nerve stimulation versus percutaneous posterior tibial nerve stimulation in the treatment of severe fecal incontinence in men
Conclusions Our study was nonrandomized with a relatively small number of patients. PPTNS had similar efficiency to the SNS in our men population. However, more studies are necessary to exclude selection bias and analyze long-term results. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 29, 2016 Category: Surgery Source Type: research

Laparoscopy following peritoneal entry during transanal endoscopic microsurgery may increase the safety and maximize the benefits of the transanal excision
Conclusions Laparoscopy after PE during TEM permits visualization and testing of the suture line. It is not associated with increased morbidity, and it may increase the safety of TEM. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 23, 2016 Category: Surgery Source Type: research

Rectal atresia and anal stenosis: the difference in the operative technique for these two distinct congenital anorectal malformations
We present a case of rectal atresia and anal stenosis to demonstrate the differences in the operative repair. The techniques described leave the anterior wall of the very distal anal canal untouched in both rectal stenosis and anal atresia; however, the dissection of the rectum differs. The atretic rectum in rectal atresia is mobilized and sutured to the anal canal circumferentially. In anal stenosis, the posterior rectum is mobilized in the form of rectal advancement, and the posterior 180° is anastomosed directly to the skin (as in a standard PSARP) with preservation of the anal canal as the anterior 180° of the ...
Source: Techniques in Coloproctology - February 22, 2016 Category: Surgery Source Type: research

Laparoscopic double-stapled colorectal anastomosis without “dog-ears”
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 22, 2016 Category: Surgery Source Type: research

Diagnosis of Lynch syndrome before colorectal resection: does it matter?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 19, 2016 Category: Surgery Source Type: research

Transanal minimally invasive surgery approach for rectal GIST
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 18, 2016 Category: Surgery Source Type: research

Super-slim endoscopy, in a patient with a Crohn’s ileocecal valve stricture, for assessment of mucosal healing
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 17, 2016 Category: Surgery Source Type: research

The use of a T drain tube to treat anastomotic leaks
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 17, 2016 Category: Surgery Source Type: research

Clinical recurrence and re-resection rates after extensive vs. segmental colectomy in Crohn’s colitis: a retrospective cohort study
Conclusions Segmental resection with primary anastomosis can be safely performed in patients with limited Crohn’s colitis with reasonable clinical recurrence rates. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 17, 2016 Category: Surgery Source Type: research

High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy
Conclusion High-grade hemorrhoids requiring surgery may be common after LVMR. The development of high-grade hemorrhoids after LVMR might be considered a predictor of rectal prolapse recurrence. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 16, 2016 Category: Surgery Source Type: research

Why diverticulosis haunts the Western world
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 12, 2016 Category: Surgery Source Type: research

Quality of patient information online for rectal prolapse
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 5, 2016 Category: Surgery Source Type: research

Author’s reply to the letter of Doll et al.
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 5, 2016 Category: Surgery Source Type: research

Management of perianal extramammary Paget’s disease involving the dentate line without abdominoperineal resection
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 1, 2016 Category: Surgery Source Type: research

Repair of a anastomotic-vaginal fistula with biological mesh (Permacol™) after surgery for low rectal cancer
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 29, 2016 Category: Surgery Source Type: research

Short-term outcomes after transanal and laparoscopic total mesorectal excision for rectal cancer
Conclusions Our initial experience demonstrates comparable short-term results for taTME and lap TME. Further investigation is necessary to assess long-term functional and oncologic outcomes. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 21, 2016 Category: Surgery Source Type: research

Laparoscopic colorectal resection versus open colorectal resection in octogenarians: a systematic review and meta-analysis of safety and efficacy
Abstract Octogenarians are more often viewed as high-risk surgical candidates. This increased risk is attributed to an age-related decline in physical function and reserve capacity coupled with the presence of various underlying diseases. There are no current guidelines or consensus on the optimal treatment strategy for this cohort of complex patients. The aim of this systematic review and meta-analysis was to compare the efficacy and safety of laparoscopic colorectal resection versus open colorectal resection in octogenarians. The meta-analysis was conducted following all aspects of the Cochrane Handbook for Syst...
Source: Techniques in Coloproctology - January 18, 2016 Category: Surgery Source Type: research

Endoanal/endovaginal ultrasound-assisted bilateral partial myotomy of the puborectalis for anismus
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 18, 2016 Category: Surgery Source Type: research

A new method for evaluation of perianal fistula: digital infrared thermal imaging
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 18, 2016 Category: Surgery Source Type: research

Percutaneous posterior tibial nerve stimulation in the treatment of refractory anal fissure
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 14, 2016 Category: Surgery Source Type: research

Diagnosis and management of splenic injury following colonoscopy: algorithm and case series
Conclusions Although very rare, splenic injury during colonoscopy is an acute, severe and possible fatal complication. Patients may present with a rapid clinical deterioration and hemodynamic instability. Physicians should be familiar with the practical management of this surgical emergency and the treatment options available. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 13, 2016 Category: Surgery Source Type: research

Validity and reliability of a Lithuanian version of low anterior resection syndrome score
Abstract Background Up to 90 % of patients undergoing low anterior resection complain of increased daily bowel movements, urgency, and a variable degree of incontinence. A symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer has recently been developed and validated. The aim of our study was to adapt the low anterior resection syndrome (LARS) scale questionnaire to the Lithuanian language, and assess its psychometric properties. Methods The LARS questionnaire was translated into Lithuanian by the Scientif...
Source: Techniques in Coloproctology - January 12, 2016 Category: Surgery Source Type: research

Four anastomotic techniques following transanal total mesorectal excision (TaTME)
We present a technical note describing these techniques and discuss the risks and benefits of each. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 12, 2016 Category: Surgery Source Type: research

Anterior intussusception descent during defecation is correlated with the severity of fecal incontinence in patients with rectoanal intussusception
Abstract Background Rectoanal intussusception (RAI) is a common finding on evacuation proctography in patients with defecation disorders. However, it remains unclear whether intussusception morphology affects the severity of fecal incontinence (FI). The aim of this study was to examine the effect of morphology during defecation on the severity of FI in patients with RAI. Methods We included 80 patients with FI who were diagnosed as having RAI on evacuation proctography. Various morphological parameters were measured, and the level of RAI was divided by t...
Source: Techniques in Coloproctology - January 12, 2016 Category: Surgery Source Type: research

Update on advances and controversy in rectal cancer treatment
Abstract Changes in the multidisciplinary treatment of rectal cancer have been recently proposed. We performed a comprehensive review of the current data on neoadjuvant and adjuvant treatment of rectal cancer, focussing on chemoradiotherapy treatment and timing of surgery. Six components were proposed as the framework for the treatment of rectal cancer: neoadjuvant therapy and changing patterns in patient selection, long- or short-course radiotherapy, adverse effects of radiotherapy, timing of surgery, non-operative management of rectal cancer and postoperative adjuvant therapy. Lack of a consistent difference...
Source: Techniques in Coloproctology - January 12, 2016 Category: Surgery Source Type: research

Identification of mesenteric lymph nodes in robotic complete mesocolic excision by near-infrared fluorescence imaging
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 5, 2016 Category: Surgery Source Type: research

Erratum to: Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 4, 2016 Category: Surgery Source Type: research

Fecal incontinence: major problem or incidental finding?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 28, 2015 Category: Surgery Source Type: research

Rectocele repair with stapled transvaginal rectal resection
Conclusions Vaginal repair carries no risk of fecal incontinence. Large anterior rectocele is considered the main indication for this technique. Using the linear stapler is a cost-effective, simple, and easy technique. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 28, 2015 Category: Surgery Source Type: research

Trans-anal endoscopic microsurgery for internal rectal prolapse
We present trans-anal endoscopic microsurgery as surgical option for management of this uncommon type of rectal prolapse in specific cases. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 21, 2015 Category: Surgery Source Type: research

Influence of body posture on defecation: a prospective study of “The Thinker” position
Conclusion “The Thinker” position seems to be a more efficient method for defecation than the sitting position. This technique may be helpful when retraining patients with constipation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 21, 2015 Category: Surgery Source Type: research

“Rectal ulcer: consider Hirschsprung’s disease” Report of the Colorectal Club meeting, Milan, June 14–15, 2015
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 21, 2015 Category: Surgery Source Type: research

Pilonidal sinus disease guidelines: a minefield?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 17, 2015 Category: Surgery Source Type: research

Implantation of SphinKeeper TM : a new artificial anal sphincter
Conclusion SphinKeeperTM can be safely implanted in patients with FI of different etiology. Implantation was well tolerated with no dislodgment of implants at 3-month follow-up. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 12, 2015 Category: Surgery Source Type: research

Treatment of minor dehiscence after endorectal advancement flap in perianal Crohn’s fistulas with ozonized oil NOVOX ®
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 7, 2015 Category: Surgery Source Type: research

Dual endolaparoscopic technique (DUET) for TAMIS proctectomy and concomitant parastomal hernia repair
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 27, 2015 Category: Surgery Source Type: research

Systematic review of pre-operative exercise in colorectal cancer patients
Abstract The aim of this systematic review was to evaluate the evidence for exercise interventions prior to surgery for colorectal cancer resection. The evidence for use of exercise to improve physical fitness and surgical outcomes is as yet unknown. A systematic search was performed of MEDLINE, EMBASE, CINAHL, AMED and BNI databases for studies involving pre-operative exercise in colorectal cancer patients. Eight studies were included in the review. There is evidence that pre-operative exercise improves functional fitness, and to a lesser extent objectively measurable cardio-respiratory fitness prior to color...
Source: Techniques in Coloproctology - November 27, 2015 Category: Surgery Source Type: research

The quest for precision in transanal total mesorectal excision
Abstract Transanal total mesorectal excision (TME) is an emerging minimally invasive approach to rectal cancer, with encouraging preliminary results. However, the new surgical anatomy of the bottom-up approach complicates surgical understanding and increases the risks of inadvertent injuries to crucial anatomical structures, including nerves. Key elements to improve the safety and stimulate interest in such a complex technique might be robotics and image guidance, to enhance the level of precision. In this editorial, some of the technologies that could be used for precision TME are outlined, in light of the ex...
Source: Techniques in Coloproctology - November 26, 2015 Category: Surgery Source Type: research

V. W. Fazio, “Vic the fighter”
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 23, 2015 Category: Surgery Source Type: research