Desmoid tumor fistulating to small bowel
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 28, 2015 Category: Surgery Source Type: research

The use of a lighted stent as a method for identifying the urethra in male patients undergoing transanal total mesorectal excision: a video demonstration
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 27, 2015 Category: Surgery Source Type: research

Laparoscopic versus open fecal diversion: does laparoscopy offer better outcomes in short term?
Conclusions Considering the short-term benefits as regards postoperative recovery and morbidity, fecal diversions should be performed laparoscopically when feasible. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 22, 2015 Category: Surgery Source Type: research

New double-stapled anastomotic technique to avoid crossing staple lines
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 18, 2015 Category: Surgery Source Type: research

Prospective multicenter observational trial on the safety and efficacy of LEVORAG ® Emulgel in the treatment of acute and chronic anal fissure
Abstract Background Anal fissure (AF) is a common cause of anal pain with a tendency not to heal spontaneously because of ischemia of the anoderm caused by sphincter spasm. Lateral internal sphincterotomy, while very effective, can cause fecal incontinence and chemical sphincterotomy by application of cream may have discouraging side effects and/or low efficacy. The aim of this prospective multicenter study was to evaluate the safety and effectiveness of a new medical treatment based on Emulgel cream, with emollient, soothing and protective agents, on AF healing. ...
Source: Techniques in Coloproctology - March 14, 2015 Category: Surgery Source Type: research

Microbial sealants do not decrease surgical site infection for clean-contaminated colorectal procedures
Conclusions Microbial sealant as employed in this study did not appear to offer any benefit in a class 2 (clean contaminated) operative procedure when perioperative care is standardized. The relative benefit of laparoscopy was also confirmed but unaffected by use of the microbial sealant. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 14, 2015 Category: Surgery Source Type: research

Surgical stress response after colorectal resection: a comparison of robotic, laparoscopic, and open surgery
Conclusions Perioperative surgical stress, as evaluated by immunological parameters, was comparable between robotic and laparoscopic surgery and higher with open surgery. Robotic surgery may be an alternative to laparoscopic surgery, as a minimally invasive surgery option for colorectal cancer. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 12, 2015 Category: Surgery Source Type: research

The Art of Surgical Proctology: A Procedural Atlas of Proctologic Gold Standards, Innovations, and Tricks of the Trade
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 11, 2015 Category: Surgery Source Type: research

Efficacy of biofeedback plus transanal stimulation in the management of pelvic floor dyssynergia: a randomized trial
Abstract Background The therapy of pelvic floor dyssynergia is mostly conservative and is based on a high-fiber diet, physical activity and biofeedback training. Our aim was to compare the outcome of biofeedback (manometric-assisted pelvic relaxation and simulated defecation training) plus transanal electrostimulation with standard therapy (diet, exercise, laxatives). Methods Clinical, physiologic and quality of life [patient assessment of constipation quality of life (PAC-QOL)] measures, anorectal manometry and balloon expulsion test results wer...
Source: Techniques in Coloproctology - March 5, 2015 Category: Surgery Source Type: research

Erosion versus recurrence: Is there a compromise using biologics for ventral rectopexy?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - March 3, 2015 Category: Surgery Source Type: research

Repair of complex parastomal hernias
Abstract Development of parastomal hernias (PH) is very common after stoma formation and carries a risk of subsequent bowel incarceration, obstruction and strangulation. The management of PH remains a challenge for the colorectal surgeon, and there are currently no standardized guidelines for the treatment of PH. Even more difficult is the management of complex parastomal hernias (CPH). We conducted a review of the literature to identify recent developments in the treatment of CPH, including analysis of the use of synthetic and biologic mesh prostheses, method of mesh placement and surgical approach. (Source: ...
Source: Techniques in Coloproctology - March 2, 2015 Category: Surgery Source Type: research

Lumbosacral discitis following laparoscopic ventral mesh rectopexy: a rare but potentially serious complication
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 27, 2015 Category: Surgery Source Type: research

Fistula-tract Laser Closure (FiLaC™): long-term results and new operative strategies
Conclusions Long-term follow-up after FiLaC™ seems to confirm the favorable short-term success rates reported for this procedure. Although sealing of chronic anal fistulas may be obtained with FiLaC™ in a single treatment, our current strategy consists of placing a loose seton into the fistula tract a few weeks prior to laser treatment. Seton treatment facilitates the following laser procedure and seems to have favorable effects on healing. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 27, 2015 Category: Surgery Source Type: research

Invited comment on van der Steeg et al.: European consensus meeting of ARM-Net members concerning diagnosis and early management of newborns with anorectal malformations
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 27, 2015 Category: Surgery Source Type: research

Robotic-assisted resection of presacral sclerosing epithelioid fibrosarcoma
Conclusions This case demonstrates the feasibility of the robot in the resection of presacral masses. It is useful especially in narrow, difficult, male pelvises. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 26, 2015 Category: Surgery Source Type: research

The OTSC ® proctology clip system for the closure of refractory anal fistulas
Conclusions The novel OTSC® proctology system is a safe and effective method for the closure of even complex and recurrent fistulas. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 26, 2015 Category: Surgery Source Type: research

Impact of analgesic modality on stress response following laparoscopic colorectal surgery: a post-hoc analysis of a randomised controlled trial
Conclusions There is a significant transient attenuating effect of TEA on stress response following laparoscopic colorectal surgery and within ERAS as expressed by serum epinephrine and insulin levels. Continuous wound infusion with local anaesthetic, however, attenuates cytokine response as expressed by interleukin-6. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 26, 2015 Category: Surgery Source Type: research

Robotic transanal surgery for local excision of rectal neoplasia, transanal total mesorectal excision, and repair of complex fistulae: clinical experience with the first 18 cases at a single institution
Conclusions Robotic transanal surgery for local excision, transanal total mesorectal excision, and repair of fistulae is feasible, although these new approaches represent a work-in-progress. Improvement in platform design will likely facilitate the ability to perform more complex procedures. Further research with robotic transanal approaches is necessary to determine whether or not this approach can provide patients with significant benefit. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 24, 2015 Category: Surgery Source Type: research

Tying up loose ends
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 24, 2015 Category: Surgery Source Type: research

Palliation of a gastrocolic fistula secondary to colon cancer with a covered colonic stent using a simultaneous dual-scope approach
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 24, 2015 Category: Surgery Source Type: research

Postoperative complications after reconstructive surgery for cloacal malformations: a systematic review
Abstract The repair of cloacal malformations is most often performed using a posterior sagittal anorecto-vagino-urethroplasty (PSARVUP) or total urogenital mobilization (TUM) with or without laparotomy. The aim of this study was to systematically review the frequency and type of postoperative complication seen after cloacal repair as reported in the literature. A systematic literature search was conducted according to preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA). Eight records were eligible for this study which were qualitatively analyzed according to the Rangel score. Ove...
Source: Techniques in Coloproctology - February 21, 2015 Category: Surgery Source Type: research

Transanal endoscopic total mesorectal excision: technical aspects of approaching the mesorectal plane from below—a preliminary report
This report describes our initial experience with a hybrid laparoscopic and transanal endoscopic technique for TME in low rectal cancer. Methods Between December 2012 and October 2013, we identified patients with rectal cancer 
Source: Techniques in Coloproctology - February 21, 2015 Category: Surgery Source Type: research

Laparoscopic-assisted extralevator abdominoperineal excision using a parastomal prophylactic mesh and a biological mesh for pelvic floor reconstruction
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 20, 2015 Category: Surgery Source Type: research

Colonic transit in the empty colon after defunctioning ileostomy: Do we really know what happens?
Conclusions Colonic transit may be abolished by the presence of diverting ileostomy. It should now be established whether clearance of the left colon alone, using enemas, is sufficient for patients undergoing low anterior resection, thus avoiding the morbidity associated with oral MBP. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 20, 2015 Category: Surgery Source Type: research

Assessment of a novel, full-thickness incisional biopsy model to restage rectal tumours after neoadjuvant chemoradiotherapy: results of an ex vivo pilot study
Conclusion This prospective data demonstrates that incisional biopsy is not suitable as a stand-alone method to restage rectal cancer after CRT. Alternate or complementary means of restaging are needed. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 17, 2015 Category: Surgery Source Type: research

A pull-through delayed “high” coloanal anastomosis: new tricks to refresh an old procedure
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 14, 2015 Category: Surgery Source Type: research

The 113th Annual Meeting of the American Society of Colon and Rectal Surgeons
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - February 12, 2015 Category: Surgery Source Type: research

Evaluation of transanal hemorrhoidal dearterialization: a single surgeon experience
Conclusions THD is a same-day procedure for the treatment of hemorrhoidal disease that is safe and effective, and offers the potential for immediate return to normal activity. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 31, 2015 Category: Surgery Source Type: research

Erratum to: Is the lateralization distance important in terms in patients undergoing the modified Limberg flap procedure for treatment of pilonidal sinus?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 24, 2015 Category: Surgery Source Type: research

Hemorrhoidopexy with the HemorPex System
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 23, 2015 Category: Surgery Source Type: research

Re: Staying on Target—reply to comments by Loyal et al.
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 23, 2015 Category: Surgery Source Type: research

European consensus meeting of ARM-Net members concerning diagnosis and early management of newborns with anorectal malformations
Abstract The ARM-Net (anorectal malformation network) consortium held a consensus meeting in which the classification of ARM and preoperative workup were evaluated with the aim of improving monitoring of treatment and outcome. The Krickenbeck classification of ARM and preoperative workup suggested by Levitt and Peña, used as a template, were discussed, and a collaborative consensus was achieved. The Krickenbeck classification is appropriate in describing ARM for clinical use. The preoperative workup was slightly modified. In males with a visible fistula, no cross-table lateral X-ray is needed and an ano...
Source: Techniques in Coloproctology - January 22, 2015 Category: Surgery Source Type: research

Extended lateral pelvic sidewall excision (ELSiE): an approach to optimize complete resection rates in locally advanced or recurrent anorectal cancer involving the pelvic sidewall
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 14, 2015 Category: Surgery Source Type: research

Is the porcelain throne to blame?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 13, 2015 Category: Surgery Source Type: research

Laparoscopic ventral rectopexy using biologic mesh for the treatment of obstructed defaecation syndrome and/or faecal incontinence in patients with internal rectal prolapse: a critical appraisal of the first 100 cases
Abstract Background Laparoscopic ventral mesh rectopexy (LVR) is gaining wider acceptance as the preferred procedure to correct internal as well as external rectal prolapse associated with obstructed defaecation syndrome and/or faecal incontinence. Very few reports exist on the use of biologic mesh for LVR. The aim of our study was to report the complication and recurrence rate of our first 100 cases of LVR for symptomatic internal rectal prolapse and/or rectocele using a porcine dermal collagen mesh. Methods Prospectively collected data on LVR for inter...
Source: Techniques in Coloproctology - January 11, 2015 Category: Surgery Source Type: research

Robotic-assisted strictureplasty for Crohn’s disease
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 8, 2015 Category: Surgery Source Type: research

Transanal total mesorectal excision: full steam ahead
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 6, 2015 Category: Surgery Source Type: research

Predictive factors for inadequate colon preparation before colonoscopy
Abstract Background It could be helpful to ascertain which patients are at risk of poor bowel preparation prior to performing sedated colonoscopy. The aim of the present study was to identify the predictive factors for poor colon preparation prior to colonoscopy. Methods A prospective study was performed at Kaohsiung Chang Gung Memorial Hospital, Taiwan, from September 2011 to May 2013. Patient characteristics, food consumed within 2 days of colonoscopy, volume of polyethylene glycol (PEG) solution, interval between completing PEG and examination, n...
Source: Techniques in Coloproctology - January 6, 2015 Category: Surgery Source Type: research

Pouch-related fistula and intraoperative tricks to prevent it
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 3, 2015 Category: Surgery Source Type: research

Triple procedure for complex anal fistula
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 1, 2015 Category: Surgery Source Type: research

Anal sphincteroplasty and gracilis muscle transposition using transvaginal access in a patient with fecal incontinence
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 1, 2015 Category: Surgery Source Type: research

Laparoscopic en bloc excision of gastrointestinal stromal tumors of the rectum after neoadjuvant imatinib therapy: anteriorly extended intersphincteric resection combined with partial resection of the prostate
Abstract We herein present a novel technique for laparoscopic en bloc excision involving anteriorly extended intersphincteric resection with partial resection of the posterior lobe of the prostate for large rectal gastrointestinal stromal tumors (GISTs). The sequence of neoadjuvant imatinib therapy and this less invasive surgery for marginally resectable rectal GISTs has the potential to obviate the need for urinary reconstruction and permanent stomas without jeopardizing the tumor margin status. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 31, 2014 Category: Surgery Source Type: research

Laparoscopic peritoneal lavage for perforated colonic diverticulitis: a definitive treatment? Retrospective analysis of 63 cases
Conclusions Laparoscopic peritoneal lavage for perforated diverticulitis can be considered a safe and effective alternative to traditional surgical resection, and using this approach, most elective colon resection might be avoided. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 30, 2014 Category: Surgery Source Type: research

R0 resection, not surgical technique, is the key consideration in pelvic exenteration surgery
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 28, 2014 Category: Surgery Source Type: research

Pudendal nerve exposure and preservation in low rectal surgery by using transvaginal access
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 24, 2014 Category: Surgery Source Type: research

Propensity adjusted appraisal of the surgical strategy for appendiceal carcinoids
Conclusions Right hemicolectomy did not seem to confer any survival advantage on patients with appendiceal carcinoids with a diameter>2 cm. For this reason, tumor size should not be considered an absolute indication for right hemicolectomy. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 5, 2014 Category: Surgery Source Type: research

Is the lateralization distance important in terms in patients undergoing the modified Limberg flap procedure for treatment of pilonidal sinus?
Conclusions No statistically significant differences in early complications or recurrence rates were found between the two different lateralization distances in the modified Limberg flap procedure. Therefore, we conclude that 1-cm lateralization of the lower part of the incision is sufficient. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 1, 2014 Category: Surgery Source Type: research

Objective assessment of technique in laparoscopic colorectal surgery: What are the existing tools?
Abstract Assessment can improve the effectiveness of surgical training and enable valid judgments of competence. Laparoscopic colon resection surgery is now taught within surgical residency programs, and assessment tools are increasingly used to stimulate formative feedback and enhance learning. Formal assessment of technical performance in laparoscopic colon resection has been successfully applied at the specialist level in the English “LAPCO” National Training Program. Objective assessment tools need to be developed for training and assessment in laparoscopic rectal cancer resection surgery. Simulati...
Source: Techniques in Coloproctology - November 27, 2014 Category: Surgery Source Type: research

Prevention of recurrent small bowel obstruction resulting from pelvic adhesions in patients who have previously undergone abdominoperineal excision of the rectum
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 26, 2014 Category: Surgery Source Type: research

Surgical site events in colorectal surgery: prevention is better than cure
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 26, 2014 Category: Surgery Source Type: research