Anastomotic leak does not affect long-term and longitudinal functional outcomes after ileal pouch surgery for ulcerative colitis when managed aggressively
ConclusionsThere is no statistical difference in longitudinal function between patients who experienced AL after IPAA surgery for UC compared with those who did not. Therefore, an acute AL does not negatively impact long-term functional outcomes in IPAA patients. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 26, 2020 Category: Surgery Source Type: research

Comparison of long-term outcome of sacral nerve stimulation for constipation and faecal incontinence with focus on explantation rate, additional visits, and patient satisfaction
ConclusionsNo significant difference was found regarding explantation rate, number of additional visits, or improvement of VAS at 5  years after SNS implantation between SNS-C patients and SNS-IFI patients. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 26, 2020 Category: Surgery Source Type: research

Right sided colorectal cancer increases with age and screening should be tailored to reflect this: a national cancer database study
AbstractBackgroundIn the United States, colorectal cancer (CRC) screening and surveillance is recommended until age 75. However, rates of surgery for CRC are greatest in the elderly, questioning current guidelines. Tumor sidedness is an emerging prognostic marker that may help guide screening and treatment decisions, with specific benefit evaluating CRC anatomic distribution in the elderly. Our objective was to investigate the anatomical distribution of CRC in the elderly and factors associated with right-sidedness.MethodsThe National Cancer Database (2004 –2016) was used to identify elderly patients with CRC. Cases ...
Source: Techniques in Coloproctology - August 26, 2020 Category: Surgery Source Type: research

Colorectal resection via natural orifice specimen extraction versus conventional laparoscopic extraction: a meta-analysis with meta-regression
AbstractBackgroundStudies have shown differences in postoperative outcomes between two minimally invasive extraction methods for colorectal lesions —natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery (CLS). The aim of this study was to discover the major differences in NOSES and CLS to refine current practice.MethodsElectronic databases were searched for articles comparing NOSES and CLS from inception till March 2020. Weighted mean differences (WMD) and odds ratio (OR) were estimated for continuous and dichotomous outcomes, respectively. Summary statistics were calculated using ...
Source: Techniques in Coloproctology - August 25, 2020 Category: Surgery Source Type: research

Continuation of minimally invasive surgery in the COVID-19 pandemic
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 25, 2020 Category: Surgery Source Type: research

Endo-VAC ® customization for sinus/anastomotic-leaks/dehiscence after colorectal anastomosis
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 19, 2020 Category: Surgery Source Type: research

Double-endoscope assisted endoscopic submucosal dissection for treating tumors in rectum and distal colon by expert endoscopists: a feasibility study
ConclusionsDEA-ESD is a feasible and safe method for treating complex or recurrent tumors in the rectum and distal colon. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 18, 2020 Category: Surgery Source Type: research

Feasibility of laparoscopic-assisted transanal pelvic exenteration in locally advanced rectal cancer with anterior invasion
ConclusionsThe results suggest that laparoscopic-assisted Ta pelvic exenteration is an acceptable procedure, may help overcome the current technical difficulties, and may improve outcomes in patients with locally advanced rectal cancer. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 18, 2020 Category: Surgery Source Type: research

Porcine dermal collagen mesh (Permacol ™) as a bioprosthesis in the ligation of intersphincteric tract (BioLIFT) procedure
ConclusionPermacol ™ mesh in BioLIFT is feasible and achieves a high primary healing rate of 80%. Prospective evidence is needed to establish the benefits of BioLIFT and determine whether Permacol™ is superior to the non-cross-linked porcine submucosal mesh. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 18, 2020 Category: Surgery Source Type: research

Does prehabilitation modify muscle mass in patients with rectal cancer undergoing neoadjuvant therapy? A subanalysis from the REx randomised controlled trial
ConclusionsPrehabilitation improved muscle mass in patients with rectal cancer who had NACRT. These results need to be explored in a larger trial to determine if the poorer short- and long-term patient outcomes associated with low muscle mass can be minimised by prehabilitation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 17, 2020 Category: Surgery Source Type: research

Impact of the number of stapler firings on anastomotic leakage in laparoscopic rectal surgery: a systematic review and meta-analysis
ConclusionsOur systematic review and meta-analysis suggest that two firings imply a higher rate of anastomotic leak than a single firing after laparoscopic rectal surgery with a double stapling technique. Coloproctologists should strive to reduce the number of linear stapler firings and try to transect the rectum with a single firing. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 17, 2020 Category: Surgery Source Type: research

Five-year single center experience of sacral neuromodulation for isolated fecal incontinence or fecal incontinence combined with low anterior resection syndrome
ConclusionsSNM therapy is a safe and effective treatment for patients with isolated FI and patients with FI and LARS. Adequate follow-up is essential to ensure long-term effectivity, especially for LARS patients. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 17, 2020 Category: Surgery Source Type: research

Stapled hemorrhoidopexy and THD/HAL-RAR: false myths of the third millennium
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 17, 2020 Category: Surgery Source Type: research

Feasibility of intraoperative ultrasound of the small bowel during Crohn ’s disease surgery
ConclusionsThis feasibility study demonstrated the safety of intraoperative ultrasound and allowed the development of a standardised protocol for intraoperative ultrasound and the data collection required to inform a randomised multicentre study. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 17, 2020 Category: Surgery Source Type: research

Resolution of multiply recurrent and multifocal diverticulitis after fecal microbiota transplantation
ConclusionsFMT could prove to be a novel therapy for refractory diverticulitis but requires further investigation. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 17, 2020 Category: Surgery Source Type: research

Pickrell graciloplasty for fecal incontinence complicating anal malperforation: a video vignette
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 17, 2020 Category: Surgery Source Type: research

Restorative surgery for ulcerative colitis in the elderly: an analysis of ileal pouch-anal anastomosis procedures from the American College of Surgeons National Surgical Quality Improvement Program
AbstractBackgroundIleal pouch-anal anastomosis (IPAA) for ulcerative colitis(UC) can be performed as either 2- or 3-stage procedure. IPAA in the elderly has been reported as safe and feasible, but little work to date has assessed outcomes by procedure. The aim of our study was to assess use and short-term outcomes of 2- and 3-stage IPAA in older adults.MethodsThe American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was searched for  ≥ 65-year-old patients who underwent IPAA for UC in 2- or 3-stage from 2012 to 2016. The primary endpoint was the rate and trends of ...
Source: Techniques in Coloproctology - August 15, 2020 Category: Surgery Source Type: research

Rectal eversion for direct access to the distal resection margin: do we need another tool in the toolbox of rectal cancer surgery?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 15, 2020 Category: Surgery Source Type: research

Correction to: Cesarean delivery to prevent anal incontinence: a systematic review and meta-analysis
The original article can be found online (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 15, 2020 Category: Surgery Source Type: research

The impact of COVID-19 on proctologic practice in Italy
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 9, 2020 Category: Surgery Source Type: research

Assessing the effectiveness of laser fistulectomy for anal fistula: a retrospective cohort study
ConclusionsOur data showed a much higher failure rate of laser fistulectomy compared to those reported in the literature. However, the small sample size, a large amount of heterogeneity in our patient population with a mixture of fistula types present, and various laser techniques applied decreased the power of this study. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 7, 2020 Category: Surgery Source Type: research

Restorative surgery for ulcerative colitis in the elderly: an analysis of ileal pouch-anal anastomosis procedures from the American College of Surgeons National Surgical Quality Improvement Program
AbstractBackgroundIleal pouch-anal anastomosis (IPAA) for ulcerative colitis (UC) can be performed as either 2- or 3-stage procedure. IPAA in the elderly has been reported as safe and feasible, but little work to date has assessed outcomes by procedure. The aim of our study was to assess use and short-term outcomes of 2- and 3-stage IPAA in older adults.MethodsThe American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) Database was searched for  ≥ 65-year-old patients who underwent IPAA for UC in 2- or 3-stage from 2012 to 2016. The primary endpoint was the rate and trends of...
Source: Techniques in Coloproctology - August 6, 2020 Category: Surgery Source Type: research

Management of colorectal anastomotic stricture with multidiameter balloon dilation: long-term results
ConclusionsEndoscopic multidiameter balloon dilation is a safe and effective method for treating benign colorectal anastomotic strictures. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - August 4, 2020 Category: Surgery Source Type: research

A new aortoiliac calcification scoring system to predict grade C anastomotic leak following rectal cancer surgery
ConclusionsAortoiliac calcification may be considered a risk factor for grade C AL after rectal cancer surgery. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Mesenchymal stem cells in perianal Crohn ’s disease
AbstractThe use of mesenchymal stem cells has resulted in a breakthrough for the treatment of complex perianal fistulas in Crohn ’s disease. This novel treatment is associated with a minimally invasive surgical technique that can be well defined. However, our previous experience has taught us that neglecting any of the critical steps in the operation can result in frequent treatment failure. We have put together a comprehen sive guide, a stepwise algorithm, for our minimally invasive approach to identify common pitfalls and reduce treatment failures. Using data we have collected over the past 15 years from drug ...
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

rSILS: initial clinical experience with single-port robotic (SPr) right colectomy
ConclusionsOur initial experience demonstrates that an SPr right colectomy is feasible and can be safely completed. We completed an oncologic resection of a cecal adenocarcinoma without complications. The SP robot facilitates the utilization of robotic technology in a single-incision platform to perform colorectal procedures and offers promising benefits in the advancement of robotic surgery. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Which is more important in the management of splenic flexure colon cancer: strict central lymph node dissection or adequate bowel resection margin?
AbstractBackgroundWhat qualifies as optimal lymph node (LN) dissection in the surgical management of splenic flexure colon cancer (SFCC) still remains controversial because few studies have evaluated the distribution of LN metastasis of SFCC. The aim of this study was to clarify detailed distribution of LN metastasis and long-term outcomes of SFCC.MethodsThis retrospective study enrolled patients who had  curative colectomy for primary transverse or descending colon cancer of pathological stage I, II, or III at a single high-volume cancer center between April 2002 and December 2018. The 538 eligible patients were divi...
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Transperineal minimally invasive APE: preliminary outcomes in a multicenter cohort
ConclusionsTpAPE seems to be feasible with acceptable perioperative morbidity and a relatively low rate of perineal wound dehiscence, while histopathological outcomes remain suboptimal. Additional evaluation of the viability of this technique is needed in the form of a prospective trial with standardization of the procedure, indication, audit of outcomes and performed by surgeons with vast experience in transanal total mesorectal excision. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Contemporary smartphone and social media resources for patients with anal cancer: an unmet need
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Correction to: Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): ulcerative colitis
The affiliation of the author Silvio Danese has been incorrectly published in the original publication. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Surgical management of colovesical fistulas
ConclusionsLaparoscopic management of colovesical fistula is both safe and feasible in a high volume laparoscopic colorectal surgery center. Laparoscopy offers potential benefits including a decreased incidence of surgical site infections and medical complications. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Pudendal neuralgia: a unifying term for pelvic floor pain syndromes
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Correction to: Inflammatory bowel disease (IBD) position statement of the Italian Society of Colorectal Surgery (SICCR): general principles of IBD management
The affiliation of the author Silvio Danese has been incorrectly published in the original publication. The complete correct affiliation should read as follows. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Correction to: Inflammatory bowel disease position statement of the Italian Society of Colorectal Surgery (SICCR): Crohn's disease
The affiliation of the author Silvio Danese has been incorrectly published in the original publication. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 13, 2020 Category: Surgery Source Type: research

Squamous cell carcinoma in untreated pilonidal cyst
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 9, 2020 Category: Surgery Source Type: research

Injection of freshly collected autologous adipose tissue into non-healing wounds after closed incision pilonidal surgery
ConclusionsFreshly collected autologous adipose tissue injected into chronic non-healing pilonidal wounds seems safe and efficient. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 8, 2020 Category: Surgery Source Type: research

Laparoscopic surgery reduces the incidence of surgical site infections compared to the open approach for colorectal procedures: a meta-analysis
ConclusionsLaparoscopic colorectal surgery significantly lowers the incidence of SSI compared to open surgery. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 8, 2020 Category: Surgery Source Type: research

Non-exposed device-assisted endoscopic full-thickness resection (FTRD) for a challenging colorectal adenoma recurrence after endoscopic mucosal resection using a test cap
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 8, 2020 Category: Surgery Source Type: research

Magnetic imaging defecography results are comparable to high-resolution manometry and conventional X-ray defecography in the assessment of functional pelvic floor disorders
ConclusionsThis study demonstrated substantial diagnostic agreement between HR-ARM and MRD in the diagnosis of pathological etiologies for functional pelvic floor disorders, mainly obstructed defecation syndrome. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 8, 2020 Category: Surgery Source Type: research

Carbon dioxide gas leaks during transanal minimally invasive surgery
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - July 6, 2020 Category: Surgery Source Type: research

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 5, 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 5, 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 5, 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 3, 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 3, 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 2, 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 1, 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