Complications and 5-year survival after radical resections which include urological organs for locally advanced and recurrent pelvic malignancies: analysis of 646 consecutive cases
ConclusionsExtended radical resections which include a urological resection are associated with significantly more major morbidity than those without urological resection. Ileal conduit formation is independently associated with the development of major morbidity. Five-year overall survival is no different for patients who had or did not have urological resection as part of extended radical surgery for locally advanced or recurrent pelvic malignancy. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 5, 2020 Category: Surgery Source Type: research

Subtotal colectomy and ileorectal anastomosis for slow transit constipation: clinical follow-up at median of 15  years
We present a follow-up study of the long-term function in patients who had surgery for laxative-resistant slow transit constipation.MethodsA postal survey was sent to assess bowel frequency, abdominal pain, St Mark ’s continence score, satisfaction with procedure, likelihood to choose the procedure again, and long-term rates of small bowel obstruction and ileostomy. Longitudinal data from a subgroup studied 23 years previously are reported.ResultsForty-two patients (male = 2) were available for follow-up out of an initial cohort of 102. Mean time since surgery was 15.9 years (range 1.7–2...
Source: Techniques in Coloproctology - January 5, 2020 Category: Surgery Source Type: research

Laparoscopic right hemicolectomy with complete mesocolic excision: a cadaver model
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - January 3, 2020 Category: Surgery Source Type: research

FiLaC ® and Crohn’s disease perianal fistulas: a pilot study of 20 consecutive patients
ConclusionsThis pilot study suggests that FiLaC® may play an important role in the management of perianal fistulas in patients with Crohn ’s disease. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 30, 2019 Category: Surgery Source Type: research

Comparision of American, German and Italian guidelines for the treatment of pilonidal disease with phenol
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 19, 2019 Category: Surgery Source Type: research

Cap-assisted aspiration mucosectomy of a laterally spreading ileocecal valve lesion
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 19, 2019 Category: Surgery Source Type: research

Anal squamous intraepithelial lesions: an update and proposed management algorithm
AbstractThe term anal squamous intraepithelial lesion (ASIL) is used to describe premalignant change of anal squamous cells that precede the development of squamous cell carcinoma. Pathophysiology is driven by the human papilloma virus (HPV), and progression and regression of ASIL being well described, with 12% of high-grade lesions progressing to invasive cancer within 5  years. Vaccination against HPV is effective for primary prevention. Management consists of identification and treatment of high-grade lesions to prevent progression to squamous cell carcinoma. Management of established ASIL aims to avoid the progres...
Source: Techniques in Coloproctology - December 12, 2019 Category: Surgery Source Type: research

Laparoscopic segmental left colectomy for splenic flexure carcinoma: a single institution experience
ConclusionsSegmental left colectomy for splenic flexure carcinoma is associated with reasonably low morbidity and very good functional results. However, survival rates are low. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 12, 2019 Category: Surgery Source Type: research

Single-port robotic left colectomy: first clinical experience using the SP robot (rSILS)
ConclusionsSingle-port robotic colectomy using the new robot is feasible and can be safely completed. The overall utility and functionality of the SP robot portends wide utilization and expansion of this technique. Careful development and analysis of the procedure outcomes, training, and cost will be necessary to properly advance the field. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 11, 2019 Category: Surgery Source Type: research

Measuring pelvic floor disorder symptoms using patient-reported instruments: proceedings of the consensus meeting of the pelvic floor consortium of the American Society of Colon and Rectal Surgeons, the International Continence Society, the American Urogynecologic Society, and the Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 10, 2019 Category: Surgery Source Type: research

Impact of TRREMS on symptoms of obstructed defecation due to rectocele: predictive factors and outcomes
ConclusionsThe TRREMS procedure significantly improved evacuation disorders in this study. Appropriate selection of patients is key for the success of this approach. Anismus even if previously treated with biofeedback, was the main predictive factor of unsuccessful treatment. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 10, 2019 Category: Surgery Source Type: research

Is the extent of obstetric anal sphincter injury correlated with the severity of fecal incontinence in the long term?
AbstractBackgroundObstetric anal sphincter injury is the most frequent cause of fecal incontinence (FI) in young women. However, the relationship between the extent of anal sphincter defects and the severity of long-term FI (at least 1 year after delivery) has been poorly studied. The aim of the present study was to determine if, in the long term, the extent of anal sphincter defects graded at anal endosonography was linked with the severity of FI.MethodsA retrospective study was conducted on women with a history of vaginal delivery, who presented with FI and had three-dimensional anorectal high-resolution manometry and en...
Source: Techniques in Coloproctology - December 8, 2019 Category: Surgery Source Type: research

Virtual ileostomy in elective colorectal surgery: a systematic review of the literature
ConclusionsVI could be a safe and effective alternative to a diverting stoma. Although currently, VI is not widely used, it could have a widespread application in laparoscopic surgery. However, definitive trials are needed before firm recommendations on the use of VI can be made. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 8, 2019 Category: Surgery Source Type: research

Prospective evaluation of functional outcomes after laparoscopic sigmoidectomy with high tie of the inferior mesenteric artery for diverticular disease in consecutive male patients
AbstractBackgroundTo date, there has been no consensus concerning the vascular approach during sigmoid colectomy for diverticular disease. The aim of this study was to determine the functional impact of elective laparoscopic sigmoidectomy performed with high ligation of the inferior mesenteric artery for diverticulitis in consecutive male patients.MethodsTwenty-five consecutive patients of median age 53  years were enrolled in a prospective single-centre pilot study at a tertiary teaching hospital. Main outcome measures were functional results. Patients were asked to complete standardized, validated questionnaires to ...
Source: Techniques in Coloproctology - December 8, 2019 Category: Surgery Source Type: research

To staple or not to staple the symptomatic rectocele
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 8, 2019 Category: Surgery Source Type: research

Robotic natural orifice specimen extraction (NOSE) total colectomy with ileorectal anastomosis: a step-by-step video-guided technical note
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - December 3, 2019 Category: Surgery Source Type: research

Megabowel with anismus
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 28, 2019 Category: Surgery Source Type: research

Implementation of laser ablation of fistula tract (LAFT) for perianal fistulas: do the results warrant continued application of this technique?
ConclusionsLAFT has now been discontinued as a treatment of cryptoglandular perianal fistulas in our centre, because of its disappointing results. Further detailed research seems to be warranted to investigate its exact indication and limitations. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 27, 2019 Category: Surgery Source Type: research

Long-term outcome of sphincteroplasty with separate suturing of the internal and the external anal sphincter
ConclusionsSphincteroplasty, with separate suturing of the internal sphincter resulted in continence for stool maintained for at least 3  years in the majority of the patients, while there was an improvement in continence in nearly two-thirds. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 25, 2019 Category: Surgery Source Type: research

The SiLaC procedure for pilonidal sinus disease: long-term outcomes of a single institution prospective study
ConclusionsSiLaC is an effective, easy to perform, reproducible, and almost painless procedure. Factors influencing healing seem to be the presence of secondary openings, postoperative complications, and, especially, infection. The SiLaC procedure could become one of the treatments of choice for pilonidal sinus disease. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 25, 2019 Category: Surgery Source Type: research

Closure of the retroperitoneal space in laparoscopic anterior resection with FLEXDEX ™
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 21, 2019 Category: Surgery Source Type: research

Comment on ‘Optimized fistulectomy using the novel FiXcision ® device: a technical feasibility study and evaluation of short term healing rates’
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 20, 2019 Category: Surgery Source Type: research

The evidence base for pilonidal sinus surgery is the pits
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 20, 2019 Category: Surgery Source Type: research

Improving outcomes for the treatment of Anal Squamous Cell Carcinoma and Anal Intraepithelial Neoplasia
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 19, 2019 Category: Surgery Source Type: research

Near-infrared fluorescence imaging for sentinel lymph node identification in colon cancer: a prospective single-center study and systematic review with meta-analysis
ConclusionsSeveral anatomical and technical difficulties make SLNM with NIR fluorescence imaging in colon cancer particularly challenging when compared to other types of cancer. As a consequence, reports of SLNM accuracy vary widely. Future studies should try to standardize the SLNM procedure and focus on early-stage colon tumors, validation of tracer composition, injection mode and improvement of real-time optical guidance. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 17, 2019 Category: Surgery Source Type: research

Stapled versus handsewn methods for ileocolic anastomoses
ConclusionsStapled functional end-to-end ileocolic anastomosis is associated with fewer leaks than handsewn anastomosis. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 14, 2019 Category: Surgery Source Type: research

Emergency surgery for obstructing and perforated colon cancer: patterns of recurrence and prognostic factors
ConclusionsMale gender, diffuse peritonitis, positive lymph nodes, type of surgeon and postoperative anastomotic dehiscence significantly influence recurrence of  colorectal cancer in this series. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 13, 2019 Category: Surgery Source Type: research

Sacral nerve stimulation in patients with slow transit constipation
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 13, 2019 Category: Surgery Source Type: research

Perineal rectosigmoidectomy for rectal prolapse —the preferred procedure for the unfit elderly patient? 10 years experience from a UK tertiary centre
AbstractBackgroundRectal prolapse is a disease presentation with a prevalence of about 1%, mainly affecting older women. It usually presents with symptoms of rectal mass, rectal bleeding, fecal incontinence or constipation, with patients frequently feeling socially isolated as a result. Perineal rectosigmoidectomy is associated with lesser morbidity and mortality than the abdominal procedure, but with a much higher recurrence rate. Therefore, this technique is mainly suitable for the frail elderly patient. Specific outcomes in an elderly population have been described in only a few studies. We evaluated the morbidity, mort...
Source: Techniques in Coloproctology - November 12, 2019 Category: Surgery Source Type: research

The cecal patch: a signature skip lesion in ulcerative colitis
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 11, 2019 Category: Surgery Source Type: research

Complicated Allen –Masters syndrome
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 11, 2019 Category: Surgery Source Type: research

A unique rectal lesion: heterotopic gastric mucosa with bland squamous cell epithelium
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 11, 2019 Category: Surgery Source Type: research

Less is more: creation and validation of a novel, affordable suturing simulator for anorectal surgery
AbstractBackgroundDuty hour restrictions have increased the role of simulation in surgical education. A simulation that recreates the unique visual, anatomic, and ergonomic challenges of anorectal surgery has yet to be described. The aim of this study was to develop a low-cost, low-fidelity anorectal surgery simulator and provide validity evidence for the model.MethodsA novel, low-fidelity simulator was constructed, and anorectal surgery workshops were implemented for general surgery interns at a single institution. Face and content validity were assessed with separate questionnaires using a 5-point Likert scale. Participa...
Source: Techniques in Coloproctology - November 10, 2019 Category: Surgery Source Type: research

Reply to ‘Comment on mesopexy and mesoplasty in sigmoid volvulus recurrence’
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - November 10, 2019 Category: Surgery Source Type: research

Botulinum toxin A versus electrogalvanic stimulation for levator ani syndrome: is one a more effective therapy?
ConclusionsBoth BTX and EGS are to some extent effective at resolving symptoms of LAS. In the short term, BTX appears to be more effective. Neither treatment sustains its benefit in the long term. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 30, 2019 Category: Surgery Source Type: research

Sterile carbon particle suspension vs India ink for endoscopic tattooing of colonic lesions: a randomized controlled trial
ConclusionsSCPS is an effective method for tattooing colonic lesions and has a better safety profile than traditional India ink in terms of post-procedure inflammatory response and intraoperative bowel adhesions.Clinical trial registrationclinicaltrials.gov (ID: NCT03637933). (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 29, 2019 Category: Surgery Source Type: research

Longer small bowel segments are resected in emergency surgery for ileocaecal Crohn ’s disease with a higher ileostomy and complication rate
AbstractBackgroundRepeated intestinal resections may have disabling consequences in patients with Crohn ’s disease even in the absence of short bowel syndrome. Our aim was to evaluate the length of resected small bowel in patients undergoing elective and emergency surgery for ileocolic Crohn’s disease.MethodsA prospective observational study was conducted on patients undergoing surgery for ileocolonic Crohn ’s disease in a single colorectal centre from May 2010 to April 2018. The following patients were included: (1) patients with first presentation of ileocaecal Crohn’s disease undergoing elective ...
Source: Techniques in Coloproctology - October 28, 2019 Category: Surgery Source Type: research

Endoscopic submucosal dissection of distal intestinal tumors using grasping forceps for traction
AbstractBackgroundThe aim of this study was to assess the efficacy of traction device-assisted endoscopic submucosal dissection (ESD) of the rectum and the distal segment of sigmoid colon using grasping forceps.MethodsA total of 43 patients scheduled for colonic ESD at our institution were enrolled between January 2013 and June 2017. The patients were randomly allocated to receive conventional ESD (group A) or traction device-assisted ESD (group B). The procedure time, complication rate, and en-block resection rate in the two groups were compared.ResultsA total of 41 patients completed the study. The procedure time, compli...
Source: Techniques in Coloproctology - October 28, 2019 Category: Surgery Source Type: research

Simultaneous transabdominal and transanal indocyanine green fluorescence imaging for low colorectal anastomosis
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 22, 2019 Category: Surgery Source Type: research

Intracorporeal versus extracorporeal anastomosis in minimally invasive right colectomy: an updated systematic review and meta-analysis
AbstractBackgroundMinimally invasive colectomy has become the standard for treatment of colonic disease in many centers. Restoration of bowel continuity following resection can be achieved by intracorporeal (IC) or extracorporeal (EC) anastomosis. The aim of this systematic review was to assess the outcomes of IC compared to EC anastomosis in minimally invasive right colectomy.MethodsA Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-compliant systematic literature search for studies assessing the outcome of IC and EC anastomosis in laparoscopic and robot-assisted right colectomy was conducted. T...
Source: Techniques in Coloproctology - October 22, 2019 Category: Surgery Source Type: research

Adipose tissue grafting for management of persistent  anastomotic leak after low anterior resection
ConclusionsAdipose tissue grafting is safe and feasible, though its effectiveness remains uncertain. It may be useful selectively in the management of persistent anastomotic leak after radiation and low anterior resection. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 14, 2019 Category: Surgery Source Type: research

Italian guidelines for the surgical management of enteral stomas in adults
ConclusionsThese guidelines are the first Italian guidelines on multidisciplinary management of enteral stomas with the aim of assisting surgeons during stoma management and care. (Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 11, 2019 Category: Surgery Source Type: research

Invite comment on Pucciarelli and Spolverato: The fate of the rectum after organ sparing approach to rectal cancer
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 9, 2019 Category: Surgery Source Type: research

Long-term oncological results after transanal total mesorectal excision for rectal carcinoma
AbstractBackgroundTransanal total mesorectal excision (TaTME) for mid and low rectal cancer has been shown to improve short-term outcomes, mostly due to lower conversion rates and with improved quality of the specimen. However, robust long-term oncological data supporting the encouraging clinical and pathological outcomes are lacking.MethodsAll consecutive patients undergoing TaTME with curative intent for mid or low rectal cancer in two referral centers in The Netherlands between January 2012 and April 2016 with a complete and minimum follow-up of 36  months were included. The primary outcome was local recurrence rat...
Source: Techniques in Coloproctology - October 9, 2019 Category: Surgery Source Type: research

Norway versus The Netherlands: will taTME stand the test of time?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 9, 2019 Category: Surgery Source Type: research

A National study on the adoption of laparoscopic colorectal surgery in the elderly population: current state and value proposition
AbstractBackgroundThe economic and clinical benefits of laparoscopic colorectal surgery are proven, yet may be underutilized in appropriate cases, especially in the elderly. Since the elderly constitute the greatest colorectal surgical volume, our goal was to identify trends in utilization and impact of laparoscopy in this cohort.MethodsA national review of elective inpatient colorectal resections from the Premier Inpatient Database between 2010 and 2015 was performed. Patients were included if elderly  (≥ 65 years), then grouped into open or laparoscopic procedures. The main outcome measures were trend...
Source: Techniques in Coloproctology - October 8, 2019 Category: Surgery Source Type: research

Resection of colonic lesions: full thickness, full monty?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 8, 2019 Category: Surgery Source Type: research

Comment on ‘Mesopexy and mesoplasty in sigmoid volvulus recurrence’
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 3, 2019 Category: Surgery Source Type: research

Purulent meningitis as a rare complication following laparoscopic ventral rectopexy: suspected etiopathogenesis and treatment
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 2, 2019 Category: Surgery Source Type: research

Pouch –uterine volvulus: a variant of floppy pouch syndrome?
(Source: Techniques in Coloproctology)
Source: Techniques in Coloproctology - October 2, 2019 Category: Surgery Source Type: research