MedWorm: Colectomy

Laparoscopic versus Open Colectomy for Colon Cancer in an Older Population: A Cohort Study

World Journal of Surgical Oncology — Tue, 07 Feb 2012 05:00:00 +0100

Conclusions: In this older population, laparoscopic colectomy practice patterns were associated with factors which likely correlate with tertiary referral centers. Although short-term and long-term survival are comparable, laparoscopic colectomy offers shorter hospitalizations and less intensive care. (Source: World Journal of Surgical Oncology)

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Implementation and Usefulness of Single Access Laparoscopic Segmental and Total Colectomy

Colorectal Disease — Mon, 06 Feb 2012 05:00:00 +0100

Conclusion: Single incision laparoscopic surgery is an effective option for abdominal surgery and seems especially suited for laparoscopic‐assisted right sided colonic resections. The Glove port technique facilitates procedural frequency and familiarity and proves economically favourable. (Source: Colorectal Disease)

Cost Comparison Between Hand-Assisted Laparoscopic Colectomy and Open Colectomy

Journal of Laparoendoscopic — Mon, 30 Jan 2012 20:22:44 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Hybrid NOTES colectomy for right‐sided colonic tumors

Asian Journal of Endoscopic Surgery — Fri, 27 Jan 2012 11:25:49 +0100

DiscussionThe operation was performed on a 42‐year‐old woman and lasted 120 minutes; blood loss was 30 mL. The patient had an uneventful recovery and was discharged on postoperative day 5. The median pain score was 2 (range, 2–3). Our preliminary experience shows that hybrid NOTES right hemicolectomy is safe and feasible. The technique eliminates the need for mini‐laparotomy in patients undergoing laparoscopic right hemicolectomy, and it offers promise in this era of minimally invasive surgery. (Source: Asian Journal of Endoscopic Surgery)

[Surgical risk of transfusion in a French Universitary Hospital.]

Annales Francaises d'Anesthesie et de Reanimation — Tue, 24 Jan 2012 05:00:00 +0100

CONCLUSION: The emergency degree of the transfusion must be taken into account for such recommendation. Each hospital should perform its own cartography to justify its own protocols. PMID: 22281232 [PubMed - as supplied by publisher] (Source: Annales Francaises d'Anesthesie et de Reanimation)

Minilaparoscopy-assisted natural orifice total colectomy: technical report of a minilaparoscopy-assisted transrectal resection

Surgical Endoscopy — Thu, 19 Jan 2012 08:04:51 +0100

Conclusions Transrectal MA-NOS total colectomy was feasible and safe in the reported case. Improvement in NOTES instrumentation and selective clinical applications are mandatory before clinical trials. Content Type Journal ArticleCategory TechniquePages 1-6DOI 10.1007/s00464-011-2117-zAuthors Antonio M. Lacy, Department of Gastrointestinal Surgery, Institute of Digestive and Metabolic Diseases, Hospital Clínic, University of Barcelona, Villarroel 170, 08036 Barcelona, SpainDavid Saavedra-Perez, Department of Gastrointestinal Surgery, Institute of Digestive and Metabolic Diseases, Hospital Clínic, University of Barcelona, Villarroel 170, 08036 Barcelona, SpainRaquel Bravo, Department of Gastrointestinal Surgery, Institute of Digestive and Metabolic Diseases, Hospit...

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Elective laparoscopic versus open colectomy for diverticulosis: an analysis of ACS-NSQIP database

Surgical Endoscopy — Thu, 19 Jan 2012 08:04:51 +0100

Conclusions In the elective setting for symptomatic diverticulosis, LC seems to be associated with lower 30-day morbidity and complication rates compared with OC. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-2142-yAuthors Venkata R. Kakarla, Department of Surgery, New York Hospital Queens, 56-45 Main Street, Flushing, NY 11355, USASteven J. Nurkin, Department of Surgery, New York Hospital Queens, 56-45 Main Street, Flushing, NY 11355, USASaurab Sharma, Department of Surgery, New York Hospital Queens, 56-45 Main Street, Flushing, NY 11355, USADan E. Ruiz, Department of Surgery, New York Hospital Queens, 56-45 Main Street, Flushing, NY 11355, USAHoward Tiszenkel, Department of Surgery, New York Hospital Queens, 56-45 Main Street, Flushing, NY 11355, USA ...

A comparison of short-term outcome after laparoscopic, transverse, and midline right-sided colectomy

International Journal of Colorectal Disease — Tue, 17 Jan 2012 07:12:52 +0100

Conclusions Although the results of this study need to be interpreted with care, our study shows that laparoscopic and transverse right hemicolectomy are equivalent and have a significant better short-term outcome compared to an open midline approach. In particular, laparoscopy and transverse laparotomy result in >50% reduction in 30-day morbidity, no reoperations, and a shorter median total hospital stay of 2 days. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00384-011-1404-4Authors E. Tanis, Department of Surgery, Tergooiziekenhuizen, P.O. Box 10016, 1201 DA Hilversum, The NetherlandsA. A. W. van Geloven, Department of Surgery, Tergooiziekenhuizen, P.O. Box 10016, 1201 DA Hilversum, The NetherlandsW. A. Bemelman, Department o...

Non-Cosmetic Benefits of Single-Incision Laparoscopic Sigmoid Colectomy for Diverticular Disease: A Case-Matched Comparison to Standard Multi-Port Laparoscopic Technique

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:48 +0100

Introduction: Single-incision laparoscopy (SIL) is an advance in laparoscopic colectomy technique and has gained significant momentum. Its popularity is due in part to improved cosmesis. Studies have shown feasibility and safety of SIL colectomy; however, the benefits of SIL colectomy are not well defined. the purpose of this study is to directly compare outcomes of SIL sigmoid colectomy for diverticular disease with standard multi-port laparoscopic (LAP) technique. Methods: We retrospectively reviewed data from our first 20 consecutive elective SIL sigmoid colectomy for diverticular disease. Cases were matched for patient age, gender, body mass index (BMI), ASA score, and presence of previous laparotomy to an equivalent number of most recent LAP sigmoid colectomy cases for diverticular di...

The Financial Burden of Training Surgical Residents: Who Should Bear the Cost?

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:47 +0100

This report analyses costs associated with five commonly performed surgical procedures with and without surgical resident assistance. 7146 surgical procedures performed between May 2004 and February 2011 were analyzed. Data pertaining to operative time, type surgery (open or laparoscopic), and training level of residents, if any, were abstracted. Two major groups and 11 procedure related subcategories were formed. Attending only (AO) cases did not involve residents, whereas cases designated as AR, involved attendings and residents. the difference in the operative times between these groups coupled with the hospital OR charges per minute of time ($15/min after the initial 30 minutes) was used to calculate the additional cost of care. the impact of resident training level on OR time was asse...

Exploring Variation in Emergent Surgical Outcomes in the Michigan Surgical Quality Collaborative: A Fertile Area for Quality Improvement

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:02 +0100

Conclusions: Emergent surgical procedures are an important target for future quality improvement efforts within Michigan. Future work will identify best practices within high-performing hospitals and disseminate these practices within the collaborative. (Source: Journal of Surgical Research)

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Surgical Readmissions in the Obese Elderly Patient

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:02 +0100

Conclusions: Obese patients have an increased risk of readmission, independent of their age, sex, race, transfer status, emergency status, and comorbidities, yet their reasons for readmission appear to be related to the procedure performed, similar to the non-obese. As CMS plans to expand the list of procedures subject to penalties for readmissions over time, appropriate risk-adjustment that includes BMI will be essential to avoid disincentives to care for the obese patient. (Source: Journal of Surgical Research)

Exploring Variation in Emergent Surgical Outcomes in the Michigan Surgical Quality Collaborative: a Fertile Area for Quality Improvement

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:01 +0100

Reliability of Risk-Adjusted Outcomes as Hospital Quality Measures

Journal of Surgical Research — Sat, 14 Jan 2012 22:29:01 +0100

Conclusions: Except for rates of colon resection morbidity, risk-adjusted outcome measures are unreliable as indicators of hospital quality. to improve the reliability of outcome measures, quality measurement programs should increase sample size by collecting one hundred percent of cases for targeted procedures, and use statistical techniques to adjust for reliability. (Source: Journal of Surgical Research)

Perioperative use of Statins in Elective Colectomy

Journal of Surgical Research — Sat, 14 Jan 2012 22:28:55 +0100

(Source: Journal of Surgical Research)

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Outcomes after escalation of infliximab therapy in ambulatory patients with moderately active ulcerative colitis

Alimentary Pharmacology and Therapeutics — Fri, 13 Jan 2012 23:00:09 +0100

Conclusions:A significant proportion of ambulatory patients with UC treated with maintenance infliximab required therapy escalation over time. This was associated with lower remission, and higher colectomy, rates. (Source: Alimentary Pharmacology and Therapeutics)

Surgical treatment of familial adenomatous polyposis: Experience from a single institution in China

Asia-Pacific Journal of Clinical Oncology — Thu, 12 Jan 2012 05:00:00 +0100

Conclusion: A proctocolectomy with ileal pouch anal anastomosis maybe the best choice for FAP patients in China. Surgical expertise, good teamwork and careful long‐term follow up are mandatory. (Source: Asia-Pacific Journal of Clinical Oncology)

The Mesocolon: a prospective observational study

Colorectal Disease — Tue, 10 Jan 2012 05:00:00 +0100

Conclusion: When the mesocolon is fully mobilized during a total mesocolic excision of the colon, several anatomic findings that have not been previously documented emerge. These findings provide a rationalization of the surgical, embryologic and anatomic approaches to the mesocolon. This has implications for all related sciences. (Source: Colorectal Disease)

Imaging assessment of desmoid tumours in familial adenomatous polyposis: is state-of-the-art 1.5 T MRI better than 64-MDCT?

The British Journal of Radiology — Tue, 03 Jan 2012 05:00:00 +0100

Conclusions: MRI is at least equivalent (and may be superior) to MDCT for the detection of desmoids in FAP. Coupled with the advantage of avoiding radiation, it should be considered as the primary imaging modality for young FAP patients. PMID: 22215881 [PubMed - as supplied by publisher] (Source: The British Journal of Radiology)

Pediatric chronic ulcerative colitis: does infliximab increase post–ileal pouch anal anastomosis complications?

Journal of Pediatric Surgery — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: Children that were treated with IFX prior to IPAA suffered twice as many postoperative complications. Long-term outcomes are similar. Currently, we recommend colectomy with end ileostomy for patients that receive IFX within 8 weeks of colectomy for CUC. (Source: Journal of Pediatric Surgery)

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The effects of the Kampo medicine (Japanese herbal medicine) “Daikenchuto” on the surgical inflammatory response following laparoscopic colorectal resection

Surgery Today — Tue, 27 Dec 2011 17:02:21 +0100

Conclusions Postoperative DKT administration significantly suppressed the CRP level and shortened the time until first flatus. DKT administration also significantly suppressed postoperative inflammation following surgery for colorectal cancer. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00595-011-0094-4Authors Kozo Yoshikawa, Department of Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, Japan, 3-18-15 Kuramoto, Tokushima, Tokushima 770-8503, JapanMitsuo Shimada, Department of Surgery, Institute of Health Biosciences, The University of Tokushima Graduate School, Japan, 3-18-15 Kuramoto, Tokushima, Tokushima 770-8503, JapanMasanori Nishioka, Department of Surgery, Institute of Health Biosciences, The...

Accuracy of water enema-MDCT in colon cancer staging: a prospective study.

Cancer Imaging — Mon, 26 Dec 2011 17:24:03 +0100

Conclusion: WE-MDCT allows good staging of colon cancer based on objective features. PMID: 22185708 [PubMed - in process] (Source: Cancer Imaging)

Necrotizing fasciitis: literature review of contemporary strategies for diagnosing and management with three case reports: torso, abdominal wall, upper and lower limbs

World Journal of Emergency Surgery — Fri, 23 Dec 2011 05:00:00 +0100

We describe three clinical cases with NF. The first is a 69 years old man with diabetes mellitus type II, who presented with NF on the posterior chest wall, shoulder and arm. He was admitted to the intensive care unit (ICU) with a clinical picture of severe sepsis. Outpatient treatment and early surgical debridement of the affected zones (inside 3 hours after admittance) and critical care therapy were performed. The second case is of a 63 years old paraplegic man with diabetes mellitus type I. Pressure sores and perineal abscesses progressed to Fournier's gangrene of the perineum and scrotum. He had NF of the anterior abdominal wall and the right thigh. Outpatient treatment and early surgical debridement of the affected zones (inside 6 hour after admittance) and critical care therapy were ...

Technical Proficiency in Hand-Assisted Laparoscopic Colon and Rectal Surgery: Determining How Many Cases Are Required to Achieve Mastery [Original Article]

Archives of Surgery — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions For HALS colorectal resection, technical proficiency occurred after approximately 105 cases, and increased surgeon experience resulted in improved short-term outcomes. These data suggest that the learning curve for HALS colorectal resection will extend beyond fellowship training for many colorectal surgeons. (Source: Archives of Surgery)

Predictive Factors of Splenic Injury in Colorectal Surgery: Data from the Nationwide Inpatient Sample, 2006-2008 [Original Article]

Archives of Surgery — Mon, 19 Dec 2011 05:00:00 +0100

Conclusions Type of resection (transverse, total, or left colectomy), type of pathology (malignancy or diverticulitis), open operation, and teaching hospital are potent independent predictors of splenic injury. Male sex, peripheral vascular disease, and emergent admission are less effective predictors. Surgeons should be aware of these risk factors and inform patients accordingly. In higher-risk circumstances, it may be appropriate to consider prophylactic vaccination. (Source: Archives of Surgery)

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Single-incision laparoscopic right colectomy in an unselected patient population

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:42 +0100

Conclusions Single-incision laparoscopic colectomy is feasible, safe, efficient, and oncologically sound for most patients who are seen in a typical colorectal practice. These data are useful as single-incision laparoscopic colectomy becomes more broadly implemented. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-2076-4Authors Brian A. Boone, Department of Surgery, Division of Surgical Oncology, University of Pittsburgh Medical Center, 5150 Centre Ave. Suite 420, Pittsburgh, PA 15232, USAPatrick Wagner, Department of Surgery, Division of Surgical Oncology, University of Pittsburgh Medical Center, 5150 Centre Ave. Suite 420, Pittsburgh, PA 15232, USAEmily Ganchuk, Department of Surgery, Division of Surgical Oncology, University of Pittsburgh Medical Cente...

Systemic inflammatory response after laparoscopic and conventional colectomy for cancer: a matched case–control study

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:39 +0100

Conclusions This matched case–control study verifies the already reported lack of differences regarding IL-1. Controversy still exists on likely IL-6 differences. The inadequately studied IL-8 does not seem to play an important role in immunologic differences. The immunologically beneficial IFN-γ, produced by the principal effectors of cell-mediated immunity Th1 cells, seems to have a more active presence following laparoscopic colectomy, potentially contributing to an immunologic “advantage” by counteracting “harmful” cytokines, such as IL-1. Content Type Journal ArticlePages 1-8DOI 10.1007/s00464-011-2052-zAuthors Dimitrios Tsamis, 1st Department of Propaedeutic Surgery, Hippokrateion General Hospital, Athens Medical School, University of Athens, Athe...

Laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis: a new step in the treatment of slow-transit constipation

Surgical Endoscopy — Sat, 17 Dec 2011 06:43:30 +0100

Conclusions Laparoscopic SCCRA confirmed the good functional results of the open approach, with no increase in morbidity rate and a faster postoperative recovery. An early higher incontinence rate did not affect quality of life. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-2092-4Authors Federico Marchesi, Section of General Surgical Clinics and Surgical Therapy, Department of Surgical Sciences, Parma University Medical School, Via Gramsci n.14, 43100 Parma, ItalyLuigi Percalli, Section of General Surgical Clinics and Surgical Therapy, Department of Surgical Sciences, Parma University Medical School, Via Gramsci n.14, 43100 Parma, ItalyFerdinando Pinna, Section of General Surgical Clinics and Surgical Therapy, Department of Surgical Sciences, Parma Univ...

Risk factors for short bowel syndrome in patients with Crohn’s disease

Surgery Today — Fri, 16 Dec 2011 06:53:19 +0100

Conclusion These results indicate that the length of remaining small bowel is closely related to SBS in patients who have undergone surgery for CD. At least 200 cm of small bowel should be preserved to prevent SBS when total colectomy and ostomy creation are performed for CD. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00595-011-0098-0Authors Motoi Uchino, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JapanHiroki Ikeuchi, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JapanToshihiro Bando, Department of Surgery, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, JapanHiroki Matsuoka, Department of Surgery, Hy...

Predicting Survival After Curative Colectomy for Cancer: Individualizing Colon Cancer Staging [Gastrointestinal Cancer]

Journal of Clinical Oncology — Fri, 16 Dec 2011 05:00:00 +0100

Conclusion Prognostic models incorporating readily available data elements outperform the current AJCC system. These models can assist in personalizing treatment and follow-up for patients with colon cancer. (Source: Journal of Clinical Oncology)

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Salvage colectomy for endoscopically removed malignant colon polyps: is it possible to determine the optimal number of lymph nodes that need to be harvested?

Colorectal Disease — Sat, 10 Dec 2011 10:02:40 +0100

Conclusion: The total number of lymph nodes examined after colectomy for endoscopically removed malignant polyps varies and is less than the recommended number of 12 in most cases: this does not appear to have long‐term prognostic significance. There is no biological reason to explain this clinical observation. (Source: Colorectal Disease)

Endoscopic mucosal ablation: a new argon plasma coagulation/injection technique to assist complete resection of recurrent, fibrotic colon polyps (with video)

Gastrointestinal Endoscopy — Fri, 09 Dec 2011 05:00:00 +0100

Conclusion: EMA appears to be a safe and easily applicable technique to assist the complete eradication of recurrent fibrotic colon polyps. (Source: Gastrointestinal Endoscopy)

Single incision laparoscopic colectomy without using special articulating instruments: An initial experience.

World Journal of Surgical Oncology — Wed, 07 Dec 2011 05:00:00 +0100

Conclusion: SILC can successfully and safely be performed with standard laparoscopic instruments. This technique might be an alternative procedure to conventional laparoscopic colectomy with better cosmetic result. (Source: World Journal of Surgical Oncology)

Infliximab salvage therapy after failure of ciclosporin in corticosteroid‐refractory ulcerative colitis: a multicentre study

Alimentary Pharmacology and Therapeutics — Mon, 05 Dec 2011 05:00:00 +0100

Conclusions Treatment with infliximab makes it possible to avoid colectomy in two‐thirds of corticosteroid‐refractory UC patients in whom ciclosporin fails. However, the rates of adverse events and mortality mean that the decision to administer sequential therapy (ciclosporin–infliximab) should be taken on an individual basis. (Source: Alimentary Pharmacology and Therapeutics)

Incidence of and impact of medications on colectomy in newly diagnosed ulcerative colitis in the era of biologics

Inflammatory Bowel Diseases — Sun, 04 Dec 2011 05:00:00 +0100

Conclusions:About one‐tenth of patients still require colectomy for UC at 5 years in the era of biologics. Oral 5‐ASA, azathioprine, and anti‐TNF therapy are not associated with a reduced need for colectomy. (Inflamm Bowel Dis 2011;) (Source: Inflammatory Bowel Diseases)

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An Original Endoluminal Magnetic Anastomotic Device Allowing Pure NOTES Transgastric and Transrectal Sigmoidectomy in a Porcine Model: Proof of Concept.

Surgical Innovation — Sun, 04 Dec 2011 05:00:00 +0100

Conclusions. MAGNAMOSIS enabled a totally NOTES partial colectomy with combined TG and TR access. The flexible delivery options and low cost of manufacturing could make MAGNAMOSIS an attractive alternative to circular staplers. PMID: 22143749 [PubMed - as supplied by publisher] (Source: Surgical Innovation)

Compression anastomoses in colon and rectal surgery with the NiTi ColonRing™

Techniques in Coloproctology — Fri, 02 Dec 2011 18:09:35 +0100

Conclusions NiTi ColonRing™ is reliable, safe and efficacious for large bowel anastomoses. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s10151-011-0794-1Authors C. Avgoustou, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, Athens, GreeceP. Penlidis, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, Athens, GreeceA. Tsakpini, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, Athens, GreeceC. Sioros, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, Athens, GreeceD. Giannousis, 2nd Department of Surgery, General Hospital of N. Ionia “Constantopoulion—Aghia Olga”, A...

Introduction of Alvimopan into an Enhanced Recovery Protocol for Colectomy Offers Benefit in Open But Not Laparoscopic Colectomy

Journal of Laparoendoscopic — Wed, 30 Nov 2011 19:57:50 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques Dec 2011, Vol. 21, No. 10: 887-891. (Source: Journal of Laparoendoscopic)

Single-incision laparoscopic colectomy feasible

Modern Medicine — Wed, 30 Nov 2011 05:00:00 +0100

NEW YORK (Reuters Health) - In selected patients, laparoscopic colectomy can be done through a single port, although the advantages of this technique seem marginal, researchers say. (Source: Modern Medicine)

Technical considerations in children undergoing laparoscopic ileal-J-pouch anorectal anastomosis for ulcerative colitis

Pediatric Surgery International — Wed, 30 Nov 2011 04:52:52 +0100

Conclusions A Multiport Instrument Access Port placed in the stoma site allowed the use of more instruments through a single incision. The very short ileo J-pouch low rectal anastomosis has been shown to be a safe, feasible, and effective reconstructive procedure. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00383-011-3030-1Authors Girolamo Mattioli, Pediatric Surgery Department, Giannina Gaslini Children’s Hospital, University of Genova, Largo G. Gaslini 5, 16147 Genova, ItalyEdoardo Guida, Pediatric Surgery Department, Giannina Gaslini Children’s Hospital, University of Genova, Largo G. Gaslini 5, 16147 Genova, ItalyAlessio Pini-Prato, Pediatric Surgery Department, Giannina Gaslini Children’s Hospital, University of Genova, Largo...

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Clinical Significance of Indefinite for Dysplasia on Pouch Biopsy in Patients with Underlying Inflammatory Bowel Disease

Journal of Gastrointestinal Surgery — Tue, 29 Nov 2011 22:21:56 +0100

Conclusions Subsequent dysplasia was uncommon in pouch patients with IND. Natural history of pouch IND warrants further long-term investigation. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s11605-011-1779-0Authors Zhao-Xiu Liu, Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, ChinaXiu-Li Liu, Department of Anatomic Pathology, Digestive Disease Institute, The Cleveland Clinic Foundation, Cleveland, OH, USADeepa T. Patil, Department of Anatomic Pathology, Digestive Disease Institute, The Cleveland Clinic Foundation, Cleveland, OH, USALei Lian, Department of Colorectal Surgery, Digestive Disease Institute, The Cleveland Clinic Foundation, Cleveland, OH, USARavi P. Kiran, Department of Colorectal Sur...

Outcomes for Consecutive Patients Undergoing Single-Site Laparoscopic Colorectal Surgery

Journal of Gastrointestinal Surgery — Tue, 29 Nov 2011 22:21:54 +0100

Conclusions SSL is safe when applied to unselected patients undergoing colorectal surgery, including those patients who have undergone a previous laparotomy. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s11605-011-1783-4Authors David B. Stewart, Department of Surgery, Division of Colon and Rectal Surgery, M. S. Hershey Medical Center, The Pennsylvania State University, 500 University Drive, Mail Code H 137, P.O. Box 850, Hershey, PA 17033, USAEvangelos Messaris, Department of Surgery, Division of Colon and Rectal Surgery, M. S. Hershey Medical Center, The Pennsylvania State University, 500 University Drive, Mail Code H 137, P.O. Box 850, Hershey, PA 17033, USA Journal Journal of Gastrointestinal SurgeryOnline ISSN 1873-4626Print IS...

Racial Differences in Short-term Surgical Outcomes Following Surgery for Diverticulitis

Journal of Gastrointestinal Surgery — Tue, 29 Nov 2011 22:21:49 +0100

Conclusion African Americans undergoing surgery for diverticulitis are more likely to have associated co-morbidities, require urgent surgery, undergo open surgery, and are at increased risk of morbidity and mortality. These findings highlight a need to address the root cause for disparities in care and outcomes after surgery. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s11605-011-1787-0Authors Karim Alavi, Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USAJ. A. Cervera-Servin, Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, Worcester, MA, USAPaul R. Sturrock, Division of Colon and Rectal Surgery, Department o...

Ovarian steroid cell tumor with biallelic adenomatous polyposis coli inactivation in a patient with familial adenomatous polyposis

Genes, Chromosomes and Cancer — Fri, 25 Nov 2011 05:00:00 +0100

AbstractFamilial adenomatous polyposis (FAP) is an autosomal dominant cancer predisposition syndrome that accounts for approximately 0.5–1% of all colorectal cancer cases. It is caused by germline mutations in the gene encoding the adenomatous polyposis coli (APC) tumor suppressor. Somatic APC inactivation due to mutation or loss of heterozygosity (LOH) promotes the development of adenomatous polyps by stabilizing the transcriptional coactivator β‐catenin. Although colorectal cancer is by far the most common malignancy seen in FAP patients, the widespread use of prophylactic colectomy in these patients has increased the clinical importance of extracolonic tumors that are part of the neoplastic spectrum in FAP. Many of these tumors exhibit LOH or somatic APC mutation, strongly supporti...

Robotic‐assisted laparoscopic stage II restorative proctectomy for toxic ulcerative colitis

The International Journal of Medical Robotics and Computer Assisted Surgery — Thu, 24 Nov 2011 05:00:00 +0100

ConclusionsThis is a case series report of a robotic‐assisted laparoscopic proctectomy with restorative ileal J‐pouch in patients with toxic UC. This technique has been previously described for use in patients with medically refractory UC and neoplasia associated with chronic UC. This series exemplifies an ideal application of a robotic system with improved visibility, rotation and ergonomics. Copyright © 2011 John Wiley & Sons, Ltd. (Source: The International Journal of Medical Robotics and Computer Assisted Surgery)

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Early severe digestive complications after lung transplantation [Original articles]

European Journal of Cardio-Thoracic Surgery — Wed, 23 Nov 2011 05:00:00 +0100

Conclusion: ESDC occurred in 7.4% of patients after LT without CPB, and was responsible for longer in-hospital stay. Relevant risk factors included older age and bilateral LT, interfering with current debate regarding recipients’ selection and procedure's choice. (Source: European Journal of Cardio-Thoracic Surgery)

Multicentre observational study of the natural history of left‐sided acute diverticulitis

British Journal of Surgery — Tue, 22 Nov 2011 23:20:42 +0100

Conclusion:Long‐term risks of recurrent AD or emergency surgery were limited and colectomy did not fully protect against recurrence. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

The impact of inflammatory bowel disease post‐liver transplantation for primary sclerosing cholangitis

Liver International — Tue, 22 Nov 2011 05:00:00 +0100

ConclusionIn conclusion, smoking at time of LT was predictive of flare of IBD and active IBD at time of transplantation had a significant effect on graft survival. Medical therapy needs to be maximised in the pre‐LT period. Patients with poorly controlled IBD refractory to medical therapy should be considered for colectomy at time of transplantation. (Source: Liver International)

Effect of surgeon specialization on long‐term survival following colon cancer resection at an NCI‐designated cancer center

Journal of Surgical Oncology — Mon, 21 Nov 2011 05:00:00 +0100

ConclusionSurgeon specialization appears to be associated with improved overall survival in the setting of an NCI‐designated cancer center. J. Surg. Oncol © 2011 Wiley Periodicals, Inc. (Source: Journal of Surgical Oncology)

Early experience of the compression anastomosis ring (CAR 27) in left-sided colon resection.

World Journal of Gastroenterology : WJG — Mon, 21 Nov 2011 05:00:00 +0100

CONCLUSION: Short-term evaluation of the CAR™ 27 anastomosis in elective left colectomy suggested it to be a safe and efficacious alternative to the standard hand-sewn or stapling technique. PMID: 22147979 [PubMed - in process] (Source: World Journal of Gastroenterology : WJG)

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Comparison of Clinical Characteristics and Management of Inflammatory Bowel Disease in Hong Kong versus Melbourne

Journal of Gastroenterology and Hepatology — Fri, 18 Nov 2011 05:00:00 +0100

Conclusions: IBD in HK is diagnosed at an older age, and had more complicated disease behavior than in Melbourne. Medical therapy, however, was less intense in HK. These differences may relate to real differences in disease or delayed diagnosis due to late presentation and less disease recognition in HK. (Source: Journal of Gastroenterology and Hepatology)

Infliximab or Cyclosporine for Acute Severe Ulcerative Colitis: A retrospective analysis

Journal of Gastroenterology and Hepatology — Fri, 18 Nov 2011 05:00:00 +0100

Conclusions Infliximab improved clinical outcomes compared to the previous use of intravenous cyclosporine in patients admitted with steroid‐refractory acute severe Ulcerative Colitis. (Source: Journal of Gastroenterology and Hepatology)

Clinical approach to severe Clostridium difficile infection: Update for the hospital practitioner.

European Journal of Internal Medicine — Wed, 16 Nov 2011 18:01:18 +0100

Authors: Pant C, Sferra TJ, Deshpande A, Minocha A Abstract The rising incidence of Clostridium difficile (C. difficile) infection or CDI is now a problem of pandemic proportions. The NAP1 hypervirulent strain of C. difficile is responsible for a majority of recent epidemics and the widespread use of fluoroquinolone antibiotics may have facilitated the selective proliferation of this strain. The NAP1 strain also is more likely to cause severe and fulminant colitis characterized by marked leukocytosis, renal failure, hemodynamic instability, and toxic megacolon. No single test suffices to diagnose severe CDI, instead; the clinician must rely on a combination of clinical acumen, laboratory testing, and radiologic and endoscopic modalities. Although oral vancomycin and metronidazole a...

Hyperglycemia Is Associated with Increased Risk of Morbidity and Mortality after Colectomy for Cancer

Journal of the American College of Surgeons — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions: Even mild hyperglycemia was associated with adverse outcomes after colectomy, suggesting that a perioperative BG target of 80 to 120 mg/dL, although avoiding hypoglycemia, might be appropriate. Randomized clinical trials are needed to confirm these findings. (Source: Journal of the American College of Surgeons)

Long-term outcome of ulcerative colitis in patients who achieve clinical remission with a first course of corticosteroids

Digestive and Liver Disease — Mon, 14 Nov 2011 05:00:00 +0100

Conclusions: Half of the ulcerative colitis patients responding to a first course of corticosteroids will require immunosuppressors mainly because of steroid-dependence. (Source: Digestive and Liver Disease)

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Totally laparoscopic colectomy with intracorporeal anastomosis achieved using a laparoscopic linear stapler: experience of a single institute

Surgery Today — Thu, 10 Nov 2011 16:50:09 +0100

Conclusion Intracorporeal functional end-to-end anastomosis using a linear stapler can be performed safely and easily for the resection of any part of the colon. We consider it an effective modality for totally laparoscopic colon resection. Favorable results have been achieved by this method, particularly for small tumors, since natural-orifice transluminal endoscopic surgery remains a challenging method to perform. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00595-011-0003-xAuthors Tetsuo Ikeda, Department of Surgery, Oita Prefectural Hospital, Oita, JapanAkira Kabasima, Department of Surgery, Oita Prefectural Hospital, Oita, JapanNaoyuki Ueda, Department of Surgery, Oita Prefectural Hospital, Oita, JapanYusuke Yonemura, Department o...

Surgery for colonic cancer in HNPCC: total vs segmental colectomy

Colorectal Disease — Thu, 10 Nov 2011 10:36:22 +0100

Conclusion Patients with HNPCC have a significant risk of MCC after SC. This is eliminated by performing TC as the primary operation for colonic cancer. (Source: Colorectal Disease)

Ghrelin Agonist TZP-101/Ulimorelin Accelerates Gastrointestinal Recovery Independently of Opioid Use and Surgery Type: Covariate Analysis of Phase 2 Data

World Journal of Surgery — Thu, 10 Nov 2011 06:45:46 +0100

Conclusions Two factors, type of surgery and total opioid use, independently modified times to recovery of GI motility following partial large bowel resection surgery. Acceleration of recovery of GI motility by ulimorelin was independent of these factors. Content Type Journal ArticlePages 1-7DOI 10.1007/s00268-011-1335-9Authors Grant Bochicchio, University of Maryland, Baltimore, Maryland, USAPhilippa Charlton, Tranzyme, Inc, 4819 Emperor Boulevard, Suite 400, Durham North Carolina, 27703 USAJohn C. Pezzullo, Georgetown University, Washington, District of Columbia, USAGordana Kosutic, Tranzyme, Inc, 4819 Emperor Boulevard, Suite 400, Durham North Carolina, 27703 USAAnthony Senagore, University of Southern California, Los Angeles, California, USA Journal World ...

Management of acute, severe ulcerative colitis

Chinese Journal of Digestive Diseases — Mon, 07 Nov 2011 05:00:00 +0100

ABSTRACTWhen a patient is hospitalized with acute, severe ulcerative colitis, the primary decision is whether or not to proceed directly to surgery. Absolute indications for immediate colectomy include exsanguinating hemorrhage, perforation and cancer. If medical therapy is undertaken, however, the decision for urgent surgery or non‐operative “salvage” therapy will still be required in the 15–50% of cases in which there is failure to respond within 3‐5 days to a standard regimen of intravenous steroids, antibiotics, decompressive maneuvers, fluid and electrolyte replacement, and other supportive measures. The options for medical salvage therapy are usually cyclosporine or infliximab. There are theoretical and practical arguments on each side; the current GETAID and CONSTRUCT tria...

Large Variations In Medicare Payments For Surgery Highlight Savings Potential From Bundled Payment Programs [Payment Reform]

Health Affairs — Mon, 07 Nov 2011 05:00:00 +0100

Payers are considering bundled payments for inpatient surgery, combining provider reimbursements into a single payment for the entire episode. We found that current Medicare episode payments for certain inpatient procedures varied by 49–130 percent across hospitals sorted into five payment groups. Intentional differences in payments attributable to such factors as geography or illness severity explained much of this variation. But after adjustment for these differences, per episode payments to the highest-cost hospitals were higher than those to the lowest-cost facilities by up to $2,549 for colectomy and $7,759 for back surgery. Postdischarge care accounted for a large proportion of the variation in payments, as did discretionary physician services, which may be driven in turn ...

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Endoscopic and surgical management of serrated colonic polyps.

The British Journal of Surgery — Fri, 04 Nov 2011 05:47:47 +0100

CONCLUSION: Even though the neoplastic potential of certain subtypes of serrated polyp is heavily supported, further studies are needed to make definitive endoscopic and surgical recommendations. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 22034178 [PubMed - in process] (Source: The British Journal of Surgery)

Evaluation of Upper and Lower Gastrointestinal Histology in Patients with Ileal Pouches

Journal of Gastrointestinal Surgery — Fri, 04 Nov 2011 05:44:02 +0100

Conclusion Histologic evaluation of duodenal biopsy may provide additional information in patients with ileal pouches, as patients with normal histology of the pouch may have an abnormal duodenal histology. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s11605-011-1766-5Authors Yinghong Wang, Victor W. Fazio, MD Center for Inflammatory Bowel Disease, Digestive Disease Institute, Cleveland, OH 44195, USAAna E. Bennett, Department of Anatomic Pathology, Cleveland Clinic Foundation, Cleveland, OH 44195, USAHui Cai, Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USALei Lian, Victor W. Fazio, MD Center for Inflammatory Bowel Disease, Digestive Disease Institute, Cleveland, OH 44195, USABo Shen, Victor W. ...

Transanal specimen retrieval using the transanal endoscopic microsurgery (TEM) system in minimally invasive colon resection

Surgical Endoscopy — Fri, 04 Nov 2011 05:43:52 +0100

Conclusions Use of the TEM system facilitates transanal removal of the specimen and protects the anorectum during laparoscopic colectomy. Content Type Journal ArticleCategory VideoPages 1-2DOI 10.1007/s00464-011-2021-6Authors Konstantinos I. Makris, Department of Surgery Minimally Invasive Surgery Program, Legacy Health System, Portland, OR, USAErwin Rieder, Department of Surgery Minimally Invasive Surgery Program, Legacy Health System, Portland, OR, USAAndrew S. Kastenmeier, Department of Surgery Minimally Invasive Surgery Program, Legacy Health System, Portland, OR, USALee L. Swanström, Division of Gastrointestinal and Minimally Invasive Surgery, The Oregon Clinic, 1040 NW 22nd Avenue, Suite 560, Portland, OR 97210, USA Journal Surgical EndoscopyOnline ISSN 14...

Effects of bromopride on abdominal wall healing with induced peritoneal sepsis after segmental colectomy and colonic anastomosis in rats.

Acta Cirurgica Brasileira — Fri, 04 Nov 2011 01:47:59 +0100

CONCLUSION: Bromopride did not have harmful effects on the healing of abdominal wall in rats. PMID: 22042104 [PubMed - in process] (Source: Acta Cirurgica Brasileira)

Metabolic and hematologic consequences of colectomy associated to hepatectomy in rats.

Acta Cirurgica Brasileira — Fri, 04 Nov 2011 01:46:15 +0100

CONCLUSION: Hepatectomy associated with colectomy lowered the uptake of radiopharmaceutical in liver and in red blood cells in rats, coinciding with changes in liver enzymatic activity. PMID: 22042115 [PubMed - in process] (Source: Acta Cirurgica Brasileira)

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Robotic vs. laparoscopic colorectal surgery: an institutional experience

Surgical Endoscopy — Wed, 02 Nov 2011 05:48:40 +0100

Miniature surgical robot for laparoendoscopic single-incision colectomy

Surgical Endoscopy — Tue, 01 Nov 2011 05:53:29 +0100

Conclusions The adoption of both laparoscopic and single-incision colectomies currently is constrained by the inadequacies of existing instruments. The described multifunctional robot provides a platform that overcomes existing limitations by operating completely within one incision in the peritoneal cavity and by improving visualization and dexterity. By repositioning the small robot to the area of the colon to be mobilized, the ability of the surgeon to perform complex surgical tasks is improved. Furthermore, the success of the robot in performing a completely in vivo colectomy suggests the feasibility of using this robotic platform to perform other complex surgeries through a single incision. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-011-1943-3Auth...

Mentorship for participants in a laparoscopic colectomy course

Surgical Endoscopy — Tue, 01 Nov 2011 05:53:28 +0100

Conclusions A significant number of surgeons (45.6%) participating in LCC have limited or no access to mentors. In particular, older surgeons, senior attending surgeons, and general surgeons have the least access to mentors. To encourage adoption of LC, training methods should be adopted that accommodate general surgeons, surgeons with a limited advanced laparoscopic case load, and surgeons without access to mentors. Possible strategies include longer or multisession courses, simulator training, and remote mentoring. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-011-1942-4Authors Vanessa P. Ho, Department of Surgery, Weill Cornell Medical College, 525 East 68 Street, New York, NY 10065, USAKoiana Trencheva, Department of Surgery, Weill Cornell Medical Col...

Clinical outcome of laparoscopic and open colectomy for right colonic carcinoma.

Annals of the Royal College of Surgeons of England — Tue, 01 Nov 2011 04:00:00 +0100

CONCLUSIONS: Our findings demonstrate advantages in favour of LRH in terms of a shorter hospital stay and reduced post-operative major complications. LRH is safe and should therefore be available to all patients requiring colonic resection. PMID: 22041236 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)

Does alvimopan enhance return of bowel function in laparoscopic right colectomy?

The American Surgeon — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Abodeely A, Schechter S, Klipfel A, Vrees M, Lagares-Garcia J Abstract Alvimopan, a peripherally acting Mu-opioid receptor antagonist, has been shown to enhance recovery of gastrointestinal (GI) function in open bowel resection. The aim of this study was to determine the effect of Alvimopan on patients undergoing laparoscopic right colectomies in preventing postoperative ileus (POI). A prospective, nonrandomized trial of laparoscopic right colectomies was carried out with and without perioperative Alvimopan. The length of stay (LOS), time to first flatus, bowel movement, and tolerance of solid foods were recorded. Additionally, any occurrences of POI defined as the need for insertion of a nasogastric tube (NGT) were also noted. Student t tests were used for statistical ana...

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Using National Surgical Quality Improvement Program (NSQIP) data for risk adjustment to compare Clavien 4 and 5 complications in open and laparoscopic colectomy

Surgical Endoscopy — Fri, 28 Oct 2011 17:00:01 +0100

Conclusion Evaluation of the NSQIP database demonstrated that laparoscopic colectomy confers an independent protective effect on the frequency of ICU-level (Clavien grade 4) complications and mortality. The protective effect remained evident after correction for preoperative conditions that might have affected outcome. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-1944-2Authors Shawn Webb, Division of Colon and Rectal Surgery, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USAIlan Rubinfeld, Department of Surgery, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USAVic Velanovich, Department of Surgery, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USAH. M. Horst, Department of Surgery, Henry F...

Laparoscopic sigmoid resection with transrectal specimen extraction: a Systematic Review

Colorectal Disease — Mon, 24 Oct 2011 04:00:00 +0100

Conclusion: To date, the evidence in favour of left‐sided laparoscopic colectomy with transrectal specimen extraction is weak (level IV‐V). Future clinical research should focus on standardization of the technique. Randomized controlled trials are necessary to show the superiority of this approach with regard to postoperative pain and morbidity, hospital stay, recovery, function and cosmesis. (Source: Colorectal Disease)

Feasibility of laparoscopic restorative proctocolectomy without diverting stoma

Digestive and Liver Disease — Mon, 24 Oct 2011 04:00:00 +0100

Conclusion: Laparoscopic restorative proctocolectomy can be performed safely without a diverting stoma in selected patients. (Source: Digestive and Liver Disease)

Prevalence of and Risk Factors for Morbidity After Elective Left Colectomy: Cancer vs Noncomplicated Diverticular Disease [Original Article]

Archives of Surgery — Mon, 17 Oct 2011 04:00:00 +0100

Conclusions Patients undergoing elective left colectomy for CC or for DD constitute 2 distinct populations with completely different risk factors for morbidity, which should be addressed differently. Improving colonic cleanliness (by antiseptic enema) may reduce morbidity in CC. In DD, morbidity may be reduced by appropriate preoperative nutritive support (by immunonutrition), even in patients with obesity, and by preference of left segmental colectomy over left hemicolectomy. By decreasing morbidity, mortality should be lowered as well, especially when reoperation becomes necessary. (Source: Archives of Surgery)

Learning to Recycle: Comment on "Prevalence of and Risk Factors for Morbidity After Elective Left Colectomy" [Invited Critique]

Archives of Surgery — Mon, 17 Oct 2011 04:00:00 +0100

(Source: Archives of Surgery)

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Basidiobolomycosis of the Colon Masquerading as Stenotic Colon Cancer

Laser Chemistry — Sun, 16 Oct 2011 14:48:29 +0100

Basidiobolus ranarum is a widespread saprophyte fungus with pathogenic potential. It affects mainly the subcutaneous tissues of the trunk and limbs. Relatively recently, occasional reports of gastrointestinal basidiobolomycosis appeared in the literature. Due to the rarity of the condition and the nonspecific presenting features, the correct diagnosis is usually hard to reach. In this paper, we describe the clinical course of an otherwise healthy female, who presented with a colonic mass. She received subtotal colectomy followed by oral itraconazole, with successful outcome. (Source: Laser Chemistry)

Randomized clinical trial comparing the cost and effectiveness of bipolar vessel sealers versus clips and vascular staplers for laparoscopic colorectal resection

British Journal of Surgery — Sun, 16 Oct 2011 01:28:32 +0100

Conclusion:BVS devices are expedient and cost‐efficient in proctectomy, left and total colectomy procedures. Registration number: NCT00487409 (http://www.clinicaltrials.gov). Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Anastomotic leakage, cystic duct stump leakage and local tumour recurrence: ‘unhappy triad’ following single port access laparoscopic right colectomy for cancer

Colorectal Disease — Sat, 15 Oct 2011 09:03:18 +0100

(Source: Colorectal Disease)

Single incision laparoscopic total colectomy and proctocolectomy for benign disease: initial experience

Colorectal Disease — Sat, 15 Oct 2011 09:03:09 +0100

Conclusion Single‐incision laparoscopic total colectomy or proctocolectomy is feasible for benign disease in selected patients. (Source: Colorectal Disease)

The ERAS protocol reduces the length of stay after laparoscopic colectomies

Surgical Endoscopy — Thu, 13 Oct 2011 05:51:38 +0100

Conclusions The postoperative length of stay was significantly reduced in the ERAS group without differences in patient outcome. It is suggested that these results are the effect of a combination of the ERAS protocol with laparoscopic colectomy. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-1877-9Authors M. P. Haverkamp, Department of Surgery, Rivierenland Hospital Tiel, President Kennedylaan 1, 4002 WP Tiel, The NetherlandsM. A. J. de Roos, Department of Surgery, Rivierenland Hospital Tiel, President Kennedylaan 1, 4002 WP Tiel, The NetherlandsK. H. Ong, Department of Surgery, Rivierenland Hospital Tiel, President Kennedylaan 1, 4002 WP Tiel, The Netherlands Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical En...

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Less adhesiolysis and hernia repair during completion proctocolectomy after laparoscopic emergency colectomy for ulcerative colitis

Surgical Endoscopy — Thu, 13 Oct 2011 05:51:32 +0100

Conclusion Laparoscopic as opposed to open emergency colectomy is associated with less adhesiolysis, fewer incisional hernias, and a shorter interval to completion proctectomy. Content Type Journal ArticlePages 1-6DOI 10.1007/s00464-011-1880-1Authors Sanne A. L. Bartels, Department of Surgery, Academic Medical Center, PO Box 22660, 1100 Amsterdam, The NetherlandsMalaika S. Vlug, Department of Surgery, Academic Medical Center, PO Box 22660, 1100 Amsterdam, The NetherlandsDaan Henneman, Department of Surgery, Academic Medical Center, PO Box 22660, 1100 Amsterdam, The NetherlandsCyriel Y. Ponsioen, Department of Gastroenterology & Hepatology, Academic Medical Center, Amsterdam, The NetherlandsPieter J. Tanis, Department of Surgery, Academic Medical Center, PO Box 22660,...

Laparoscopic versus robotic right colectomy: a single surgeon’s experience

Journal of Robotic Surgery — Wed, 12 Oct 2011 16:06:11 +0100

Abstract There is increased interest in robotic techniques for colon resection, but the role of robotics in colorectal surgery has not yet been defined. The purpose of this study was to compare our recent experience with robotic right colectomy to that with laparoscopic right colectomy. From November 2008 to June 2011, a total of 47 consecutive patients underwent elective, right colectomy: 25 laparoscopic right colectomies (LRC) and 22 robotic right colectomies (RRC). All procedures in this study were performed by a single, board-certified colon and rectal surgeon (H.J.L.). Main outcomes recorded included conversion rate, operative time (OT), estimated blood loss (EBL), length of extraction sites, length of stay (LOS), and complications. Data studied were prospectively rec...

The CD4(+)CD28(null) and the regulatory CD4(+)CD25(High) T-cell phenotypes in patients with ulcerative colitis during active and quiescent disease, and following colectomy.

Cytokine — Sat, 08 Oct 2011 21:47:01 +0100

Authors: Yokoyama Y, Fukunaga K, Ikeuchi H, Kamikozuru K, Hida N, Ohda Y, Iimuro M, Yoshida K, Kikuyama R, Kato K, Nagase K, Nakamura S, Miwa H, Matsumoto T Abstract The CD4(+)CD25(High) T-cell phenotype has an essential immunoregulatory role, while the CD4(+)CD28(null) T-cell reflects immune pathology. We investigated the profiles of the CD4(+)CD25(High) and the CD4(+)CD28(null) T-cell phenotypes in patients with ulcerative colitis (UC) during active and quiescent phases as well as following colectomy. Fifty-nine UC patients, 34 active (UCa) and 25 quiescent (UCq) together with 19 healthy controls (HC) were included. Ten of 34 UCa patients underwent colectomy due to unremitting UC (UCo). Immunohistochemical phenotypic of the peripheral blood lymphocytes bearing CD4, CD25 or CD28 w...

Emergency laparoscopic sub-total colectomy: A general surgical operation?

International Journal of Surgery — Thu, 06 Oct 2011 22:52:32 +0100

Aim: Sub-total colectomy (STC) is the treatment of choice for acute colitis refractory to medical therapy. Laparoscopic colorectal surgery improves the early outcomes of pain and hospital stay. Colonic surgery is increasingly undertaken by surgeons with a colorectal subspecialist interest. Should laparoscopic surgery for acute colitis be an operation for the emergency general surgeon? (Source: International Journal of Surgery)

Perioperative rehabilitation approaches in those over 75 years with respiratory dysfunction from chronic obstructive pulmonary disease undergoing abdominal tumor surgery.

Disability and Rehabilitation — Thu, 06 Oct 2011 04:00:00 +0100

Conclusion: Comprehensive perioperative rehabilitation appears to be effective in high-risk patients with severe COPD who need surgery for abdominal cancer. [Box: see text]. PMID: 21978100 [PubMed - as supplied by publisher] (Source: Disability and Rehabilitation)

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Laparoscopy-assisted resection of an undiagnosed liver tumor and ascending colon cancer via mini median laparotomy: Report of a case

Surgery Today — Tue, 04 Oct 2011 05:59:15 +0100

We describe how we resected a hepatic angiomyolipoma and ascending colon cancer synchronously via laparoscopic left lateral segmentectomy and laparoscopic right colectomy, respectively. The patient was a 72-year-old man, admitted to our hospital after a liver tumor and ascending colon cancer were detected during a general health check. Computed tomography (CT) showed a hypervascular liver tumor mimicking hepatocellular carcinoma, 2 cm in diameter, in segment 3 of the liver. The ascending colon cancer was diagnosed as T2N0M0, Stage I. The left lateral liver and right colon were mobilized laparoscopically and hepatic transaction, followed by resection and anastomosis of the colon, were performed extracorporeally through the same 7-cm upper median incision. This type of laparoscopyassis...

Laparoscopic right hemicolectomy with D3 lymph node dissection for a patient with situs inversus totalis: Report of a case

Surgery Today — Tue, 04 Oct 2011 05:58:53 +0100

Abstract Situs inversus totalis (SIT) is a rare congenital anomaly characterized by an inversion of the thoracic and abdominal viscera that creates a mirror image. The transposition of the organs imposes special demands on the diagnostic and technical skills of the surgeon, especially when performing laparoscopic surgery. We herein report the case of a 63-year-old man with colon cancer of the hepatic fl exure who received a laparoscopic right hemicolectomy. Careful recognition by the surgeon of the mirror image anatomy and skillful use of his left hand resulted in a successful outcome. The surgery was not otherwise different from ordinary cases. Therefore, laparoscopic colectomy is considered to be a safe and feasible option for patients with colorectal cancer and SIT. ...

The use of magnets with single-site umbilical laparoscopic surgery

Seminars in Pediatric Surgery — Mon, 03 Oct 2011 17:22:54 +0100

This study is a retrospective analysis of all magnet-assisted laparoscopic operations performed at the Fundacion Hospitalaria Private Children's Hospital from September 2009 to January 2011. Outcomes include demographics, diagnosis, operative time, intraoperative complications, and conversion rates. Forty-four magnet-assisted laparoscopic operations were performed. The operations included 23 appendectomies, 8 cholecystectomies, 3 Nissen fundoplications, 2 gastrojejunostomies, 2 splenectomies, 2 ovarian tumor/cyst resections, 1 retroperitoneal lymphangioma resection, 1 left adrenalectomy, 1 total abdominal colectomy and 1 pulmonary wedge resection. The mean operative times for the most commonly performed operations were 61 minutes for appendectomy and 93 minutes for cholecystectomy. The ope...

An Alternative to Colectomy for Severe C difficile ColitisAn Alternative to Colectomy for Severe C difficile Colitis

Medscape Today Headlines — Mon, 03 Oct 2011 14:41:00 +0100

Commentary on a study on whether a minimally invasive approach rather than total colectomy could serve as an alternative treatment for severe CDAD, published September 2011 in the Annals of Surgery. Medscape General Surgery (Source: Medscape Today Headlines)

Single-incision laparoscopic colectomy for cancer: Assessment of oncologic resection and short-term outcomes in a case-matched comparison with standard laparoscopy

Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Purpose: To compare single-incision laparoscopic (SIL) with multiport laparoscopic (LAP) colectomy in patients with colon cancer to assess oncologic resection and 1-year outcomes.Methods: We compared patients who underwent SIL colectomy for colon cancer with an equal number of case-matched LAP colectomy patients based on age, gender, body mass index (BMI), American Society of Anesthesiologists (ASA) score, previous abdominal operations, and operation type. Results of oncologic resection included lymph node (LN) yield and margins. One-year outcomes included cancer recurrence and death.Results: Twenty-six patients were identified for SIL and LAP colectomy groups with no differences in case matching (age, P = .70; gender, P > .99; BMI, P = .74; ASA score, P > .99; previous abdominal operation...

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Single-incision laparoscopic total abdominal colectomy for refractory ulcerative colitis

Surgical Endoscopy — Fri, 30 Sep 2011 06:29:40 +0100

Conclusions In our experience, a single-incision laparoscopic approach to total abdominal colectomy for refractory ulcerative colitis has been shown to be safe and feasible. Initial results suggest that this technique can lead to improvements in short-term outcomes in selected patients. Content Type Journal ArticleCategory Dynamic ManuscriptPages 1-7DOI 10.1007/s00464-011-1925-5Authors Alessandro Fichera, Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Ave, MC 5095, Chicago, IL 60637, USAMarco Zoccali, Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Ave, MC 5095, Chicago, IL 60637, USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical Endoscopy)

Elevation of Liver Function Tests After Laparoscopic Gastrectomy Using a Nathanson Liver Retractor

World Journal of Surgery — Fri, 30 Sep 2011 06:22:08 +0100

Conclusions LG resulted in frequent elevation of LFTs. Care should be taken to minimize intraoperative liver damage when performing LG using a Nathanson retractor. Content Type Journal ArticlePages 1-9DOI 10.1007/s00268-011-1301-6Authors Yousuke Kinjo, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507 JapanHiroshi Okabe, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507 JapanKazutaka Obama, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507 JapanShigeru Tsunoda, Department of Surgery, Graduate School of Medicine, Kyoto University, 54 Kawahara-cho, Shogoin,...

Thirty-Day Outcomes in Patients Treated with En Bloc Colectomy and Pancreatectomy for Locally Advanced Carcinoma of the Colon

Journal of Gastrointestinal Surgery — Thu, 29 Sep 2011 06:16:59 +0100

Conclusions Perioperative outcomes with en bloc pancreatectomy and colectomy include increased pulmonary complications, blood transfusions, wound complications, and length of stay compared to patients treated with colectomy alone for colon cancer. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s11605-011-1691-7Authors Ian M. Paquette, Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota Medical Center, Minneapolis, MN, USABrian R. Swenson, Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota Medical Center, Minneapolis, MN, USAMary R. Kwaan, Department of Surgery, Division of Colon and Rectal Surgery, University of Minnesota Medical Center, Minneapolis, MN, USAAnders F. Mellgre...

Alvimopan shortens stay after laparoscopic partial colectomy

Modern Medicine — Wed, 28 Sep 2011 04:00:00 +0100

NEW YORK (Reuters Health) - The mu-opioid receptor antagonist alvimopan (Entereg) can speed recovery after laparoscopic partial colectomy, a new study found. (Source: Modern Medicine)

Managing chronic disease in Ireland: hospital admission rates and clinical outcomes in a large ulcerative colitis population

Irish Journal of Medical Science — Sat, 24 Sep 2011 05:45:33 +0100

Conclusions The majority of patients with colitis have an uncomplicated disease course and do not require thiopurines, biologic agents or hospital admission. Principal management at a primary care level may be appropriate in many cases. Colectomy rates at a specialist centre in Ireland compare favourably with international figures. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s11845-011-0760-yAuthors A. N. Desmond, Department of Medicine, Alimentary Pharmabiotic Centre, Cork University Hospital, University College Cork, National University of Ireland, Wilton, Cork, IrelandF. Shanahan, Department of Medicine, Alimentary Pharmabiotic Centre, Cork University Hospital, University College Cork, National University of Ireland, Wilton, Cork, Ir...

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Double primary malignancies associated with colon Cancer in patients with Situs Inversus Totalis: Two Case Reports

World Journal of Surgical Oncology — Fri, 23 Sep 2011 04:00:00 +0100

Situs inversus totalis (SIT) is not itself a premalignant condition, however, rare synchronous or metachronous multiple primary malignancies have been reported. Herein we present a case of synchronous transverse and sigmoid colon cancers and a case of metachronous rectosigmoid colon and gastric cancers in patients with SIT.A 66-year-old male with SIT was referred for a two-month history of hematochezia. Synchronous colonic tumors were found on the proximal transverse and sigmoid colon. The patient underwent open total colectomy and was discharged without incident. A 71-year-old female with rectosigmoid colon cancer and SIT underwent laparoscopy-assisted low anterior resection. Fourteen months after the surgery, the patient developed a single hepatic metastasis and underwent hepatic segment...

Urinary Tract Infection after Colon and Rectal Resections: More Common than Predicted by Risk-Adjustment Models

Journal of the American College of Surgeons — Fri, 23 Sep 2011 04:00:00 +0100

Conclusions: Colorectal resections incur substantial risk of postoperative UTI, exceeding rates predicted by the NSQIP model. Because of their patients' unanticipated high incidence of UTI, surgeons with a specialty interest in colorectal surgery risk being flagged as “high outliers,” particularly if they perform many rectal resections. A simple set of risk factors discriminates 10-fold differences in the rate of UTI after colorectal resection. (Source: Journal of the American College of Surgeons)

Introduction of Alvimopan into an Enhanced Recovery Protocol for Colectomy Offers Benefit in Open But Not Laparoscopic Colectomy

Journal of Laparoendoscopic — Thu, 22 Sep 2011 14:25:12 +0100

Journal of Laparoendoscopic & Advanced Surgical Techniques , Vol. 0, No. 0. (Source: Journal of Laparoendoscopic)

Learning laparoscopic colectomy during colorectal residency: what does it take and how are we doing?

Surgical Endoscopy — Thu, 22 Sep 2011 05:47:52 +0100

Conclusions Performing more than 10 LR colectomies and more than 30 LL colectomies provided the vast majority of colorectal residents with the ability to be very comfortable with these procedures as they entered practice. A concerning number of trainees (46% of LL and 24% of LR trainees) did not reach this benchmark. The new general minimal American Board of Colon and Rectal Surgery (ABCRS) requirement of 50 laparoscopic resections seems appropriate but may require definition regarding the side of the procedure. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-011-1906-8Authors Sharon Stein, Department of Surgery, Case Medical Center, University Hospitals, Case Western Reserve University, Cleveland, USAJonah Stulberg, Department of Epidemiology and Biostatis...

Laparoscopic subtotal colectomy with transrectal extraction of the colon and ileorectal anastomosis

Surgical Endoscopy — Thu, 22 Sep 2011 05:47:50 +0100

Conclusion Laparoscopic subtotal colectomy with transrectal removal of the colon is a safe and effective procedure that can be added to the armamentarium of surgeons performing laparoscopic colon surgery. This technique may provide both an attractive way to reduce abdominal wall morbidity and a bridge to NOTES colon surgery. Content Type Journal ArticleCategory Dynamic ManuscriptPages 1-3DOI 10.1007/s00464-011-1926-4Authors Ziad T. Awad, Division of Minimally Invasive Surgery, Department of Surgery, University of Florida College of Medicine Jacksonville, 633 West 8th Street, Jacksonville, FL 32209, USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical Endoscopy)

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Surgical Site Infections and Cost in Obese Patients Undergoing Colorectal Surgery [Original Article]

Archives of Surgery — Mon, 19 Sep 2011 04:00:00 +0100

Conclusions Obesity increases the risk of an SSI after colectomy by 60%, and the presence of infection increases the colectomy cost by a mean of $17 324. Pay-for-performance policies that do not account for this increased rate of SSI and cost of caring for obese patients may lead to perverse incentives that could penalize surgeons who care for this population. (Source: Archives of Surgery)

Single port access surgery in colorectal disease: preliminary results.

Cirugia eEspanola — Sat, 17 Sep 2011 04:00:00 +0100

CONCLUSIONS: The single port access technique is safe and reproducible, maintaining oncological criteria, for surgeons accustomed to colorectal surgery by conventional laparoscopy. A larger number of cases would be required to standardise the technique. PMID: 21930264 [PubMed - as supplied by publisher] (Source: Cirugia eEspanola)

Antibiotic treatment for Clostridium difficile-associated diarrhea in adults.

Cochrane Database of Systematic Reviews — Fri, 16 Sep 2011 09:32:03 +0100

CONCLUSIONS: Current evidence leads to uncertainty whether mild CDAD needs to be treated. The studies provide little evidence for antibiotic treatment of severe CDAD as many studies excluded these patients. Considering the two goals of therapy: improvement of the patient's clinical condition and prevention of spread of C. difficile infection to other patients, one should choose the antibiotic that brings both symptomatic cure and bacteriologic cure. A recommendation to achieve these goals cannot be made because of the small numbers of patients in the included studies and the high risk of bias in these studies, especially related to dropouts. Most of the active comparator studies found no statistically significant difference in efficacy between vancomycin and other antibiotics including met...

Surgical management of ulcerative colitis

Langenbeck's Archives of Surgery — Fri, 16 Sep 2011 05:50:57 +0100

Conclusions Although the morbidity remains significant after surgery, the quality of life is good with a satisfactory long-term functional outcome. Content Type Journal ArticleCategory Review ArticlePages 1-7DOI 10.1007/s00423-011-0848-xAuthors Malika Bennis, Department of Digestive Surgery, Hôpital Saint-Antoine AP-HP, University Paris VI (Pierre et Marie Curie), 184 rue du Faubourg Saint-Antoine, 75571 Paris Cedex 12, FranceEmmanuel Tiret, Department of Digestive Surgery, Hôpital Saint-Antoine AP-HP, University Paris VI (Pierre et Marie Curie), 184 rue du Faubourg Saint-Antoine, 75571 Paris Cedex 12, France Journal Langenbeck's Archives of SurgeryOnline ISSN 1435-2451Print ISSN 1435-2443 (Source: Langenbeck's Archives of Surgery)

Alternative specimen extraction techniques after laparoscopic emergency colectomy in inflammatory bowel disease

Surgical Endoscopy — Sat, 10 Sep 2011 05:47:11 +0100

Conclusions Specimen extraction via the rectum or stoma site is a safe, alternative way to extract the specimen after laparoscopic colectomy. No infectious complications were observed postoperatively and no pelvic adhesions were found during completion proctectomy. Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-011-1888-6Authors Tjibbe J. Gardenbroek, Department of Surgery, Academic Medical Center, G4-146.1, PO Box 22660, 1100 DD Amsterdam, The NetherlandsEmma J. Eshuis, Department of Surgery, Academic Medical Center, G4-146.1, PO Box 22660, 1100 DD Amsterdam, The NetherlandsGijs J. D. van Acker, Department of Surgery, Medical Center Haaglanden, The Hague, The NetherlandsPieter J. Tanis, Department of Surgery, Academic Medical Center, G4-146.1, PO Box 22660,...

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Total Abdominal Colectomy for Refractory Ulcerative Colitis. Surgical Treatment in Evolution

Journal of Gastrointestinal Surgery — Sat, 10 Sep 2011 05:47:05 +0100

Conclusion Single incision laparoscopy offers a safe alternative to other laparoscopic approaches. Despite the higher technical complexity, the duration of surgery is shorter with faster resumption of oral intake. Studies with larger sample size and longer follow-up will be required to confirm the benefits of this approach. Content Type Journal ArticleCategory 2011 SSAT Poster PresentationPages 1-8DOI 10.1007/s11605-011-1666-8Authors Alessandro Fichera, Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Ave, MC 5095, Chicago, IL 60637, USAMarco Zoccali, Department of Surgery, University of Chicago Medical Center, 5841 S. Maryland Ave, MC 5095, Chicago, IL 60637, USACarla Felice, Department of Medicine, University of Chicago Medical Center,...

Laparoscopic Colectomy for Carcinoma of the Colon in Octogenarians

Journal of Gastrointestinal Surgery — Sat, 10 Sep 2011 05:47:05 +0100

Conclusions LC in the elderly is safe, with a shorter hospital stay, and carries a short-term benefit for selected patients and could be offered to all elderly patients. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s11605-011-1671-yAuthors Nidal Issa, Surgery Department, Hasharon Hospital, Rabin Medical Center, Petah-Tikva, and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelChiara Grassi, Hasharon Hospital, Rabin Medical Center, Petah-Tikva, and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelYededia Melki, Hasharon Hospital, Rabin Medical Center, Petah-Tikva, and the Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, IsraelEldad Powsner, Hasharon Hospital, Rabin Medical Center, Petah-Tik...

Anastomosis by use of compression anastomosis ring (CAR™ 27) in laparoscopic surgery for left-sided colonic tumor

International Journal of Colorectal Disease — Fri, 09 Sep 2011 16:45:35 +0100

Conclusions The anastomosis using the CAR™ 27 is an innovative technique. The CAR™ 27 anastomosis in patients undergoing laparoscopic colectomy for left-sided colonic tumor proved to be a safe and efficacious alternative to the standard double stapling technique. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00384-011-1310-9Authors Eun-Jung Koo, Department of Surgery, Dong-A University Medical Center, 3-1 Dongdaeshin-Dong, Seo-Gu, Pusan 602-715, South KoreaHong-Jo Choi, Department of Surgery, Dong-A University Medical Center, 3-1 Dongdaeshin-Dong, Seo-Gu, Pusan 602-715, South KoreaJin-Hee Woo, Department of Surgery, Dong-A University Medical Center, 3-1 Dongdaeshin-Dong, Seo-Gu, Pusan 602-715, South KoreaKi-Jae Park, Department of Sur...

Serum Adiponectin, Resistin, and Circulating Soluble Receptor for Advanced Glycation End Products in Colectomy Patients

Infectious Diseases in Obstetrics and Gynecology — Wed, 07 Sep 2011 23:58:45 +0100

Conclusions. Serum adiponectin, resistin, and sRAGE have the potential to develop into a panel of stress markers. Higher sRAGE levels in sera of LAP and ERP patients may be indicative of a protective and syngeristic role for colectomy recovery. (Source: Infectious Diseases in Obstetrics and Gynecology)

Laparoscopic restorative proctocolectomy: safety & critical level of the ileal pouch anal anastomosis

Colorectal Disease — Wed, 07 Sep 2011 04:00:00 +0100

Conclusion: In laparoscopic‐assisted RPC a limited Pfannenstiel incision allows safe construction of the IPAA at an appropriate level. Laparoscopic RPC is safe and the emerging long‐term follow‐up data show the benefitof this approach with very low rates of small bowel obstruction and incisional hernia formation. (Source: Colorectal Disease)

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Toll-like receptors in the inflammatory response during open and laparoscopic colectomy for colorectal cancer

Surgical Endoscopy — Tue, 06 Sep 2011 15:48:59 +0100

Conclusion The inflammatory response and the resultant stress response are significantly less during laparoscopic colectomy than during open colectomy for colorectal cancer. This is an obvious short-term clinical benefit for the patient, providing tinder for further study to investigate the long-term results of laparoscopic colectomy versus open colectomy for colorectal cancer (Registered clinical trial no. NCT00942461; www.clinicaltrials.gov). Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-1871-2Authors Konstantinos E. Tsimogiannis, Department of Surgery, “G. Hatzikosta” General Hospital, Hippocratus 3, Stavraki, GR-45332 Ioannina, GreeceConstantinos C. Tellis, Laboratory of Biochemistry, Chemistry Department, Ioannina University, Ioannina, Greece...

Laparoscopic colectomy for colonic carcinoma

Techniques in Coloproctology — Fri, 02 Sep 2011 05:48:34 +0100

Conclusion Laparoscopic colectomy for cancer, in the hands of an experienced laparoscopic surgeon, is a safe and efficient procedure. Content Type Journal ArticlePages 1-3DOI 10.1007/s10151-011-0748-7Authors M. G. Pramateftakis, Surgical Department, “European Medical Center”, Macedonias 2 Str, 55535 Pilea, Thessaloniki, GreeceD. Raptis, Surgical Department, “European Medical Center”, Macedonias 2 Str, 55535 Pilea, Thessaloniki, GreeceI. Mantzoros, Surgical Department, “European Medical Center”, Macedonias 2 Str, 55535 Pilea, Thessaloniki, GreeceD. Kanellos, Surgical Department, “European Medical Center”, Macedonias 2 Str, 55535 Pilea, Thessaloniki, GreeceS. Angelopoulos, Surgical Department, “European Medical Center”, Macedonias 2 Str, 55535 Pilea, T...

Single incision laparoscopic colorectal surgery: a single surgeon experience of 102 consecutive cases

Techniques in Coloproctology — Fri, 02 Sep 2011 05:48:23 +0100

Conclusions With proper patient selection and laparoscopic experience, single port colorectal surgery can be performed for even the most complex colorectal procedures. Further studies are needed to assess the benefits that single port colorectal surgery has over a conventional laparoscopic approach. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s10151-011-0756-7Authors D. Geisler, West Penn Allegheny Health System, Pittsburgh, PA, USAT. Garrett, West Penn Allegheny Health System, Pittsburgh, PA, USA Journal Techniques in ColoproctologyOnline ISSN 1128-045XPrint ISSN 1123-6337 (Source: Techniques in Coloproctology)

Angiosarcoma of sigmoid colon with intraperitoneal bleeding: case report and literature review.

Annals of the Royal College of Surgeons of England — Thu, 01 Sep 2011 04:00:00 +0100

We report a case of an angiosarcoma of the sigmoid colon with intraperitoneal bleeding but not rectal bleeding. A 21-year-old female patient received a laparotomy and a mass lesion over the sigmoid colon was found with active bleeding. A sigmoid colectomy was performed as a curative resection. Grossly, the sigmoid colon contained a kidney shaped, hemorrhagic tumour from the submucosal layer extension to the antimesenteric side. Intraluminally, the mucosa of the colon was intact. Microscopic examination revealed a high grade angiosarcoma composed of fascicles of spindle cells and solid sheets of epithelioid cells. Immunohistochemical stains revealed a positive result for CD31 and the endothelial nature of the malignancy was confirmed. Smooth muscle antigens, desmins, cytokeratins AE1/AE3 an...

S606 parecoxib and dipyrone for postoperative analgesia following colectomy

European Journal of Pain Supplements — Thu, 01 Sep 2011 04:00:00 +0100

(Source: European Journal of Pain Supplements)

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Localization of a colonic lesion in the era of laparoscopic colectomy

ANZ Journal of Surgery — Wed, 31 Aug 2011 23:00:00 +0100

(Source: ANZ Journal of Surgery)

Endoscopic and surgical management of serrated colonic polyps

British Journal of Surgery — Mon, 29 Aug 2011 23:00:00 +0100

Conclusion:Even though the neoplastic potential of certain subtypes of serrated polyp is heavily supported, further studies are needed to make definitive endoscopic and surgical recommendations. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. (Source: British Journal of Surgery)

Adjuvant Chemotherapy for Stage II Colon Cancer With Poor Prognostic Features [Gastrointestinal Cancer]

Journal of Clinical Oncology — Mon, 29 Aug 2011 23:00:00 +0100

Conclusion Among Medicare patients identified with stage II colon cancer, either with or without poor prognostic features, adjuvant chemotherapy did not substantially improve overall survival. This lack of benefit must be considered in treatment decisions for similar older adults with colon cancer. (Source: Journal of Clinical Oncology)

Impact of preoperative change in physical function on postoperative recovery: Argument supporting prehabilitation for colorectal surgery

Surgery — Mon, 29 Aug 2011 22:07:57 +0100

Conclusion: In a group of patients undergoing scheduled colorectal surgery, meaningful changes in functional capacity can be achieved over several weeks of prehabilitation. Patients and those who care for them, especially those with poor physical capacity, should consider a prehabilitation regimen to enhance functional exercise capacity before colectomy. (Source: Surgery)

Preoperative hypoalbuminemia is associated with adverse outcomes after ileoanal pouch surgery

Inflammatory Bowel Diseases — Sun, 28 Aug 2011 23:00:00 +0100

Conclusions:Preoperative serum albumin is an easily available, inexpensive marker in risk stratifying patients undergoing ileoanal pouch surgery. Serum albumin may provide an objective indicator in supporting the decision to undertake a subtotal colectomy as a first step rather than total proctocolectomy with immediate pouch creation. (Inflamm Bowel Dis 2011;) (Source: Inflammatory Bowel Diseases)

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Functional outcome, quality of life, and efficacy of probiotics in postoperative patients with colorectal cancer

Surgery Today — Sat, 27 Aug 2011 05:49:44 +0100

Conclusions Not only rectal resection but also rightside colectomy affected bowel dysfunction. Probiotics could be an effective treatment for improvement in functional outcome and QOL after colorectal resection. Content Type Journal ArticleCategory Original ArticlePages 1200-1206DOI 10.1007/s00595-010-4450-6Authors Seiji Ohigashi, Department of Gastroenterological Surgery, St Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560 JapanYoshinori Hoshino, Department of Surgery, Keio University Hospital, Tokyo, JapanSachiko Ohde, Center for Epidemiology, St Luke’s Life Science Institute, Tokyo, JapanHisashi Onodera, Department of Gastroenterological Surgery, St Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560 Japan Jo...

Postoperative Morbidity Index: A Quantitative Measure of Severity of Postoperative Complications

Journal of the American College of Surgeons — Thu, 25 Aug 2011 04:00:00 +0100

Conclusions: Quantification of severity of postoperative complications is possible using American College of Surgeons' National Surgical Quality Improvement Program methods and the Accordion Severity Grading System. Procedural PMI can be useful in assessing surgical outcomes. Certain limitations, particularly the need for risk adjustment, still need to be addressed. (Source: Journal of the American College of Surgeons)

Single‐incision laparoscopic colonic surgery

Colorectal Disease — Sat, 20 Aug 2011 16:39:55 +0100

Conclusion This preliminary experience shows that SILS is technically feasible and safe for colonic resection. (Source: Colorectal Disease)

Minimally Invasive Surgery for Colorectal Cancer: Past, Present, and Future

Clinical and Developmental Immunology — Sat, 20 Aug 2011 12:13:31 +0100

A rapid progression from conventional open surgery to minimally invasive approaches in the surgical management of colorectal cancer has occurred over the last 2 decades. Initial concerns that this new approach was oncologically inferior to open surgery were ultimately refuted when several prospective randomized trials concluded that laparoscopic colectomy could achieve similar oncologic outcomes to open surgery. On the contrary, level 1 data has not yet matured regarding the oncologic safety of minimally invasive approaches for rectal cancer. We review the published literature pertaining to the evolution of minimally invasive techniques used to treat colorectal cancer surgery, including barriers to adoption, and the prospects for future advances related to innovative techniques. (Source: C...

Robot-assisted laparoscopic surgery of the colon and rectum

Surgical Endoscopy — Sat, 20 Aug 2011 05:41:04 +0100

Conclusions Robotic applications in colorectal surgery are feasible with low conversion rates and favorable morbidity. Further studies are required to evaluate its oncologic and patient-oriented outcomes. Content Type Journal ArticleCategory ReviewPages 1-11DOI 10.1007/s00464-011-1867-yAuthors Stavros A. Antoniou, Department of General and Visceral Surgery, Center for Minimally Invasive Surgery, Hospital “Maria v. d. Aposteln” Neuwerk, Mönchengladbach, GermanyGeorge A. Antoniou, Vascular Institute, Northern General Hospital, Sheffield Teaching Hospitals, Sheffield, UKOliver O. Koch, Department of General Surgery, Hospital Zell am See, Zell am See, AustriaRudolf Pointner, Department of General Surgery, Hospital Zell am See, Zell am See, AustriaFrank A. Granderath...

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Advances in cancer surgery: Natural orifice surgery (NOTES) for oncological diseases

Surgical Oncology — Wed, 17 Aug 2011 09:11:34 +0100

Abstract: Natural orifice transluminal endoscopic surgery (NOTES) is a new concept that attempts to reduce the impact of surgery on the patient. In surgical oncology several studies have already revealed that a minimally invasive approach provides at least the same, if not a better, long-term outcome. One could hypothesize that a less invasive approach such as NOTES could further enhance such advantages. Since its initial description, NOTES has become clinical reality and today nearly every organ is accessible by a transluminal approach, in at least the experimental setting. Subsequent to published research, first clinical studies on NOTES in oncology were reported and the accuracy of transgastric peritoneoscopy for staging of pancreas cancer was shown to be similar to laparoscopy in human...

Outcomes of Right vs. Left Colectomy for Colon Cancer

Journal of Gastrointestinal Surgery — Tue, 16 Aug 2011 06:10:09 +0100

Conclusions RC patients were older and had more comorbidities and postoperative complications. Patient characteristics and comorbidities were more important in determining overall postoperative complications than anastomotic types. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s11605-011-1655-yAuthors Hossein Masoomi, Department of Surgery, University of California, Irvine Medical Center, 333 City Blvd. West Suite 700, Orange, CA 92868, USABrian Buchberg, Department of Surgery, University of California, Irvine Medical Center, 333 City Blvd. West Suite 700, Orange, CA 92868, USAPhat Dang, Department of Surgery, University of California, Irvine Medical Center, 333 City Blvd. West Suite 700, Orange, CA 92868, USAJoseph C. Carmichael, Departme...

Trichoblastic carcinoma arising from colostomy

American Journal of Surgery — Tue, 16 Aug 2011 04:00:00 +0100

We report a case of an 84-year-old man who presented with a tumor on the stoma of the descending colon, which was preoperatively diagnosed as colon cancer. He underwent colectomy with adjacent skin, and the tumor was diagnosed as trichoblastic carcinoma by postoperative pathological examination. We are not aware of any similar cases published in the English literature. Therefore, we report this case because it is quite a rare condition. (Source: American Journal of Surgery)

Endovascular Repair of Bilateral Iliac Artery Aneurysms in a Patient With Loeys–Dietz Syndrome

Annals of Vascular Surgery — Thu, 11 Aug 2011 04:00:00 +0100

Conclusion: LDS is a rare connective tissue disorder characterized by vascular aneurysms and arterial tortuosity. When vascular reconstruction is necessary, open techniques are often preferred given the lack of data on endovascular procedures. In the present case, we report the first successful abdominal EVAR in a high-risk patient with LDS, providing excellent short-term results. (Source: Annals of Vascular Surgery)

Laparoscopic Right Hepatectomy With Intrahepatic Transection of the Right Bile Duct

Annals of Surgical Oncology — Sat, 06 Aug 2011 05:57:44 +0100

Discussion Laparoscopic major hepatectomy is feasible. As in open hepatectomies, intrahepatic transection of the right bile duct may be safer because there is a decreased risk of injury to the left hepatic duct.4 , 5 Larger series with longer-term follow-up are necessary. Content Type Journal ArticlePages 1-2DOI 10.1245/s10434-011-1927-5Authors Tzu-jung Tsai, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USAElie K. Chouillard, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USAAndrew A. Gumbs, Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)

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Current misunderstandings in the management of ulcerative colitis

Gut — Fri, 05 Aug 2011 23:00:00 +0100

Past and ongoing therapeutic concepts for ulcerative colitis have only been moderately successful. A significant proportion of patients with ulcerative colitis will still have to undergo colectomy and overall half of the patients do not achieve sustained remission, leading to impairment of physical and mental health, social life, employment issues and sexual activity. Reluctance to treat patients early on with sufficiently potent drug regimens is obvious. Several popular misconceptions might have led to this situation. First, ulcerative colitis is still considered a more ‘benign’ disease than Crohn's disease. Furthermore, the general assumption is often that colectomy can ‘cure’ the disease. Mucosal healing as a therapeutic target has not been widely accepted. Final...

Total colonic aganglionosis: a surgical challenge. How to avoid complications?

Pediatric Surgery International — Tue, 02 Aug 2011 06:15:18 +0100

Conclusion Total colonic aganglionosis remains a serious surgical challenge. Patients suffering from the condition, have multiple complications, sequelae, and often require reoperations. We found that it is possible to prevent many of these by properly fixing the stoma, avoiding pouch or patch procedures, delaying ileostomy closure, having pathology expertise, and with meticulous surgical technique starting the dissection/anastomosis well above the dentate line. Content Type Journal ArticlePages 1-6DOI 10.1007/s00383-011-2960-yAuthors Andrea Bischoff, Division of Pediatric Surgery, Colorectal Center for Children, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, ML 2023, Cincinnati, OH 45229, USAMarc A. Levitt, Division of Pediatric Surgery, Colo...

Postoperative Complications and Mortality Following Colectomy for Ulcerative Colitis

Clinical Gastroenterology and Hepatology — Mon, 01 Aug 2011 04:00:00 +0100

Conclusions: Postoperative complications frequently occur after colectomy for UC, predominantly among elderly patients with multiple comorbidities. Patients who were admitted to the hospital under emergency conditions and did not respond to medical treatment had worse outcomes when surgery was performed 14 or more days after admission. (Source: Clinical Gastroenterology and Hepatology)

Backwash Ileitis Does Not Affect Pouch Outcome in Patients With Ulcerative Colitis With Restorative Proctocolectomy

Clinical Gastroenterology and Hepatology — Mon, 01 Aug 2011 04:00:00 +0100

Conclusions: Ileal inflammation is not a contraindication for restorative proctocolectomy with ileal pouch construction in patients with UC or idiopathic inflammatory bowel disease of indeterminate type. Ileal inflammation with pancolitis is not a useful criterion for classifying otherwise typical UC as colitis of indeterminate type, because pouch outcomes are not affected. (Source: Clinical Gastroenterology and Hepatology)

Effects of carbon dioxide pneumoperitoneum on hepatic and renal morphology of rats after segmental colectomy and colonic anastomosis.

Acta Cirurgica Brasileira — Sun, 31 Jul 2011 23:00:00 +0100

Authors: Farias IE, Morais PH, Durães Lde C, Carneiro FP, Oliveira PG, Sousa JB To evaluate the effects of increased intraperitoneal pressure caused by carbon dioxide pneumoperitoneum on the hepatic and renal morphology of rats. PMID: 21808840 [PubMed - in process] (Source: Acta Cirurgica Brasileira)

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Fulminant Epstein-Barr Virus-associated T-cell Lymphoproliferative Disorder in an Immunocompetent Middle-aged Man Presenting with Chronic Diarrhea and Gastrointestinal Bleeding.

J Korean Med Sci — Sun, 31 Jul 2011 23:00:00 +0100

Authors: Abdul-Ghafar J, Kim JW, Park KH, Cho MY Abstract The World Health Organization (WHO) recently defined systemic Epstein-Barr virus (EBV)-positive T-cell lymphoproliferative disorders (LPD) of childhood as a life-threatening illness. However, this rare disease has not been extensively studied. Here we report a case of systemic EBV-positive T-cell LPD in a previously healthy middle-aged man with a chief complaint of chronic diarrhea. The initial colon biopsy showed focal infiltration of EBV-positive small lymphocytes without any atypia. However, the disease rapidly progressed and the patient required a total colectomy due to severe gastrointestinal bleeding. Three and half months after admission, the patient died from a complication of disseminated intravascular coagulation. ...

Older patients with diverticulitis have low recurrence rates and rarely need surgery

Surgery — Fri, 29 Jul 2011 19:52:42 +0100

Conclusion: The majority of elderly patients newly diagnosed with diverticulitis did not have an operation or experience recurrent episodes. The apparent benign course of this disease in this population suggests that a conservative approach to the management may be appropriate. (Source: Surgery)

Anatomic mechanisms for splenic injury during colorectal surgery

Clinical Anatomy — Wed, 27 Jul 2011 23:00:00 +0100

AbstractIntraoperative iatrogenic splenic injury during colorectal surgery is rare but may cause significant morbidity. We aimed to describe the anatomic mechanisms of iatrogenic injury to the spleen during colonic surgery. All adult surgical patients who sustained a splenic injury during colectomy at our institution from 1992 to 2007 were retrospectively identified. The operative and pathologic reports were reviewed, and anatomic details of the injuries were collected. Results are reported as a proportion or median, with range reported in brackets. Of 13,897 colectomies, 71 splenic injuries among 58 patients were identified. Splenic flexure colonic mobilization occurred in 53 (91%) of these patients. The median number of tears was 1 (1–3). The average length of tear was 4.59 cm. The dis...

Single-Incision Laparoscopic Colorectal Surgery, Experience with 50 Consecutive Cases

Journal of Gastrointestinal Surgery — Wed, 27 Jul 2011 18:48:07 +0100

Conclusion SILS colectomy is a safe and feasible procedure even in more complex cases. Comparative studies are needed to demonstrate advantages over traditional laparoscopic surgery. Content Type Journal ArticlePages 1-6DOI 10.1007/s11605-011-1626-3Authors Peter B. van den Boezem, Department of Surgery, Gelderse Vallei Hospital, 6716 RP Ede, The NetherlandsColin Sietses, Department of Surgery, Gelderse Vallei Hospital, 6716 RP Ede, The Netherlands Journal Journal of Gastrointestinal SurgeryOnline ISSN 1873-4626Print ISSN 1091-255X (Source: Journal of Gastrointestinal Surgery)

Primum non nocere: A Word of Caution Regarding Prophylactic Colectomy in the Setting of Incurable Metastatic Disease

Annals of Surgical Oncology — Wed, 27 Jul 2011 05:48:36 +0100

Content Type Journal ArticlePages 1-3DOI 10.1245/s10434-011-1953-3Authors Martin R. Weiser, Colorectal Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, USA Journal Annals of Surgical OncologyOnline ISSN 1534-4681Print ISSN 1068-9265 (Source: Annals of Surgical Oncology)

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Laparoscopic colectomy significantly decreases length of stay compared with open operation

Surgical Endoscopy — Wed, 27 Jul 2011 05:48:27 +0100

Conclusions These results indicate that laparoscopic colectomy independently decreases SLOS compared with open colectomy. This study is unique in using statistical methods to control for selection bias of patients who might be more “surgically fit.” Content Type Journal ArticlePages 1-5DOI 10.1007/s00464-011-1840-9Authors Amalia J. Stefanou, Division of General Surgery, Department of Surgery, Henry Ford Hospital, Clara Ford Pavillion—Office 433, 2799 W. Grand Boulevard, Detroit, MI 48202, USACraig A. Reickert, Division of Colon and Rectal Surgery, Department of Surgery, Henry Ford Hospital, Detroit, MI, USAVic Velanovich, Division of General Surgery, Department of Surgery, Henry Ford Hospital, Clara Ford Pavillion—Office 433, 2799 W. Grand Boulevard, Detroit,...

Single-incision versus conventional laparoscopic sigmoid colectomy: a case-matched series

Surgical Endoscopy — Wed, 27 Jul 2011 05:48:21 +0100

Conclusion Compared with conventional laparoscopic technique, single-incision laparoscopic surgery results in similar intraoperative and postoperative outcomes. The technique avoids use of multiple trocar sites and may safely be performed in patients with a history of previous abdominal surgery while maintaining a short length of hospital stay and low complication rate. Content Type Journal ArticlePages 1-7DOI 10.1007/s00464-011-1833-8Authors Diego I. Ramos-Valadez, Division of Minimally Invasive Colon and Rectal Surgery, Department of Surgery, University of Texas Medical School at Houston, 7900 Fannin Street, Suite 2700, Houston, TX 77054, USAMadhu Ragupathi, Division of Minimally Invasive Colon and Rectal Surgery, Department of Surgery, University of Texas Medical...

Review of the disease course among adult ulcerative colitis population‐based longitudinal cohorts

Inflammatory Bowel Diseases — Mon, 25 Jul 2011 23:00:00 +0100

Conclusions:This review shows how the clinical course of UC has changed over time and alerts to the need for more prospective cohort studies to evaluate long‐term outcomes especially to study the impact of biologic agents on UC. (Inflamm Bowel Dis 2011;) (Source: Inflammatory Bowel Diseases)

Update on the Management of Ulcerative Colitis

Current Gastroenterology Reports — Mon, 25 Jul 2011 15:44:46 +0100

Abstract The treatment options for inflammatory bowel disease have expanded with the introduction of biological therapies. Recently published controlled clinical trials were searched and those that impact the clinical management of ulcerative colitis (UC) are discussed in this review. In the management of mild to moderate UC, mesalamine still remains the first choice of drug. The newly developed once daily formulations have shown equal efficacy to divided doses and possibly portend better compliance owing to a simplified regimen. In outpatients with moderate to severe UC, recent data indicate that infliximab induced and maintained remission leads to decreased colectomy rates and fewer hospitalizations. An alternative anti-tumor necrosis factor (TNF) agent, adalimumab, was ...

Colectomy Performance Improvement within NSQIP 2005–2008

Journal of Surgical Research — Mon, 25 Jul 2011 04:00:00 +0100

Conclusion: It appears that laparoscopic colectomies are growing in popularity over open colectomies, but the need for emergent open procedures remains unchanged. Across all colectomies, however, key postoperative and perioperative complications have improved over time. Participation in ACS NSQIP demonstrates quality improvement and may encourage greater enrollment. (Source: Journal of Surgical Research)

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Optimising surgical training: use of feedback to reduce errors during a simulated surgical procedure

Postgraduate Medical Journal — Sun, 24 Jul 2011 23:00:00 +0100

Conclusion The provision of standardised proximate feedback was associated with significantly fewer errors and an improved learning curve. Reducing errors in the skills lab environment should lead to safer clinical performance. This may help to make training more efficient and improve patient safety. (Source: Postgraduate Medical Journal)

A case of posterior reversible encephalopathy syndrome in a child with Crohn's disease treated with Infliximab

Journal of Critical Care — Thu, 21 Jul 2011 04:00:00 +0100

Conclusions: Awareness of this rare condition in patients receiving immunosuppressive treatment is important to prevent poor outcomes for patients. The increasing number of these cases recognised in patients receiving Infliximab should be kept under close clinical surveillance due to the possibility of a link between the two.Highlights: ► Posterior reversible encephalopathy syndrome(PRES) is a multifactorial disorder. ► This is the 4th published case of PRES in IBD patients treated with infliximab. ► PRES cases and infliximab have been described more in children. (Source: Journal of Critical Care)

Single incision laparoscopic (SILS) restorative proctocolectomy with ileal pouch-anal anastomosis

Surgical Endoscopy — Fri, 15 Jul 2011 05:53:04 +0100

Conclusion SILS restorative proctocolectomy is safe with good early functional outcomes when performed by an experienced laparoscopic surgeon. Content Type Journal ArticlePages 1-4DOI 10.1007/s00464-011-1814-yAuthors K. J. Gash, Department of Colorectal Surgery, Frenchay Hospital, Bristol, UKA. C. Goede, Department of Colorectal Surgery, Frenchay Hospital, Bristol, UKB. Kaldowski, Department of General, Visceral & Thorax Surgery, Klinikum Leverkusen, Leverkusen, GermanyB. Vestweber, Department of General, Visceral & Thorax Surgery, Klinikum Leverkusen, Leverkusen, GermanyA. R. Dixon, Department of Colorectal Surgery, Frenchay Hospital, Bristol, UK Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical Endoscopy)

Use of an electrothermal bipolar sealing device in ligation of major mesenteric vessels during laparoscopic colorectal resection

Techniques in Coloproctology — Thu, 14 Jul 2011 16:50:44 +0100

Conclusions Use of the LigaSure™ device to seal and divide the major mesenteric vessels during laparoscopic colorectal resection is very effective, with a high success rate of 99.8%. Caution should be exercised in elderly atherosclerotic patients, particularly when using the 5-mm LigaSure™ device. Content Type Journal ArticlePages 1-5DOI 10.1007/s10151-011-0707-3Authors S. T. Martin, Department of Colorectal Surgery, St. Vincent’s University Hospital, Elm Park, Dublin 4, IrelandA. Heeney, Department of Colorectal Surgery, St. Vincent’s University Hospital, Elm Park, Dublin 4, IrelandC. Pierce, Department of Colorectal Surgery, St. Vincent’s University Hospital, Elm Park, Dublin 4, IrelandP. R. O’Connell, Department of Colorectal Surgery, St. Vincent’s ...