MedWorm: Colectomy

Cytomegalovirus in inflammatory bowel disease: Pathogen or innocent bystander?

Inflammatory Bowel Diseases — Tue, 16 Mar 2010 00:00:00 +0100

This article reviews the immunobiology of CMV disease, the evidence for CMV's role in disease severity, and discusses the outcomes with antiviral therapy. (Inflamm Bowel Dis 2010) (Source: Inflammatory Bowel Diseases)

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Concurrent amoebic and histoplasma colitis: A rare cause of massive lower gastrointestinal bleeding.

World Journal of Gastroenterology : WJG — Fri, 12 Mar 2010 17:04:06 +0100

Authors: Koh PS, Roslani AC, Vimal KV, Shariman M, Umasangar R, Lewellyn R Infective colitis can be a cause of massive lower gastrointestinal bleeding requiring acute surgical intervention. Causative organisms include entamoeba and histoplasma species. However, concurrent colonic infection with both these organisms is very rare, and the in vivo consequences are not known. A 58-year-old male presented initially to the physicians with pyrexia of unknown origin and bloody diarrhea. Amoebic colitis was diagnosed based on biopsies, and he was treated with metronidazole. Five days later, the patient developed massive lower gastrointestinal bleeding with hemorrhagic shock. Emergency total colectomy with end-ileostomy was performed. However, he deteriorated and died on the second postoperative...

Short-Term Outcomes of Laparoscopic Colectomy for Transverse Colon Cancer

Journal of Gastrointestinal Surgery — Fri, 12 Mar 2010 06:49:22 +0100

Conclusions Laparoscopic resection for TCC can be performed safely with similar short-term postoperative outcomes seen for colon cancer at other sites. Laparoscopic resection may be associated with faster gastrointestinal recovery and shorter length of hospital stay, compared with open surgery. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11605-010-1182-2Authors Takashi Akiyoshi, Cancer Institute Hospital Gastroenterological Center, Department of Gastroenterological Surgery 3-10-6 Ariake, Koto-ku Tokyo 135-8550 JapanHiroya Kuroyanagi, Cancer Institute Hospital Gastroenterological Center, Department of Gastroenterological Surgery 3-10-6 Ariake, Koto-ku Tokyo 135-8550 JapanYoshiya Fujimoto, Cancer Institute Hospital Gastroenterological Center, Dep...

MEFV gene mutations and its impact on the clinical course in ulcerative colitis patients

Rheumatology International — Thu, 11 Mar 2010 18:12:11 +0100

Abstract Ulcerative colitis (UC) is an inflammatory disease of the colonic mucosa. The presence of gene responsible for FMF, MEFV, which frequently causes inflammation, may aggravate the clinical course of UC. We aimed to determine the prevalence of MEFV mutations in UC patients and its impact on the clinical course. Four groups were formed as group 1 UC with distal disease, group 2 UC with pancolonic disease, group 3 UC with total colectomy, and group 4 Rheumatoid Arthritis (RA) patients. Eleven mutations of FMF gene were investigated. The mean age of group 1, 2, 3, and 4 were 46.7 ± 13.9, 43.8 ± 12.9, 44.8 ± 14.2, and 45.8 ± 10.9 years, respectively. The mutations were identified in 19 of the 54 UC patients (35.2%). Homozyg...

Laparoscopic subtotal colectomy for medically refractory ulcerative colitis: the time has come

Surgical Endoscopy — Wed, 10 Mar 2010 16:00:45 +0100

Conclusion Laparoscopic STC confers the benefits of improved cosmesis, reduced intraoperative blood loss, negligible wound complications, and shorter hospital stay. Laparoscopy is a feasible and safe alternative to open STC in patients with UC refractory to medical therapy requiring urgent or emergent operation. Content Type Journal ArticleDOI 10.1007/s00464-009-0819-2Authors Dana A. Telem, The Mount Sinai Medical Center Department of Surgery 1010 Fifth Avenue New York NY 10128 USAAnthony J. Vine, The Mount Sinai Medical Center Department of Surgery 1010 Fifth Avenue New York NY 10128 USAGarry Swain, The Mount Sinai Medical Center Department of Surgery 1010 Fifth Avenue New York NY 10128 USACelia M. Divino, The Mount Sinai Medical Center Department of Surgery 1010 F...

Surgery for ulcerative colitis in 1,000 patients

International Journal of Colorectal Disease — Wed, 10 Mar 2010 15:33:50 +0100

Conclusion A restorative proctocolectomy with an IPAA is a safe procedure, with low rates of mortality and major morbidity. We do not recommend routine application of IPAA in any subset of patients with known CD. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-010-0915-8Authors Hiroki Ikeuchi, Hyogo College of Medicine Department of Surgery 1-1 Mukogawa-cho Nishinomiya Hyogo 663-8501 JapanMotoi Uchino, Hyogo College of Medicine Department of Surgery 1-1 Mukogawa-cho Nishinomiya Hyogo 663-8501 JapanHiroki Matsuoka, Hyogo College of Medicine Department of Surgery 1-1 Mukogawa-cho Nishinomiya Hyogo 663-8501 JapanToshihiro Bando, Hyogo College of Medicine Department of Surgery 1-1 Mukogawa-cho Nishinomiya Hyogo 663-8501 JapanTakayuki Matsumoto, Hy...

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Phase II study of preoperative chemoradiotherapy (CRT) with irinotecan plus S-1 in locally advanced rectal cancer.

Sat, 06 Mar 2010 00:00:00 +0100

CONCLUSIONS: This study demonstrated the efficacy of preoperative CRT with S-1 and irinotecan with 21% of complete response. However, prompt recognition and management of infection is needed to use it in patients with locally advanced rectal cancer. PMID: 20211505 [PubMed - as supplied by publisher] (Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology)

Endoscopic placement of self-expandable metal stents for malignant colonic obstruction: long-term outcomes and complication factors

Gastrointestinal Endoscopy — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Colorectal SEMS placement is relatively safe and effective but with a complication rate of nearly 25%. Patient characteristics and technical variables appear to affect the outcome of SEMS therapy. (Source: Gastrointestinal Endoscopy)

Succinylated gelatin substantially increases en bloc resection size in colonic EMR: a randomized, blinded trial in a porcine model

Gastrointestinal Endoscopy — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: SG is safe and results in a 42% increased surface area for en bloc EMR. Given its other favorable properties, it represents a significant step toward defining the ideal EMR solution. (Source: Gastrointestinal Endoscopy)

Further reduction of hospital stay for laparoscopic colon resection by modifications of the fast-track care plan

American Journal of Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Our modified fast-track plan achieved significant improvement in length of stay for laparoscopic colectomy compared with previous results. (Source: American Journal of Surgery)

Laparoscopic colectomy for complex diverticular disease: a justifiable choice?

Surgical Endoscopy — Fri, 26 Feb 2010 06:51:48 +0100

Conclusions The laparoscopic management of complicated diverticular disease is feasible and appears to be safe in the hands of experts. Despite a high rate of conversion to open surgery, laparoscopy was the sole operative intervention for the majority of patients with complicated diverticular disease. Further studies are needed to allow rigorous comparison with an open control group. Content Type Journal ArticleDOI 10.1007/s00464-010-0951-zAuthors Guillaume Martel, The Ottawa Hospital, University of Ottawa Minimally Invasive Surgery Research Group, Division of General Surgery 501 Smyth Road Ottawa ON K1H 8L6 CanadaAlexandre Bouchard, The Ottawa Hospital, University of Ottawa Minimally Invasive Surgery Research Group, Division of General Surgery 501 Smyth Road Ottawa...

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Poor catch-up growth after proctocolectomy in pediatric patients with ulcerative colitis receiving prolonged steroid therapy

Pediatric Surgery International — Thu, 25 Feb 2010 06:51:42 +0100

Conclusion Preoperative prolonged high steroid therapy may disturb growth recovery of pediatric patients with UC, while early induction of colectomy allowed pediatric patients with PSL dependency to become free of steroids and get normal growth. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00383-010-2577-6Authors Keiichi Uchida, Mie University Department of Gastrointestinal and Pediatric Surgery, Graduate School of Medicine 2-174 Edobashi Tsu Mie 514-8507 JapanToshimitsu Araki, Mie University Department of Gastrointestinal and Pediatric Surgery, Graduate School of Medicine 2-174 Edobashi Tsu Mie 514-8507 JapanMikihiro Inoue, Mie University Department of Gastrointestinal and Pediatric Surgery, Graduate School of Medicine 2-174 Edobashi Tsu Mie 514...

Assessing Operative Performance in Advanced Laparoscopic Colorectal Surgery

World Journal of Surgery — Thu, 25 Feb 2010 06:49:22 +0100

Conclusions This new assessment tool of generic and specific technical skills in advanced laparoscopic colorectal surgery is reliable and has face, content, concurrent, and construct validities. The tool has the possibility of being used as a surgical training and appraisal tool. Content Type Journal ArticleDOI 10.1007/s00268-010-0486-4Authors Sudip K. Sarker, Whittington Hospital Colorectal Surgical Unit London N19 5NF UKIsis Kumar, University College London Academic Surgery London WC1E 6BT UKConor Delaney, University Hospitals Case Medical Centre Department of Colorectal Surgery Cleveland OH 44106 USA Journal World Journal of SurgeryOnline ISSN 1432-2323Print ISSN 0364-2313 (Source: World Journal of Surgery)

Decision Model of Segmental Compared With Total Abdominal Colectomy for Colon Cancer in Hereditary Nonpolyposis Colorectal Cancer [Surgical Oncology]

Journal of Clinical Oncology — Wed, 24 Feb 2010 23:01:02 +0100

Conclusion SEG and TAC are approximately equivalent strategies for patients with colon cancer and Lynch syndrome. The decision regarding which operation is preferable should be made on the basis of patient factors and preferences, with special emphasis on age and the ability of the patient to utilize intensive surveillance. (Source: Journal of Clinical Oncology)

The benefit of an enhanced recovery programme following elective laparoscopic sigmoid colectomy

International Journal of Colorectal Disease — Tue, 23 Feb 2010 07:20:01 +0100

Conclusion The application of the ERP (RAPID) to patients undergoing laparoscopic sigmoid colon resection results in a significant improvement in length of hospital stay, with comparable morbidity and readmission rates. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-010-0902-0Authors Hasan Al Chalabi, Incorporating the National Children’s Hospital Adelaide and Meath Hospital Tallaght Dublin 24 IrelandDara O. Kavanagh, Incorporating the National Children’s Hospital Adelaide and Meath Hospital Tallaght Dublin 24 IrelandLana Hassan, AMNCH Tallaght Department of Minimally Invasive Surgery Dublin 24 IrelandKate O. Donnell, Incorporating the National Children’s Hospital Adelaide and Meath Hospital Tallaght Dublin 24 IrelandEmmeline Nugent, In...

Comparison of immunologic outcomes of laparoscopic vs open approaches in clinical stage III colorectal cancer

International Journal of Colorectal Disease — Tue, 23 Feb 2010 07:19:59 +0100

Conclusion The mHLA-DR on POD5 was affected less by the LC compared to the OC. The LC demonstrated minimal immunological advantage when compared to the OC. However, further study is required to clarify the immunological benefits of the LC on colorectal cancer prognosis. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-010-0882-0Authors Sang-Ah Han, Sungkyunkwan University School of Medicine Department of Surgery, Samsung Medical Center Irwon-dong #50, Gangnam-gu Seoul Korea 135-710Woo Yong Lee, Sungkyunkwan University School of Medicine Department of Surgery, Samsung Medical Center Irwon-dong #50, Gangnam-gu Seoul Korea 135-710Chi-Min Park, Sungkyunkwan University School of Medicine Department of Surgery, Samsung Medical Center Irwon-dong #50,...

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Transumbilical single-incision laparoscopic surgery for sigmoid colon cancer

Surgical Endoscopy — Tue, 23 Feb 2010 07:08:03 +0100

Conclusion Single-incision laparoscopic colectomy is feasible and safe for selected patients and gives a favorable cosmetic result. By well-trained surgeons, this technique could be a realistic option for colorectal cancer surgery. Content Type Journal ArticleCategory VideoDOI 10.1007/s00464-010-0948-7Authors Ichiro Takemasa, Graduate School of Medicine, Osaka University Department of Surgery 2-2 Yamadaoka Suita, Osaka 565-0871 JapanMitsugu Sekimoto, Graduate School of Medicine, Osaka University Department of Surgery 2-2 Yamadaoka Suita, Osaka 565-0871 JapanMasataka Ikeda, Graduate School of Medicine, Osaka University Department of Surgery 2-2 Yamadaoka Suita, Osaka 565-0871 JapanTsunekazu Mizushima, Graduate School of Medicine, Osaka University Department of Surgery...

When should ulcerative colitis patients undergo colectomy for dysplasia? Mismatch between patient preferences and physician recommendations

Inflammatory Bowel Diseases — Tue, 23 Feb 2010 00:00:00 +0100

The objective was to learn if UC patients' perceptions of their colon cancer risk and if their preferences for elective colectomy match with physicians' recommendations if dysplasia was found.A self-administered written survey included 199 patients with UC for at least 8 years (mean age 49 years, 52% female) who were recruited from Dartmouth-Hitchcock (n = 104) and the University of Chicago (n = 95). The main outcome was the proportion of patients who disagree with physicians' recommendations for colectomy because of dysplasia.Almost all respondents recognized that UC raised their chance of getting colon cancer. In all, 74% thought it was "unlikely" or "very unlikely" to get colon cancer within the next 10 years and they quantified this risk to be 23%; 60% of patients would refuse a physic...

Laparoscopic colectomy is safe and leads to a significantly shorter hospital stay for octogenarians

Surgical Endoscopy — Sat, 20 Feb 2010 06:50:46 +0100

Conclusion Complications and other outcomes are similar for LC and OC, and the earlier recovery associated with LC, as evidenced by a shorter hospital stay, may encourage a wider adoption of LC for patients older than 80 years. Content Type Journal ArticleDOI 10.1007/s00464-010-0900-xAuthors Lei Lian, Cleveland Clinic Digestive Disease Center-A30, Department of Colorectal Surgery 9500 Euclid Avenue Cleveland OH 44195 USAMatthew Kalady, Cleveland Clinic Digestive Disease Center-A30, Department of Colorectal Surgery 9500 Euclid Avenue Cleveland OH 44195 USADaniel Geisler, Cleveland Clinic Digestive Disease Center-A30, Department of Colorectal Surgery 9500 Euclid Avenue Cleveland OH 44195 USARavi Pokala Kiran, Cleveland Clinic Digestive Disease Center-A30, Departme...

Short- and long-term costs of laparoscopic colectomy are significantly less than open colectomy

Surgical Endoscopy — Sat, 20 Feb 2010 06:50:42 +0100

Conclusion We demonstrate both short- and long-term financial benefits of LC in a high-volume tertiary care hospital. Content Type Journal ArticleDOI 10.1007/s00464-010-0909-1Authors David P. Eisenberg, University of Pittsburgh School of Medicine Division of Surgical Oncology 497 Scaife Hall Pittsburgh PA 15261 USAJane Wey, LSU Health Sciences Center Department of Surgery New Orleans LA USAPhilip Q. Bao, University of Pittsburgh School of Medicine Division of Surgical Oncology 497 Scaife Hall Pittsburgh PA 15261 USAMelissa Saul, University of Pittsburgh School of Medicine Department of Biomedical Informatics Pittsburgh PA USAAndrew R. Watson, University of Pittsburgh School of Medicine Division of Surgical Oncology 497 Scaife Hall Pittsburgh PA 15261 USAWolfgang H. Schr...

Comparison of short- and medium-term results between laparoscopically assisted and totally laparoscopic right hemicolectomy: a case-control study

Surgical Endoscopy — Sat, 20 Feb 2010 06:50:35 +0100

Conclusions The findings seem to demonstrate that TL right colectomy is feasible and safe, yielding results comparable with those of the open approach but offering improved postoperative patient comfort. The limits of this retrospective comparative study do not allow definitive conclusions to be drawn despite the encouraging data for the next prospective randomized studies. Content Type Journal ArticleDOI 10.1007/s00464-010-0902-8Authors Massimiliano Fabozzi, Aosta Valley Regional Hospital “Umberto Parini” Department of General Surgery via Adamello, 16 11100 Aosta ItalyRosaldo Allieta, Aosta Valley Regional Hospital “Umberto Parini” Department of General Surgery via Adamello, 16 11100 Aosta ItalyRiccardo Brachet Contul, Aosta Valley Regional Hospital “Umbe...

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Laparoscopic anterior resection

Techniques in Coloproctology — Sat, 13 Feb 2010 06:48:13 +0100

This article deals with the technique of laparoscopic anterior resection. Resection of rectosigmoid or upper rectal tumors is first described, followed by the more difficult sphincter-saving total mesorectal excision. We have been using and modifying this technique of laparoscopic anterior resection for rectal cancer since 1990s. In our recent review, the local recurrence rate was 7.4%, and the overall 5-year survival was 70%. Our data suggest laparoscopic resection for rectal cancer is safe and is the procedure of choice in selected patients. Content Type Journal ArticleCategory How I Do ItDOI 10.1007/s10151-009-0557-4Authors H. Y. S. Cheung, Special Administrative Region (SAR) Department of Surgery, Pamela Youde Nethersole Eastern Hospital Chai Wan Hong Kong ChinaC. C. Chung, Sp...

Risk Factors for Early Postoperative Small Bowel Obstruction After Colectomy for Colorectal Cancer

World Journal of Surgery — Fri, 12 Feb 2010 07:07:46 +0100

Conclusions Early postoperative SBO cases are more likely to occur with OC and rectal cancer. LAC is an effective surgical procedure from the perspective of reducing the incidence of early postoperative SBO after colectomy for colorectal cancer. Content Type Journal ArticleDOI 10.1007/s00268-010-0462-zAuthors Jun Nakajima, Iwate Medical University School of Medicine Department of Surgery 19-1 Uchimaru Morioka 020-8505 JapanAkira Sasaki, Iwate Medical University School of Medicine Department of Surgery 19-1 Uchimaru Morioka 020-8505 JapanKoki Otsuka, Iwate Medical University School of Medicine Department of Surgery 19-1 Uchimaru Morioka 020-8505 JapanToru Obuchi, Iwate Medical University School of Medicine Department of Surgery 19-1 Uchimaru Morioka 020-8505 JapanSatosh...

[Use of TNFalpha antibodies in treatment of inflammatory bowel disease.]

Tidsskrift for den Norske Laegeforening — Thu, 11 Feb 2010 00:00:00 +0100

This article provides an overview of indications, contraindications, efficacy, and side effects of this so-called biological treatment of IBD. Material and methods. Based on the clinical experience of the authors, literature was selected through a non-systematic search in PubMed. Results. TNFalpha-antibodies have a documented initial effect in 60-70 % of patients with moderate to severe luminal and/or fistulising IBD. Approximately 30 % of patients achieve remission after a relatively short treatment period. However, the effect seems to decrease during long-term treatment. It is still unsettled whether these drugs prevent colectomy in ulcerative colitis. The treatment seems to increase the risk of serious infections and there are also some indications of an increased risk of malignancy. Co...

Case report LESS (laparo-endoscopic single-site surgery) right hemicolectomy

Thu, 04 Feb 2010 15:00:25 +0100

We describe LESS right hemicolectomy. Hospital stay was 3 days and no postoperative complications were observed. LESS colectomy can provide satisfactory oncological resection. (Source: Articles of Videosurgery and Other Miniinvasive Techniques - TERMEDIA publishing house)

Laparoscopic Colectomy for Crohn’s Colitis. A Large Prospective Comparative Study

Journal of Gastrointestinal Surgery — Tue, 02 Feb 2010 07:00:25 +0100

Conclusions Laparoscopic colectomy is a safe and effective technique in the hands of experienced surgeons. Benefits of laparoscopic colectomy in Crohn’s disease include reduced operative blood loss, quicker return of bowel function, and shorter hospital length of stay. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11605-010-1157-3Authors Konstantin Umanskiy, University of Chicago Hospitals Department of Surgery, MC 5095 5841 S. Maryland Avenue Chicago IL 60637 USAGautam Malhotra, University of Chicago Hospitals Department of Surgery, MC 5095 5841 S. Maryland Avenue Chicago IL 60637 USAAyana Chase, University of Chicago Hospitals Department of Surgery, MC 5095 5841 S. Maryland Avenue Chicago IL 60637 USAMichele A. Rubin, University of Chicago Hosp...

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Laparoscopic extensive colectomy with transanal Soave pull-through for intestinal neuronal dysplasia in 17 children.

World Journal of Pediatrics : WJP — Mon, 01 Feb 2010 00:00:00 +0100

CONCLUSIONS: Laparoscopic procedure for left colectomy and subtotal colectomy with transanal Soave pull-through in infants and children with IND is safe, feasible, and effective. The location of barium stagnation in proximal margin may be used as a method to predict initially the proximal margin of the resected bowel segment. PMID: 20143211 [PubMed - in process] (Source: World Journal of Pediatrics : WJP)

Comparison of intracorporeal versus extracorporeal anastomosis in laparoscopic-assisted hemicolectomy

Surgical Endoscopy — Fri, 29 Jan 2010 12:15:53 +0100

Conclusion In comparison to the extracorporeal technique, resection and creation of the anastomosis intracorporeally produces superior results with earlier return of bowel function, decreased postoperative narcotic use, and decreased length of stay and morbidity. Further studies will be needed to verify our findings. Content Type Journal ArticleDOI 10.1007/s00464-009-0865-9Authors Jayleen Grams, Mount Sinai Medical Center Department of Surgery 5 East 98th Street Box 1259 New York NY 10029 USAWinnie Tong, Mount Sinai Medical Center Department of Surgery 5 East 98th Street Box 1259 New York NY 10029 USAAlex J. Greenstein, Mount Sinai Medical Center Department of Surgery 5 East 98th Street Box 1259 New York NY 10029 USABarry Salky, Mount Sinai Medical Center Department o...

Advantages of fast-track recovery after laparoscopic right hemicolectomy for colon cancer

Surgical Endoscopy — Thu, 28 Jan 2010 07:01:13 +0100

Conclusions Fast-track recovery is independently associated with a shorter LOS and decreased morbidity after laparoscopic right hemicolectomy. Content Type Journal ArticleDOI 10.1007/s00464-009-0871-yAuthors Vassiliki L. Tsikitis, Mayo Clinic Division of Colorectal Surgery 200 First Street SW Rochester MN 66905 USAStefan D. Holubar, Mayo Clinic Division of Colorectal Surgery 200 First Street SW Rochester MN 66905 USAEric J. Dozois, Mayo Clinic Division of Colorectal Surgery 200 First Street SW Rochester MN 66905 USARobert R. Cima, Mayo Clinic Division of Colorectal Surgery 200 First Street SW Rochester MN 66905 USAJohn H. Pemberton, Mayo Clinic Division of Colorectal Surgery 200 First Street SW Rochester MN 66905 USADavid W. Larson, Mayo Clinic Division of Colorectal Su...

Totally laparoscopic right colectomy with transvaginal specimen extraction: the authors’ initial institutional experience

Surgical Endoscopy — Thu, 28 Jan 2010 07:01:11 +0100

Conclusion Totally laparoscopic right colectomy with transvaginal extraction appears to be safe and feasible. This technique may provide both an attractive way to reduce abdominal wall morbidity and a bridge to NOTES colon surgery. Content Type Journal ArticleCategory TechniqueDOI 10.1007/s00464-009-0870-zAuthors Shaun McKenzie, City of Hope National Medical Center Department of General and Oncologic Surgery 1500 East Duarte Road Duarte CA 91010-3000 USAJeong-Heum Baek, Gachon University of Medicine and Science Department of Surgery Incheon KoreaMark Wakabayashi, City of Hope National Medical Center Department of General and Oncologic Surgery 1500 East Duarte Road Duarte CA 91010-3000 USAJulio Garcia-Aguilar, City of Hope National Medical Center Department of General a...

Complications Following Colectomy with Mesenteric Closure vs. No Mesenteric Closure: Does It Really Matter?

Journal of Surgical Research — Mon, 25 Jan 2010 16:42:14 +0100

Conclusion: Closure of the mesenteric defect was associated with a higher leak rate and bleeding and may not be necessary following abdominal colectomy. (Source: Journal of Surgical Research)

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Is Laparoscopic Colorectal Experience Increasing for General Surgery Residents?

Journal of Surgical Research — Mon, 25 Jan 2010 16:42:04 +0100

Conclusions: Adoption of laparoscopic colectomy at an academic general surgery training program translates into changes in the operative learning experience for residents. While trainees today are not necessarily reporting more colectomies overall, a greater proportion of these cases are laparoscopic. In addition, residents log these cases in advanced roles, implying active involvement in the performance of the operation. Surgery residents at this program are exposed to more advanced colorectal procedures, which may reflect a growing trend toward minimally invasive colorectal surgery, and the increasing experience with and focus on laparoscopic training. (Source: Journal of Surgical Research)

Does Timing of Operative Care during Fellowship Training Impact Patient Care?

Journal of Surgical Research — Mon, 25 Jan 2010 16:42:04 +0100

Introduction: It has been reported that during the weeks or months immediately following the transition of surgical residents to the next graduate level, there is significant negative impact in patient outcomes, including an increase in patient mortality. Despite the dramatic increase in popularity of post-surgical training, no previous studies have documented the safety and outcomes of patients treated by surgical fellows in their transition to fellowship from residency. The aim of this study was to examine the outcomes of patients treated by fellows who underwent laparoscopic colectomy and to determine if there is a distinction in outcomes in the beginning versus the end of the academic year. Methods: For this study, data was analyzed from a prospective IRB approved database for laparosc...

Outcomes of Laparoscopic and Open Total Colectomy in the Pediatric Population

Journal of Surgical Research — Mon, 25 Jan 2010 16:42:02 +0100

Conclusions: This series demonstrates that laparopscopic colectomy yields similar outcomes as the traditional open method, both in type and severity of complications. Interestingly, patients who had an ileal pouch created through the laparoscopic approach have had less occurrences of pouchitis. Continued follow-up and further study in the laparoscopic group is likely indicated. (Source: Journal of Surgical Research)

Development of an Evaluation Tool to Assess Technical Skill in Laparoscopic Colorectal Surgery: A Delphi Approach

Journal of Surgical Research — Mon, 25 Jan 2010 16:41:29 +0100

Conclusions: The Delphi method allowed the determination of expert consensus regarding the essential surgical sub-steps to be included in an evaluation tool designed to measure technical competence in laparoscopic colorectal surgery. The final technical skills assessment tool represents the consensus of experts in minimally invasive colorectal surgery from Canada, the United States, Europe, and Australia. This represents the initial step in outlining a rigorous methodology to define technical competence in laparoscopic colorectal surgery. (Source: Journal of Surgical Research)

Intensive Care Unit Staffing and Failure to Rescue with Major Surgery

Journal of Surgical Research — Mon, 25 Jan 2010 16:41:22 +0100

Conclusions: Hospitals with the presence of full-time intensivists who manage or co-manage all ICU patients are associated with lower mortality and failure to rescue rates after high risk surgery. Efforts to implement an ICU staffing standard across the United States should continue to emphasize the potential improvements in patient safety. (Source: Journal of Surgical Research)

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Comparison of Thirty-Day Outcomes after Emergency General Surgery Procedures: Areas for Targeted Improvement

Journal of Surgical Research — Mon, 25 Jan 2010 16:41:21 +0100

Conclusion: All three emergency general surgery procedures were associated with substantial 30-day overall morbidity and serious morbidity/mortality. Most hospitals did not have uniform outcomes across all three procedures. Individual hospitals should examine their procedure-specific outcomes after emergency general surgeries to focus quality improvement initiatives appropriately. (Source: Journal of Surgical Research)

Hand-Assisted Laparoscopic Compared to Laparoscopic-Assisted Colectomies: Are We Bending Oncologic Principles?

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:57 +0100

Introduction: Benefits of laparoscopic over open techniques in colon surgery are well recognized. Hand-assisted laparoscopic colectomy (HAL) and laparoscopic-assisted colectomy (LAC) are both modalities employed in the treatment of colon cancer. Superiority of either technique has yet to be determined in oncologic procedures. Methods: A five-year retrospective study comparing outcomes of hand-assisted laparoscopic and laparoscopic-assisted colectomies for cancer was conducted at our community-based teaching hospital. Demographic data, tumor location and stage were analyzed. Outcomes compared between the two procedures included number of lymph nodes retrieved, presence of positive margins, operative time, length of stay, and number of immediate postoperative complications. Results: Forty-ei...

Hand Assisted Laparoscopic Surgery for Colorectal Cancer: Short-Term Outcomes in Over 300 Patients

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:57 +0100

We present 30 day outcomes associated with 326 colorectal cancer (CRC) patients who underwent HALS over a 5-year period. Methods: We identified all CRC cancer patients from 2004-2009 using a prospectively maintained database. Demographics, peri-operative variables, and 30-day outcomes are reported. Selection criterion for HALS was based on surgeon preference. Data represent frequency (proportion), or median (interquartile range). Results: Over 5-years, 326 patients underwent HALS procedures. Age was 65 (53 - 73) years, 39% were women, BMI 27 (24-31) kg/m2. All operations were elective. Diagnoses included 194 (59%) colon cancers (CC), 129 (40%) rectal cancers (RC) and 3 (1%) had synchronous colon and rectal cancer. Demographics are presented in Table 1. A total of 131 (40%) patients had pri...

Resection of the Primary STE May Benefit Elderly Patients with Metastatic Colorectal Cancer

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:53 +0100

Conclusions: Elderly patients appear to have less extensive tumors, but are more commonly node positive. Despite limitations related to selection bias, elderly patients, similar to young patients, may benefit from resection of their primary site. (Source: Journal of Surgical Research)

Factors Affecting Morbidity/Mortality of Emergency General Surgery

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:35 +0100

This study aims to determine the predictive factors for postoperative complications of EGS. Methods: A retrospective study of all randomly selected Brigham and Women's Hospital (BWH) American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) patients who had an EGS procedure from January 1, 2007 to December 31, 2008 were selected for this study. BWH IRB approved this study. The study applied the inclusion and exclusion criteria as defined by ACS NSQIP using select preoperative and all postoperative data variables. Additional non-ACS NSQIP data points were added and analyzed as possible predictors of poor outcomes. These included blood glucose levels closest to the time of surgical incision, length of time from ED arrival to incision, total volume of intravenous...

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Effective Multi-Modal Recovery after Open Right Hemicolectomy

Journal of Surgical Research — Mon, 25 Jan 2010 16:40:27 +0100

Conclusion: When peri-operative care is optimised, recovery after elective open right hemicolectomy is comparable with laparoscopic resection. (Source: Journal of Surgical Research)

Outcomes after Completion Mucosectomy for Retained Rectal Mucosa Following Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis

Journal of Surgical Research — Mon, 25 Jan 2010 16:39:41 +0100

Introduction: Restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) has become the definitive curative operation for patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP) requiring colectomy. Despite consensus on many technical aspects of this operation, controversy remains regarding the appropriate ileal pouch-anal anastomotic technique: hand-sewn vs. double stapled. Prior to the hand-sewn anastomosis, the anorectal mucosa is removed via transanal mucosectomy; in contrast, a cuff ranging from 2-6cm of retained rectal mucosa (RRM) remains in the anal transition zone (ATZ) following the double stapled technique. The RRM carries a lifelong risk of malignant transformation and is vulnerable to chronic inflammation (cuffitis) as seen in nearly 90% ...

Delayed surgery for acute severe colitis is associated with increased risk of postoperative complications

British Journal of Surgery — Mon, 25 Jan 2010 00:00:00 +0100

This study determined the long-term outcome after colectomy for acute severe ulcerative colitis (ASUC) and assessed whether the duration of in-hospital medical therapy is related to postoperative outcome.All patients who underwent urgent colectomy and ileostomy for ASUC between 1994 and 2000 were identified from a prospective database. Patient details, preoperative therapy and complications to last follow-up were recorded.Eighty patients were identified, who were treated with intravenous steroids for a median of 6 (range 1-22) days before surgery. Twenty-three (29 per cent) also received intravenous ciclosporin. There were 23 complications in 22 patients in the initial postoperative period. Sixty-eight patients underwent further planned surgery, including restorative ileal pouch-anal anast...

Delayed surgery for acute severe colitis is associated with increased risk of postoperative complications.

The British Journal of Surgery — Mon, 25 Jan 2010 00:00:00 +0100

CONCLUSION:: Delayed surgery for patients with ASUC who do not respond to medical therapy is associated with an increased risk of postoperative complications. Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 20101648 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)

Cytomegalovirus Infection in Patients Who Required Colectomy for Toxic Megacolon or Severe Steroid-Refractory Ulcerative Colitis

Digestive Diseases and Sciences — Fri, 22 Jan 2010 09:52:48 +0100

Content Type Journal ArticleCategory CorrespondenceDOI 10.1007/s10620-009-1109-5Authors J. Barahona-Garrido, Instituto de Enfermedades Digestivas y Nutricionales Avenida Reforma 7-62 zona 9, Edificio Aristos Reforma, Oficina 109 01009 Guatemala City GuatemalaB. Martínez-Benítez, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Department of Pathology Mexico City MexicoE. Espinosa-Cárdenas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán Department of Pathology Mexico City MexicoH. M. Sarti, Dermo.Patología Clinic Guatemala City GuatemalaJ. I. Gutiérrez-Manjarrez, Universidad de Guadalajara Department of Internal Medicine, Hospital Civil de Guadalajara Guadalajara Jalisco MexicoR. Aguirre-Gutiérrez, Instituto Nacional de Ciencias Médic...

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Robot-assisted laparoscopic radical prostatectomy after previous cancer surgery

Journal of Robotic Surgery — Fri, 22 Jan 2010 02:10:43 +0100

We present our experience of robot-assisted laparoscopic radical prostatectomy (RALP) in patients with previous cancer surgery. Seven patients with a history of previous surgery for malignancy underwent RALP. All the prostatectomies were performed using the da Vinci™ S surgical system by a single surgeon. All operations were approached transperitoneally. We reviewed perioperative data and surgical outcomes retrospectively. The mean age at surgery was 68.43 years (range 63–82). The mean operative time was 214 ± 47.32 min, and the median estimated blood loss was 500 ml (range 200–1,300). The mean hospital stay was 6.57 ± 2.15 days, and the mean duration of catheterization was 8.29 ± 3.09 days. Nerve-sparing procedure and p...

Simple score to identify colectomy risk in ulcerative colitis hospitalizations

Inflammatory Bowel Diseases — Thu, 21 Jan 2010 00:00:00 +0100

Patients hospitalized for ulcerative colitis (UC) are at high risk for colectomy. Despite growing interest in research using administrative data in inflammatory bowel disease, there is no available tool in such research to stratify disease severity or identify patients at high risk for colectomy.Using the Nationwide Inpatient Sample (NIS) 2004, we identified patients hospitalized for UC flare through appropriate ICD-9-CM discharge diagnosis codes (556.x). Our primary outcome of interest was undergoing total colectomy (45.8). Multivariate logistic regression models were constructed to identify independent predictors of colectomy. From this, a cumulative risk score was developed. Hospitalizations were divided into 3 strata (low, intermediate, high) based on the odds of colectomy.There were a...

Objective evaluation of the performance of surgical trainees on a porcine model of open colectomy

British Journal of Surgery — Thu, 21 Jan 2010 00:00:00 +0100

Evaluation of surgical trainee operative performance is rarely objective. A rating system is proposed that assesses trainee performance objectively and quantifies technical improvement.General surgery trainees were evaluated while performing porcine segmental colectomy. Initial instruction was provided for the critical operative steps. Evaluations were later repeated without additional instruction. Performance in 17 critical areas was scored.Twenty-three trainees were evaluated. Performance was divided into thirds, with a significant difference detected between tertiles (P < 0·001). Postgraduate year 2 trainees scored lower than those in years 3 and 4 (P < 0·001), but there was no difference between year 3 and 4 trainees (P = 0·557). Mean repeat scores were improved by 35 per cent, with...

Objective evaluation of the performance of surgical trainees on a porcine model of open colectomy.

The British Journal of Surgery — Thu, 21 Jan 2010 00:00:00 +0100

CONCLUSION:: The results support the use of this rating system as a tool for the objective evaluation of trainee operative skill. Instruction in the performance of segmental colectomy using deconstructed, step-by-step direction improved the ability of junior trainees to complete the operation. This evaluation system may be useful in the assessment, instruction and technical development of surgical trainees. Copyright (c) 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 20095021 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)

Meta-analysis of randomized studies evaluating chewing gum to enhance postoperative recovery following colectomy

NeLM - Surgery — Mon, 18 Jan 2010 00:00:00 +0100

The objectives and inclusion criteria of the review were clear. Relevant sources were searched for studies without language restriction. It was unclear whether the review was limited to published studies, but formal assessment did not provide evidence of publication bias. Steps were taken to minimise the risk of bias and error by having more than one author extract data, but it was unclear whether this applied also to study selection and validity assessment. Although the Jadad scale covers some basic aspects of study validity, it has limitations and some important characteristics of quality (such as allocation concealment) were not ... (Source: NeLM - Surgery)

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What Determines the Later Clinical Course of Patients Who Do Not Undergo Colectomy at the First Attack? A Japanese Cohort Study on Ulcerative Colitis

Digestion — Tue, 12 Jan 2010 23:00:00 +0100

Digestion 2010;81:104112 (DOI:10.1159/000229773) (Source: Digestion)

Trough serum infliximab as a predictive factor of clinical outcome for infliximab treatment in acute ulcerative colitis

NeLM - News — Thu, 07 Jan 2010 00:00:00 +0100

In this study, researchers evaluated the relationship between trough serum concentrations of infliximab and antibody formation on clinical outcomes, in patients with moderately severe to severe, steroid-refractory acute ulcerative colitis (UC) treated with three-dose induction followed by scheduled maintenance infliximab. The study involved 115 patients and examined rates of clinical remission and colectomy, antibodies to infliximab and trough serum infliximab. The following findings were reported: . Rates of remission were 32% at week 10 and 37% at week 54. . Colectomy occurred in 40% of patients, at a median of 5.3 months. . Detectable trough serum infliximab was present in 39% of patients and, among patients with undetectable in...

Normal colon epithelium: a dataset for the analysis of gene expression and alternative splicing events in colon disease.

BMC Genomics - Latest articles — Mon, 04 Jan 2010 00:00:00 +0100

Conclusions: The findings from this study represent the first comprehensive expression profile for non-neoplastic colonic epithelial cells reported. Our analysis of splice variants illustrate that this is a very labor intensive procedure, requiring vigilant examination of the data. It is projected that the contribution of this set of data derived from pure colonic epithelial cells will enhance studies in colon-related disease and offer a vital baseline for studies aimed at elucidating the mechanisms of alternative splicing. (Source: BMC Genomics - Latest articles)

Laparoscopic surgery for inflammatory bowel disease: does weight matter?

Surgical Endoscopy — Fri, 01 Jan 2010 06:44:47 +0100

Conclusions Patients with IBD who were overweight or obese and who underwent laparoscopic bowel resection had no significant differences in the rates of conversion, major postoperative complications, or length of stay when comparing to patients with normal BMI. Therefore, the benefits of laparoscopic bowel resection should not be denied to overweight or obese patients based strictly on their BMI. Content Type Journal ArticleDOI 10.1007/s00464-009-0759-xAuthors Jorge Canedo, Cleveland Clinic Florida Department of Colorectal Surgery 2950 Cleveland Clinic Blvd Weston FL 33331 USARodrigo A. Pinto, Cleveland Clinic Florida Department of Colorectal Surgery 2950 Cleveland Clinic Blvd Weston FL 33331 USASthela Regadas, Cleveland Clinic Florida Department of Colorectal Surger...

Response

Gastrointestinal Endoscopy — Fri, 01 Jan 2010 00:00:00 +0100

We thank Dr Koulaouzidis for sharing the interesting images and the hypothesized mechanism underlying these endoscopic lesions. Other reports, also showing mucosal scarring in collagenous colitis, have been recently published. Allende et al also report on colectomy specimens from collagenous colitis patients with ragged mucosal defect and induration of the wall, suggestive of scarring. (Source: Gastrointestinal Endoscopy)

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Emergency subtotal colectomy for fulminant Clostridium difficile colitis--is a surgical solution considered for all patients?

Annals of the Royal College of Surgeons of England — Fri, 01 Jan 2010 00:00:00 +0100

CONCLUSIONS: Colectomy for C. difficile colitis has a high mortality but can be life-saving, even in extremely sick patients. Although heavy antibiotic use is a predisposing factor, this is not an obligatory prerequisite in the development of C. difficile. Neither is it a disease of the elderly, making it difficult to predict vulnerable patients. There are large differences in colectomy rates between specialties and we suggest there may be a place for a surgical opinion in all cases of severe C. difficile colitis. PMID: 20056063 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)

Spontaneous perforation of solitary ulcer of transverse colon.

Indian Journal of Pathology and Microbiology — Fri, 01 Jan 2010 00:00:00 +0100

Authors: Galanis I, Dragoumis D, Kalogirou T, Lakis S, Kotakidou R, Atmatzidis K Spontaneous ruptures of the colon and rectum are extremely uncommon clinical entities and always require laparotomy. A 44-year-old female was admitted with a 12-hour history of severe abdominal pain periumbilically and at the right hypochondrium. The patient was immediately transferred to the department of surgery for close surgical observation. Computed tomography (CT) of the entire abdomen performed just before the operation demonstrated thickening of the wall of the ascending colon with pericolic fat stranding. Surgery revealed a perforation at the antimesenteric wall of the transverse colon and segmental colectomy of the transverse colon was performed. The histological evaluation demonstrated a perfora...

Is the laparoscopic approach to colectomy safe for the morbidly obese?

Surgical Endoscopy — Thu, 24 Dec 2009 19:57:15 +0100

Conclusions Laparoscopic colectomy is feasible for morbidly obese patients and results in recovery of intestinal function and LOS equivalent to that for nonobese patients. As expected, morbidity and conversion rates are higher for morbidly obese patients undergoing LC than for nonobese patients. Content Type Journal ArticleDOI 10.1007/s00464-009-0770-2Authors Wisam Khoury, Cleveland Clinic Foundation Department of Colorectal Surgery 9500 Euclid Avenue Cleveland OH 44195 USARavi P. Kiran, Cleveland Clinic Foundation Department of Colorectal Surgery 9500 Euclid Avenue Cleveland OH 44195 USATimothy Jessie, Cleveland Clinic Foundation Department of Colorectal Surgery 9500 Euclid Avenue Cleveland OH 44195 USADaniel Geisler, Cleveland Clinic Foundation Department of Colorec...

Laparoscopic versus open colectomy for patients with American Society of Anesthesiology (ASA) classifications 3 and 4: the minimally invasive approach is associated with significantly quicker recovery and reduced costs

Surgical Endoscopy — Thu, 24 Dec 2009 19:57:07 +0100

Conclusion The findings show that LC is a safe option for patients with a high ASA classification. The LC approach is associated with faster postoperative recovery, lower morbidity rates, and lower hospital costs than the OC approach. Content Type Journal ArticleDOI 10.1007/s00464-009-0761-3Authors Andre da Luz Moreira, Cleveland Clinic Department of Colorectal Surgery, Digestive Disease Institute 9500 Euclid Avenue Cleveland OH 44195 USARavi P. Kiran, Cleveland Clinic Department of Colorectal Surgery, Digestive Disease Institute 9500 Euclid Avenue Cleveland OH 44195 USAHasan T. Kirat, Cleveland Clinic Department of Colorectal Surgery, Digestive Disease Institute 9500 Euclid Avenue Cleveland OH 44195 USAFeza H. Remzi, Cleveland Clinic Department of Colorectal Surgery, ...

Post-surgical follow-up of colorectal cancer: role of contrast-enhanced CT colonography

Abdominal Imaging — Thu, 24 Dec 2009 19:55:59 +0100

Conclusions CTC is a feasible and minimally invasive method for full exploration of the colon after surgical resection allowing detection of cancer recurrence, metachronous disease, and distant metastases in one single study, and represents a valid alternative to conventional colonoscopy in this patient population. Content Type Journal ArticleDOI 10.1007/s00261-009-9596-6Authors Emanuele Neri, University of Pisa Diagnostic and Interventional Radiology Via Paradisa 2 56100 Pisa ItalyPaola Vagli, University of Pisa Diagnostic and Interventional Radiology Via Paradisa 2 56100 Pisa ItalyFrancesca Turini, University of Pisa Diagnostic and Interventional Radiology Via Paradisa 2 56100 Pisa ItalyFrancesca Cerri, University of Pisa Diagnostic and Interventional Radiology Via ...

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Increased liver regeneration rate and decreased liver function after synchronous liver and colon resection in rats

Annals of Surgical Innovation and Research — Thu, 24 Dec 2009 00:00:00 +0100

Conclusions: In our model morbidity seems to be related to the extent of hepatic resection. In rats undergoing liver resection, simultaneous colectomy induced a higher degree of hepatic regeneration rate. Body weight changes and branched amino acids to tyrosine ratio were negatively affected by simultaneous colectomy. (Source: Annals of Surgical Innovation and Research)

Laparoscopic colectomy for transverse colon carcinoma

Techniques in Coloproctology — Wed, 23 Dec 2009 22:33:31 +0100

Conclusions The results of laparoscopic colon resection for transverse colon carcinoma are comparable to the results of laparoscopic resection of right or sigmoid colon cancer and open resection of transverse colon carcinoma. These results suggest that laparoscopic resection of transverse colon carcinoma is safe and feasible. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s10151-009-0551-xAuthors O. Zmora, Sackler School of Medicine Department of Surgery and Transplantation, Sheba Medical Center, Tel-Hashomer 52621 Tel-Aviv IsraelA. Bar-Dayan, Sackler School of Medicine Department of Surgery and Transplantation, Sheba Medical Center, Tel-Hashomer 52621 Tel-Aviv IsraelM. Khaikin, Sackler School of Medicine Department of Surgery and Transplantation, Sh...

Impact of Advancing Age on Abdominal Surgical Outcomes [Original Article]

Archives of Surgery — Mon, 21 Dec 2009 20:52:21 +0100

Conclusions Among older adults, the risk of complications and early death after commonly performed abdominal procedures is greater than previously reported. These rates should be considered in ongoing quality improvement initiatives and may be helpful when counseling patients regarding abdominal operations. (Source: Archives of Surgery)

Health Care–Associated Clostridium difficile Infection in Canada: Patient Age and Infecting Strain Type Are Highly Predictive of Severe Outcome and Mortality

Clinical Infectious Diseases Latest Issue — Mon, 21 Dec 2009 20:28:47 +0100

Conclusions. Our study confirms the strong age association with infection due to the NAP1 strain and severe CDI. In addition, patients 60–90 years of age infected with NAP1 are approximately twice as likely to die or to experience a severe CDI‐related outcome, compared with those with non‐NAP1 infections. Patients >90 years of age experience high rates of severe CDI, regardless of strain type. (Source: Clinical Infectious Diseases Latest Issue)

Outcome after surveillance of low-grade and indefinite dysplasia in patients with ulcerative colitis

Inflammatory Bowel Diseases — Mon, 21 Dec 2009 00:00:00 +0100

We report a low rate of progression to HGD or CRC in patients who underwent surveillance for LGD or IND; polypoid dysplasia showed less risk of progression than flat dysplasia. (Inflamm Bowel Dis 2010;) (Source: Inflammatory Bowel Diseases)

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Quiz Page January 2010: A Colonic Mass in a Kidney Transplant Recipient

American Journal of Kidney Diseases — Thu, 17 Dec 2009 15:30:56 +0100

A 60-year-old woman was admitted for diarrhea and hematochezia. One year ago, she received a deceased donor kidney transplant for end-stage renal disease secondary to diabetes. Other medical history includes colon cancer 16 years before transplant requiring partial colectomy, with pretransplant colonoscopy showing no recurrence of cancer. Human immunodeficiency virus (HIV) serologic test results were negative, and cytomegalovirus (CMV) serologic test results were negative in the recipient but positive in the donor. Immunosuppressive medications included cyclosporine, sirolimus, and prednisone, along with valganciclovir prophylactic therapy. One month before presentation, serum creatinine level was 1.5 mg/dL (133 μmol/L; estimated glomerular filtration rate, 38 mL/min/1.73 m2 [0.63 mL/s/1....

Subcutaneous emphysema of the neck after colectomy

International Journal of Colorectal Disease — Tue, 15 Dec 2009 06:46:58 +0100

Content Type Journal ArticleCategory Letter to the EditorDOI 10.1007/s00384-009-0873-1Authors Klaas Koop, Harbour Hospital Rotterdam Department of Surgery Rotterdam The NetherlandsFemke L. Akkermans, Harbour Hospital Rotterdam Department of Surgery Rotterdam The NetherlandsT. H. Mennema-Vastenhout, Harbour Hospital Rotterdam Department of Pulmonary Diseases Rotterdam The NetherlandsW. R. Schouten, Erasmus Medical Centre Department of Surgery Rotterdam The NetherlandsJet H. van Dam, Harbour Hospital Rotterdam Department of Surgery Rotterdam The NetherlandsGerard J. Collet, Harbour Hospital Rotterdam Department of Surgery Rotterdam The Netherlands Journal International Journal of Colorectal DiseaseOnline ISSN 1432-1262Print ISSN 0179-1958 (Source: International Journal of Colorect...

Phlegmonous colitis: another source of sepsis in cirrhotic patients?

BMC Gastroenterology — Tue, 15 Dec 2009 00:00:00 +0100

Conclusions: These data suggest that cirrhotic patients with PHC may progress towards PC, which, in turn, may be the cause for life-threatening sepsis. (Source: BMC Gastroenterology)

Trough serum infliximab: a predictive factor of clinical outcome for infliximab treatment in acute ulcerative colitis

Gut — Fri, 11 Dec 2009 04:48:46 +0100

Conclusions: For patients with ulcerative colitis treated with infliximab, a detectable trough serum infliximab predicts clinical remission, endoscopic improvement and a lower risk for colectomy. An undetectable trough serum infliximab, irrespective of antibody status, is associated with less favourable outcomes. (Source: Gut)

Improving surgical outcomes through adoption of evidence-based process measures: Intervention specific or associated with overall hospital quality?

Surgery — Fri, 11 Dec 2009 00:00:00 +0100

Conclusion: Compliance with peri-operative β-blockade resulted in a significant reduction in mortality after open AAA repair over time, but it had no crossover effect on mortality associated with other high-risk operations in the same hospital. These data suggest that improvements in outcomes resulting from the adoption of evidence-based process measures are procedure specific and do not necessarily reflect overall hospital quality. (Source: Surgery)

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Laparoscopic treatment of splenosis: Report of a case

Surgery Today — Mon, 07 Dec 2009 19:37:44 +0100

Abstract A 52-year-old woman with a history of splenectomy for a splenic injury 45 years earlier underwent investigations for a pre-existing gynecologic disease. Contrastenhanced abdominal computed tomography (CT) and magnetic resonance imaging (MRI) showed a tumor, 3 cm in diameter, adjacent to the sigmoid colon, suggestive of a gastrointestinal stromal tumor (GIST). Laparoscopic exploration revealed a white mass protruding from the subserosa of the sigmoid colon, and we performed laparoscopic-assisted sigmoidectomy to rule out a GIST. Pathological studies showed splenic tissue, thus confirming a diagnosis of splenosis, given the history of splenic injury. This case of splenosis mimicking GIST following splenic injury was diagnosed correctly and treated successfully with ...

Single Incision Laparoscopic Cholecystectomy

Journal of the American College of Surgeons — Thu, 03 Dec 2009 00:00:00 +0100

This report describes an initial series of LESS cholecystectomies to date, and details operative technique, clinical outcomes, and early (24-hour) postoperative narcotic usage. (Source: Journal of the American College of Surgeons)

Saint Louis University Hospital Is One Of First To Perform Total Abdominal Colectomy Via Single-incision Laparoscopic Surgery

Health News from Medical News Today — Wed, 02 Dec 2009 10:00:00 +0100

Building upon the momentum and success of its rapidly growing single-incision laparoscopic surgery program, Saint Louis University Hospital recently performed one of the first total abdominal colectomies, including reconstruction of the intestinal tract by reconnection of the remaining small intestine to the rectum, via single-incision laparoscopy. This procedure is a critical advancement in minimally-invasive surgery. Ovunc Bardakcioglu, M.D... (Source: Health News from Medical News Today)

Saint Louis University Hospital Is One Of First To Perform Total Abdominal Colectomy Via Single-incision Laparoscopic Surgery

GastroIntestinal News From Medical News Today — Wed, 02 Dec 2009 10:00:00 +0100

Building upon the momentum and success of its rapidly growing single-incision laparoscopic surgery program, Saint Louis University Hospital recently performed one of the first total abdominal colectomies, including reconstruction of the intestinal tract by reconnection of the remaining small intestine to the rectum, via single-incision laparoscopy... (Source: GastroIntestinal News From Medical News Today)

Saint Louis University Hospital Is One Of First To Perform Total Abdominal Colectomy Via Single-incision Laparoscopic Surgery

GastroIntestinal News From Medical News Today — Wed, 02 Dec 2009 10:00:00 +0100

Building upon the momentum and success of its rapidly growing single-incision laparoscopic surgery program, Saint Louis University Hospital recently performed one of the first total abdominal colectomies, including reconstruction of the intestinal tract by reconnection of the remaining small intestine to the rectum, via single-incision laparoscopy... (Source: GastroIntestinal News From Medical News Today)

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Laparoscopic single-port colectomy for sigmoid cancer

Techniques in Coloproctology — Wed, 02 Dec 2009 08:35:59 +0100

Conclusion Single-port laparoscopic surgery may allow common benign procedures via an incision in the umbilicus. It can also be performed with good surgical and oncologic results in selected patients with a colorectal cancer. Content Type Journal ArticleCategory Technical NoteDOI 10.1007/s10151-009-0545-8Authors F. H. Remzi, Cleveland Clinic Foundation Department of Colorectal Surgery Cleveland OH USAH. T. Kirat, Cleveland Clinic Foundation Department of Colorectal Surgery Cleveland OH USAD. P. Geisler, Cleveland Clinic Foundation Department of Colorectal Surgery Cleveland OH USA Journal Techniques in ColoproctologyOnline ISSN 1128-045XPrint ISSN 1123-6337 (Source: Techniques in Coloproctology)

Clostridium difficile enteritis after colectomy.

The American Surgeon — Tue, 01 Dec 2009 00:00:00 +0100

This article reviews the current available literature on C. difficile enteritis to highlight this potentially serious condition in postoperative colectomy patients who present with low-grade fevers, abdominal or pelvic pain, and increased ileostomy output. PMID: 19999913 [PubMed - in process] (Source: The American Surgeon)

Robotics: Right Colon

Seminars in Colon and Rectal Surgery — Tue, 01 Dec 2009 00:00:00 +0100

Robotic colectomy has been shown to be a feasible and safe procedure. Although left-sided colectomy and proctectomy have received the most attention in robotics application, the advantages of robotic technology apply equally to resection of the right colon. A description of a technique for robotic right hemicolectomy with intracorporeal anastomosis is presented, and it addresses some of the inherent limitations of current robotic systems. The potential advantages and disadvantages of robotics for right colon surgery are also discussed. (Source: Seminars in Colon and Rectal Surgery)

Robotics: Left Colon and Sigmoid Resection

Seminars in Colon and Rectal Surgery — Tue, 01 Dec 2009 00:00:00 +0100

There are many potential advantages of using robotics for resection of the left colon and the sigmoid colon. These include stable traction of the vascular pedicles, preservation of the aortic and the hypogastric nerve plexus, improved accessibility for take-down of the splenic flexure, and easily applicable intracorporeal colorectal or colocolic anastomosis. This chapter provides a detailed description of the technique used in a robotic dissection for a left colectomy or sigmoidectomy. (Source: Seminars in Colon and Rectal Surgery)

Report 90-Day Colectomy Mortality Risk, Not Just 30-Day Risk: Study

Medscape Today Headlines — Mon, 30 Nov 2009 22:49:07 +0100

Citing only the 30-day mortality after colorectal surgery can be misleading when counseling patients about the risks of surgery, because postoperative deaths nearly double between 30 and 90 days, study findings suggest. Reuters Health Information (Source: Medscape Today Headlines)

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Med Sci Monit 2009; 15(12):CS169-173 "Magnified endoscopic observation using narrow-band imaging of periampullary adenoma in a patient with familial adenomatous polyposis"

Medical Science Monitor — Mon, 30 Nov 2009 15:38:23 +0100

Conclusions: Thus, endoscopic surveillance and removal of ampullary adenomas appear to be justified. (Source: Medical Science Monitor)

A black-white comparison of the quality of stage-specific colon cancer treatment

Cancer — Mon, 30 Nov 2009 00:00:00 +0100

Several studies have attributed racial disparities in cancer incidence and mortality to variances in socioeconomic status and health insurance coverage. However, an Institute of Medicine report found that blacks received lower quality care than whites after controlling for health insurance, income, and disease severity.To examine the effects of race on colorectal cancer outcomes within a single setting, the authors performed a retrospective cohort study that analyzed the cancer registry, billing, and medical records of 365 university hospital patients (175 blacks and 190 whites) diagnosed with stage II-IV colon cancer between 2000 and 2005. Racial differences in the quality (effectiveness and timeliness) of stage-specific colon cancer treatment (colectomy and chemotherapy) were examined af...

Quantitative Comparison of the Difficulty of Performing Laparoscopic Colectomy at Different Tumor Locations

World Journal of Surgery — Sun, 29 Nov 2009 09:38:21 +0100

Conclusions Tumor location, complications, and OR time affected postoperative resource use, whereas greater OR time signified an increased occurrence of complications. Developers of LC training programs or healthcare policy makers should consider the quantitative impact of tumor locations when attempting to improve effective skill training or to survey the quality of LC performance. Content Type Journal ArticleDOI 10.1007/s00268-009-0292-zAuthors Kazuaki Kuwabara, Kyushu University, Graduate School of Medical Sciences Department of Health Care Administration and Management 3-1-1 Maidashi Higashi-ku Fukuoka 812-8582 JapanShinya Matsuda, University of Occupational and Environmental Health Department of Preventive Medicine and Community Health Kitakyushu JapanKiyohide Fu...

Diagnostic advances in inflammatory bowel disease (imaging and laboratory)

Current Gastroenterology Reports — Sun, 29 Nov 2009 09:36:53 +0100

Abstract Autoimmune and antimicrobial antibodies currently play only an adjunctive role in the diagnosis of inflammatory bowel disease (IBD). Their sensitivity and specificity are not high enough to be relied upon alone to secure a diagnosis; however, their most promising role seems to be in identifying Crohn’s disease patients at a higher risk of progression to intestinal complications. Serum C-reactive protein (CRP) correlates well with other measures of biologic activity but not as well with clinical activity. CRP can help predict IBD relapses, and in patients with severely active ulcerative colitis may indicate which patients are most likely to progress to colectomy. Similarly, fecal lactoferrin and calprotectin are reasonably accurate and noninvasive measures of dis...

Use of severity classification systems in the surgical decision-making process in emergency laparotomy for perforated diverticulitis

International Journal of Colorectal Disease — Sun, 29 Nov 2009 09:31:38 +0100

Conclusion None of the tested scores can be used to help the surgeon decide whether a PA or HP is appropriate in a specific patient. Comorbidity, represented as CCI in this study, might be more important than the locoregional situation. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-009-0852-6Authors Itai Pasternak, Triemli Hospital Department of Surgery Birmensdorferstr. 497 8063 Zurich SwitzerlandMichael Dietrich, Triemli Hospital Department of Surgery Birmensdorferstr. 497 8063 Zurich SwitzerlandRichard Woodman, Flinders University Department of General Practice Bedford Park 5042 SA AustraliaUrs Metzger, Triemli Hospital Department of Surgery Birmensdorferstr. 497 8063 Zurich SwitzerlandDavid A. Wattchow, Flinders University Department of Su...

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Long-Term Outcome of Metachronous Rectal Cancer Following Ileorectal Anastomosis for Familial Adenomatous Polyposis

Journal of Gastrointestinal Surgery — Wed, 25 Nov 2009 17:02:31 +0100

Conclusions Effective IRA requires selection of patients without invasive rectal cancer and without dense rectal polyps in whom long-term postoperative follow-up of the residual rectum is possible. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11605-009-1105-2Authors Tomohiro Yamaguchi, National Cancer Center Hospital Colorectal Surgery Division 5-1-1, Tsukiji, Chuo-ku Tokyo 104-0045 JapanSeiichiro Yamamoto, National Cancer Center Hospital Colorectal Surgery Division 5-1-1, Tsukiji, Chuo-ku Tokyo 104-0045 JapanShin Fujita, National Cancer Center Hospital Colorectal Surgery Division 5-1-1, Tsukiji, Chuo-ku Tokyo 104-0045 JapanTakayuki Akasu, National Cancer Center Hospital Colorectal Surgery Division 5-1-1, Tsukiji, Chuo-ku Tokyo 104-0045 JapanYoshih...

Robotic Right Colectomy: Brief History and Technique

Medscape Today Headlines — Tue, 24 Nov 2009 19:07:53 +0100

Surgery, unlike Medicine, retains its link with ancient traditions. Society of American Gastrointestinal Endoscopic Surgeons (Source: Medscape Today Headlines)

Completion Mucosectomy for Retained Rectal Mucosa Following Restorative Proctocolectomy with Double-Stapled Ileal Pouch–Anal Anastomosis

Journal of Gastrointestinal Surgery — Tue, 24 Nov 2009 07:14:59 +0100

Discussion The clear patient advantage of functional continence has pushed this procedure to the forefront in treating both UC and FAP. As a result, the procedure continues to evolve with recent debate centering on the question of whether to perform a double-stapled technique without rectal mucosectomy or a handsewn anastomosis following transanal mucosectomy. Although continence and complication rates continue to be hotly debated, it is understood that performing the stapled procedure does leave a rectal cuff, which carries with it the possibility of disease persistence or recurrence. As such, if the rectal cuff becomes symptomatic or dysplastic, it must be removed. This is accomplished by performing a transanal completion mucosectomy and reconstructing the ileal pouch–a...

C. difficile Colitis—Predictors of Fatal Outcome

Journal of Gastrointestinal Surgery — Tue, 24 Nov 2009 07:14:58 +0100

Conclusions Our study identified several clinical factors, which were associated with mortality from CDC. Future clinical studies will have to focus on the disease progression and the fatalities occurring either without an attempt for or despite surgical intervention, as an earlier intervention might have proven lifesaving. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11605-009-1093-2Authors Haig Dudukgian, University of Southern California Department of Colorectal Surgery, Keck School of Medicine 1441 Eastlake Avenue, Suite 7418 Los Angeles CA 90033 USAEster Sie, University of Southern California Department of Colorectal Surgery, Keck School of Medicine 1441 Eastlake Avenue, Suite 7418 Los Angeles CA 90033 USAClaudia Gonzalez-Ruiz, University of ...

The Diagnosis of Diverticulitis in Outpatients: On What Evidence?

Journal of Gastrointestinal Surgery — Sat, 21 Nov 2009 09:50:08 +0100

Conclusion Diverticulitis in the outpatient setting is often characterized by infrequent use of CT scans, lack of leukocytosis, and rare need for urgent surgery or early admission. As this diagnostic label appears to be commonly applied without objective evidence, further study is needed to evaluate its validity. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11605-009-1098-xAuthors Erin S. O’Connor, University of Wisconsin School of Medicine and Public Health Department of Surgery Madison WI USAGlen Leverson, University of Wisconsin School of Medicine and Public Health Department of Surgery Madison WI USAGregory Kennedy, University of Wisconsin School of Medicine and Public Health Department of Surgery Madison WI USACharles P. Heise, University o...

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Postoperative Ileus: It Costs More Than You Expect

Journal of the American College of Surgeons — Wed, 18 Nov 2009 00:00:00 +0100

Conclusions: POI occurred in 24% (84% primary) of colectomy patients and disproportionately affected cost at the index admission. Interestingly, delayed POI was similar in cost to readmission for other serious adverse surgical complications. (Source: Journal of the American College of Surgeons)

Death After Colectomy: It's Later Than We Think [Original Article]

Archives of Surgery — Mon, 16 Nov 2009 20:51:30 +0100

Conclusion The 30-day mortality significantly underreports the true risk of death after CRS. The 90-day mortality rate should be included as a standard outcome measure after CRS because it serves as a better estimation of risk for counseling patients. (Source: Archives of Surgery)

Splenic Salvage After Intraoperative Splenic Injury During Colectomy [Original Article]

Archives of Surgery — Mon, 16 Nov 2009 20:51:30 +0100

Conclusions Splenic injury is an infrequent but morbid complication. Splenic salvage is frequently unsuccessful; our data suggest that surgeons should not be reluctant to perform splenectomy when initial repair attempts fail. (Source: Archives of Surgery)

Opportunity cost in the evaluation of surgical innovations: a case study of laparoscopic versus open colectomy

Surgical Endoscopy — Fri, 13 Nov 2009 07:47:27 +0100

Conclusions Although frequently overlooked, opportunity cost is a potentially very important element in assessing the true costs of surgical innovation. Content Type Journal ArticleDOI 10.1007/s00464-009-0728-4Authors Abhishek Chatterjee, Dartmouth Hitchcock Medical Center Department of Surgery Lebanon NH USALilian Chen, Dartmouth Medical School Lebanon NH USAElie A. Goldenberg, Dartmouth Clinic at Concord Hospital Department of Surgery Lebanon NH USAHarold T. Bae, Dartmouth Institute of Health Policy and Clinical Practice Lebanon NH USASamuel R. G. Finlayson, Dartmouth Hitchcock Medical Center Department of Surgery Lebanon NH USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical Endoscopy)

Influence of colectomy on hydrogen excretion in breath

International Journal of Colorectal Disease — Mon, 09 Nov 2009 19:13:23 +0100

Conclusions Partial colectomy does not influence the capacity for H2 excretion after oral unabsorbable carbohydrate administration. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-009-0832-xAuthors Francesc Casellas, Hospital Universitari Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd) Digestive System Research Unit Pso. Vall d’Hebron 119 Barcelona 08035 SpainA. Torrejón, Hospital Universitari Vall d’Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd) Digestive System Research Unit Pso. Vall d’Hebron 119 Barcelona 08035 SpainJ. Vilaseca, Hospital Universitari Vall d’Hebron, Centro de Investigación Biomédica en Red de Enferme...

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Can the gastrocolic trunk of Henle serve as an anatomical landmark in laparoscopic right colectomy? A postmortem anatomical study

American Journal of Surgery — Fri, 06 Nov 2009 00:00:00 +0100

Conclusions: Although the GTH is a constant and conspicuous anatomic entity, it is not easily accessible, because of its tight relations to the right colon arteries. Instead, the authors advocate the use the superior right colic vein as an anatomic landmark leading to the GTH during laparoscopic right colectomy. (Source: American Journal of Surgery)

A feared complication during laparoscopic left colectomy: the torsion of the colonic stump at stapling

International Journal of Colorectal Disease — Tue, 03 Nov 2009 21:13:18 +0100

Content Type Journal ArticleCategory Letter to the EditorDOI 10.1007/s00384-009-0835-7Authors Renato Costi, Hôpital Victor Dupouy Service de Chirurgie Viscérale, Digestive et Urologique Argenteuil FranceXavier Pouliquen, Hôpital Victor Dupouy Service de Chirurgie Viscérale, Digestive et Urologique Argenteuil FranceChristine Manceau, Hôpital Victor Dupouy Service de Chirurgie Viscérale, Digestive et Urologique Argenteuil FranceBernard Vacher, Hôpital Victor Dupouy Service de Chirurgie Viscérale, Digestive et Urologique Argenteuil FranceVincenzo Violi, Università di Parma Istituto di Clinica Chirurgica Generale e Terapia Chirurgica, Dipartimento di Scienze Chirurgiche Via Gramsci 14 43100 Parma ItalyAlain Valverde, Hôpital Victor Dupouy Service de Chirurgie Viscérale, Digestiv...

Effects of hospital and surgeon volumes on operating times, postoperative complications, and length of stay following laparoscopic colectomy

Surgery Today — Mon, 02 Nov 2009 17:57:13 +0100

Conclusions Our analysis of data related to laparoscopic colectomy revealed that surgeons’ experience was associated with faster surgery, but not necessarily with reduced operative morbidity. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00595-008-4052-8Authors Hideo Yasunaga, University of Tokyo Department of Health Management and Policy, Graduate School of Medicine 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 JapanYutaka Matsuyama, University of Tokyo Department of Biostatistics, School of Public Health 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 JapanKazuhiko Ohe, University of Tokyo Department of Medical Informatics and Economics, Graduate School of Medicine 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 JapanJapan Surgical Society Journal Surgery TodayOnlin...

Adenosquamous carcinoma of the sigmoid colon treated by the less invasive procedures of endoscopy and laparoscopy: Report of a case

Surgery Today — Mon, 02 Nov 2009 17:57:08 +0100

We report a case of adenosquamous carcinoma of the sigmoid colon treated by less invasive approaches consisting of an endoscopic mucosal resection and a subsequent laparoscopic colectomy. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s00595-009-3961-5Authors Koji Okabayashi, Keio University School of Medicine Department of Surgery 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582 JapanHirotoshi Hasegawa, Keio University School of Medicine Department of Surgery 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582 JapanYoshiyuki Ishii, Keio University School of Medicine Department of Surgery 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582 JapanTakashi Endo, Keio University School of Medicine Department of Surgery 35 Shinanomachi, Shinjuku-ku Tokyo 160-8582 JapanYuko Kitagawa, Keio Universit...

Specialty Skills in Coloproctology Stage 1

NLH - Gastroenterology & Liver Diseases - Events — Mon, 02 Nov 2009 14:22:54 +0100

This new course had been developed in collaboration with the ACGBI. The course sessions focus on the evaluation and treatment of benign anorectal diseases, pilondal disease and stoma surgery, as well as operative procedures on the abdominal colon including right and left colectomy and Hartmann's procedures. Emphasis will be placed on small group teaching and will be predominantly skills based with utilisation of both animal models and cadaveric dissection. (Source: NLH - Gastroenterology & Liver Diseases - Events)

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Refining the Evaluation of Operating Room Performance

Journal of Surgical Education — Sun, 01 Nov 2009 00:00:00 +0100

Conclusions: Substantial time elapses between performance in the operating room and the completion of the evaluation. This raises the question of whether surgeons remember the nuances of the procedure well enough to rate performance accurately. The item type used for rating does not affect the absolute rating assigned or the rank ordering of the performance. Differences in stringency of evaluators indicate the need for multiple resident performance observations by multiple surgeons. These findings are the foundation for an upcoming multi-institutional trial. (Source: Journal of Surgical Education)

New Studies Demonstrate Benefits of Minimally Invasive Hysterectomy and Colectomy When Compared To Open Surgery(Oct 30, 2009)

Johnson and Johnson — Fri, 30 Oct 2009 08:45:01 +0100

Cincinnati, OH (October 26, 2009)– Ethicon Endo-Surgery today announced results from two newly published studies that demonstrate a minimally invasive approach in three common procedures resulted in a reduced rate of complications and lower overall cost of care, including a difference of more than $15,000 on average for minimally invasive colectomies, when compared to open surgery. One study compared two types of minimally invasive hysterectomy procedures to open abdominal hysterectomy1 (Source: Johnson and Johnson)

Laparoscopic anterior resection for rectosigmoid cancer: Patient outcomes after implementation of a clinical pathway

Asian Journal of Endoscopic Surgery — Wed, 28 Oct 2009 00:00:00 +0100

A clinical pathway designed for a single type of laparoscopic colorectal surgery for cancer might be helpful in decreasing complication rates and total hospital costs. It has been reported to be effective in reducing costs and shortening length of hospital stays in many situations such as laparoscopic cholecystectomy, colon resection, total colectomy, and gastrointestinal bleeding, as well as when caring for patients in the intensive care unit. A clinical pathway, including surgical details and perioperative management, for patients undergoing laparoscopic anterior resection for rectosigmoid cancer was designed and implemented. From January 2003 to December 2006, it was applied to 80 patients. The average length of a hospital stay for these patients was 9.06 d. The mean hospital stay and t...

New Studies Demonstrate Benefits Of Minimally Invasive Hysterectomy And Colectomy When Compared To Open Surgery

Health News from Medical News Today — Tue, 27 Oct 2009 08:00:00 +0100

Ethicon Endo-Surgery announced results from two newly published studies that demonstrate a minimally invasive approach in three common procedures resulted in a reduced rate of complications and lower overall cost of care, including a difference of more than $15,000 on average for minimally invasive colectomies, when compared to open surgery. (Source: Health News from Medical News Today)

[Hand assistance is an alternative to conversion to laparotomy during laparoscopic sigmoidectomy.]

Cirugia eEspanola — Tue, 27 Oct 2009 00:00:00 +0100

CONCLUSIONS: If there is difficulty in exposure or dissection during a laparoscopically assisted sigmoid colectomy, the hand assisted approach is an alternative before the laparotomy. PMID: 19875109 [PubMed - as supplied by publisher] (Source: Cirugia eEspanola)

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Cost-effectiveness of infliximab for the treatment of acute exacerbations of ulcerative colitis

The European Journal of Health Economics — Wed, 21 Oct 2009 09:06:10 +0100

Conclusion Infliximab induction regimen appears to be a cost-effective treatment option for UC patients hospitalised with an acute exacerbation. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s10198-009-0199-5Authors Yogesh Suresh Punekar, Schering-Plough Ltd Welwyn Garden City AL7 1TW UKNeil Hawkins, Oxford Outcomes Oxford UK Journal The European Journal of Health EconomicsOnline ISSN 1618-7601Print ISSN 1618-7598 (Source: The European Journal of Health Economics)

Randomized clinical trial of the effect of glucocorticoids on peritoneal inflammation and postoperative recovery after colectomy

British Journal of Surgery — Tue, 20 Oct 2009 23:00:00 +0100

Recent data have suggested a relationship between postoperative fatigue and the peritoneal cytokine response after surgery. The aim of this study was to test the hypothesis that preoperative administration of glucocorticoids before surgery would decrease fatigue and enhance recovery, by reducing the peritoneal production of cytokines.In a double-blind randomized controlled study, patients undergoing elective, open colonic resection were administered 8 mg dexamethasone or normal saline. Patients were treated within an enhanced recovery after surgery programme. Primary outcomes were cytokine levels in peritoneal drain fluid and fatigue as measured by the Identity-Consequence Fatigue Scale (ICFS).Baseline parameters were similar for 29 patients in the dexamethasone group and 31 in the placebo...

Randomized clinical trial of the effect of glucocorticoids on peritoneal inflammation and postoperative recovery after colectomy.

The British Journal of Surgery — Tue, 20 Oct 2009 23:00:00 +0100

CONCLUSION:: Preoperative administration of dexamethasone resulted in a significant reduction in early postoperative fatigue, associated with an attenuated early peritoneal cytokine response. Peritoneal production of cytokines may therefore be important in postoperative recovery. Registration number: ACTRN12607000066482 (http://www.anzctr.org.au/). Copyright (c) 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. PMID: 19847865 [PubMed - as supplied by publisher] (Source: The British Journal of Surgery)

Early Readmission After Colectomy Linked to Higher Mortality in Cancer Patients

Medscape Today Headlines — Mon, 19 Oct 2009 18:09:03 +0100

The mortality rate is more than doubled in cancer patients who require readmission within a month of colectomy than for those who do not require early readmission (16% vs 7%). Medscape Medical News (Source: Medscape Today Headlines)

Successful treatment of nonocclusive mesenteric ischemia that developed during the peritransplant period following ABO-incompatible kidney transplantation

Clinical and Experimental Nephrology — Fri, 16 Oct 2009 17:54:53 +0100

We describe a 54-year-old man who developed NOMI during the peritransplant period following ABO-incompatible living-donor kidney transplantation, but who was successfully treated with his renal graft function unimpaired. Abdominal pain appeared on the sixth postoperative day (POD), and emergency surgery was performed on POD 8. Discontinuous segmental necrosis extended throughout the small intestine, and the necrotic segments were entirely removed. He thereafter had ischemia of the ascending colon, which was treated with colectomy, and prostaglandin E1 delivered through the related artery prevented advanced necrosis. Temporary colostomy was closed 20 months after surgery. He maintains excellent graft function at present without secondary disorder. There has been no ABO-...

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Readmission Mortality Rates Are Surprisingly Higher Than Expected In Elderly Patients After Colectomy

Health News from Medical News Today — Fri, 16 Oct 2009 09:00:00 +0100

Readmission to a hospital after standard surgical treatment for colon cancer is far more common than suspected for elderly patients according to researchers who presented their findings at the 2009 Clinical Congress of the American College of Surgeons. (Source: Health News from Medical News Today)

Modelling dysplasia detection in ulcerative colitis: clinical implications of surveillance intensity

Gut — Thu, 15 Oct 2009 22:22:00 +0100

Conclusions: Random biopsy surveillance is sufficiently sensitive to detect large dysplastic fields with significant colorectal cancer risk. Enhanced endoscopy can detect much smaller dysplastic fields, but these have unknown (perhaps much lower) colorectal cancer risk. Small dysplastic fields should not be assumed to indicate a high colorectal cancer risk that warrants colectomy. Prospective studies are needed to define the colorectal cancer risk and optimal management of small dysplastic lesions. (Source: Gut)

Infliximab Linked to Lower Colectomy Rates in Moderate to Severe Active Ulcerative Colitis

Medscape Medical News Headlines — Wed, 14 Oct 2009 16:59:05 +0100

In randomized controlled trials, patients treated with infliximab for moderately to severely active ulcerative colitis were less likely to undergo colectomy through 54 weeks vs those receiving placebo. Medscape Medical News (Source: Medscape Medical News Headlines)

Peripheral T-cell lymphoma developing at ileocolonic anastomosis site after colectomy for adenocarcinoma.

Pathology, Research and Practice — Tue, 13 Oct 2009 23:00:00 +0100

Authors: Ikeda JI, Yamauchi A, Hoshida Y, Okamura S, Hashimoto K, Aozasa K, Morii E A 69-year-old man underwent right hemicolectomy for colon cancer in the transverse colon in 2005. Two years after surgery, he was admitted with abdominal pain. Colonoscopy revealed a submucosal tumor of approximately 4cm in size at the ileocolonic anastomosis site. In the biopsied samples from the anastomosis site, there was diffuse proliferation of large lymphoid cells, which were immunohistochemically positive for CD3 and CD4, but negative for CD8 and CD20. Clonality analysis of T-cell receptor-beta gene rearrangement revealed a single band, indicating monoclonal proliferation of the T- lymphocytes. Epstein-Barr virus in situ hybridization did not reveal any positive signals in any of the tumor cells....

Hybrid Hand-Assisted Colectomy for Transverse Colon Cancer: A Useful Technique for Non-Expert Laparoscopic Surgeons

World Journal of Surgery — Tue, 13 Oct 2009 08:11:43 +0100

Conclusions We conclude that hybrid-HALC for transverse colon cancer is a feasible, convenient, and less-invasive technique, and that it is a useful alternative, especially for non-expert laparoscopic surgeons. Content Type Journal ArticleDOI 10.1007/s00268-009-0244-7Authors Yuji Takakura, Graduate School of Biomedical Science, Hiroshima University Department of Endoscopic Surgery and Surgical Science 1-2-3 Kasumi, Minami-ku Hiroshima 734-8551 JapanMasazumi Okajima, Graduate School of Biomedical Science, Hiroshima University Department of Endoscopic Surgery and Surgical Science 1-2-3 Kasumi, Minami-ku Hiroshima 734-8551 JapanMasanori Yoshimitsu, Graduate School of Biomedical Science, Hiroshima University Department of Surgery, Division of Frontier Medical Science, Prog...

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Neonatal Peritoneal Candidiasis Successfully Treated with Anidulafungin Add-On Therapy (November).

The Annals of Pharmacotherapy — Mon, 12 Oct 2009 23:00:00 +0100

CONCLUSIONS: Peritoneal candidiasis is a common complication of bowel perforation in neonates. Anidulafungin's pharmacokinetic and antifungal properties make it a viable therapeutic option in the treatment of this disease in critically ill infants and children. PMID: 19826094 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

Familial adenomatous polyposis

Orphanet Journal of Rare Diseases — Sun, 11 Oct 2009 23:00:00 +0100

(FAP) is characterized by the development of hundreds to thousands of adenomas in the rectum and colon during the second decade of life. FAP has an incidence at birth of about 1/8,300, manifests equally in both sexes, and accounts for less than 1% colorectal cancer (CRC) cases. In the European Union, prevalence has been estimated at 1/11,300-37,600. Most patients are asymptomatic for years until the adenomas are large and numerous, and cause rectal bleeding or even anemia, or cancer develops. Generally, cancers start to develop a decade after the appearance of the polyps. Nonspecific symptoms may include constipation or diarrhea, abdominal pain, palpable abdominal masses and weight loss. FAP may present some extraintestinal manifestations such as osteomas, dental abnormalities (unerupted ...

Comparison of colectomy rate after treatment of ulcerative colitis with placebo or infliximab

NeLM - News — Wed, 07 Oct 2009 23:00:00 +0100

Source: Gastroenterology Area: News An article in Gastroenterology from the investigators of the ACT-1 and ACT-2 multicentre trials, report long-term data on colectomy and hospitalisations among patients with moderate-to-severe ulcerative colitis (UC) randomised to infliximab or placebo. In these studies, 728 patients received placebo or infliximab (5 or 10 mg/kg) at weeks 0, 2, and 6, then every 8 weeks through week 46 (ACT-1) or 22 (ACT-2). Colectomy, hospitalisation, and surgery/procedure data through 54 weeks after the first infusion were obtained from ACT-1, ACT-2, and associated data sources. In the pre-specified analysis, all data were combined to ascertain time to colectomy. The following findings were reported: . 87% (630 of 728) of patients ...

Robotic-assisted single-incision right colectomy: early experience

The International Journal of Medical Robotics and Computer Assisted Surgery — Sun, 04 Oct 2009 23:00:00 +0100

We describe our early experience with three robotic single-incision right hemicolectomies.Three robotic single-incision right hemicolectomies were performed using the daVinci-S robotic system, utilizing a single 4 cm incision through or around the umbilicus. The procedure was performed using three robotic arms, a 12 mm camera and two 8 mm robotic ports. A medial to lateral approach was used and an extracorporeal resection and anastomosis was performed after undocking the robot.There were no intraoperative or postoperative complications. Average operative time was 152 min. The first case was converted to non-robotic single-incision right hemicolectomy during mobilization of the ascending colon, due to uncontrollable air leakage around the ports. The second and third cases were successfully ...

Ulcerative Colitis Treatment Reduces Need for Surgery by Almost Half

Drugs.com - Clinical Trials — Sat, 03 Oct 2009 12:47:49 +0100

ROCHESTER, Minn., Oct. 1 /PRNewswire-USNewswire/ -- A new study led by Mayo Clinic researchers has found that ulcerative colitis patients had a 41 percent reduction in colectomy after a year when treated with infliximab, according to a study... (Source: Drugs.com - Clinical Trials)

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Need For Surgery Almost Halved By Ulcerative Colitis Treatment

Irritable-Bowel Syndrome News From Medical News Today — Sat, 03 Oct 2009 08:00:00 +0100

A new study led by Mayo Clinic researchers has found that ulcerative colitis patients had a 41 percent reduction in colectomy after a year when treated with infliximab, according to a study published in the October 2009 issue of Gastroenterology... (Source: Irritable-Bowel Syndrome News From Medical News Today)

Need For Surgery Almost Halved By Ulcerative Colitis Treatment

Health News from Medical News Today — Sat, 03 Oct 2009 07:00:00 +0100

Drug May Help Colitis Patients Avoid Surgery

Forbes.com Health News — Fri, 02 Oct 2009 18:00:00 +0100

Infliximab linked to fewer colectomies in study patients (Source: Forbes.com Health News)

Drug May Help Colitis Patients Avoid Surgery

MedlinePlus Health News — Fri, 02 Oct 2009 18:00:00 +0100

Infliximab linked to fewer colectomies in study patients Source: HealthDay Related MedlinePlus Topics: Medicines, Ulcerative Colitis (Source: MedlinePlus Health News)

Ulcerative Colitis Treatment Reduces Need for Surgery

Disabled World — Thu, 01 Oct 2009 23:23:25 +0100

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Ulcerative Colitis Treatment Reduces Need For Surgery By Almost Half

Health News from Medical News Today — Thu, 01 Oct 2009 23:00:00 +0100

A new study led by Mayo Clinic researchers has found that ulcerative colitis patients had a 41 percent reduction in colectomy after a year when treated with infliximab, according to a study published in the October 2009 issue of Gastroenterology. Ulcerative colitis, an inflammatory bowel disease (IBD) that causes chronic inflammation of the colon, is characterized by abdominal pain and diarrhea. (Source: Health News from Medical News Today)

Drug Tied to Lower Colectomy Rate in Ulcerative Colitis

Modern Medicine — Thu, 01 Oct 2009 23:00:00 +0100

In patients with moderate-to-severe ulcerative colitis, treatment with infliximab is associated with a significantly lower likelihood of undergoing colectomy within one year, according to a study published in the October Gastroenterology. (Source: Modern Medicine)

Preoperative infliximab treatment in patients with ulcerative and indeterminate colitis does not increase rate of conversion to emergent and multistep abdominal surgery

International Journal of Colorectal Disease — Thu, 01 Oct 2009 18:31:56 +0100

Conclusion Infliximab does not appear to increase rates of emergent surgery or multistep procedures in patients undergoing treatment for ulcerative or indeterminative colitis at our institution. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00384-009-0800-5Authors Liliana Bordeianou, Harvard Medical School MGH Crohn’s & Colitis Center Boston MA USAHiroko Kunitake, Harvard Medical School MGH Crohn’s & Colitis Center Boston MA USAPaul Shellito, Harvard Medical School MGH Crohn’s & Colitis Center Boston MA USARichard Hodin, Harvard Medical School MGH Crohn’s & Colitis Center Boston MA USA Journal International Journal of Colorectal DiseaseOnline ISSN 1432-1262Print ISSN 0179-1958 (Source: International Journal of Colorectal Disease)

Image overlay navigation by markerless surface registration in gastrointestinal, hepatobiliary and pancreatic surgery

Journal of Hepato-Biliary-Pancreatic Surgery — Thu, 01 Oct 2009 18:14:26 +0100

Conclusions Our non-invasive markerless registration using physiological markers on the body surface reduced logistical efforts. The image overlay technique is a useful tool when highlighting hidden structures, giving more information. Content Type Journal ArticleCategory TopicsDOI 10.1007/s00534-009-0199-yAuthors Maki Sugimoto, Teikyo University Chiba Medical Center Department of Surgery 3426-3 Anesaki, Ichihara Chiba 299-0111 JapanHideki Yasuda, Teikyo University Chiba Medical Center Department of Surgery 3426-3 Anesaki, Ichihara Chiba 299-0111 JapanKeiji Koda, Teikyo University Chiba Medical Center Department of Surgery 3426-3 Anesaki, Ichihara Chiba 299-0111 JapanMasato Suzuki, Teikyo University Chiba Medical Center Department of Surgery 3426-3 Anesaki, Ichihara Ch...

Ulcerative Colitis Treatment Reduces Need For Surgery By Almost Half, Study Suggests

ScienceDaily Headlines — Thu, 01 Oct 2009 18:11:01 +0100

A new study has found that ulcerative colitis patients had a 41 percent reduction in colectomy after a year when treated with infliximab. (Source: ScienceDaily Headlines)

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Infliximab Lowers Risk of Colectomy in Ulcerative Colitis (CME/CE)

MedPage Today Gastroenterology — Thu, 01 Oct 2009 13:02:11 +0100

Treatment of moderate-to-severe ulcerative colitis with infliximab appears to reduce the need for colectomy, according to an analysis of data from two double-blind studies. (Source: MedPage Today Gastroenterology)

Infliximab reduces need for surgery in ulcerative colitits

Medicineworld.org: New Article Alert — Thu, 01 Oct 2009 12:43:47 +0100

A newly released study led by Mayo Clinic scientists has observed that ulcerative colitis patients had a 41 percent reduction in colectomy after a year when treated with infliximab, as per a research studyreported in the October 2009 issue of Gastroenterology. Typically ulcerative colitis, an inflammatory bowel disease (ibd) that causes chronic inflammation of the colon, is characterized by abdominal pain and diarrhea. Like Crohn's disease, another common IBD, ulcerative colitis can be debilitating and often lead to colectomy or surgical removal of the colon........ (Source: Medicineworld.org: New Article Alert)

Ulcerative colitis treatment reduces need for surgery by almost half

EurekAlert! - Medicine and Health — Thu, 01 Oct 2009 04:00:00 +0100

(Mayo Clinic) A new study led by Mayo Clinic researchers has found that ulcerative colitis patients had a 41 percent reduction in colectomy after a year when treated with infliximab, according to a study published in the October 2009 issue of Gastroenterology. (Source: EurekAlert! - Medicine and Health)

Is laparoscopic colon surgery appropriate in patients who have had previous abdominal surgery?

The American Surgeon — Thu, 01 Oct 2009 00:00:00 +0100

The objective of this study was to determine the feasibility of a laparoscopic colectomy in patients who have previously undergone abdominal surgery. We performed a retrospective, single-institution review of laparoscopic colorectal procedures for benign or malignant pathology between October 2002 and September 2008. Our analysis included 55 patients who previously had laparoscopic, open, or a combination of procedures and subsequently underwent laparoscopic colorectal surgery. We observed a 14.5 per cent conversion rate (n = 8). Of the patients who had previous open procedures (n = 48 [87.3%]), the conversion rate was 16.7 per cent. Only one patient (12.5%) who had a history of only laparoscopic surgery required conversion. The highest conversion rate in our study was from patients who un...

Diverticulitis in California from 1995 to 2006: increased rates of treatment for younger patients.

The American Surgeon — Thu, 01 Oct 2009 00:00:00 +0100

Authors: Etzioni DA, Cannom RR, Ault GT, Beart RW, Kaiser AM Colonic diverticular disease is responsible for over 300,000 admissions and expenditures exceeding $2.7 billion/year. There is recent evidence that rates of treatment for diverticulitis have increased in the United States over the last decade. We hypothesize that these national trends of increasing rates of hospitalizations for diverticulitis would be found in an analysis of a single-state discharge database. Data from the Office of Statewide Health Planning and Development were used to analyze treatment for diverticulitis in California from 1995 to 2006. For each hospitalization, surgical care was determined based on procedure codes for left colon resection and/or colostomy. Overall numbers of admissions for acute diverticul...

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Adenocarcinoma in ileal pouch after proctocolectomy for familial adenomatous polyposis: report of a case.

J Korean Med Sci — Wed, 30 Sep 2009 23:00:00 +0100

We report a case of adenocarcinoma in ileal pouch after proctocolectomy with ileal pouch-anal anastomosis. A 56-yr-old woman was diagnosed as having familial adenomatous polyposis. Total colectomy with ileorectal anastomosis was performed. Six years later, she underwent completion-proctectomy with ileal J pouch-anal anastomosis including anorectal mucosectomy for rectal cancer. After 7 yr, she presented with anal spotting. Endoscopic biopsies revealed adenocarcinoma at the ileal pouch. Resection of the ileal pouch and permanent ileostomy were performed. The risk of cancer in an ileal pouch and its prevention with regular surveillance must be emphasized. PMID: 19795007 [PubMed - in process] (Source: J Korean Med Sci)

Laparoscopic colorectal surgery: summary of the current evidence.

Annals of the Royal College of Surgeons of England — Wed, 30 Sep 2009 23:00:00 +0100

CONCLUSIONS: Laparoscopic colorectal surgery proved to be safe, cost-effective and with improved short-term outcomes. However, further studies are needed to assess the role of laparoscopic rectal cancer surgery and the value of enhanced recovery protocols in patients undergoing laparoscopic colorectal resections. PMID: 19833012 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)

Prophylactic colectomy for hyperplastic polyposis

Irish Journal of Medical Science — Tue, 29 Sep 2009 01:06:11 +0100

Conclusion This case highlights the complexity in the management of HP and that even in the absence of confirmed invasive disease, patients may elect to undergo prophylactic colonic resection. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11845-009-0422-5Authors D. Doran, St. Vincent’s University Hospital Department of Colorectal Surgery Elm Park Dublin 4 IrelandJ. P. Burke, St. Vincent’s University Hospital Department of Colorectal Surgery Elm Park Dublin 4 IrelandA. M. Hanly, St. Vincent’s University Hospital Department of Colorectal Surgery Elm Park Dublin 4 IrelandD. C. Winter, St. Vincent’s University Hospital Department of Colorectal Surgery Elm Park Dublin 4 Ireland Journal Irish Journal of Medical ScienceOnline ISSN 1863-4362Print ...

Comparison of outcomes after hand-sewn versus stapled ileal pouch-anal anastomosis in 3,109 patients

Surgery — Mon, 28 Sep 2009 17:44:49 +0100

Background: The aim of this study was to compare outcomes after primary hand-sewn versus stapled ileal pouch-anal anastomosis (IPAA).Methods: Patients undergoing a primary IPAA (1983–2007) were identified from a prospective pelvic pouch database. Differences between group A (hand-sewn) and group B (stapled) for pre-operative and peri-operative factors, complications, functional outcomes, and quality of life (QOL) were investigated.Results: Of 3,382 patients with a primary IPAA, 3,109 were included. Median follow-up was 7.1 years (0.1–24). Mean age was 37.9 ± 13.2 years. Overall, 1,741 patients (56%) were male. Group A (n = 474) and group B (n = 2635) had similar age (P = .28), sex (P = .8), albumin level (P = .74), prior colectomy (P = .98), and use of steroids (P = .1). Group A had...

Evolution of Surgical Treatment of Amebiasis-Associated Colon Perforation

Journal of Gastrointestinal Surgery — Thu, 24 Sep 2009 14:32:28 +0100

Conclusions Perforation is the most frequent surgical complication of invasive amebiasis of the colon, occurring principally in masculine gender and in the fourth decade of life. Resection and stoma creation is the procedure of choice that can resolve the septic focus from the first surgical procedure, depending on the general status of the patient. However, morbidity and mortality are high, and there is a tendency for these to be lower on comparing initial cases with those with recently conducted surgical procedures. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11605-009-1036-yAuthors César Athié-Gutiérrez, Hospital General de México Servicio de Cirugía General Secretaría de Salud (SSA) Mexico City MexicoHeriberto Rodea-Rosas, Hospital Ge...

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High prevalence of tcdC deletion-carrying Clostridium difficile and lack of association with disease severity

Diagnostic Microbiology and Infectious Disease — Thu, 24 Sep 2009 00:00:00 +0100

Abstract: We assessed the prevalence of tcdC deletion-carrying Clostridium difficile using a stool polymerase chain reaction (PCR) assay that detects previously described 18- and 39-bp deletions (J. Clin. Microbiol. 2008;46:1996). We divided inpatients into 2 groups, those for whom the assay detected a deletion in tcdC and those for whom no deletion was detected. We compared risk factors (antibiotic use, hospitalization, nursing home stay, immunocompromise, age >65 years), complications (pseudomembranous colitis, toxic megacolon, colonic perforation, colectomy, and intensive care unit admission), duration of antibiotic treatment, and 30-day mortality between the groups. Forty-two of 141 patients had deletion-positive C. difficile. Prior nursing home stay and age >65 years were significantl...

The effect of a total colectomy on the motor inhibition of the upper gut induced by intraileal stimuli in conscious dogs

Surgery Today — Wed, 23 Sep 2009 05:51:20 +0100

Conclusion The intraileal stimuli-induced motor inhibition decreased after a total colectomy after the administration of glucose, but not after the administration of either oleate or capsaicin. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00595-009-3953-5Authors Munenori Nagao, Tohoku University Graduate School of Medicine Division of Biological Regulation and Oncology, Department of Surgery 1-1 Seiryo-machi, Aoba-ku Sendai 980-8574 JapanChikashi Shibata, Tohoku University Graduate School of Medicine Division of Biological Regulation and Oncology, Department of Surgery 1-1 Seiryo-machi, Aoba-ku Sendai 980-8574 JapanYuji Funayama, Tohoku University Graduate School of Medicine Division of Biological Regulation and Oncology, Department of Surgery 1-1 ...

Single-incision laparoscopically assisted colectomy using standard laparoscopic instrumentation

Surgical Endoscopy — Thu, 17 Sep 2009 12:41:58 +0100

Conclusions Single-incision laparoscopic surgery for colectomy is feasible. It can be performed without specialized instrumentation and at no extra cost. Further evaluation is required. Content Type Journal ArticleDOI 10.1007/s00464-009-0683-0Authors Nicholas A. Rieger, The Queen Elizabeth Hospital and the University of Adelaide 11 Woodville Road Woodville South Australia 5011 AustraliaFrancis F. Lam, The Queen Elizabeth Hospital and the University of Adelaide 11 Woodville Road Woodville South Australia 5011 Australia Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical Endoscopy)

Ileal pouch for everyone, even when we are not sure of the diagnosis before or at colectomy?

Inflammatory Bowel Diseases — Tue, 15 Sep 2009 23:00:00 +0100

No abstract. (Source: Inflammatory Bowel Diseases)

Comparison of the clinical and economic outcomes between open and minimally invasive appendectomy and colectomy: evidence from a large commercial payer database

Surgical Endoscopy — Tue, 15 Sep 2009 20:43:54 +0100

Conclusions Minimally invasive appendectomy and colectomy were associated with lower infection rates, fewer complications, shorter hospital stays, and lower expenditures than open surgery. Content Type Journal ArticleDOI 10.1007/s00464-009-0675-0Authors Terrence M. Fullum, Howard University College of Medicine Washington DC USAJoseph A. Ladapo, Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA USABijan J. Borah, i3 Innovus Eden Prairie MN USACandace L. Gunnarsson, S2 Statistical Solutions, Inc 3276 East Sharon Road Cincinnati OH 45241 USA Journal Surgical EndoscopyOnline ISSN 1432-2218Print ISSN 0930-2794 (Source: Surgical Endoscopy)

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Report of a rare case of colon cancer complicated by anomalies of intestinal rotation and fixation: a case report

Cases Journal — Sun, 13 Sep 2009 23:00:00 +0100

Conclusion: The anomaly of situs viscerum inversus influenced the surgical strategy in this case because of the vascular and lymphatic anomalies. Lymphatic vessels were therefore marked with subserosal injection of patent blue in the proximity of the tumor. Subsequently, right colectomy was performed. Colectomy extended from the distal ileum to the descending colon, by ligature of the right colic artery and vein at the origin from the superior mesenteric vessels. Patent blue guided lymphadenectomy was also performed with curative intent. Finally, a mechanical ileo-colic anastomosis was carried out. After right colectomy and ileo-descending anastomosis, the Ladd's procedure for intestinal malrotation was unnecessary. The authors believe that this strategy, despite the anatomical difficultie...

Acute fulminant necrotizing amoebic colitis: a rare and fatal complication of amoebiasis: a case report

Cases Journal — Thu, 10 Sep 2009 23:00:00 +0100

Acute Fulminant Necrotizing Amoebic Colitis is a rare complication of amoebiasis that is associated with high mortality. Only one to four such cases are seen per year in large hospitals of India, and only few such cases have been reported in the literature. The condition requires early diagnosis and surgical intervention. We recently cared for a patient who presented with acute abdomen with history of intermittent abdominal pain and diarrhea. Before presenting to our institution he was misdiagnosed as a case of inflammatory bowel disease and had been treated with steroids. On emergency exploration, extensive necrosis and multiple perforations in retroperitoneum involving entire colon were seen. Total colectomy with ileostomy was performed. Postoperative course was marked by septicaemia and...

Synchronous ileal carcinoid and primary colonic neoplasms: a case report

Cases Journal — Tue, 08 Sep 2009 23:00:00 +0100

This article describes a case of adenomatous colonic polyps, adenocarcinoma of sigmoid colon and concurrent malignant carcinoid tumour of ileocaecal junction, detected on colonoscopic examination. The radiological staging investigations revealed no distant spread of disease. The patient was effectively treated with subtotal colectomy, resection of terminal ileum, excision of locoregional lymph nodes and the bowel continuity was restored with stapled ileo-rectal anastomosis. This article is as an example of concomitant presence of two types of malignant tumours, effectively managed surgically. (Source: Cases Journal)

Lymphocyte apoptosis after major abdominal surgery is not influenced by anesthetic technique: a comparative study of general anesthesia versus combined general and epidural analgesia

Journal of Clinical Anesthesia — Tue, 08 Sep 2009 23:00:00 +0100

Conclusions: Epidural block could not suppress postoperative lymphocyte apoptosis, increases in cortisol, CRP, or ESR compared with general anesthesia. (Source: Journal of Clinical Anesthesia)