Diseases of the Colon and Rectum

BACKGROUND: Despite the widely accepted association between excessive straining and perineal descent, the clinical significance of perineal descent in patients with obstructed defecation syndrome is still unclear. OBJECTIVE: To evaluate the prevalence of pathological perineal descent in patients with obstructed defecation syndrome and the impact of perineal descent on symptoms severity. DESIGN: This was a prospective multi-center uncontrolled study...

BACKGROUND: Clinical experience teaches that intraperitoneal adhesions are more severe in patients with familial adenomatous polyposis than in patients without it. This impression may come from the common association of familial adenomatous polyposis with desmoid disease. OBJECTIVES: To determine whether patients with familial adenomatous polyposis and desmoid disease develop more severe adhesions than those without desmoid disease. DESIGN: Prospectively collected data study...

BACKGROUND: Rubber band ligation of hemorrhoids causes less pain than excisional hemorrhoidectomy, but many patients still experience significant post-procedure discomfort. OBJECTIVE: This study aims to determine if topical lidocaine, with or without diltiazem, is more effective than placebo for analgesia following hemorrhoid banding. DESIGN: This is a prospective, randomized, double-blinded, placebo controlled trial. Patients were randomized to 2% lidocaine, 2% lidocaine with 2% diltiazem, or placebo ointment...

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BACKGROUND: Chronic pelvic sepsis mostly originates from complicated pelvic surgery and failed interventions. This is a challenging condition that often requires extensive salvage surgery consisting of complete debridement with source control and filling of the dead space with well-vascularized tissue such as an autologous tissue flap. The abdominal wall (rectus abdominis flap), or leg (gracilis flap) are mostly used as donor sites for this indication, while gluteal flaps might be attractive alternatives...

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BACKGROUND: Recent studies have shown patient-derived tumor organoid can predict the drug response of cancer patients. However, the prognostic value of patient-derived tumor organoid-based drug tests in predicting the progression-free survival of stage IV colorectal cancer patients after surgery remains unknown. OBJECTIVE: To explore the prognostic value of patient-derived tumor organoid-based drug tests in stage IV colorectal cancer patients after surgery. DESIGN: Retrospective cohort study...

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BACKGROUND: Pilonidal disease is classically treated with a wide local excision, though a number of minimally invasive approaches are currently under investigation. We aimed to determine the safety and feasibility of laser ablation of pilonidal sinus disease. IMPACT OF INNOVATION: Laser ablation provides a minimally invasive means of obliterating pilonidal sinus tracts without a need for excessive tract dilation. Laser ablation can be performed more than once on the same patient if necessary...

BACKGROUND: Short-course radiation therapy and consolidation chemotherapy with nonoperative intent has emerged as a novel treatment paradigm for patients with rectal cancer, but there are no data on the predictors of clinical complete response. OBJECTIVE: To evaluate the predictors of clinical complete response and survival. DESIGN: Retrospective cohort. SETTINGS: NCI-designated cancer center. PATIENTS: Stage I-III rectal adenocarcinoma treated between 01/2018 and 05/2019 (n = 86)...

BACKGROUND: Transanal endoscopic surgery is an organ-sparing treatment for early-stage rectal cancer. Patients with advanced lesions are recommended for total mesorectal excision. However, some patients have prohibitive co-morbidities or refuse major surgery. OBJECTIVE: To assess the cancer outcomes of patients with T2 or T3 rectal cancers who received transanal endoscopic surgery as their sole surgical treatment. DESIGN: This study used a prospectively maintained database...

Single Port Robotic Completion Proctectomy.

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