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Rectal Abscess

Anders Dige, Helene Tarri Hougaard, Jørgen Agnholt, Bodil Ginnerup Pedersen, Michaela Tencerova, Moustapha Kassem, Klaus Krogh, Lilli Lundby
BACKGROUND AND AIMS: Perianal fistulas are common in patients with Crohn´s disease (CD). Injections of cultured autologous and allogeneic adipose tissue-derived stem cells have been shown to heal CD-associated fistulas. Unfortunately, this treatment is time-consuming and expensive. We investigated the effects of injecting freshly collected autologous adipose tissue into perianal fistulas in patients with CD. METHODS: In a prospective interventional study freshly collected autologous adipose tissues were injected into complex perianal fistulas of 21 patients with CD, from March 2015 through June 2018...
February 14, 2019: Gastroenterology
Tomohiko Machida, Shuhei Ohta, Yoshihito Kakimoto, Akira Toyoda, Yoshitake Endou, Osamu Murakami
An 81-year old man with a perirectal abscess was referred in May 2017 by another hospital. We observed swelling in the anal region at the 4 o'clock position and performed incisional drainage. Although this alleviated the pain and inflammation in the anal region, the irritation recurred in early June. The patient presented with bloody stools and a low-grade fever since late June. Pelvic magnetic resonance imaging(MRI)confirmed a solid tumor in the center of the lower rectum(Rb), outside of the anal fistula. We surmised this was rectal cancer...
January 2019: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Alberto Mangano, Eduardo Fernandes, Federico Gheza, Roberto Bustos, Liaohai Leo Chen, Mario Masrur, Pier Cristoforo Giulianotti
BACKGROUND: Leakage of the anastomosis after colorectal surgery is a severe complication, and one of the most important causes is poor vascular supply. However, a microvascular deficit is often not detectable during surgery under white light. Near-infrared indocyanine green (ICG)-enhanced fluorescence may be useful for assessing microvascular deficits and conceivably preventing anastomotic leakage. OBJECTIVES: This paper presents a preliminary retrospective case series on robotic colorectal surgery...
February 1, 2019: Surgical Technology International
Landon K Brown, Norman R Clark, Jason Conway, Girish Mishra
Background and study aims  The merits of rectal ultrasound for rectal cancer staging are well documented. Conventional approaches to accessing perirectal and presacral lesions entail computed tomography guidance via a transgluteal approach or frank surgical exploration. We report on the safety and efficacy of performing rectal ultrasound with fine-needle aspiration (RUS-FNA) for evaluating perirectal, presacral, and pelvic abnormalities. Patients and methods  Patients who underwent RUS-FNA of perirectal, presacral, or pelvic lesions between August 2005 and September 2016 were identified using an institutional database...
February 2019: Endoscopy International Open
Tao Wu, Long Wen, Jixin Zhang, Yingchao Wu, Yong Jiang, Guowei Chen, Xin Wang, Shanjun Huang, Yuanlian Wan
OBJECTIVE: To investigate the value of neoadjuvant chemoradiotherapy (nCRT) combined with total pelvic exenteration (TPE) in the treatment of primary T4b rectal cancer. METHODS: A retrospective cohort study was conducted to analyze the clinicopathological data of 31 patients with primary T4b rectal cancer who underwent TPE from January 2008 to December 2015 at Peking University First Hospital. INCLUSION CRITERIA: preoperative clinical stage (cTNM) was defined as cT4b primary rectal cancer with only front wall Invasion; the lower edge of tumor was within 10 cm from the anal margin; TPE was performed; R0 resection was confirmed by pathology...
January 25, 2019: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Michiko Hamanaka, Masafumi Noda, Ayako Imada, Jihyung Song, Kei Kimura, Akihito Babaya, Masayoshi Kobayashi, Kiyoshi Tsukamoto, Haruyuki Takaki, Tomoki Yamano, Masataka Ikeda, Koichiro Yamakado, Naohiro Tomita
We experienced 2 cases of pelvic recurrence from rectal cancer. These patients received radiofrequency ablation(RFA) therapy. Case 1 was a 76-year-old man who underwent intersphincteric resection for lower rectal cancer in October 2013. In May 2015, the patient received systemic chemotherapy for multiple lung metastases and pelvic local recurrence. In January 2017, RFA was performed to reduce the pain of the pelvic recurrence. Immediately after RFA, the pain markedly reduced, and 2 months after treatment, the patient discontinued his pain therapy...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Giuseppe Portale, George Octavian Popesc, Matteo Parotto, Francesco Cavallin
BACKGROUND: Delayed colo-anal anastomosis (DCAA) has received renewed interest thanks to its reduction in anastomotic leakage rate without the use of stoma to protect a low rectal anastomosis. The aim of this review was to summarize the available literature on DCAA following rectal cancer resection and to report clinical, oncological and functional results. METHODS: A comprehensive literature review was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials...
January 28, 2019: World Journal of Surgery
Hulya Ozturk, Emine Dagistan, Hayrettin Ozturk
Tailgut cyst (cystic hamartoma) is a rare congenital pathology that arises -from post-natal primitive gut remnants in the retrorectal-presacral space. Because of the rarity of the lesion and the variability of the anatomical position, its diagnosis and surgical treatment are often difficult. Complete surgical excision of the multilocular and multicystic process prevents recurrent draining sinuses and eliminates the possibility of malignant change. We describe a case in which a tailgut cyst localized in the retrorectal and presacral space was characterized by abscess, repeated urinary tract infection, and rectal pain...
October 2018: Acta Gastro-enterologica Belgica
Nathan R Manley, John P Sharpe, Richard H Lewis, Mark S Iltis, Rishi Chaudhuri, Timothy C Fabian, Martin A Croce, Louis J Magnotti
INTRODUCTION: Conflicting evidence exists regarding the definitive management of destructive colon injuries. Although diversion with an end ostomy can theoretically decrease initial complications, it mandates a more extensive reversal procedure. Conversely, anastomosis with proximal loop ostomy diversion, while simplifying the reversal, increases the number of suture lines and potential initial morbidity. Thus, the purpose of this study was to evaluate the impact of diversion technique on morbidity and mortality in patients with destructive colon injuries...
November 15, 2018: Journal of Trauma and Acute Care Surgery
Mostafa Shalaby, Waleed Thabet, Oreste Buonomo, Nicola Di Lorenzo, Mosaad Morshed, Giuseppe Petrella, Mohamed Farid, Pierpaolo Sileri
Purpose: We evaluate the role of transanal tube drainage (TD) as a conservative treatment for patients with anastomotic leakage (AL). Methods: Patients treated for AL who had undergone a low or an ultralow anterior resection with colorectal or coloanal anastomosis for the treatment of rectal cancer between January 2013 and January 2017 were enrolled in this study. The data were collected prospectively and analyzed retrospectively. The primary outcomes were the diagnosis and the management of AL...
December 20, 2018: Annals of Coloproctology
Carla Felice, Pietro Leccese, Luigia Scudeller, Ennio Lubrano, Fabrizio Cantini, Fabiana Castiglione, Paolo Gionchetti, Ambrogio Orlando, Carlo Salvarani, Raffaele Scarpa, Maurizio Vecchi, Ignazio Olivieri, Alessandro Armuzzi
Collaboration between gastroenterologists and rheumatologists is recommended for correct management of patients with associated spondyloarthritis (SpA) and inflammatory bowel disease (IBD). We aimed to establish the appropriateness of several red flags for a prompt specialist referral. A systematic review of the literature was performed using the GRADE method to describe the prevalence of coexisting IBD-SpA and the diagnostic accuracy of red flags proposed by a steering committee. Then, a consensus among expert gastroenterologists and rheumatologists (10 in the steering committee and 13 in the expert panel) was obtained using the RAND method to confirm the appropriateness of each red flag as "major" (1 sufficient for patient referral) or "minor" (at least 3 needed for patient referral) criteria for specialist referral...
December 15, 2018: Clinical and Experimental Immunology
M Popiolek, K Dehlaghi, S Gadan, B Baban, P Matthiessen
BACKGROUND AND AIMS: In mid-rectal cancer, the low colorectal anastomosis is, although feasible, sometimes avoided. The aim was to compare low Hartmann's procedure with intersphincteric abdomino-perineal excision of the rectum, in patients operated with total mesorectal excision for mid-rectal cancer in whom the low anastomosis was technically feasible but for patient-related reasons undesired. MATERIAL AND METHODS: A total of 64 consecutive patients with mid-rectal cancer who underwent low Hartmann's procedure (n = 34) or intersphincteric abdomino-perineal excision (n = 30) at one colorectal unit were compared regarding patient demography, short-term oncology, surgical outcome at 3 and 24 months, and long-term overall survival...
November 25, 2018: Scandinavian Journal of Surgery: SJS
B C Olsen, S T Sakkestad, F Pfeffer, A Karliczek
BACKGROUND AND AIMS: The International Study Group of Rectal Cancer has proposed that a pelvic abscess in the proximity of the anastomosis is considered an anastomotic leak, whether or not its point of origin is detectable. This study describes how the inclusion of pelvic abscesses alters the leakage rate. MATERIAL AND METHODS: Risk factors and postoperative complications in patients with visible anastomotic leakage ("direct leakage"), pelvic abscesses alone in the vicinity of a visibly intact anastomosis ("abscess leakage"), and no leakage were retrospectively evaluated...
November 25, 2018: Scandinavian Journal of Surgery: SJS
Elodie Bonin, Valérie Bridoux, Rachid Chati, Sabrina Kermiche, Julien Coget, Jean Jacques Tuech, Horace Roman
OBJECTIVE: Deep endometriosis may simultaneously infiltrate the vagina and the rectosigmoid, which associated resection may increase the risk of postoperative complications. Among these complications, rectovaginal fistula is one of the worst. To reduce the risk of rectovaginal fistula and related complications, surgeons may employ diverting stoma. The literature is rich in data concerning the usefulness of stoma in patients managed for low rectal cancer. However, extrapolation of these data to patients managed for rectal endometriosis is disputable...
January 2019: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Mateusz Rubinkiewicz, Agata Czerwińska, Piotr Zarzycki, Piotr Małczak, Michał Nowakowski, Piotr Major, Andrzej Budzyński, Michał Pędziwiatr
BACKGROUND: Transanal total mesorectal excision (TaTME) is a new technique that is designed to overcome the limits of the open and laparoscopic approach for rectal resections. OBJECTIVE: This study is designed to compare TaTME with standard laparoscopic TME (LaTME). METHODS: We searched Medline, Embase, and Scopus databases covering a up to October 2018. Inclusion criteria for study enrolment: (1) study comparing laparoscopic resection of rectal cancer vs...
November 19, 2018: Journal of Clinical Medicine
Chun-Hui Peng, Ya-Jun Chen, Wen-Bo Pang, Ting-Chong Zhang, Zeng-Meng Wang, Dong-Yang Wu, Kai Wang
This study was undertaken to explore the causes, diagnosis, and treatment of anastomotic leakage after pull-through (PT) procedure for Hirschsprung disease (HD).A retrospective analysis of patients with anastomotic leakage after a PT procedure in the General Surgery Department of Beijing Children's Hospital from July 2013 to June 2016 was undertaken. The surgical characteristics, diagnosis, and treatment were retrospectively analyzed.Among the 213 patients who underwent PT procedures, 5 patients had a documented anastomotic leakage...
November 2018: Medicine (Baltimore)
Kerry J Roulston, Tehmina Bharucha, Jane F Turton, Katie L Hopkins, Damien J F Mack
Introduction: Hypervirulent capsular type K1 Klebsiella pneumoniae strains of clonal complex 23 (CC23) are associated with severe community-acquired pyogenic liver abscesses, often complicated by metastatic infections and significant mortality. The majority of hypervirulent strains reported are susceptible to most antibiotics except ampicillin. To the best of our knowledge, this is the first case of New Delhi metallo-β-lactamase ( bla NDM )-producing hypervirulent K. pneumoniae from the UK...
September 2018: JMM Case Reports
Xin Wang, Yongyang Yu, Wenjian Meng, Dan Jiang, Xiangbing Deng, Bing Wu, Hua Zhuang, Cun Wang, Yali Shen, Lie Yang, Hong Zhu, Ke Cheng, Yaqin Zhao, Zhiping Li, Memg Qiu, Hongfeng Gou, Feng Bi, Feng Xu, Rrenmin Zhong, Sen Bai, Ziqiang Wang, Zongguang Zhou
BACKGROUND AND PURPOSE: To evaluate the safety and efficacy of Total neoadjuvant treatment (TNT) in patients with rectal cancer with high risk factors. METHODS AND MATERIALS: We did this phase 2 trial in patients who were diagnosed with stage II-III rectal cancer with at least one of the high risk factors. Three cycles of induction CAPOX were followed by pelvic radiotherapy of 50.4 Gy/28 fractions and two cycles of concurrent CAPOX. Three cycles of consolidation CAPOX were delivered after radiotherapy...
November 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Khaoula Jellali, Ihsane Mellouki, Adil Ibrahimi
Many disorders of the digestive tract cause cutaneous manifestations that may be an indication of an underlying condition; hence dermatologist plays a key role in recommending that the patient see a gastroenterologist. Conversely, gastroenterologist often sees patients with mucocutaneous lesions suggesting possible association with well-known digestive disorders. Chronic inflammatory bowel diseases are the typical example of this essential collaboration between the two specialities. We report a case of Crohn's disease revealed by cheilitis granulomatosa...
2018: Pan African Medical Journal
Muhammed A Memon, Rossita M Yunus, Breda Memon, Aiman Awaiz, Shahjahan Khan
AIMS AND OBJECTIVES: The aim was to conduct a systematic review and meta-analysis of the randomized evidence to determine the relative merits of perioperative outcomes of laparoscopic-assisted (LARR) versus open rectal resection (ORR) for proven rectal cancer. MATERIALS AND METHODS: A search of the Medline, Embase, Science Citation Index, Current Contents and PubMed databases identified English-language randomized clinical trials comparing LARR and ORR. The meta-analysis was prepared in accordance with the PRISMA statement...
October 23, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
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