Clinics in Colon and Rectal Surgery最新文献_第10页

Preparing the Bowel (Microbiome) for Surgery: Surgical Bioresilience. 为手术准备肠道（微生物组）：手术生物复原力。

IF 1.2 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-02-03 eCollection Date: 2023-03-01 DOI: 10.1055/s-0042-1760675

Heidi Paine, Faye Jones, James Kinross

{"title":"Preparing the Bowel (Microbiome) for Surgery: Surgical Bioresilience.","authors":"Heidi Paine, Faye Jones, James Kinross","doi":"10.1055/s-0042-1760675","DOIUrl":"10.1055/s-0042-1760675","url":null,"abstract":"The preparation of the bowel for radical surgery is a corner stone of elective colorectal practice. The evidence for this intervention is of variable quality and it is often contradictory, yet there is now a global move toward the adoption of oral antibiotic therapy for the reduction of perioperative infective complications, such as surgical site infections. The gut microbiome is a critical mediator of the systemic inflammatory response to surgical injury, wound healing, and perioperative gut function. The loss of critical microbial symbiotic functions caused by bowel preparation and surgery has an adverse impact on surgical outcomes, yet the mechanisms through which this occurs are poorly defined. In this review, the evidence for bowel preparation strategies is critically appraised in the context of the gut microbiome. The impact of antibiotic therapy on the surgical gut microbiome and the importance of the intestinal \"resistome\" to surgical recovery is described. Data to support the augmentation of the microbiome through diet, probiotic and symbiotic approaches, as well as fecal transplantation are also appraised. Finally, we propose a novel strategy of bowel preparation defined as \" surgical bioresilience \" and define areas or prioritization in this emerging field. This describes the optimization of surgical intestinal homeostasis and core surgical exposome-microbiome interactions that regulate the wound immune microenvironment, the systemic inflammatory response to surgical injury, and gut function across the perioperative time course.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 2","pages":"138-145"},"PeriodicalIF":1.2,"publicationDate":"2023-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9356486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preoperative Assessment and Optimization of Cardiopulmonary Disease in Noncardiac Surgery. 非心脏手术中心肺疾病的术前评估和优化。

IF 1.4 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-01-28 eCollection Date: 2023-05-01 DOI: 10.1055/s-0043-1760869

Kelsey E Savery, Amanda M Kleiman, Susan M Walters

{"title":"Preoperative Assessment and Optimization of Cardiopulmonary Disease in Noncardiac Surgery.","authors":"Kelsey E Savery, Amanda M Kleiman, Susan M Walters","doi":"10.1055/s-0043-1760869","DOIUrl":"10.1055/s-0043-1760869","url":null,"abstract":"More than 50 million surgical procedures are carried out every year in the United States with the estimated risk of major adverse cardiac events perioperatively between 1.4 and 3.9%. Given that the majority of surgeries are elective, this allows ample opportunity to identify patients at higher risk of perioperative adverse events and optimize them for surgery. Preexisting cardiopulmonary disease is a major risk factor for adverse events perioperatively and can lead to significant morbidity and mortality. It can predispose patients to perioperative myocardial ischemia and infarction, perioperative pulmonary complications, and perioperative stroke among other complications. This article details an approach to preoperative interview and examination, indications for preoperative testing, and strategies for optimization in patients with underlying cardiopulmonary disease. It also includes guidelines on optimal timing of elective surgery in certain clinical scenarios that can escalate perioperative risk. Through the use of thorough preoperative assessment, targeted preoperative testing, and multidisciplinary optimization of preexisting disease, perioperative risk can be decreased significantly and perioperative outcomes improved.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 3","pages":"167-174"},"PeriodicalIF":1.4,"publicationDate":"2023-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9421199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Social Determinants of Health and Impact in Perioperative Space. 健康的社会决定因素及对围术期空间的影响。

IF 1.4 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-01-28 eCollection Date: 2023-05-01 DOI: 10.1055/s-0043-1761155

Courtney L Devin, Virginia O Shaffer

引用次数: 0

Informed Consent and Shared Decision Making in the Perioperative Environment. 围术期环境中的知情同意和共同决策。

IF 1.4 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-01-28 eCollection Date: 2023-05-01 DOI: 10.1055/s-0043-1761158

Elizabeth D Krebs, Sook C Hoang

引用次数: 0

Perioperative Nutritional Considerations in Colon and Rectal Surgery. 结肠和直肠手术围手术期营养注意事项。

IF 1.4 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-01-25 eCollection Date: 2023-05-01 DOI: 10.1055/s-0043-1761152

Thomas Curran

{"title":"Perioperative Nutritional Considerations in Colon and Rectal Surgery.","authors":"Thomas Curran","doi":"10.1055/s-0043-1761152","DOIUrl":"10.1055/s-0043-1761152","url":null,"abstract":"Malnutrition is common in surgical patients and is associated with substantially increased morbidity and mortality. Dedicated assessment of nutritional status is advised by major nutrition and surgical societies. Assessment may utilize comprehensive and validated nutritional assessment tools or targeted history, physical examination with accompanying serologic markers to identify nutritional risk preoperatively. Emergent surgery in malnourished patients should proceed as the clinical situation dictates with consideration of ostomy or primary anastomosis with proximal fecal diversion to mitigate postoperative infectious complications. Nonemergent surgery should be delayed to facilitate nutritional optimization via oral nutritional supplementation preferably and total parenteral nutrition if necessary for at least 7 to 14 days. Exclusive enteral nutrition may be considered to optimize nutritional status and inflammation in patients with Crohn's disease. Immunonutrition use in the preoperative setting is not supported by evidence. Perioperative and postoperative immunonutrition may be of benefit but requires dedicated study in the contemporary era. Close attention to preoperative nutritional status and optimization represents a critical opportunity to improve outcomes in patients undergoing colorectal surgery.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 3","pages":"192-197"},"PeriodicalIF":1.4,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10125286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9421194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Role of Bacteria in the Development of Colorectal Cancer. 细菌在大肠癌发病中的作用。

IF 1.4 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-01-25 eCollection Date: 2023-03-01 DOI: 10.1055/s-0042-1760679

Ryan M Thomas

{"title":"Role of Bacteria in the Development of Colorectal Cancer.","authors":"Ryan M Thomas","doi":"10.1055/s-0042-1760679","DOIUrl":"10.1055/s-0042-1760679","url":null,"abstract":"Colorectal cancer (CRC) is the second leading cause of cancer-related death in the United States. Once limited to older populations, the incidence of CRC in patients under the age of 50 years is increasing and the etiology for this is uncertain. One hypothesis lies on the impact of the intestinal microbiome. The intestinal microbiome, composed primarily of bacteria but also viruses, fungi, and archaea, has been shown to regulate CRC development and progression both in vitro and in vivo. In this review, the role and intersection of the bacterial microbiome in various stages of clinical CRC development and management are discussed beginning with CRC screening. Various mechanisms whereby the microbiome has been shown to modulate CRC development including the influence of diet on the microbiome, bacterial-induced injury to the colonic epithelium, bacterial-produced toxins, and alteration of normal cancer immunosurveillance by the microbiome are discussed. Finally, the influence of microbiome on the response of CRC to treatment is discussed while highlighting ongoing clinical trials. The complexities of the microbiome and its role in CRC development and progression have become apparent and will require ongoing commitment to translate laboratory findings into meaningful clinical results that will aid more than 150,000 patients that develop CRC every year.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 2","pages":"105-111"},"PeriodicalIF":1.4,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10850287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bacterial Decontamination: Bowel Preparation and Chlorhexidine Bathing. 细菌净化：肠道准备和洗必泰洗浴。

IF 1.2 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-01-25 eCollection Date: 2023-05-01 DOI: 10.1055/s-0043-1761154

Yadin Bornstein, Elizabeth C Wick

引用次数: 0

Traci L. Hedrick, MD, MSc, FACS, FASCRS. Traci L. Hedrick, MD, MSc, FACS, FASCRS.

IF 1.4 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-01-25 eCollection Date: 2023-05-01 DOI: 10.1055/s-0043-1760866

Scott R Steele

引用次数: 0

Microbiome. 微生物组。

IF 1.4 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-01-25 eCollection Date: 2023-03-01 DOI: 10.1055/s-0042-1760677

Benjamin D Shogan

引用次数: 0

A Brief History of Microbial Study and Techniques for Exploring the Gastrointestinal Microbiome. 微生物研究简史和探索胃肠道微生物组的技术。

IF 1.2 4区医学

Clinics in Colon and Rectal Surgery Pub Date : 2023-01-25 eCollection Date: 2023-03-01 DOI: 10.1055/s-0042-1760678

Ashley M Sidebottom

{"title":"A Brief History of Microbial Study and Techniques for Exploring the Gastrointestinal Microbiome.","authors":"Ashley M Sidebottom","doi":"10.1055/s-0042-1760678","DOIUrl":"10.1055/s-0042-1760678","url":null,"abstract":"Over the past 20 years, the study of microbial communities has benefited from simultaneous advancements across several fields resulting in a high-resolution view of human consortia. Although the first bacterium was described in the mid-1600s, the interest in community membership and function has not been a focus or feasible until recent decades. With strategies such as shotgun sequencing, microbes can be taxonomically profiled without culturing and their unique variants defined and compared across phenotypes. Approaches such as metatranscriptomics, metaproteomics, and metabolomics can define the current functional state of a population through the identification of bioactive compounds and significant pathways. Prior to sample collection in microbiome-based studies it is critical to evaluate the requirements of downstream analyses to ensure accurate processing and storage for generation of high data quality. A common pipeline for the analysis of human samples includes approval of collection protocols and method finalization, patient sample collection, sample processing, data analysis, and visualization. Human-based microbiome studies are inherently challenging but with the application of complementary multi-omic strategies there is an unbounded potential for discovery.","PeriodicalId":48754,"journal":{"name":"Clinics in Colon and Rectal Surgery","volume":"36 2","pages":"98-104"},"PeriodicalIF":1.2,"publicationDate":"2023-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9340882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0