Techniques in Coloproctology最新文献

筛选
英文 中文
Hemoclip-suture-rubber band traction improves efficiency of colonic ESD: a randomized controlled trial. 夹血-缝合-橡皮筋牵引提高结肠ESD的疗效:一项随机对照试验。
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-30 DOI: 10.1007/s10151-025-03194-4
X Leng, W Wang, F Wang, H Cang, Y Gao, H Liu, Y Sun
{"title":"Hemoclip-suture-rubber band traction improves efficiency of colonic ESD: a randomized controlled trial.","authors":"X Leng, W Wang, F Wang, H Cang, Y Gao, H Liu, Y Sun","doi":"10.1007/s10151-025-03194-4","DOIUrl":"10.1007/s10151-025-03194-4","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the efficacy and safety of a novel, simple internal traction method using a hemoclip, suture, and rubber band during endoscopic submucosal dissection (ESD) for colonic lesions.</p><p><strong>Methods: </strong>A total of 96 patients undergoing ESD at Jiangyin Hospital Affiliated with Nantong University between January 2021 and December 2024 were randomized into two groups: Group A (n = 48) underwent conventional ESD, while Group B (n = 48) underwent ESD with hemoclip-suture-rubber band traction. The study included patients with early stage colon cancer, precancerous lesions (e.g., adenomas with high-grade dysplasia), and neuroendocrine tumors. Outcome measures included total procedure time, mucosal dissection time, number of submucosal injections, en bloc resection rate, adverse events, and the size of lesion area.</p><p><strong>Results: </strong>The hemoclip-suture-rubber band traction group (Group B) demonstrated significantly shorter total procedure time (72.63 ± 34.14 min versus 85.13 ± 38.18 min, P < 0.05) and mucosal dissection time (53.56 ± 29.03 min versus 71.63 ± 39.18 min, P < 0.001) compared with the conventional ESD group (Group A). Group B also required significantly fewer submucosal injections (1.63 ± 1.23 versus 4.75 ± 1.62, P < 0.001). Lesions in Group B were significantly larger (7.650 [2.857, 10.386] cm<sup>2</sup> versus 4.895 [2.062, 6.774] cm<sup>2</sup>, P < 0.05). There were no statistically significant differences in en bloc resection rate or adverse events between the two groups (P > 0.05). However, in Group B, two patients experienced intraoperative muscularis propria injury (2/48, 4.2%) and presented with postoperative abdominal pain.</p><p><strong>Conclusions: </strong>The hemoclip-suture-rubber band traction technique facilitates colonic ESD by reducing procedure time and the need for submucosal injections, especially in larger lesions.While overall safety is comparable to conventional ESD, the potential for muscularis propria injury warrants further study in larger, multicenter trials.This simple and effective method holds promise for improving the efficiency and potentially the safety of colonic ESD.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"156"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
The application of EPSiT in pilonidal sinus disease: an international Delphi consensus study endorsed by the Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI). EPSiT在脊髓窦疾病中的应用:一项由英国和爱尔兰腹腔镜外科医生协会(ALSGBI)认可的国际德尔菲共识研究。
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-30 DOI: 10.1007/s10151-025-03191-7
H K Sekhon Inderjit Singh, P Meinero, F C Campanile, A Quddus, R Rajaganeshan, J Warusavitarne, V Dotlacil, A Bhargava, P Giordano, A Pini Prato, V Shatkar, P Jalali, V C Halahakoon, G Gallo, M Milone, S Mantoo, C A Leo, C Esposito, M Farghaly, T Arulampalam, N Pawa
{"title":"The application of EPSiT in pilonidal sinus disease: an international Delphi consensus study endorsed by the Association of Laparoscopic Surgeons of Great Britain and Ireland (ALSGBI).","authors":"H K Sekhon Inderjit Singh, P Meinero, F C Campanile, A Quddus, R Rajaganeshan, J Warusavitarne, V Dotlacil, A Bhargava, P Giordano, A Pini Prato, V Shatkar, P Jalali, V C Halahakoon, G Gallo, M Milone, S Mantoo, C A Leo, C Esposito, M Farghaly, T Arulampalam, N Pawa","doi":"10.1007/s10151-025-03191-7","DOIUrl":"10.1007/s10151-025-03191-7","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic pilonidal sinus treatment (EPSiT) is a novel, minimally invasive surgical technique that has shown promise in the treatment of pilonidal sinus disease. Despite the apparent benefits and call for increased use, widespread uptake has been slow. This study aims to gather and understand expert international opinions on EPSiT and develop recommendations for its application in the surgical community.</p><p><strong>Methods: </strong>Expert international panellists were identified and recruited to participate. A three-round modified Delphi consensus consisting of 43 questions regarding the application of EPSiT was posed. A combination of a five-point Likert scale, binary 'yes/no' scale and multiple-choice questions was used. The consensus threshold was set at 70% agreement. When consensus was not achieved or further insight was required, statement questions were posed. The study has been performed in accordance with ACcurate COnsensus Reporting Document (ACCORD) explanation and elaboration guidelines.</p><p><strong>Results: </strong>Twenty experts from six countries participated in all rounds, with a 100% response rate. Our experts agreed on 28 statements including: the absence of absolute contraindications to EPSiT; administering intravenous induction antibiotics routinely but not post-operative oral antibiotics; recommending laser epilation; offering re-EPSiT to the informed patient after first and second procedure failures; and that EPSiT should be incorporated into surgical training programmes.</p><p><strong>Conclusions: </strong>This is the first study to provide an international expert consensus on the specific application of EPSiT in primary and recurrent adult and paediatric patients with pilonidal sinus disease. The findings of this study contribute to the development of protocols for EPSiT in pilonidal sinus disease management, addressing key areas of consensus and controversy and promoting procedure uptake.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"155"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Modified transanal opening of the intersphincteric space (TROPIS): a safe and effective procedure for transsphincteric fistula-in-ano in comparison with ligation of intersphincteric fistula tract (LIFT). 改良的经肛门打开括约肌间隙(TROPIS):与结扎括约肌间瘘管束(LIFT)相比,一种安全有效的经括约肌内瘘手术。
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-30 DOI: 10.1007/s10151-025-03193-5
Z J Zhang, M S Ali, R Hegde, R H Jugo, T A Zhang, S H Kurtzman
{"title":"Modified transanal opening of the intersphincteric space (TROPIS): a safe and effective procedure for transsphincteric fistula-in-ano in comparison with ligation of intersphincteric fistula tract (LIFT).","authors":"Z J Zhang, M S Ali, R Hegde, R H Jugo, T A Zhang, S H Kurtzman","doi":"10.1007/s10151-025-03193-5","DOIUrl":"10.1007/s10151-025-03193-5","url":null,"abstract":"<p><strong>Purpose: </strong>For treating complex transsphincteric fistula, a two-stage approach is usually administered: an initial seton placement followed by a sphincter-sparing procedure. However, success rates are not optimal. This study aimS to describe the modified transanal opening of the intersphincteric space (TROPIS), a single-staged procedure for managing transsphincteric fistula with or without concurrent anorectal abscess, and to compare its efficacy with the LIFT.</p><p><strong>Methods: </strong>Thirty-six patients who presented with mid-high transsphincteric fistula with or without associated anorectal abscess and consented to the procedure from 2020 to 2023 were managed with modified TROPIS. The primary outcome measures were recurrent fistulas and fecal continence. These results were compared with our previous study data of 24 patients who underwent LIFT procedure from 2011 to 2013.</p><p><strong>Results: </strong>Thirty-six patients received modified TROPIS; nine (25.0%) had an associated ischiorectal abscess. At the 8-month and 14-month follow-up, zero patients experienced fistula recurrence or fecal incontinence. In comparison with our previous study, 24 patients with transsphincteric fistula with or without associated abscess were treated with initial seton placement, then LIFT. With a follow-up range of 14-36 months, five (20.8%) patients presented with recurrent fistulas; no patients experienced fecal incontinence. These results were statistically significant.</p><p><strong>Conclusions: </strong>Our results reflect that modified TROPIS is a safe, simple, and effective procedure for treating patients with transsphincteric fistula with or without associated abscess. Patients healed with no fistula recurrence, which is significant in comparison with previous patients treated with LIFT. Modified TROPIS does not require an initial seton placement for managing transsphincteric fistula with associated abscess.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"153"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Quality of life following ileostomy takedown: single-centre, retrospective clinical trial-does closure time matter? 回肠造口术后的生活质量:单中心、回顾性临床试验——闭合时间重要吗?
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-30 DOI: 10.1007/s10151-025-03196-2
G Didrikaite, M Klimovskij, I Civilka, B Buckus, T Aukstikalnis, E Sileika, A Dulskas
{"title":"Quality of life following ileostomy takedown: single-centre, retrospective clinical trial-does closure time matter?","authors":"G Didrikaite, M Klimovskij, I Civilka, B Buckus, T Aukstikalnis, E Sileika, A Dulskas","doi":"10.1007/s10151-025-03196-2","DOIUrl":"10.1007/s10151-025-03196-2","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to assess whether early closure of loop ileostomy reduces the rate of postoperative complications related to ileostomy closure and improves patients' quality of life, as measured by the Low Anterior Resection Syndrome (LARS) and Wexner questionnaires.</p><p><strong>Methods: </strong>All patients who underwent low anterior resection + ileostomy with subsequent reversal between January 2019 and May 2023 were included in the study. Patients were divided into two groups: early (< 3 months) and late closure (> 3 months). There were 46 (43%) patients in the early closure group and 61 (57%) in late closure. In this study, patients' demographics and complication rate (categorised by severity using the Clavien-Dindo scale) were assessed.</p><p><strong>Results: </strong>We assessed and contacted 180 patients. Of these, 107 (59%) completed the LARS and Wexner questionnaires. Of the 107 patients, 51 were male (47.7%) and 56 female (52.3%). The time to ileostomy closure ranged between 0.5 and 28 months, with a median of 5. In the early and late closure groups, postoperative complications were observed in 4.3% vs. 14.8% (p = 0.08) of patients and postoperative ileus occurred in 6.5% vs. 4.9% (p = 0.72) of patients respectively. Median LARS score was 25 vs. 20 (p = 0.99) and Wexner's 2.5 vs. 2 (p = 0.82), respectively. The previously discussed indicators (postoperative ileostomy complications, postoperative ileus rate, LARS and Wexner scores) were not statistically significantly different.</p><p><strong>Conclusion: </strong>In our small retrospective study, early ileostomy closure did not affect postoperative complications related to ileostomy closure and bowel dysfunction rates compared to late closure.</p><p><strong>Trial registration: </strong>This study was a secondary analysis of the prospective trial registered at ClinicalTrials.gov no. NCT03607370, 01.07.2017.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"154"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Inferior versus medial approach in laparoscopic and robotic surgery with complete mesocolic excision for right-sided colon cancer: propensity score-matched analysis. 右侧结肠癌腹腔镜和机器人手术结肠系膜完全切除的下入路与内侧入路:倾向评分匹配分析。
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-30 DOI: 10.1007/s10151-025-03199-z
S Izukawa, M Numata, T Harada, Y Atsumi, K Kazama, S Sawazaki, T Godai, H Mushiake, A Higuchi, H Tamagawa, Y Suwa, J Watanabe, T Sato, A Saito
{"title":"Inferior versus medial approach in laparoscopic and robotic surgery with complete mesocolic excision for right-sided colon cancer: propensity score-matched analysis.","authors":"S Izukawa, M Numata, T Harada, Y Atsumi, K Kazama, S Sawazaki, T Godai, H Mushiake, A Higuchi, H Tamagawa, Y Suwa, J Watanabe, T Sato, A Saito","doi":"10.1007/s10151-025-03199-z","DOIUrl":"10.1007/s10151-025-03199-z","url":null,"abstract":"<p><strong>Background: </strong>Right-sided colon cancer surgery is a highly difficult operation, and ensuring perioperative safety is an important issue. While various approaches have been proposed for right-sided colon cancer, there are few reports comparing them. The present study compared the inferior approach (IA) and medial approach (MA) for right-sided colon cancer surgery and evaluated their safety.</p><p><strong>Methods: </strong>We compared 528 cases of right-sided colon cancer surgery performed at our five affiliated institutions from 2017 to 2023, divided into IA and MA groups of 122 cases each using propensity score matching. Short-term outcomes of both groups were retrospectively evaluated, focusing on perioperative complications and perioperative mortality as the primary outcomes.</p><p><strong>Results: </strong>After propensity score matching, all baseline variables were well balanced. All patients underwent complete mesocolic excision. No statistically significant difference (p < 0.05) was observed between the two groups in the incidence of postoperative complications, and no cases of severe complications were observed in either group. The incidence rates of Clavien-Dindo grade ≥ 3 complications (IA/ MA): anastomotic leakage (0%/ 0.8%); intraabdominal abscess (0.8%/ 1.6%); surgical site infection (0.8%/ 3.2%); ileus (0%/ 0.8%); and anastomotic bleeding: (0%/ 0%). Postoperative hospital stay was significantly shorter in the IA group. Although there was a significant difference in the number of dissected lymph nodes, both groups had good R0 resection rates.</p><p><strong>Conclusions: </strong>Both IA and MA represent safe and feasible approaches for right-sided colon cancer and can be selected on the basis of the surgeon's preference.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"157"},"PeriodicalIF":2.9,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Increasing age, neural invasion, extramural vascular invasion, and short-course radiotherapy in locally advanced rectal cancer are associated with decreased tumor regression: a retrospective cohort study. 一项回顾性队列研究表明,年龄增加、神经侵犯、外血管侵犯和局部晚期直肠癌的短期放疗与肿瘤消退减少有关。
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-27 DOI: 10.1007/s10151-025-03180-w
O F Johnsen, R Riis, S Meltzer, K M Augestad
{"title":"Increasing age, neural invasion, extramural vascular invasion, and short-course radiotherapy in locally advanced rectal cancer are associated with decreased tumor regression: a retrospective cohort study.","authors":"O F Johnsen, R Riis, S Meltzer, K M Augestad","doi":"10.1007/s10151-025-03180-w","DOIUrl":"10.1007/s10151-025-03180-w","url":null,"abstract":"<p><strong>Background: </strong>We investigated factors associated with pathologic complete response (pCR) and tumor regression grade (TRG) on the basis of clinical and pathological variables and their impact on cancer-free survival (CFS) after surgery for locally advanced rectal cancer (LARC).</p><p><strong>Methods: </strong>All patients with LARC undergoing neoadjuvant treatment before curative total mesorectal excision surgery were included in a prospective institutional database connected to the National Mortality Registry. One-way analysis of variance and Pearson's chi-squared test were utilized to compare TRG groups. The Kaplan-Meier method and regression models were used to evaluate CFS, radiation modality, and staging factors.</p><p><strong>Results: </strong>Of 700 patients operated on for rectal cancer between 2014 and 2024, 159 (22.7%) had LARC without known systemic cancer. Twenty-seven patients had pCR (TRG 0, 17.0%), 46 TRG 1 (29.0%), 70 TRG 2 (44.0%), and 16 TRG 3 (10%). Poor tumor regression was associated with increasing age (p = 0.009), vascular (p < 0.001) and neural invasion (p = 0.005), less differentiated tumors (p < 0.001), short-course 5 Gy × 5 (p < 0.001) rather than long-course 2 Gy × 25 radiotherapy, and omission of neoadjuvant chemotherapy (p < 0.001). Older age was a predictor of short-course radiotherapy and omission of chemotherapy (p < 0.001). Follow-up time was 46.6 months (IQR 20-80.3 months). No differences were found in CFS between TRG groups 0-3 (p = 0.18), however pCR was associated with improved CFS (p = 0.047).</p><p><strong>Conclusions: </strong>Decreased tumor regression was associated with reduced radiotherapy and chemotherapy, neural and vascular invasion, poor differentiation, and increasing age. The latter may reflect reduced application of neoadjuvant treatment in older patients. Complete responders experienced increased cancer-free survival.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"152"},"PeriodicalIF":2.9,"publicationDate":"2025-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Neoadjuvant therapy for lateral pelvic lymph nodes: choosing between long course chemoradiation or short course radiotherapy with consolidation chemotherapy. 骨盆外侧淋巴结的新辅助治疗:选择长期放化疗或短期放疗合并巩固化疗。
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-25 DOI: 10.1007/s10151-025-03177-5
Subhathira Manohkaran, T Vispute, A Mor, K Prakash, M Kazi, A Sharma, S K Ankathi, A Desouza, A Saklani
{"title":"Neoadjuvant therapy for lateral pelvic lymph nodes: choosing between long course chemoradiation or short course radiotherapy with consolidation chemotherapy.","authors":"Subhathira Manohkaran, T Vispute, A Mor, K Prakash, M Kazi, A Sharma, S K Ankathi, A Desouza, A Saklani","doi":"10.1007/s10151-025-03177-5","DOIUrl":"10.1007/s10151-025-03177-5","url":null,"abstract":"<p><strong>Background: </strong>The response of lateral pelvic lymph nodes (LPLNs) to various neoadjuvant treatments has not been thoroughly investigated. This study aims to compare the effects of long-course chemoradiotherapy (LCCRT) and total neoadjuvant therapy (TNT), i.e., short-course radiotherapy (SCRT) with consolidation chemotherapy, on LPLNs size reduction. The secondary objective is to compare the pathological positivity rates of LPLNs dissection (LPLND) postneoadjuvant treatment.</p><p><strong>Methods: </strong>This is a retrospective analysis based on a prospectively maintained database. Patients with rectal cancer registered between January 2020 and December 2021 with radiologically positive LPLNs who underwent neoadjuvant radiation therapy were included. Patients were divided into two groups: LCCRT and TNT.</p><p><strong>Results: </strong>Among 1200 registered rectal cancer cases, 160 had positive LPLNs, with 142 included in the analysis. A total of 61 patients received LCCRT, and 81 patients received TNT. No significant differences were found in tumor (T) and node (N) staging between the groups. However, the TNT cohort had a significantly higher proportion of patients with metastases (p < 0.001), poorly differentiated tumors (p = 0.021), and extramural venous invasion (p = 0.002). Baseline mean nodal sizes were similar between groups. Postneoadjuvant nodal sizes were 5.3 mm for LCCRT and 6.2 mm for TNT, with mean reductions of 5.7 mm and 4.6 mm, respectively (p = 0.136 and 0.54). Surgery was conducted in 77% of the LCCRT group and 59% of the TNT group, with 22 (46.8%) and 26 (54.1%) undergoing LPLND in their respective groups. The pathological positivity rates for LPLNs were similar (27.3% versus 23.1%, p = 0.731).</p><p><strong>Conclusions: </strong>SCRT with consolidation chemotherapy does not provide a significant advantage over LCCRT in reducing LPLNs size or reducing the need for LPLND.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"151"},"PeriodicalIF":2.9,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12296789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Rerouting of the tract in the treatment of high anal fistula: a single-center experience. 在高位肛瘘的治疗中改道:单中心经验。
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-24 DOI: 10.1007/s10151-025-03179-3
Mahmoud Refaat Shehata, Mahmoud Mohamed Mohamed Abdelghany, Gamal Abdel-Hamid Ahmed Eid, Ragai Sobhi Hanna
{"title":"Rerouting of the tract in the treatment of high anal fistula: a single-center experience.","authors":"Mahmoud Refaat Shehata, Mahmoud Mohamed Mohamed Abdelghany, Gamal Abdel-Hamid Ahmed Eid, Ragai Sobhi Hanna","doi":"10.1007/s10151-025-03179-3","DOIUrl":"10.1007/s10151-025-03179-3","url":null,"abstract":"<p><strong>Background: </strong>High anal fistulae require more complicated treatment than low anal fistulae. Because of their complexity, this study aimed to assess the rerouting role in high anal fistulae treatment, as well as to assess recurrence and incontinence, and determine whether rerouting of the tract is a good option for treating high anal fistulae.</p><p><strong>Methods: </strong>This is a prospective interventional study that was conducted on 83 patients with high perianal fistula, ranging in age from 18 to 72 years old, of both genders. All cases were assigned to history taking, laboratory investigations, clinical examination (general examination and local examination), and magnetic resonance imaging (MRI) for objective delineation of the fistulous tract and its association to the anal sphincters.</p><p><strong>Results: </strong>After a minimum follow-up period of 9 months, five cases (6.02%) experienced recurrence. Mild incontinence was reported in four patients (4.8%), while four patients (4.8%) developed infection. In addition, tract gangrene was observed in two patients (2.41%). In multivariate regression analysis, suprasphincteric fistulae and infection were independent predictors for recurrence.</p><p><strong>Conclusions: </strong>The rerouting procedure is a feasible and safe surgical option for managing high transsphincteric perianal fistulae. It is associated with low postoperative complication rates, including short-term recurrence. It combines the advantages of fistulotomy and sphincter-preserving fistula surgery. However, further studies involving a large number of suprasphincteric fistula cases are needed to evaluate the efficacy of the rerouting technique in treating such fistulae.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"150"},"PeriodicalIF":2.9,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12289857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Anatomical distribution of hemorrhoidal piles in advanced disease: clinical insights and correlations. 晚期疾病中痔疮的解剖分布:临床见解和相关性。
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-22 DOI: 10.1007/s10151-025-03184-6
I Osmanov, E Ergüder, J Ahmadov, C Ersak, S Leventoğlu, B B Menteş
{"title":"Anatomical distribution of hemorrhoidal piles in advanced disease: clinical insights and correlations.","authors":"I Osmanov, E Ergüder, J Ahmadov, C Ersak, S Leventoğlu, B B Menteş","doi":"10.1007/s10151-025-03184-6","DOIUrl":"10.1007/s10151-025-03184-6","url":null,"abstract":"<p><strong>Background: </strong>A precise evaluation of the positional distribution of hemorrhoidal piles has not been distinctly conducted. We hypothesized that the distribution of hemorrhoidal piles follows a predictable anatomical pattern influenced by disease duration and recurrence.</p><p><strong>Methods: </strong>Our retrospective study analyzed the demographic data, surgical records, operative photographs, previous treatments, and associated colorectal symptoms of patients who underwent invasive procedures for advanced hemorrhoidal disease (2020-2024).</p><p><strong>Results: </strong>Of the 171 patients (123 male; 71.9%; median age 41 ± 12.04 years, range 18-88), 35 had prior interventions (recurrent cases). The largest pile was most commonly in the left lateral quadrant (40.14%), followed by right posterior (31.97%), right anterior (23.47%), and atypical locations (4.42%). Left lateral predominance was significantly higher in primary cases than in recurrent cases (p = 0.031). Most patients had more than one pile (87.7%). Symptom duration positively correlated with pile number (Spearman's rho = 0.229, p = 0.013), but not with hemoroid grade (p = 0.977). No significant differences in pile distribution were observed in patients with defecation disorders, labor history, or concomitant anal fissure (p > 0.05). Of the 48 patients with anal fissure had significantly shorter symptom duration compared to those without fissure (p = 0.011).</p><p><strong>Conclusion: </strong>The classical three-quadrant distribution is confirmed, with the left lateral pile being predominant in primary cases. The association between prolonged symptom duration and increased pile number offers novel insights, highlighting left lateral predominance in primary cases and its reduction in recurrence, enhancing clinical understanding and management.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"147"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Long-term incontinence rates after traditional lateral internal sphincterotomy: a 5-year retrospective analysis from a high-volume tertiary referral center for proctologic disorders. 传统外侧内括约肌切开术后的长期尿失禁率:来自直肠疾病大容量三级转诊中心的5年回顾性分析。
IF 2.9 3区 医学
Techniques in Coloproctology Pub Date : 2025-07-22 DOI: 10.1007/s10151-025-03189-1
A Realis Luc, A Di Vittori, A Salvatore, G Gravante, V De Simone, A Micarelli, G Clerico, M Trompetto, G Gallo
{"title":"Long-term incontinence rates after traditional lateral internal sphincterotomy: a 5-year retrospective analysis from a high-volume tertiary referral center for proctologic disorders.","authors":"A Realis Luc, A Di Vittori, A Salvatore, G Gravante, V De Simone, A Micarelli, G Clerico, M Trompetto, G Gallo","doi":"10.1007/s10151-025-03189-1","DOIUrl":"10.1007/s10151-025-03189-1","url":null,"abstract":"<p><strong>Background: </strong>Chronic anal fissures (CAF) are a common proctological condition that significantly impacts patients' quality of life. Lateral internal sphincterotomy (LIS) is widely considered the gold-standard treatment for CAF; however, postoperative fecal incontinence remains a potential risk. The aim of this study is to evaluate long-term incontinence rates following traditional LIS for CAF.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with CAF who underwent traditional LIS. Patients with any degree of continence impairment prior to surgery, as well as those who experienced events potentially affecting continence function after surgery, were excluded from the analysis. Incontinence was assessed using the Vaizey score both preoperatively and at follow-up.</p><p><strong>Results: </strong>Between January 2014 and May 2019, 98 patients met the inclusion criteria. The mean follow-up duration was 7 years (range 5-10 years). At follow-up, the Vaizey score ranged from 1 to 4 in 19 patients (19.4%) and from 5 to 9 in 5 patients (5.1%). Incontinence primarily involved gas or liquid stool; no patients reported solid stool incontinence. A total of four patients (4.1%) experienced defecatory urgency. No patients required constipating medications or reported lifestyle changes; only one patient (1.0%) required the use of pads. No correlation was found with age, sex, BMI, or smoking status.</p><p><strong>Conclusions: </strong>When present, incontinence following traditional LIS is generally mild, does not require constipating medications, and does not interfere with patients' lifestyle.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"149"},"PeriodicalIF":2.9,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信