Seminars in Colon and Rectal Surgery最新文献_第4页

After anoplasty for anorectal malformations: Issues continue in adolescence and adulthood 肛肠畸形的肛管成形术后:问题继续在青少年和成年期

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Seminars in Colon and Rectal Surgery Pub Date : 2023-10-17 DOI: 10.1016/j.scrs.2023.100989

J.C. Chen MD , Alessandra C Gasior DO

{"title":"After anoplasty for anorectal malformations: Issues continue in adolescence and adulthood","authors":"J.C. Chen MD , Alessandra C Gasior DO","doi":"10.1016/j.scrs.2023.100989","DOIUrl":"10.1016/j.scrs.2023.100989","url":null,"abstract":"<div>Advancements in the surgical and medical care of anorectal malformation (ARMs) have led to greater life expectancy and improved quality of life. Patients with ARM frequently experience fecal incontinence (17–77 %), constipation (23–87 %), and rectal prolapse (4–60 %). Upper urinary tract abnormalities occur in 40-83 %, leading to end-stage renal disease in 5–18 % and kidney transplantation in 2–8 %. Urinary incontinence occurs in 0–41 % of patients. Mullerian anomalies occur in up to 60 % of patients, and 36–41 % present with hematometra, which may impact fertility. Cryptorchidism is seen in 19 % and may lead to reduced paternity rates. Sexual dysfunction impacts 6–66 % of patients and coital debut is delayed, often due to fear of flatus or soiling. While fertility rates vary, childbirth is still possible. However, pregnancies carry a higher risk of miscarriage and premature delivery, and delivery via Cesarean section is recommended. Malignancy is uncommon, but patient anatomy is imperative to consider when assessing cancer risk, screening needs, and the impact of cancer treatment. Depression and anxiety occur in 80 %, with up to 15 % reporting suicidal ideation, yet only 12–40 % receive treatment. The high prevalence of ongoing complications highlights the need for continued multidisciplinary care after index ARM repair.</div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 4","pages":"Article 100989"},"PeriodicalIF":0.3,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135811835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Medical and surgical management of enterocutaneous fistula 肠皮瘘的内科和外科治疗

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Seminars in Colon and Rectal Surgery Pub Date : 2023-10-17 DOI: 10.1016/j.scrs.2023.100987

Matthew A. Fuglestad , John RT Monson MD

{"title":"Medical and surgical management of enterocutaneous fistula","authors":"Matthew A. Fuglestad , John RT Monson MD","doi":"10.1016/j.scrs.2023.100987","DOIUrl":"10.1016/j.scrs.2023.100987","url":null,"abstract":"<div>Development of enterocutaneous fistula (ECF) remains a challenging complication of gastrointestinal surgery and fistulizing disease processes. Successful management of ECF is dependent on timely diagnosis, effective treatment of resulting intra-abdominal sepsis, wound/nutrition management, and supporting the patient though the perioperative optimization period. When approached in multi-disciplinary setting with teams specializing in ECF/intestinal failure, care is optimized and can allow for patients to have greater independence even with complex wounds. While resolution of the ECF remains the overarching goal, a methodical and stepwise approach to management remains paramount both before and after surgical intervention. This chapter outlines ECF management from initial diagnosis to intra-operative decision making after a patient is deemed a candidate for surgery. Further, it highlights patient-specific considerations that can be overlooked in the big picture view of ECF management. While ECF treatment is challenging, the chance to cure a patient of their fistula is a rewarding experience for the patient and ECF/intestinal failure team members alike.</div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 4","pages":"Article 100987"},"PeriodicalIF":0.3,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135809849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anorectal mucosal melanoma 肛门直肠粘膜黑色素瘤

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Seminars in Colon and Rectal Surgery Pub Date : 2023-10-17 DOI: 10.1016/j.scrs.2023.100990

Janet Alvarez MD , J. Joshua Smith MD, PhD

引用次数: 0

How to manage a patient with chronic liver disease undergoing colorectal surgery? 如何处理接受结直肠手术的慢性肝病患者?

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Seminars in Colon and Rectal Surgery Pub Date : 2023-10-17 DOI: 10.1016/j.scrs.2023.100986

Benoît Dupont MD , Arnaud Alves MD, PhD

{"title":"How to manage a patient with chronic liver disease undergoing colorectal surgery?","authors":"Benoît Dupont MD , Arnaud Alves MD, PhD","doi":"10.1016/j.scrs.2023.100986","DOIUrl":"10.1016/j.scrs.2023.100986","url":null,"abstract":"<div>The indications for colorectal surgery in cirrhotic patients have recently been broadened, mostly due to a better understanding and multidisciplinary management of cirrhosis. However, anesthesia and colorectal surgery may both exacerbate deteriorations in liver function in a patient with chronic liver disease such that careful preoperative patient selection remains mandatory. Four scores (i.e., Child-Turcotte-Pugh, the Model for End-Stage Liver Disease, Mayo Risk Score, and (VOCAL)-Penn cirrhosis surgical risk score) are currently available to assess the severity of cirrhosis, determine the risk of decompensation, and to estimate postoperative mortality. For colorectal resection to be safely performed electively in patients with compensated liver disease, optimization of the patient is mandatory in the preoperative setting. Preoperative transjugular intrahepatic portosystemic shunt (TIPS) is a promising strategy in patients with portal hypertension, but it requires further evaluation. Similarly, further studies are needed to validate both the feasibility and safety of the laparoscopic approach to colorectal surgery in cirrhotic patients. In summary, preoperative identification and optimization combined with meticulous postoperative care are essential for optimum outcomes in patients with chronic liver disease undergoing colorectal surgery.</div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 4","pages":"Article 100986"},"PeriodicalIF":0.3,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135809855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How can the surgeon reduce recurrence after surgery for ileocolic Crohn's disease? 外科医生如何减少回肠结肠性克罗恩病手术后的复发?

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Seminars in Colon and Rectal Surgery Pub Date : 2023-10-17 DOI: 10.1016/j.scrs.2023.100985

Steven R. Brown MD (Professor of Surgery)

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Local tumor complications in stage IV colorectal cancer 癌症IV期局部肿瘤并发症

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Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100973

Smadar R. Bogardus MD , Gregory K. Low MD

引用次数: 0

Sequence of colorectal and liver resection in patients with surgically-treatable stage IV colorectal cancer 可手术治疗的IV期结直肠癌患者的结肠和肝脏切除顺序

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Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100969

Calista Harbaugh MD, MSc , Aneel Damle MD, MBA

{"title":"Sequence of colorectal and liver resection in patients with surgically-treatable stage IV colorectal cancer","authors":"Calista Harbaugh MD, MSc , Aneel Damle MD, MBA","doi":"10.1016/j.scrs.2023.100969","DOIUrl":"10.1016/j.scrs.2023.100969","url":null,"abstract":"<div>Approximately 25-30% of patients with colorectal cancer develop hepatic metastases. For patients diagnosed with resectable colorectal hepatic metastases, variation exists regarding the timing of resection of the colorectal primary and the hepatic metastases including three approaches: (1) the “classical” colorectal-first staged approach, (2) the “combined” or simultaneous/synchronous approach, and (3) the “reverse” or liver-first staged approach. The purpose of this chapter is to review the current literature regarding the timing of colorectal and hepatic resection in patients with surgically treatable colorectal adenocarcinoma hepatic metastases. There are inadequate data at the current time to provide definitive recommendations as to the optimal timing and sequence of surgery. Our recommendations based on existing data favor delivery of neoadjuvant therapy followed by either: (1) the combined approach for low-risk resections, (2) the liver-first staged strategy for high-risk hepatic resections or mid- to distal rectal tumors that may benefit from total neoadjuvant therapy, or (3) the colorectal-first approach for symptomatic primary colon tumors.</div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 3","pages":"Article 100969"},"PeriodicalIF":0.3,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41828736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Advances in systemic chemotherapy and immunotherapy for metastatic colorectal cancer 转移性癌症的全身化疗和免疫治疗进展

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Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100972

Nikhil Grandhi MD , Bindiya Patel MD , Olivia Aranha MD, PhD

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Epidemiological trends in stage IV colorectal cancer 结直肠癌IV期流行病学趋势

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Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100967

Jeffrey Roberson MD, Lillias Maguire MD

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Resecting the asymptomatic colon cancer primary in stage IV disease with unresectable metastases 切除无症状结肠癌原发于IV期疾病并有不可切除的转移

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Seminars in Colon and Rectal Surgery Pub Date : 2023-09-01 DOI: 10.1016/j.scrs.2023.100971

Kristen A. Ban MD, MS

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