Seminars in Colon and Rectal Surgery最新文献_第5页

Biofluorescence in surgery: Present and future 外科手术中的生物荧光--现状与未来

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Seminars in Colon and Rectal Surgery Pub Date : 2024-03-01 DOI: 10.1016/j.scrs.2024.101004

Mr Rory F. Kokelaar MBBS MA (Oxon) MEd FRCS (Eng) PhD (Clinical Associate Professor) , Mr Manish Chand MBBS BSc FRCS (Eng) FASCRS MBA PhD (Associate Professor of Surgery)

{"title":"Biofluorescence in surgery: Present and future","authors":"Mr Rory F. Kokelaar MBBS MA (Oxon) MEd FRCS (Eng) PhD (Clinical Associate Professor) , Mr Manish Chand MBBS BSc FRCS (Eng) FASCRS MBA PhD (Associate Professor of Surgery)","doi":"10.1016/j.scrs.2024.101004","DOIUrl":"10.1016/j.scrs.2024.101004","url":null,"abstract":"<div>Biofluorescence is a physical phenomenon that has gained a multitude of clinical applications since its introduction to medicine in the 1940s. The utilisation of biofluorescence in colorectal surgery has grown from the development of the fluorophore indocyanine green (ICG) and its prior applications in assessing vascular beds in other fields of surgery. However, despite the increasing adoption of ICG in the assessment of colonic conduit perfusion, the evidence base for its utilisation remains controversial, although a range of other uses for this technology are emerging. Advances in semi-quantitative and artificial intelligence augmented platforms are providing greater objectivity in the application of biofluorescent techniques in colorectal surgery, although they are still in a largely developmental phase. Molecular-targeted biofluorescent technologies are also opening up new surgical paradigms for intraoperative real-time assessment of tumours and their locoregional spread and may in time facilitate surgeons to find equipoise in the radicality of oncologic resection.</div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 1","pages":"Article 101004"},"PeriodicalIF":0.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1043148924000034/pdfft?md5=67d95fd01beefe671bde19bdd0e26efe&pid=1-s2.0-S1043148924000034-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139888701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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Endoluminal and next generation robotics in colorectal surgery 结直肠手术中的腔内和下一代机器人技术

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Seminars in Colon and Rectal Surgery Pub Date : 2024-03-01 DOI: 10.1016/j.scrs.2024.101006

Barbara Seeliger MD, PhD , Jacques Marescaux MD, PhD

{"title":"Endoluminal and next generation robotics in colorectal surgery","authors":"Barbara Seeliger MD, PhD , Jacques Marescaux MD, PhD","doi":"10.1016/j.scrs.2024.101006","DOIUrl":"10.1016/j.scrs.2024.101006","url":null,"abstract":"<div>Innovative approaches leverage cutting-edge technologies to advance the field of minimally invasive colorectal surgery. The implementation of complex endoluminal and transluminal procedures is challenging and requires extensive training. Recent technological advances not only enable improved detection of colorectal neoplasms with the support of computer science, but also enhanced surgical treatment with robotic instrumentation. Early diagnosis will revolutionize colorectal cancer treatment by avoiding surgery, as has been demonstrated in the treatment of early-stage gastric cancer using third-space endoscopy. Automated colorectal cancer screening with polyp detection and classification can change the therapeutic strategy and orient towards resection during endoscopy, including full-thickness resection, with endoscopic bimanual suturing to close the defect. Several therapeutic flexible endoscopic robotic systems are expected to provide surgery-like dexterity for endo- and transluminal approaches by enabling tissue triangulation while lowering the technical hurdles for endoscopic submucosal dissection and other highly sophisticated procedures such as endoscopic creation or revision of anastomoses. In the curvilinear anatomy of the colon and rectum, navigation assistance for improved spatio-temporal orientation will aid in the detection and documentation of lesions and facilitate their localization for excision and follow-up. Flexible robotic systems encourage surgeons as well as gastroenterologists to perform advanced intra- and transluminal resections.</div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 1","pages":"Article 101006"},"PeriodicalIF":0.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139823455","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

Computer vision in colorectal surgery: Current status and future challenges 结直肠手术中的计算机视觉：现状与未来挑战

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Seminars in Colon and Rectal Surgery Pub Date : 2024-03-01 DOI: 10.1016/j.scrs.2024.101008

Daichi Kitaguchi, Masaaki Ito

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The role of artificial intelligence in colonoscopy 人工智能在结肠镜检查中的作用

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Seminars in Colon and Rectal Surgery Pub Date : 2024-03-01 DOI: 10.1016/j.scrs.2024.101007

Hyun Jae Kim , Nasim Parsa , Michael F. Byrne

引用次数: 0

Transitions 转换

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Seminars in Colon and Rectal Surgery Pub Date : 2023-10-21 DOI: 10.1016/j.scrs.2023.100991

Thomas E. Read MD, FACS, FASCRS

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The failed colorectal anastomosis: Turnbull–Cutait as a salvage option 结直肠吻合术失败:特恩布尔切口术作为挽救选择

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Seminars in Colon and Rectal Surgery Pub Date : 2023-10-20 DOI: 10.1016/j.scrs.2023.100988

Carla F. Justiniano MD, MPH , Tracy Hull MD

{"title":"The failed colorectal anastomosis: Turnbull–Cutait as a salvage option","authors":"Carla F. Justiniano MD, MPH , Tracy Hull MD","doi":"10.1016/j.scrs.2023.100988","DOIUrl":"10.1016/j.scrs.2023.100988","url":null,"abstract":"<div>The incidence of colorectal anastomotic leaks is approximately 5–19 % of cases, posing a threat to intestinal continuity, particularly if the leak arises after a low or ultra-low colorectal anastomosis. A Turnbull–Cutait procedure can be a salvage option for such patients and they may be eligible if they are adequate redo pelvic surgery candidates, who are motivated to regain intestinal continuity, and who have good continence and anal function at baseline. The first stage of the procedure is colonic mobilization and pull-through after perineal division at the top of the anorectal complex and mucosectomy. A diverting loop ileostomy is utilized. The second stage is amputation of the excess colon and creation of a hand-sewn colo-anal anastomosis, typically performed 7 days later. Outcomes after a Turnbull–Cutait procedure are reasonable based on a series from specialized centers with 80–90 % of patients having a complete Turnbull–Cutait and reversal of the diverting ileostomy. Low anterior resection syndrome is common. In the long-term, studies show that just over half of patients will remain stoma free at 5 years; fecal incontinence is the main reason for failure and return to a stoma. The prospect of a Turnbull–Cutait can be kept in mind when addressing an anastomotic leak in appropriate patients; this may allow for surgical decision-making that makes it feasible to utilize a Turnbull–Cutait in the future.</div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 4","pages":"Article 100988"},"PeriodicalIF":0.3,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135965474","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

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}

引用次数: 0

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