Seminars in Colon and Rectal Surgery最新文献_第8页

Combined Endo-Laparoscopic Surgery (CELS) for the management of complex colorectal lesions 联合内镜-腹腔镜手术（CELS）治疗复杂结肠直肠病变

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Seminars in Colon and Rectal Surgery Pub Date : 2024-06-01 Epub Date: 2024-05-09 DOI: 10.1016/j.scrs.2024.101022

Brian Williams MD, Sang W. Lee MD

{"title":"Combined Endo-Laparoscopic Surgery (CELS) for the management of complex colorectal lesions","authors":"Brian Williams MD, Sang W. Lee MD","doi":"10.1016/j.scrs.2024.101022","DOIUrl":"10.1016/j.scrs.2024.101022","url":null,"abstract":"<div><p>Detection of colon polyps is common and is expected in 20–30 % of screening colonoscopies. As the number of colonoscopies performed increases, the detection of advanced and difficult to resect polyps will also rise. These polyps tend to be larger, greater than 2 cm, have flat morphology, and are in difficult anatomic locations behind haustral folds or at sharp flexures of the colon. Advanced endoscopic techniques such as endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are useful to remove these polyps. However, many polyps remain unresectable with these techniques. Combined endoscopic laparoscopic surgery (CELS) has shown to be an effective technique to facilitate safe removal of complex polyps. CELS encompasses a variety of techniques including laparoscopic assisted ESD/EMR and laparo-endoscopic full thickness excisions (FLEX). Success rate of CELS ranges from 70 to 100 %, with less than 5 % conversion to colectomy. Perioperative outcomes boast shorter hospital length of stay, with low rates of serious post-op complications when compared to colectomy. Malignancy rate after CELS in appropriately selected patients is low, ranging from 1.6 %-10 % of cases. Polyp recurrence rate after CELS is also low, usually less than 10 %. Use of CELS for early-stage cancers remains controversial but maybe adequate in appropriately selected patients. Further evaluation and long-term studies are needed to study its efficacy in cases of known cancer. The purpose of this review is to provide recommendations for use of CELS techniques, appropriate indications, describe technical tips, and review potential future applications.</p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"35 2","pages":"Article 101022"},"PeriodicalIF":0.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141027853","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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How to adopt endoluminal surgery in a new colorectal surgery practice and endoluminal management of T1 colon cancers 如何在新的结直肠外科实践中采用腔内手术以及 T1 结肠癌的腔内治疗

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Seminars in Colon and Rectal Surgery Pub Date : 2024-06-01 Epub Date: 2024-05-09 DOI: 10.1016/j.scrs.2024.101024

Bradford Sklow MD

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Computer-Generated modelling in surgery 外科手术中的计算机生成模型

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Seminars in Colon and Rectal Surgery Pub Date : 2024-03-01 Epub Date: 2024-02-07 DOI: 10.1016/j.scrs.2024.101003

Jordan Fletcher, Danilo Miskovic

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The evolution of natural orifice transluminal endoscopic surgery (NOTES) in colon & rectal surgery 结肠和直肠外科自然腔道内窥镜手术（NOTES）的发展历程

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Seminars in Colon and Rectal Surgery Pub Date : 2024-03-01 Epub Date: 2024-02-07 DOI: 10.1016/j.scrs.2024.101005

Katherine F Donovan MD , Ameer Farooq MD , Patricia Sylla MD

引用次数: 0

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 Epub Date: 2024-02-07 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><p>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.</p></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 Epub Date: 2024-02-07 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><p>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.</p></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 Epub Date: 2024-02-07 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 Epub Date: 2024-02-07 DOI: 10.1016/j.scrs.2024.101007

Hyun Jae Kim , Nasim Parsa , Michael F. Byrne

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 : 2023-12-01 Epub 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><p><span>Advancements in the surgical and medical care of anorectal malformation (ARMs) have led to greater life expectancy and improved </span>quality of life<span><span><span><span>. Patients with ARM frequently experience fecal incontinence (17–77 %), constipation (23–87 %), and </span>rectal prolapse (4–60 %). </span>Upper urinary tract<span><span> abnormalities occur in 40-83 %, leading to end-stage renal disease in 5–18 % and kidney transplantation<span> 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 </span></span>hematometra, which may impact fertility. </span></span>Cryptorchidism<span><span><span> 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<span> or soiling. While fertility rates vary, childbirth is still possible. However, pregnancies carry a higher risk of miscarriage and premature delivery<span>, and delivery via Cesarean section is recommended. </span></span></span>Malignancy is uncommon, but patient </span>anatomy<span> is imperative to consider when assessing cancer risk, screening needs, and the impact of cancer treatment<span>. 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.</span></span></span></span></p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 4","pages":"Article 100989"},"PeriodicalIF":0.3,"publicationDate":"2023-12-01","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 : 2023-12-01 Epub 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><p>Development of enterocutaneous fistula<span><span> (ECF) remains a challenging complication of gastrointestinal surgery<span> 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 </span></span>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.</span></p></div>","PeriodicalId":55956,"journal":{"name":"Seminars in Colon and Rectal Surgery","volume":"34 4","pages":"Article 100987"},"PeriodicalIF":0.3,"publicationDate":"2023-12-01","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