Seminars in Colon and Rectal Surgery最新文献_第9页

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 : 2023-12-01 Epub Date: 2023-10-17 DOI: 10.1016/j.scrs.2023.100990

Janet Alvarez MD , J. Joshua Smith MD, PhD

引用次数: 0

Transitions 转换

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Seminars in Colon and Rectal Surgery Pub Date : 2023-12-01 Epub Date: 2023-10-21 DOI: 10.1016/j.scrs.2023.100991

Thomas E. Read MD, FACS, FASCRS

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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 : 2023-12-01 Epub 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":"2023-12-01","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 : 2023-12-01 Epub Date: 2023-10-17 DOI: 10.1016/j.scrs.2023.100985

Steven R. Brown MD (Professor of Surgery)

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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 : 2023-12-01 Epub 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":"2023-12-01","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

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 Epub Date: 2023-06-07 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 Epub Date: 2023-06-07 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 Epub Date: 2023-06-07 DOI: 10.1016/j.scrs.2023.100972

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

引用次数: 0

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 Epub Date: 2023-06-07 DOI: 10.1016/j.scrs.2023.100967

Jeffrey Roberson MD, Lillias Maguire MD

引用次数: 0

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