Annals of Coloproctology最新文献

{"title":"Lower pain, less itching, and faster healing after ultrasound scalpel-assisted hemorrhoidectomy using an intimate cleaner containing chlorhexidine, acid hyaluronic acid, and natural anti-inflammatories: a multicenter observational case-control study.","authors":"Antonio Brillantino, Luigi Marano, Maurizio Grillo, Alessio Palumbo, Fabrizio Foroni, Luciano Vicenzo, Alessio Antropoli, Michele Lanza, Maria Laura Sandoval Sotelo, Nicola Sangiuliano, Mauro Maglio, Rosanna Filosa, Lucia Abbatiello, Maria Preziosa Romano, Luana Passariello, Pasquale Talento, Giovanna Ioia, Corrado Rispoli, Mariano Fortunato Armellino, Vincenzo Bottino, Adolfo Renzi, Carlo Bartone, Luigi Monaco, Paolino Mauro, Stefano Picardi, Maria Paola Menna, Elisa Palladino, Mario Massimo Mensorio, Vinicio Mosca, Claudio Gambardella, Luigi Brusciano, Ludovico Docimo","doi":"10.3393/ac.2024.00570.0081","DOIUrl":"https://doi.org/10.3393/ac.2024.00570.0081","url":null,"abstract":"<p><strong>Purpose: </strong>Postoperative pain is a major concern for patients undergoing ultrasound scalpel-assisted hemorrhoidectomy, potentially exacerbated by delayed wound healing. This study aimed to evaluate the impact of an intimate cleansing gel containing chlorhexidine, hyaluronic acid, and other anti-inflammatory agents (Antroclean Fisioderm) on postoperative pain, itching, and wound healing in patients who had undergone this procedure.</p><p><strong>Methods: </strong>This multicenter observational case-control study involved a cohort of consecutive adult patients who underwent hemorrhoidectomy using an ultrasound device. The study compared 2 different postoperative wound management strategies over 1 month after surgery: washing with warm water twice per day (control group) versus a 2-minute topical application of intimate cleansing gel (Antroclean Fisioderm) followed by a warm water wash (intervention group).</p><p><strong>Results: </strong>The median postoperative pain score was significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). The percentage of patients reporting anal itching was also significantly lower in the intervention group than in the control group at each follow-up point (P<0.01). All patients in the intervention group achieved complete wound healing 4 weeks after surgery, compared to 88 (82%) in the control group (P<0.01). No adverse events were reported.</p><p><strong>Conclusion: </strong>The topical application of intimate cleansing gel (Antroclean Fisioderm) twice daily for 1 month following ultrasound scalpel-assisted hemorrhoidectomy appears to be associated with faster healing, reduced pain, decreased itching, and improved quality of life, without any adverse effects. Further larger and prospective randomized trials are recommended to confirm these findings.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"40 6","pages":"602-609"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920712","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}

{"title":"Botulinum injection technique to reduce spasms in refractory anal fissures and after anal fistula or hemorrhoid surgery.","authors":"Pankaj Garg, Vipul D Yagnik, Kaushik Bhattacharya","doi":"10.3393/ac.2023.00696.0099","DOIUrl":"https://doi.org/10.3393/ac.2023.00696.0099","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"40 6","pages":"610-612"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920711","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}

{"title":"Robotic abdominoperineal resection, bilateral robotic groin node dissection and simultaneous perineal gracilis flap reconstruction for locally advanced node-positive anal squamous cell carcinoma.","authors":"Mohammed Ali, Melanie Holzgang, Vivekanandan Kumar, Dhalia Masud, Sandeep Kapur, Ahmed El-Hadi, Dolly Dowsett, Irshad Shaikh","doi":"10.3393/ac.2023.00801.0114","DOIUrl":"https://doi.org/10.3393/ac.2023.00801.0114","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"40 6","pages":"613-615"},"PeriodicalIF":3.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920713","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}

{"title":"A unique surgical approach to the management of life-threatening, obscure lower gastrointestinal bleeding.","authors":"Nelson Chen, Tessa Daly, Neil Strugnell, Russell Hodgson, David Bird","doi":"10.3393/ac.2024.00101.0014","DOIUrl":"10.3393/ac.2024.00101.0014","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"515-518"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456788","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}

{"title":"Tips and tricks for transluminal specimen extraction and extra-abdominal sigmoid colon resection.","authors":"Vladimir Balaban, Mikhail Mutyk, Kamil Abumuslimov, Mikhail Klochkov, Ivan Mishchenko, Petr Tsarkov","doi":"10.3393/ac.2023.00689.0098","DOIUrl":"10.3393/ac.2023.00689.0098","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"519-520"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141578818","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}

{"title":"Ileostomy volvulus as an underreported problem causing small bowel obstruction in patients living with ostomy: a case report and literature review.","authors":"Julianna Seo, Ishith Seth, Dilshad Dooreemeah, Chun Hin Angus Lee","doi":"10.3393/ac.2022.00976.0139","DOIUrl":"10.3393/ac.2022.00976.0139","url":null,"abstract":"<p><strong>Purpose: </strong>Ileostomy volvulus is a rare cause of small bowel obstruction. We present an unusual case of ileostomy volvulus without the presence of adhesions. Additionally, a systematic literature review was performed to collate the current literature on the causes, diagnosis, treatment, and preventative measures of ileostomy-related small bowel obstruction.</p><p><strong>Methods: </strong>PubMed (MEDLINE), Embase, Google Scholar, Scopus, and CENTRAL were searched from their inception up to August 2022. This study adhered to the PRISMA guidelines and was registered on PROSPERO. The primary outcomes included patients' demographics, imaging modality, indication for initial surgery, type and configuration of stoma, surgical treatment, and recurrence of volvulus. The quality of included studies was assessed using the Murad tool. Written informed consent was obtained from the patient.</p><p><strong>Results: </strong>Seven studies were included, comprising 967 patients. Stoma outlet obstruction (SOO) was reported in all 159 patients, and 12 had ileostomy volvulus as the cause. A majority of patients had loop ostomies for ileostomy volvulus. No complications or mortality were reported in the included studies, and half of the included studies were deemed to be of good quality.</p><p><strong>Conclusion: </strong>This case demonstrates the need for high clinical suspicion of SOO in patients with loop ileostomy, and rapid management should be undertaken. Whilst loop ileostomies, increased rectus abdominal muscle thickness, and lower preoperative total glucocorticoid dosage are associated with SOO, large-scale retrospective studies are needed to validate our findings.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"424-430"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10818670","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}

{"title":"Proctitis distal to colorectal anastomosis: a retrospective cohort study of an underreported complication after sigmoidectomy.","authors":"Ajmal Khan, Maziar Nikberg, Kenneth Smedh, Abbas Chabok","doi":"10.3393/ac.2023.00675.0096","DOIUrl":"10.3393/ac.2023.00675.0096","url":null,"abstract":"<p><strong>Purpose: </strong>Proctitis distal to colorectal anastomosis is rare and infrequently reported. We evaluated the incidence, symptoms, treatment, and potential risk factors associated with this condition.</p><p><strong>Methods: </strong>We conducted a retrospective population-based cohort study in Västmanland County, Sweden. This investigation included all patients who underwent sigmoidectomy with colorectal anastomosis between 2008 and 2020. We excluded patients without an anastomosis and those with inflammatory bowel disease.</p><p><strong>Results: </strong>Of the 546 patients identified, 233 fulfilled the inclusion criteria, of whom 26 (11.2%) developed proctitis distal to colorectal anastomosis. The most frequent symptoms included urgency (n=16, 61.5%), increased stool frequency (n=12, 46.2%), and anorectal pain (n=12, 46.2%). Endoscopic balloon dilation was performed in 20 cases (76.9%), with 10 requiring only a single therapeutic procedure. The median number of dilations was 3 (range, 1-8). Multivariable analysis revealed that surgery due to malignancy and emergency surgery were associated with elevated risk of proctitis. A subgroup analysis of patients who underwent surgery due to malignancy indicated that smoking (odds ratio, 3.9; 95% confidence interval, 1.1-14.0) and emergency surgery (odds ratio, 6.5; 95% confidence interval, 1.1-37.1) were also associated with increased proctitis risk.</p><p><strong>Conclusion: </strong>Proctitis distal to colorectal anastomosis is not uncommon following sigmoidectomy. Patients undergoing emergency surgery or surgery due to malignancy and who had a history of smoking displayed an increased risk of developing proctitis. Due to the paucity of symptoms observed, particularly in patients with a diverting stoma, routine endoscopic rectal examination should be performed during follow-up after sigmoidectomy.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"498-505"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456791","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}

{"title":"The impact of short-course total neoadjuvant therapy, long-course chemoradiotherapy, and upfront surgery on the technical difficulty of total mesorectal excision: an observational study with an intraoperative perspective.","authors":"Cheryl Xi-Zi Chong, Frederick H Koh, Hui-Lin Tan, Sharmini Su Sivarajah, Jia-Lin Ng, Leonard Ming-Li Ho, Darius Kang-Lie Aw, Wen-Hsin Koo, Shuting Han, Si-Lin Koo, Connie Siew-Poh Yip, Fu-Qiang Wang, Fung-Joon Foo, Winson Jianhong Tan","doi":"10.3393/ac.2023.00899.0128","DOIUrl":"10.3393/ac.2023.00899.0128","url":null,"abstract":"<p><strong>Purpose: </strong>Total neoadjuvant therapy (TNT) is becoming the standard of care for locally advanced rectal cancer. However, surgery is deferred for months after completion, which may lead to fibrosis and increased surgical difficulty. The aim of this study was to assess whether TNT (TNT-RAPIDO) is associated with increased difficulty of total mesorectal excision (TME) compared with long-course chemoradiotherapy (LCRT) and upfront surgery.</p><p><strong>Methods: </strong>Twelve laparoscopic videos of low anterior resection with TME for rectal cancer were prospectively collected from January 2020 to October 2021, with 4 videos in each arm. Seven colorectal surgeons assessed the videos independently, graded the difficulty of TME using a visual analog scale and attempted to identify which category the videos belonged to.</p><p><strong>Results: </strong>The median age was 67 years, and 10 patients were male. The median interval to surgery from radiotherapy was 13 weeks in the LCRT group and 24 weeks in the TNT-RAPIDO group. There was no significant difference in the visual analog scale for difficulty in TME between the 3 groups (LCRT, 3.2; TNT-RAPIDO, 4.6; upfront, 4.1; P=0.12). A subgroup analysis showed similar difficulty between groups (LCRT 3.2 vs. TNT-RAPIDO 4.6, P=0.05; TNT-RAPIDO 4.6 vs. upfront 4.1, P=0.54). During video assessments, surgeons correctly identified the prior treatment modality in 42% of the cases. TNT-RAPIDO videos had the highest recognition rate (71%), significantly outperforming both LCRT (29%) and upfront surgery (25%, P=0.01).</p><p><strong>Conclusion: </strong>TNT does not appear to increase the surgical difficulty of TME.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":"40 5","pages":"451-458"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142543355","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}

{"title":"The management of complex fistula in ano by transanal opening of the intersphincteric space (TROPIS): short-term results.","authors":"Shrivats Mishra, Dileep S Thakur, Uday Somashekar, Amrendra Verma, Dhananjay Sharma","doi":"10.3393/ac.2022.01018.0145","DOIUrl":"10.3393/ac.2022.01018.0145","url":null,"abstract":"<p><strong>Purpose: </strong>Many methods have been used to treat complex fistulas, but no single technique has been considered standard. Damage to the sphincter may sometimes be unavoidable, and incontinence may be an important cause of morbidity. This study aimed to validate the results of transanal opening of the intersphincteric space (TROPIS), as a technique that avoids damaging the anal sphincter, in patients with complex fistula in ano.</p><p><strong>Methods: </strong>A prospective study was conducted among 35 consecutive patients with complex fistula in ano. After a preoperative magnetic resonance fistulogram, TROPIS was performed in all patients. The St. Mark's incontinence score was assessed preoperatively and postoperatively at 3 months.</p><p><strong>Results: </strong>The tracts were intersphincteric in 16 patients, transsphincteric in 10, extrasphincteric in 2, and horseshoe in 3. Four patients had recurrent tracts (3 transsphincteric and 1 intersphincteric). A defined follow-up schedule was used. Curettage was done if postoperative pus drainage from the wound was noted. The fistula healed in 29 patients (82.89%) following TROPIS. The remaining 6 patients received curettage, with healing in 3 (overall healing rate, 91.4%). Patients who received curettage were followed for 3 months, and the outcome was labeled as healed or failed. The mean preoperative incontinence score was 0. One patient developed incontinence to gas postoperatively in week 2, but there was no significant change in the scores at 3 months postoperatively. The mean postoperative incontinence score was 0.02.</p><p><strong>Conclusion: </strong>TROPIS is an effective method for the treatment of complex fistula in ano, with minimal risk for incontinence.</p>","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"474-480"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9590294","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}

{"title":"Early detection of anastomotic leakage in colon cancer surgery: the role of early warning score and C-reactive protein.","authors":"Gyung Mo Son","doi":"10.3393/ac.2024.00661.0094","DOIUrl":"10.3393/ac.2024.00661.0094","url":null,"abstract":"","PeriodicalId":8267,"journal":{"name":"Annals of Coloproctology","volume":" ","pages":"415-416"},"PeriodicalIF":3.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456789","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}