首页 > 最新文献

Colorectal Disease最新文献

英文 中文
Efficacy of anal duct ligation and muscle closure: A novel sphincter-preserving surgical technique for fistula-in-ano 肛管结扎和肌肉闭合的效果:一种新的保留肛门括约肌的手术技术。
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-10 DOI: 10.1111/codi.17260
Yoon Hyung Kang, Keehoon Hyun, Dong Ho Cho, Jong-Kyun Lee, Do-Yeon Hwang

Aim

Although various sphincter-preserving techniques exist for treating anal fistulas, none have demonstrated clear superiority. Therefore, the aim of this study was to introduce a novel sphincter-preserving technique for anal duct ligation and muscle closure (ALMC) and analyse its perioperative outcomes.

Method

The data for patients who underwent ALMC for fistula-in-ano at Seoul Song Do Hospital between 2009 and 2023 were retrospectively reviewed. Patient demographics, intraoperative information and postoperative outcomes were assessed. The main outcomes were recurrence and wound healing. Recurrence was defined as the presence of a fistula tract or discharge more than 12 weeks after the primary surgery after achieving complete healing. Faecal incontinence was also investigated clinically.

Results

Overall, 556 patients (84.0% male; mean age 41.7 ± 12.3 years) underwent ALMC. Among these, 152 (27.3%) had a history of fistula surgery and 261 (46.9%) had suprasphincteric fistulas. Fistula-in-ano recurred in 33 patients (5.9%), wound healing was delayed in 97 (17.4%) and faecal incontinence was observed in 12 (2.2%). The mean follow-up duration was 10.0 ± 16.0 months, and the average duration until recurrence was 13.8 ± 10.7 months. The proportion of suprasphincteric fistulas was similar in those who experienced recurrence and those who did not (57.6% vs. 46.3%, respectively; p = 0.239). The proportion of suprasphincteric fistulas in the delayed wound healing group was slightly higher, although the differences were not statistically significant (56.7% vs. 44.9%, respectively; p = 0.054).

Conclusion

ALMC appeared to be a safe and feasible option for treating anal fistulas, providing good perioperative outcomes, particularly when sphincter preservation was crucial.

目的:尽管存在多种保留括约肌的技术来治疗肛瘘,但没有一种技术表现出明显的优越性。因此,本研究的目的是介绍一种用于肛管结扎和肌肉闭合(ALMC)的新型括约肌保留技术,并分析其围手术期结果。方法:回顾性分析2009年至2023年在首尔松岛医院行静脉瘘ALMC治疗的患者资料。评估患者人口统计学、术中信息和术后结果。主要观察结果为复发和创面愈合。复发定义为在初次手术完全愈合后超过12周仍存在瘘道或分泌物。临床上也对大便失禁进行了调查。结果:556例患者(男性84.0%;平均年龄(41.7±12.3岁)。其中152例(27.3%)有瘘管手术史,261例(46.9%)有胆囊上瘘。瘘管复发33例(5.9%),伤口愈合延迟97例(17.4%),大便失禁12例(2.2%)。平均随访时间10.0±16.0个月,平均复发时间13.8±10.7个月。复发组和未复发组的胃门上瘘比例相似(分别为57.6%和46.3%;p = 0.239)。延迟创面愈合组的肾盂上瘘比例略高,但差异无统计学意义(分别为56.7%比44.9%;p = 0.054)。结论:ALMC似乎是治疗肛瘘的一种安全可行的选择,提供了良好的围手术期效果,特别是当括约肌保存是至关重要的。
{"title":"Efficacy of anal duct ligation and muscle closure: A novel sphincter-preserving surgical technique for fistula-in-ano","authors":"Yoon Hyung Kang,&nbsp;Keehoon Hyun,&nbsp;Dong Ho Cho,&nbsp;Jong-Kyun Lee,&nbsp;Do-Yeon Hwang","doi":"10.1111/codi.17260","DOIUrl":"10.1111/codi.17260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Although various sphincter-preserving techniques exist for treating anal fistulas, none have demonstrated clear superiority. Therefore, the aim of this study was to introduce a novel sphincter-preserving technique for anal duct ligation and muscle closure (ALMC) and analyse its perioperative outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The data for patients who underwent ALMC for fistula-in-ano at Seoul Song Do Hospital between 2009 and 2023 were retrospectively reviewed. Patient demographics, intraoperative information and postoperative outcomes were assessed. The main outcomes were recurrence and wound healing. Recurrence was defined as the presence of a fistula tract or discharge more than 12 weeks after the primary surgery after achieving complete healing. Faecal incontinence was also investigated clinically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 556 patients (84.0% male; mean age 41.7 ± 12.3 years) underwent ALMC. Among these, 152 (27.3%) had a history of fistula surgery and 261 (46.9%) had suprasphincteric fistulas. Fistula-in-ano recurred in 33 patients (5.9%), wound healing was delayed in 97 (17.4%) and faecal incontinence was observed in 12 (2.2%). The mean follow-up duration was 10.0 ± 16.0 months, and the average duration until recurrence was 13.8 ± 10.7 months. The proportion of suprasphincteric fistulas was similar in those who experienced recurrence and those who did not (57.6% vs. 46.3%, respectively; <i>p</i> = 0.239). The proportion of suprasphincteric fistulas in the delayed wound healing group was slightly higher, although the differences were not statistically significant (56.7% vs. 44.9%, respectively; <i>p</i> = 0.054).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ALMC appeared to be a safe and feasible option for treating anal fistulas, providing good perioperative outcomes, particularly when sphincter preservation was crucial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Postoperative outcomes in colorectal surgery by day of surgery: A national cohort study 结直肠手术的术后结果:一项国家队列研究。
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-10 DOI: 10.1111/codi.17251
Nejo Joseph, William Xu, Matthew J. McGuinness, Chris Varghese, Wal Baraza, Greg O'Grady, Ian Bissett, Christopher Harmston, Cameron I. Wells

Aim

Poorer postoperative outcomes have been observed for patients admitted and operated on later in the week and over the weekend. This is thought to be related to temporal fluctuations in the quality of perioperative care. The aim of this work was to identify if the day of surgery influenced outcomes in a national cohort of colorectal cancer (CRC) resections.

Method

A retrospective population-based study of patients undergoing CRC resection during the period 2010–2020 in Aotearoa New Zealand (AoNZ) was conducted. Ninety-day postoperative mortality, morbidity, postoperative length of stay (PLOS), reoperation and failure to rescue (FTR) were calculated for elective and acute cohorts, stratified by the day of surgery. FTR-Surgical (mortality following reoperation within 90 days of the index operation) was also analysed by day of reoperation. Univariable and mixed-effects, multivariate, logistic regression models were analysed.

Results

The overall cohort included 17 174 patients who underwent surgery for CRC. The 90-day mortality in the elective and acute cohorts was 2.4% (336/13 744) and 11% (371/3430), respectively. Ninety-day mortality, inpatient complications, FTR and PLOS did not differ by day of surgery in acute and elective cohorts. Notably, patients having elective surgery on a Wednesday had a significantly higher rate of reoperation (OR 1.29, 95% CI 1.06–1.56, p = 0.012). Furthermore, reoperation following complication of the index surgery was associated with a significantly higher 90-day mortality (FTR-Surgical) for patients having reoperation on a Friday (OR 2.10, 95% CI 1.01–4.33, p = 0.045).

Conclusion

There is no variation in postoperative outcomes across the week for both elective and emergency cases. This study does, however, highlight a higher FTR-S later on Friday, suggesting that these high-risk patients may require closer postoperative monitoring over the weekend.

目的:观察到在一周晚些时候和周末住院和手术的患者术后预后较差。这被认为与围手术期护理质量的时间波动有关。这项工作的目的是确定手术日期是否影响结直肠癌(CRC)切除术的国家队列的结果。方法:对2010-2020年期间在新西兰Aotearoa (AoNZ)接受结直肠癌切除术的患者进行回顾性人群研究。计算择期组和急性组的术后90天死亡率、发病率、术后住院时间(PLOS)、再手术和抢救失败(FTR),并按手术日期分层。FTR-Surgical(指数手术后90天内再手术死亡率)也按再手术天数进行分析。单变量和混合效应、多变量、logistic回归模型进行分析。结果:整个队列包括17174例接受结直肠癌手术的患者。择期组和急性组的90天死亡率分别为2.4%(336/13 744)和11%(371/3430)。在急性组和择期组中,90天死亡率、住院并发症、FTR和PLOS没有随手术日期的不同而不同。值得注意的是,周三择期手术的患者再手术率明显更高(OR 1.29, 95% CI 1.06-1.56, p = 0.012)。此外,指数手术并发症后的再手术与周五再手术患者的90天死亡率(FTR-Surgical)显著升高相关(OR 2.10, 95% CI 1.01-4.33, p = 0.045)。结论:择期和急诊病例的术后结果在一周内没有变化。然而,这项研究确实强调了周五晚些时候更高的FTR-S,这表明这些高风险患者可能需要在周末进行更密切的术后监测。
{"title":"Postoperative outcomes in colorectal surgery by day of surgery: A national cohort study","authors":"Nejo Joseph,&nbsp;William Xu,&nbsp;Matthew J. McGuinness,&nbsp;Chris Varghese,&nbsp;Wal Baraza,&nbsp;Greg O'Grady,&nbsp;Ian Bissett,&nbsp;Christopher Harmston,&nbsp;Cameron I. Wells","doi":"10.1111/codi.17251","DOIUrl":"10.1111/codi.17251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Poorer postoperative outcomes have been observed for patients admitted and operated on later in the week and over the weekend. This is thought to be related to temporal fluctuations in the quality of perioperative care. The aim of this work was to identify if the day of surgery influenced outcomes in a national cohort of colorectal cancer (CRC) resections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective population-based study of patients undergoing CRC resection during the period 2010–2020 in Aotearoa New Zealand (AoNZ) was conducted. Ninety-day postoperative mortality, morbidity, postoperative length of stay (PLOS), reoperation and failure to rescue (FTR) were calculated for elective and acute cohorts, stratified by the day of surgery. FTR-Surgical (mortality following reoperation within 90 days of the index operation) was also analysed by day of reoperation. Univariable and mixed-effects, multivariate, logistic regression models were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The overall cohort included 17 174 patients who underwent surgery for CRC. The 90-day mortality in the elective and acute cohorts was 2.4% (336/13 744) and 11% (371/3430), respectively. Ninety-day mortality, inpatient complications, FTR and PLOS did not differ by day of surgery in acute and elective cohorts. Notably, patients having elective surgery on a Wednesday had a significantly higher rate of reoperation (OR 1.29, 95% CI 1.06–1.56, <i>p</i> = 0.012). Furthermore, reoperation following complication of the index surgery was associated with a significantly higher 90-day mortality (FTR-Surgical) for patients having reoperation on a Friday (OR 2.10, 95% CI 1.01–4.33, <i>p</i> = 0.045).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is no variation in postoperative outcomes across the week for both elective and emergency cases. This study does, however, highlight a higher FTR-S later on Friday, suggesting that these high-risk patients may require closer postoperative monitoring over the weekend.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Appraisal of current surgical guidelines for inflammatory bowel disease using the AGREE-S instrument: A scoping review 使用AGREE-S仪器评估当前炎症性肠病手术指南:范围回顾
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-10 DOI: 10.1111/codi.17258
Zarnigar Mussarat Khan, Camille Ball, Dalha Saeed, Grace Tai, Shaneil Chandran, Abhishek Vashista, Simon Davey, Matthew James Lee, Steven R. Brown, Daniel Hind, Adele Elizabeth Sayers

Aim

Guidelines play a crucial role in improving patient care by providing clinicians with up to date evidence-based recommendations. A vast number of guidelines exist on the surgical management of inflammatory bowel disease (IBD). The aim of this scoping review was to identify current surgical IBD guidelines, assess their quality and identify areas of variation between the existing guidelines.

Method

A systematic search of the literature from January 2008 to September 2023 was conducted. After identifying eligible guidelines, they were assessed for quality using the Appraisal of Guidelines for Research and Evaluation for Surgical Interventions (AGREE-S) instrument. Data were extracted on descriptive guideline characteristics and recommendations.

Results

Fifteen guidelines were identified globally. Most guidelines were published between 2011 and 2023, with six focusing solely on Crohn's disease, five on ulcerative colitis and four on both. Six guidelines focused exclusively on surgical management, while nine contained both medical and surgical recommendations. The overall mean AGREE-S score was 59%, with more recent guidelines scoring higher.

Conclusions

The quality of IBD surgical guidelines varies considerably. High-quality, collaborative, international guidelines are needed to reduce duplication and ensure consistent, evidence-based surgical care for IBD patients worldwide. Future guideline development should adhere to the AGREE-S criteria to enhance methodological rigour and transparency.

目的:通过向临床医生提供最新的循证建议,指南在改善患者护理方面发挥着至关重要的作用。关于炎症性肠病(IBD)的外科治疗有大量的指南。本综述的目的是确定当前的外科IBD指南,评估其质量并确定现有指南之间的差异。方法:系统检索2008年1月~ 2023年9月的文献。在确定合格的指南后,使用外科干预研究和评估指南评估(AGREE-S)工具对其质量进行评估。从描述性指南特征和建议中提取数据。结果:全球确定了15项指南。大多数指南是在2011年至2023年期间发布的,其中6份仅针对克罗恩病,5份针对溃疡性结肠炎,4份针对两者。6项指南专门侧重于外科治疗,9项指南包含医学和外科建议。总体平均AGREE-S得分为59%,最新的指南得分更高。结论:IBD手术指南的质量差异很大。需要制定高质量、协作性的国际指南,以减少重复并确保全世界IBD患者获得一致的循证外科护理。未来指南的制定应遵循协议- s标准,以提高方法的严谨性和透明度。
{"title":"Appraisal of current surgical guidelines for inflammatory bowel disease using the AGREE-S instrument: A scoping review","authors":"Zarnigar Mussarat Khan,&nbsp;Camille Ball,&nbsp;Dalha Saeed,&nbsp;Grace Tai,&nbsp;Shaneil Chandran,&nbsp;Abhishek Vashista,&nbsp;Simon Davey,&nbsp;Matthew James Lee,&nbsp;Steven R. Brown,&nbsp;Daniel Hind,&nbsp;Adele Elizabeth Sayers","doi":"10.1111/codi.17258","DOIUrl":"10.1111/codi.17258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Guidelines play a crucial role in improving patient care by providing clinicians with up to date evidence-based recommendations. A vast number of guidelines exist on the surgical management of inflammatory bowel disease (IBD). The aim of this scoping review was to identify current surgical IBD guidelines, assess their quality and identify areas of variation between the existing guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A systematic search of the literature from January 2008 to September 2023 was conducted. After identifying eligible guidelines, they were assessed for quality using the Appraisal of Guidelines for Research and Evaluation for Surgical Interventions (AGREE-S) instrument. Data were extracted on descriptive guideline characteristics and recommendations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen guidelines were identified globally. Most guidelines were published between 2011 and 2023, with six focusing solely on Crohn's disease, five on ulcerative colitis and four on both. Six guidelines focused exclusively on surgical management, while nine contained both medical and surgical recommendations. The overall mean AGREE-S score was 59%, with more recent guidelines scoring higher.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The quality of IBD surgical guidelines varies considerably. High-quality, collaborative, international guidelines are needed to reduce duplication and ensure consistent, evidence-based surgical care for IBD patients worldwide. Future guideline development should adhere to the AGREE-S criteria to enhance methodological rigour and transparency.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A matter of survival—patients' and carers' perspectives on the decision to undergo pelvic exenteration surgery for locally advanced and recurrent rectal cancer 对于局部晚期和复发性直肠癌患者是否接受盆腔切除手术,生存患者和护理人员的观点。
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-10 DOI: 10.1111/codi.17259
Kilian G. M. Brown, Kate White, Michael J. Solomon, Paul Sutton, Kheng-Seong Ng, Cherry E. Koh, Daniel Steffens

Aim

Pelvic exenteration is the only potentially curative treatment for patients with locally advanced or recurrent rectal cancer. This study aimed to investigate how patients decide to undergo such radical surgery.

Method

This qualitative study employed an exploratory interpretive design informed by hermeneutic philosophy. During semi-structured interviews, individuals who had undergone pelvic exenteration at a specialised centre and their carers were asked to reflect on the decision-making process around surgery.

Results

Thirty-eight interviews were conducted with 39 participants (34 patients and five carers). Four themes were identified. There really wasn't a choice—participants indicated that long-term survival was their absolute priority, with many feeling that there was no alternative. Only one participant expressed decision regret due to the consequences of surgery. Grappling with the magnitude of surgery—despite extensive preoperative education and counselling, the enormity of the surgery and recovery experience was incomprehensible to participants until they were ‘in it’, with many surprised by a slow and protracted recovery. A spectrum of psychological states and support needs—participants reflected on their psychological state prior to surgery, identifying family or professional pre-surgery counselling as sources of support. Understanding life after surgery—although most participants were willing to accept anything in order to survive, many identified the impact on bodily functions, body image and overall quality of life as important.

Conclusions

Long-term survival was the principal factor influencing the decision to undergo pelvic exenteration. Individualised preoperative counselling may improve patient preparedness for the consequences of surgery.

目的:盆腔切除是局部晚期或复发直肠癌患者唯一可能治愈的治疗方法。本研究旨在探讨患者如何决定接受这种根治性手术。方法:本定性研究采用解释学哲学的探索性解释设计。在半结构化访谈中,在专门中心接受盆腔切除术的患者及其护理人员被要求反思手术的决策过程。结果:对39名参与者(34名患者和5名护理人员)进行了38次访谈。确定了四个主题。确实没有选择——参与者表示,长期生存是他们的绝对优先事项,许多人感到别无选择。只有一位参与者对手术的后果表示后悔。与手术的重要性作斗争——尽管有广泛的术前教育和咨询,但手术和康复经历的巨大程度对参与者来说是不可理解的,直到他们“参与其中”,许多人对缓慢而漫长的康复感到惊讶。一系列的心理状态和支持需求——参与者在手术前反思他们的心理状态,确定家庭或专业的术前咨询作为支持的来源。了解手术后的生活——尽管大多数参与者为了生存愿意接受任何事情,但许多人认为对身体功能、身体形象和整体生活质量的影响是重要的。结论:长期生存是影响盆腔切除决定的主要因素。个体化术前咨询可以提高患者对手术后果的准备。
{"title":"A matter of survival—patients' and carers' perspectives on the decision to undergo pelvic exenteration surgery for locally advanced and recurrent rectal cancer","authors":"Kilian G. M. Brown,&nbsp;Kate White,&nbsp;Michael J. Solomon,&nbsp;Paul Sutton,&nbsp;Kheng-Seong Ng,&nbsp;Cherry E. Koh,&nbsp;Daniel Steffens","doi":"10.1111/codi.17259","DOIUrl":"10.1111/codi.17259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Pelvic exenteration is the only potentially curative treatment for patients with locally advanced or recurrent rectal cancer. This study aimed to investigate how patients decide to undergo such radical surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This qualitative study employed an exploratory interpretive design informed by hermeneutic philosophy. During semi-structured interviews, individuals who had undergone pelvic exenteration at a specialised centre and their carers were asked to reflect on the decision-making process around surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-eight interviews were conducted with 39 participants (34 patients and five carers). Four themes were identified. <i>There really wasn't a choice—</i>participants indicated that long-term survival was their absolute priority, with many feeling that there was no alternative. Only one participant expressed decision regret due to the consequences of surgery. <i>Grappling with the magnitude of surgery—</i>despite extensive preoperative education and counselling, the enormity of the surgery and recovery experience was incomprehensible to participants until they were ‘in it’, with many surprised by a slow and protracted recovery. <i>A spectrum of psychological states and support needs—</i>participants reflected on their psychological state prior to surgery, identifying family or professional pre-surgery counselling as sources of support. <i>Understanding life after surgery—</i>although most participants were willing to accept anything in order to survive, many identified the impact on bodily functions, body image and overall quality of life as important.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Long-term survival was the principal factor influencing the decision to undergo pelvic exenteration. Individualised preoperative counselling may improve patient preparedness for the consequences of surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of the quadruple assessment technique in the prevention of colorectal anastomotic leaks: Highlighting the evidence 四重评估技术预防结直肠吻合口瘘的疗效:突出证据。
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-09 DOI: 10.1111/codi.17263
Sameh Hany Emile, Steven D. Wexner
{"title":"Efficacy of the quadruple assessment technique in the prevention of colorectal anastomotic leaks: Highlighting the evidence","authors":"Sameh Hany Emile,&nbsp;Steven D. Wexner","doi":"10.1111/codi.17263","DOIUrl":"10.1111/codi.17263","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Acute pilonidal abscess: Prospective nationwide audit in the Netherlands 急性毛毛脓肿:荷兰的前瞻性全国审计。
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-05 DOI: 10.1111/codi.17254
Eleonora A. Huurman, A. A. Sophie den Otter, Christel A. L. de Raaff, Rosaline van den Berg, Sara J. Baart, Bas P. L. Wijnhoven, Ruben Schouten, Edgar J. B. Furnée, Robert M. Smeenk, Boudewijn R. Toorenvliet, the PITS Collaborative Study Group

Aim

The aim of this study was to assess Dutch surgical practice and outcomes for acute pilonidal abscess.

Method

Patients with pilonidal sinus disease (PSD) who underwent surgical treatment between 1 March 2020 and 1 March 2021 at 36 participating hospitals were included in a prospective observational cohort study. For the present study, only patients with an acute abscess were included for analysis. Outcomes included symptoms, wound healing, time to resume daily activities and complications. Follow-up was 1 year and included questionnaires on recurrent abscesses, symptomatic chronic PSD, quality of life and patient-reported experience measures.

Results

Of 681 included patients, 208 presented with an acute pilonidal abscess. Incision and drainage (I&D) was performed in 205 of these patients (99%). The wound healing rate after I&D was 42.2% at the outpatient clinic, with a median time to closure of 43 days. The complication rate was 4.4%. One-year questionnaires were completed by 158 out of 205 patients (77.1%). Fifteen patients (7.3%) had a recurrent abscess within 1 year. The symptomatic chronic PSD rate was 8.8%.

Conclusion

Of all the patients presenting with PSD in this prospective national study cohort, 30% had a pilonidal abscess. Incision and drainage showed a low complication rate but successful wound healing in less than half of the patients. The study showed that 91.2% of patients did not undergo additional surgical treatment for symptomatic chronic PSD within 1 year of follow-up.

目的:本研究的目的是评估荷兰的手术实践和急性毛鞘脓肿的结果。方法:将2020年3月1日至2021年3月1日期间在36家参与研究的医院接受手术治疗的毛毛窦疾病(PSD)患者纳入前瞻性观察队列研究。在本研究中,只有急性脓肿患者被纳入分析。结果包括症状、伤口愈合、恢复日常活动的时间和并发症。随访1年,包括关于复发性脓肿、症状性慢性PSD、生活质量和患者报告的体验措施的问卷调查。结果:681例患者中,208例表现为急性毛韧带脓肿。其中205例(99%)行切口引流术。门诊I&D后伤口愈合率为42.2%,平均愈合时间为43天。并发症发生率为4.4%。205例患者中有158例(77.1%)完成了为期一年的问卷调查。15例(7.3%)1年内复发脓肿。有症状的慢性PSD发生率为8.8%。结论:在这个前瞻性的国家研究队列中,所有出现PSD的患者中,30%有毛毛脓肿。切口引流术后并发症发生率低,但创面愈合成功率不到一半。研究显示,91.2%的患者在随访1年内没有接受额外的手术治疗。
{"title":"Acute pilonidal abscess: Prospective nationwide audit in the Netherlands","authors":"Eleonora A. Huurman,&nbsp;A. A. Sophie den Otter,&nbsp;Christel A. L. de Raaff,&nbsp;Rosaline van den Berg,&nbsp;Sara J. Baart,&nbsp;Bas P. L. Wijnhoven,&nbsp;Ruben Schouten,&nbsp;Edgar J. B. Furnée,&nbsp;Robert M. Smeenk,&nbsp;Boudewijn R. Toorenvliet,&nbsp;the PITS Collaborative Study Group","doi":"10.1111/codi.17254","DOIUrl":"10.1111/codi.17254","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to assess Dutch surgical practice and outcomes for acute pilonidal abscess.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Patients with pilonidal sinus disease (PSD) who underwent surgical treatment between 1 March 2020 and 1 March 2021 at 36 participating hospitals were included in a prospective observational cohort study. For the present study, only patients with an acute abscess were included for analysis. Outcomes included symptoms, wound healing, time to resume daily activities and complications. Follow-up was 1 year and included questionnaires on recurrent abscesses, symptomatic chronic PSD, quality of life and patient-reported experience measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 681 included patients, 208 presented with an acute pilonidal abscess. Incision and drainage (I&amp;D) was performed in 205 of these patients (99%). The wound healing rate after I&amp;D was 42.2% at the outpatient clinic, with a median time to closure of 43 days. The complication rate was 4.4%. One-year questionnaires were completed by 158 out of 205 patients (77.1%). Fifteen patients (7.3%) had a recurrent abscess within 1 year. The symptomatic chronic PSD rate was 8.8%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Of all the patients presenting with PSD in this prospective national study cohort, 30% had a pilonidal abscess. Incision and drainage showed a low complication rate but successful wound healing in less than half of the patients. The study showed that 91.2% of patients did not undergo additional surgical treatment for symptomatic chronic PSD within 1 year of follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Single-port robotic transanal minimally invasive surgery (SPR-TAMIS): another giant leap forward? 单端口机器人经肛门微创手术(SPR-TAMIS):又一个巨大的飞跃?
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-05 DOI: 10.1111/codi.17252
Davide Ferrari, Thomas Peponis, Tommaso Violante, Jyi Ng Cheng, William R. Perry, David W. Larson, Kevin T. Behm

Aim

Minimally invasive transanal platforms are now the standard of care for select low-risk rectal tumours. However, existing platforms come with persistent technical challenges. The da Vinci SP Surgical System™ offers a new alternative designed to work effectively in narrow spaces. This technology has the potential to enhance the feasibility and proximal extent of complex transanal resections. This study aimed to describe the morbidity and technical success in patients undergoing single-port robotic transanal minimally invasive surgery (SPR-TAMIS). Secondary outcomes include rates of local recurrence.

Methods

A retrospective analysis was conducted on all patients who underwent SPR-TAMIS at our institution between February 2019 and December 2023.

Results

The study included 31 patients (19 men, 12 women) with a mean age of 61 ± 13.3 years. The average tumour distance from the anal verge was 10 cm. Thirty patients completed SPR-TAMIS, with one patient requiring conversion to robotic sigmoidectomy due to location in the mid-sigmoid colon. The mean operating time was 106 ± 42 min. Twenty-eight out of 30 patients underwent full-thickness excision and all but two were successfully closed. All specimens were resected intact, and margins were negative in 93.5% of cases. The average tumour size was 13 ± 34 cm2, with 13 lesions classified as adenomas and 16 as adenocarcinomas. All patients who did not undergo associated procedures were discharged on the day of surgery. Two patients experienced 30-day morbidity. At a mean follow-up of 18 months (± 13), no local or systemic recurrences were identified.

Conclusion

SPR-TAMIS for excision of low-risk rectal tumours is associated with high rates of technical success and low 30-day morbidity. Further research is needed to compare SPR-TAMIS with other techniques to determine potential advantages over current transanal platforms.

目的:微创经肛门平台现在是标准的护理选择低风险的直肠肿瘤。然而,现有平台面临着持续的技术挑战。达芬奇SP手术系统™提供了一种新的选择,可以在狭窄的空间内有效地工作。该技术有可能提高复杂经肛门切除术的可行性和近端范围。本研究旨在描述单孔机器人经肛门微创手术(SPR-TAMIS)患者的发病率和技术成功。次要结局包括局部复发率。方法:对2019年2月至2023年12月在我院接受sp - tamis治疗的所有患者进行回顾性分析。结果:31例患者(男19例,女12例),平均年龄61±13.3岁。肿瘤距肛门边缘的平均距离为10 cm。30例患者完成了SPR-TAMIS,其中1例患者由于位于乙状结肠中部,需要改用机器人乙状结肠切除术。平均手术时间106±42 min。30例患者中有28例接受了全层切除,除2例外,其余均成功闭合。所有标本均被完整切除,93.5%的病例边缘呈阴性。肿瘤平均大小为13±34 cm2,其中腺瘤13例,腺癌16例。所有未接受相关手术的患者均于手术当日出院。2例患者发病30天。平均随访18个月(±13),未发现局部或全身复发。结论:SPR-TAMIS用于低危直肠肿瘤的切除具有高技术成功率和低30天发病率。需要进一步的研究将SPR-TAMIS与其他技术进行比较,以确定其相对于目前的跨肛门平台的潜在优势。
{"title":"Single-port robotic transanal minimally invasive surgery (SPR-TAMIS): another giant leap forward?","authors":"Davide Ferrari,&nbsp;Thomas Peponis,&nbsp;Tommaso Violante,&nbsp;Jyi Ng Cheng,&nbsp;William R. Perry,&nbsp;David W. Larson,&nbsp;Kevin T. Behm","doi":"10.1111/codi.17252","DOIUrl":"10.1111/codi.17252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Minimally invasive transanal platforms are now the standard of care for select low-risk rectal tumours. However, existing platforms come with persistent technical challenges. The da Vinci SP Surgical System™ offers a new alternative designed to work effectively in narrow spaces. This technology has the potential to enhance the feasibility and proximal extent of complex transanal resections. This study aimed to describe the morbidity and technical success in patients undergoing single-port robotic transanal minimally invasive surgery (SPR-TAMIS). Secondary outcomes include rates of local recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on all patients who underwent SPR-TAMIS at our institution between February 2019 and December 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 31 patients (19 men, 12 women) with a mean age of 61 ± 13.3 years. The average tumour distance from the anal verge was 10 cm. Thirty patients completed SPR-TAMIS, with one patient requiring conversion to robotic sigmoidectomy due to location in the mid-sigmoid colon. The mean operating time was 106 ± 42 min. Twenty-eight out of 30 patients underwent full-thickness excision and all but two were successfully closed. All specimens were resected intact, and margins were negative in 93.5% of cases. The average tumour size was 13 ± 34 cm<sup>2</sup>, with 13 lesions classified as adenomas and 16 as adenocarcinomas. All patients who did not undergo associated procedures were discharged on the day of surgery. Two patients experienced 30-day morbidity. At a mean follow-up of 18 months (± 13), no local or systemic recurrences were identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SPR-TAMIS for excision of low-risk rectal tumours is associated with high rates of technical success and low 30-day morbidity. Further research is needed to compare SPR-TAMIS with other techniques to determine potential advantages over current transanal platforms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ten-year survival and pattern of recurrence in patients with locally recurrent rectal or sigmoid cancer undergoing resection 局部复发直肠或乙状结肠癌切除术患者的十年生存率和复发模式。
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-05 DOI: 10.1111/codi.17226
J. N. Wiig, Vegar Johansen Dagenborg, Stein Gunnar Larsen

Aim

The aim of this work is to report actual overall survival (AOS) at 5 and 10 years after multimodal treatment for locally recurrent rectal or sigmoid cancer (LRRC) and the importance of local re-recurrence (reLRRC) and distant metastases for AOS.

Method

All patients resected for LRRC at a single centre between years 1990 and 2007 were included. Resections were based on images taken after neoadjuvant treatment. Patients were prospectively followed up for 5 years. After a minimum of 10 years, the records of referring hospitals were analysed.

Results

A total of 224 patients underwent resection. At 5 and 10 years 33% and 17%, respectively, had survived. Median survival was 38 months [interquartile range (IQR) 62 months]. Patients with complete resections had 5- and 10-year survival of 56% and 28%, respectively, versus 22% and 11% for those with microscopic remaining tumour; none with macroscopic remains survived beyond 4 years. Median survival was 71 months (IQR 106 months), 33 months (IQR 35 months) and 15 months (IQR 17 months), respectively. With a median survival of 123 months (IQR 80 months), the 54 patients without recurrence had 5- and 10-year survival of 69% and 59%, respectively. The independent predictor of survival was R-stage. Of the 197 patients who had radical resection, 83 developed reLRRC and 108 distant metastases. ReLRRC appeared at a median of 18 months (IQR 21 months) and distant metastases at 12 months (IQR 21 months). Lung metastases were the most common form of distant disease.

Conclusion

More than 5 years postoperatively the mortality from cancer was substantial. Most metastases appeared not to be secondary to reLRRC. Planning surgery from pretreatment images might reduce reLRRC.

目的:本研究的目的是报告局部复发性直肠或乙状结肠癌(LRRC)多模式治疗后5年和10年的实际总生存率(AOS),以及局部复发(reLRRC)和远处转移对AOS的重要性。方法:纳入1990年至2007年间在同一中心接受LRRC手术的所有患者。切除基于新辅助治疗后的图像。患者随访5年。至少10年后,对转诊医院的记录进行分析。结果:共224例患者行手术切除。5年和10年存活率分别为33%和17%。中位生存期为38个月[四分位间距62个月]。完全切除患者的5年和10年生存率分别为56%和28%,而显微镜下残留肿瘤患者的5年和10年生存率分别为22%和11%;肉眼可见的遗骸存活时间均未超过4年。中位生存期分别为71个月(IQR为106个月)、33个月(IQR为35个月)和15个月(IQR为17个月)。54例无复发患者的5年和10年生存率分别为69%和59%,中位生存期为123个月(IQR为80个月)。生存的独立预测因子为r期。在197例接受根治性切除的患者中,83例发生reLRRC, 108例发生远处转移。ReLRRC出现的中位时间为18个月(IQR 21个月),远处转移出现的中位时间为12个月(IQR 21个月)。肺转移是最常见的远处病变。结论:术后5年以上肿瘤死亡率较高。大多数转移似乎不是继发于reLRRC。根据预处理图像计划手术可能会降低reLRRC。
{"title":"Ten-year survival and pattern of recurrence in patients with locally recurrent rectal or sigmoid cancer undergoing resection","authors":"J. N. Wiig,&nbsp;Vegar Johansen Dagenborg,&nbsp;Stein Gunnar Larsen","doi":"10.1111/codi.17226","DOIUrl":"10.1111/codi.17226","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this work is to report actual overall survival (AOS) at 5 and 10 years after multimodal treatment for locally recurrent rectal or sigmoid cancer (LRRC) and the importance of local re-recurrence (reLRRC) and distant metastases for AOS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>All patients resected for LRRC at a single centre between years 1990 and 2007 were included. Resections were based on images taken after neoadjuvant treatment. Patients were prospectively followed up for 5 years. After a minimum of 10 years, the records of referring hospitals were analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 224 patients underwent resection. At 5 and 10 years 33% and 17%, respectively, had survived. Median survival was 38 months [interquartile range (IQR) 62 months]. Patients with complete resections had 5- and 10-year survival of 56% and 28%, respectively, versus 22% and 11% for those with microscopic remaining tumour; none with macroscopic remains survived beyond 4 years. Median survival was 71 months (IQR 106 months), 33 months (IQR 35 months) and 15 months (IQR 17 months), respectively. With a median survival of 123 months (IQR 80 months), the 54 patients without recurrence had 5- and 10-year survival of 69% and 59%, respectively. The independent predictor of survival was R-stage. Of the 197 patients who had radical resection, 83 developed reLRRC and 108 distant metastases. ReLRRC appeared at a median of 18 months (IQR 21 months) and distant metastases at 12 months (IQR 21 months). Lung metastases were the most common form of distant disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>More than 5 years postoperatively the mortality from cancer was substantial. Most metastases appeared not to be secondary to reLRRC. Planning surgery from pretreatment images might reduce reLRRC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Triple-stapling anastomosis in minimal access low anterior resection for rectal cancer: Feasible, safe and oncologically optimal—A video vignette 三吻合器吻合术在直肠癌低位前切除术中的应用:可行性、安全性和肿瘤学最佳。
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-05 DOI: 10.1111/codi.17249
Francesco Di Fabio, Niccolo Allievi, Brendan Moran
{"title":"Triple-stapling anastomosis in minimal access low anterior resection for rectal cancer: Feasible, safe and oncologically optimal—A video vignette","authors":"Francesco Di Fabio,&nbsp;Niccolo Allievi,&nbsp;Brendan Moran","doi":"10.1111/codi.17249","DOIUrl":"10.1111/codi.17249","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Laparoscopic-assisted extralevator abdominoperineal excision (ELAPE), posterior vaginectomy and perineal turnover flap for residual anal squamous cell carcinoma—A video vignette 腹腔镜辅助腹外展式会阴切除术(ELAPE)、后阴道切除术及会阴翻转皮瓣治疗残留肛门鳞状细胞癌的影像分析。
IF 2.9 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2024-12-02 DOI: 10.1111/codi.17253
Nasra N Alam, Peter J Mitchell, Madhu Chaudhary, Milind Dalal, Srinivasan Iyer, Edward Parkin
{"title":"Laparoscopic-assisted extralevator abdominoperineal excision (ELAPE), posterior vaginectomy and perineal turnover flap for residual anal squamous cell carcinoma—A video vignette","authors":"Nasra N Alam,&nbsp;Peter J Mitchell,&nbsp;Madhu Chaudhary,&nbsp;Milind Dalal,&nbsp;Srinivasan Iyer,&nbsp;Edward Parkin","doi":"10.1111/codi.17253","DOIUrl":"10.1111/codi.17253","url":null,"abstract":"","PeriodicalId":10512,"journal":{"name":"Colorectal Disease","volume":"27 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Colorectal Disease
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1