A. Ibrahim, L. Gertallah, M. Abdelaziz, Rehab Hemeda, A. Gomaa, Mahmoud Ghoneme, Mahmoud Sherbeiny, A. Sharaf, O. Harb, M. Amin
Abstract Background Due to few sufficient data regarding the comparison between endoscopic and surgical resection of malignant colorectal polyps regarding outcomes and survival benefits, there are no clear guidelines of management strategies of malignant colorectal polyps. The aims of the present study were to compare endoscopic resection alone and surgical resection in patients with malignant polyps in the colon (T1N0M0) readings advantages, disadvantages, recurrence risks, survival benefits, and long-term prognosis to detect how management strategy affects outcome. Patients and methods we included 350 patients. All included patients were divided into 2 groups; the first group included 100 patients who underwent only endoscopic polypectomy and the second group included 250 patients who underwent endoscopic polypectomy followed by definitive surgical resection after histopathological diagnosis. We followed all patients for about 5 years, ranging from 18 to 55 months. The primarily evaluated parameters are surgical consequences and patients' morbidity. The secondary evaluated parameters are recurrence risks, recurrence free survival, and overall survival rates. Results The age of patients who underwent polypectomy is usually younger than the surgical group, males have more liability to polypectomy in comparison with females. Patients with tumors in the left colon have more liability to polypectomy in comparison with the right colon ( p < 0.0001). Tumor factors associated with more liability to surgical resection are presence of lymphovascular invasion, high grade, and poor tumor differentiation ( p < 0.0001). The management strategy was the most significant predictor of overall and recurrence free survival rates in patients with malignant colon polyps ( p < 0.001). Conclusions We found that survival benefits and lower incidence of recurrence are detected in the surgical resection group more than in the polypectomy group.
{"title":"Prognostic Roles and Survival Benefits of Endoscopic Resection Versus Surgical Resection in the Management of Malignant Colon Polyps","authors":"A. Ibrahim, L. Gertallah, M. Abdelaziz, Rehab Hemeda, A. Gomaa, Mahmoud Ghoneme, Mahmoud Sherbeiny, A. Sharaf, O. Harb, M. Amin","doi":"10.1055/s-0043-1769922","DOIUrl":"https://doi.org/10.1055/s-0043-1769922","url":null,"abstract":"Abstract Background Due to few sufficient data regarding the comparison between endoscopic and surgical resection of malignant colorectal polyps regarding outcomes and survival benefits, there are no clear guidelines of management strategies of malignant colorectal polyps. The aims of the present study were to compare endoscopic resection alone and surgical resection in patients with malignant polyps in the colon (T1N0M0) readings advantages, disadvantages, recurrence risks, survival benefits, and long-term prognosis to detect how management strategy affects outcome. Patients and methods we included 350 patients. All included patients were divided into 2 groups; the first group included 100 patients who underwent only endoscopic polypectomy and the second group included 250 patients who underwent endoscopic polypectomy followed by definitive surgical resection after histopathological diagnosis. We followed all patients for about 5 years, ranging from 18 to 55 months. The primarily evaluated parameters are surgical consequences and patients' morbidity. The secondary evaluated parameters are recurrence risks, recurrence free survival, and overall survival rates. Results The age of patients who underwent polypectomy is usually younger than the surgical group, males have more liability to polypectomy in comparison with females. Patients with tumors in the left colon have more liability to polypectomy in comparison with the right colon ( p < 0.0001). Tumor factors associated with more liability to surgical resection are presence of lymphovascular invasion, high grade, and poor tumor differentiation ( p < 0.0001). The management strategy was the most significant predictor of overall and recurrence free survival rates in patients with malignant colon polyps ( p < 0.001). Conclusions We found that survival benefits and lower incidence of recurrence are detected in the surgical resection group more than in the polypectomy group.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"126 - 132"},"PeriodicalIF":0.0,"publicationDate":"2023-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42292226","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}
Liliane Moretti Carneiro, A. M. Ferreira, M. A. Rigotti, Jaqueline Aparecida dos Santos Sokem, Alessandra Lyrio Barbosa Giroti, Rodrigo Aranda Serra, Maiara Oliveira Diniz
Abstract Objective To characterize the sociodemographic and clinical variables of people with intestinal stomas. Materials and Methods We conducted a cross-sectional study with 47 patients of a Specialized Rehabilitation Center (CER II/APAE) in the municipality of Três Lagoas, state of Mato Grosso do Sul, Midwestern Brazil, from December 2019 to June 2020. Data was analyzed using inferential descriptive statistics (Anderson-Darling, Chi-squared, and Mann-Whitney normality tests). Results Regarding the patients, 87.23% were from Três Lagoas, 51.06% were female, 40.43% were aged from 60 to 69 years, 59.57% were married, 53.19% were brown, 59.57% were catholic, 36.17% finished elementary school, 46.81% were retired, and 57.45% earned a monthly income below 1 minimum wage. Moreover, 61.70% had undergone terminal colostomy (61.70%), 61.70% had received guidance about its placing, 57.45% had it placed due to situations of urgency, 74.47% had a stoma installed due to a neoplasia, 38.30% were permanent, with 46.81% located in the inferior left quadrant (ILQ), 59.57% presented pasty effluent, 63.83% had a circular diameter, 53.19% had pouches with 2 pieces and 57.45%, with a flexible base, 87.23% had other adjunct equipment, and 95.74% had been trained in self-care. The most common complication was skin/peristomal irritant contact dermatitis (59,57%), and 65,95% of these cases were solved by teaching self-care. The type of stoma was significantly associated with the consistency of the effluent and the size of the protrusion ( p > 0.05). Conclusion The results found can support strategies to implement practices to promote health, develop new public policies, to provide training in self-care, and prevent and treat complications.
{"title":"Epidemiological Characterization of Patients with Intestinal Stomas","authors":"Liliane Moretti Carneiro, A. M. Ferreira, M. A. Rigotti, Jaqueline Aparecida dos Santos Sokem, Alessandra Lyrio Barbosa Giroti, Rodrigo Aranda Serra, Maiara Oliveira Diniz","doi":"10.1055/s-0043-1769920","DOIUrl":"https://doi.org/10.1055/s-0043-1769920","url":null,"abstract":"Abstract Objective To characterize the sociodemographic and clinical variables of people with intestinal stomas. Materials and Methods We conducted a cross-sectional study with 47 patients of a Specialized Rehabilitation Center (CER II/APAE) in the municipality of Três Lagoas, state of Mato Grosso do Sul, Midwestern Brazil, from December 2019 to June 2020. Data was analyzed using inferential descriptive statistics (Anderson-Darling, Chi-squared, and Mann-Whitney normality tests). Results Regarding the patients, 87.23% were from Três Lagoas, 51.06% were female, 40.43% were aged from 60 to 69 years, 59.57% were married, 53.19% were brown, 59.57% were catholic, 36.17% finished elementary school, 46.81% were retired, and 57.45% earned a monthly income below 1 minimum wage. Moreover, 61.70% had undergone terminal colostomy (61.70%), 61.70% had received guidance about its placing, 57.45% had it placed due to situations of urgency, 74.47% had a stoma installed due to a neoplasia, 38.30% were permanent, with 46.81% located in the inferior left quadrant (ILQ), 59.57% presented pasty effluent, 63.83% had a circular diameter, 53.19% had pouches with 2 pieces and 57.45%, with a flexible base, 87.23% had other adjunct equipment, and 95.74% had been trained in self-care. The most common complication was skin/peristomal irritant contact dermatitis (59,57%), and 65,95% of these cases were solved by teaching self-care. The type of stoma was significantly associated with the consistency of the effluent and the size of the protrusion ( p > 0.05). Conclusion The results found can support strategies to implement practices to promote health, develop new public policies, to provide training in self-care, and prevent and treat complications.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"117 - 125"},"PeriodicalIF":0.0,"publicationDate":"2023-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57981320","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}
Abstract The gold-standard procedure for anal canal examination is anoscopy. Nonetheless, patients are referred for a colonoscopy for many reasons, and a routine exam might provide an opportunity to diagnose anal pathologies, such as hemorrhoids, anal fissures, anal polyps, condylomas, and anal squamous cell carcinoma. It is important to know the main features of these conditions and relevant information to report in order to help guide patient treatment and follow-up.
{"title":"Identification and Reporting of Anal Pathology during Routine Colonoscopies","authors":"A. Albuquerque, I. Etienney","doi":"10.1055/s-0043-1769921","DOIUrl":"https://doi.org/10.1055/s-0043-1769921","url":null,"abstract":"Abstract The gold-standard procedure for anal canal examination is anoscopy. Nonetheless, patients are referred for a colonoscopy for many reasons, and a routine exam might provide an opportunity to diagnose anal pathologies, such as hemorrhoids, anal fissures, anal polyps, condylomas, and anal squamous cell carcinoma. It is important to know the main features of these conditions and relevant information to report in order to help guide patient treatment and follow-up.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"152 - 158"},"PeriodicalIF":0.0,"publicationDate":"2023-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44464939","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}
R. E. Colbran, A. Warwick, H. Krause, J. Goh, C. Gillespie
Abstract Objective Pelvic floor dysfunction can manifest as a spectrum including anorectal dysfunction, vaginal prolapse, and urinary incontinence. Sacrospinous fixation is a procedure performed by gynecologists to treat vaginal prolapse. The present study aims to evaluate the impact of transvaginal prolapse surgery on anorectal function. Materials and Methods We conducted a retrospective review of patients undergoing sacrospinous fixation surgery for vaginal prolapse between 2014 to 2020. Those with anorectal dysfunction who had also been evaluated by the colorectal service preoperatively and postoperatively were included for analysis. These patients were assessed with symptom-specific validated questionnaires. The effect of surgery on constipation and fecal incontinence symptoms was analyzed. Results A total of 22 patients were included for analysis. All patients underwent transvaginal sacrospinous fixation, and 95.4% also had posterior colporrhaphy for vaginal prolapse. There were a statistically significant improvements in the Fecal Incontinence Severity Index (FISI), the St. Mark's Incontinence Score (Vaizey), the embarrassment and lifestyle components of the Fecal Incontinence Quality of Life Score, the Constipation Scoring System, the Obstructed Defecation Score, and components of the Patient Assessment of Constipation Quality of Life score. Conclusion Transvaginal prolapse surgery leads to a favorable effect on anorectal function, with improvements in both obstructed defecation and fecal incontinence scores in this small series.
{"title":"The Effect of Transvaginal Prolapse Surgery on Anorectal Function","authors":"R. E. Colbran, A. Warwick, H. Krause, J. Goh, C. Gillespie","doi":"10.1055/s-0043-1764196","DOIUrl":"https://doi.org/10.1055/s-0043-1764196","url":null,"abstract":"Abstract Objective Pelvic floor dysfunction can manifest as a spectrum including anorectal dysfunction, vaginal prolapse, and urinary incontinence. Sacrospinous fixation is a procedure performed by gynecologists to treat vaginal prolapse. The present study aims to evaluate the impact of transvaginal prolapse surgery on anorectal function. Materials and Methods We conducted a retrospective review of patients undergoing sacrospinous fixation surgery for vaginal prolapse between 2014 to 2020. Those with anorectal dysfunction who had also been evaluated by the colorectal service preoperatively and postoperatively were included for analysis. These patients were assessed with symptom-specific validated questionnaires. The effect of surgery on constipation and fecal incontinence symptoms was analyzed. Results A total of 22 patients were included for analysis. All patients underwent transvaginal sacrospinous fixation, and 95.4% also had posterior colporrhaphy for vaginal prolapse. There were a statistically significant improvements in the Fecal Incontinence Severity Index (FISI), the St. Mark's Incontinence Score (Vaizey), the embarrassment and lifestyle components of the Fecal Incontinence Quality of Life Score, the Constipation Scoring System, the Obstructed Defecation Score, and components of the Patient Assessment of Constipation Quality of Life score. Conclusion Transvaginal prolapse surgery leads to a favorable effect on anorectal function, with improvements in both obstructed defecation and fecal incontinence scores in this small series.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"018 - 023"},"PeriodicalIF":0.0,"publicationDate":"2023-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42352586","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}
Hugo Samartine, Lauro Igor Silva, Lucas Rosasco Mazzini, Daniel Ferreira Paiva, Giovanna Bertazzola Gracitelli, J. Aquino, E. D. T. Mendes
Abstract Introduction The presentation of abstracts in a congress is an important step for the dissemination of scientific information. The American Congress of Coloproctology is promoted by the American Society of Colon & Rectal Surgeons (ASCRS), and it is the largest in number of participants within the specialty, followed by the Brazilian Congress of Coloproctology. The present study aims to evaluate variables related to the quality of the scientific production of the abstracts presented in these two events and their conversion rate to published manuscripts. Materials and Methods The present bibliometric study assesses secondary data from the review of abstracts presented in these 2 important conferences in 2016, followed by a research of the publications from these congress presentations. Results The total number of abstracts evaluated was 854. The rate of articles containing statistical analyses was of 73.7% in the American congress, and of 34.1% in the Brazilian congress. Multicentric studies were more prevalent in the American congress (23.1%). Regarding study design, the most common were case reports in the Brazilian (44.8%) congress and retrospective studies in the American congress (67.7%). As for the works presented, the rate of conversion into full manuscripts in the American congress was of 24.2% compared with 10.6% in the Brazilian congress. Most papers from the American congress (93.7%) have citations compared with 68.6% of the other event evaluated. Conclusion The scientific performance demonstrated by the conversion rate of abstracts into publications is below ideal, mainly in relation to the Brazilian meeting; yet, there were significant differences between the two events in terms of the profile of the presentations and several variables analyzed.
{"title":"An American and Brazilian Perspective on Abstracts Presented in Coloproctology Conferences Converted into Published Manuscripts","authors":"Hugo Samartine, Lauro Igor Silva, Lucas Rosasco Mazzini, Daniel Ferreira Paiva, Giovanna Bertazzola Gracitelli, J. Aquino, E. D. T. Mendes","doi":"10.1055/s-0043-1769917","DOIUrl":"https://doi.org/10.1055/s-0043-1769917","url":null,"abstract":"Abstract Introduction The presentation of abstracts in a congress is an important step for the dissemination of scientific information. The American Congress of Coloproctology is promoted by the American Society of Colon & Rectal Surgeons (ASCRS), and it is the largest in number of participants within the specialty, followed by the Brazilian Congress of Coloproctology. The present study aims to evaluate variables related to the quality of the scientific production of the abstracts presented in these two events and their conversion rate to published manuscripts. Materials and Methods The present bibliometric study assesses secondary data from the review of abstracts presented in these 2 important conferences in 2016, followed by a research of the publications from these congress presentations. Results The total number of abstracts evaluated was 854. The rate of articles containing statistical analyses was of 73.7% in the American congress, and of 34.1% in the Brazilian congress. Multicentric studies were more prevalent in the American congress (23.1%). Regarding study design, the most common were case reports in the Brazilian (44.8%) congress and retrospective studies in the American congress (67.7%). As for the works presented, the rate of conversion into full manuscripts in the American congress was of 24.2% compared with 10.6% in the Brazilian congress. Most papers from the American congress (93.7%) have citations compared with 68.6% of the other event evaluated. Conclusion The scientific performance demonstrated by the conversion rate of abstracts into publications is below ideal, mainly in relation to the Brazilian meeting; yet, there were significant differences between the two events in terms of the profile of the presentations and several variables analyzed.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"110 - 116"},"PeriodicalIF":0.0,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44309043","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}
Abstract Introduction Puerperium is defined as the period of about 6 weeks after childbirth during which the mother's reproductive organs return to their original nonpregnant condition. Perianal problems, including constipation, hemorrhoids, and fissure, are among the most common digestive complications among women in puerperium, observed in about 30 to 50 percent of women. Considering this great prevalence and the paucity of similar research in this aspect in an Indian population, the present study was done to assess the prevalence of perianal problems seen in puerperium and the risk factors associated with it. Methods This was a prospective observational cohort study done over the span of 3 years on 902 puerperal women. A self-structured questionnaire covered detailed history and per-rectal and proctoscopy examination. Patients were followed up telephonically for regression of perianal problems post management. Results The total prevalence of all the perianal problems in puerperium encountered in the present study, out of 902 subjects, was 36.3% (327 subjects). The perianal problems encountered were fissure in 185 patients (20.5%) followed by hemorrhoids in 110 patients (12.2%), perianal episiotomy infections in 25 patients (2.8%), and perineal tears in 7 patients (0.8%). On comparative analysis, positive family history, macrosomia, past history of perianal diseases, and second stage of labour > 50 minutes showed a higher prevalence in the perianal disease group as compared with the healthy group. Out of these, positive family history of perianal diseases ( p = 0.015) and past history of perianal diseases ( p = 0.016) were statistically significant. The percentage of multipara with hemorrhoids was more when compared to primipara ( p = 0.01), patients who had a past history of any perianal disease have a higher chance of hemorrhoids during puerperium ( p = 0.00). Patients with constipation in pregnancy have higher chance of hemorrhoids in pregnancy ( p = 0.00). Patients who had a past history of any perianal disease had higher chance of fissure during puerperium ( p = 0.00). A total of 27.74% of the study subjects with macrosomic babies had fissure in their puerperal period which on comparison with patients with non macrosomic babies was only 19.22%, which was statistically significant ( p = 0.02). Conclusion Constipation, hemorrhoids, and anal fissures are the most common perianal problems in postpartum period causing significant reduction in the quality of life of those afflicted with them.
{"title":"Perianal Complications in Puerperium and Associated Risk Factors","authors":"S. Iyer, S. Jadhav, A. Kandi, Suraj A. Soyam","doi":"10.1055/s-0043-1769488","DOIUrl":"https://doi.org/10.1055/s-0043-1769488","url":null,"abstract":"Abstract Introduction Puerperium is defined as the period of about 6 weeks after childbirth during which the mother's reproductive organs return to their original nonpregnant condition. Perianal problems, including constipation, hemorrhoids, and fissure, are among the most common digestive complications among women in puerperium, observed in about 30 to 50 percent of women. Considering this great prevalence and the paucity of similar research in this aspect in an Indian population, the present study was done to assess the prevalence of perianal problems seen in puerperium and the risk factors associated with it. Methods This was a prospective observational cohort study done over the span of 3 years on 902 puerperal women. A self-structured questionnaire covered detailed history and per-rectal and proctoscopy examination. Patients were followed up telephonically for regression of perianal problems post management. Results The total prevalence of all the perianal problems in puerperium encountered in the present study, out of 902 subjects, was 36.3% (327 subjects). The perianal problems encountered were fissure in 185 patients (20.5%) followed by hemorrhoids in 110 patients (12.2%), perianal episiotomy infections in 25 patients (2.8%), and perineal tears in 7 patients (0.8%). On comparative analysis, positive family history, macrosomia, past history of perianal diseases, and second stage of labour > 50 minutes showed a higher prevalence in the perianal disease group as compared with the healthy group. Out of these, positive family history of perianal diseases ( p = 0.015) and past history of perianal diseases ( p = 0.016) were statistically significant. The percentage of multipara with hemorrhoids was more when compared to primipara ( p = 0.01), patients who had a past history of any perianal disease have a higher chance of hemorrhoids during puerperium ( p = 0.00). Patients with constipation in pregnancy have higher chance of hemorrhoids in pregnancy ( p = 0.00). Patients who had a past history of any perianal disease had higher chance of fissure during puerperium ( p = 0.00). A total of 27.74% of the study subjects with macrosomic babies had fissure in their puerperal period which on comparison with patients with non macrosomic babies was only 19.22%, which was statistically significant ( p = 0.02). Conclusion Constipation, hemorrhoids, and anal fissures are the most common perianal problems in postpartum period causing significant reduction in the quality of life of those afflicted with them.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"093 - 098"},"PeriodicalIF":0.0,"publicationDate":"2023-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45163873","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}
Abstract Pseudomyxoma peritonei (PMP) refers to a growth disorder characterized by glycoprotein neoplasm in the peritoneum, where mucin oversecretion occurs. The tumors of the appendix region are well associated with PMP; however, ovarian, colon, stomach, pancreas, and urachus tumors have also been linked to PMP. Other mucinous tumors in the pelvis, paracolic gutters, greater omentum, retrohepatic space, and Treitz ligament can be the reason for PMP. Despite being rare and having a slow growth rate, PMP can be lethal without treatment. It is treated with neoadjuvant chemotherapy with the option of cytoreductive surgery and intraperitoneal chemotherapy. In the current study, we hypothesize that there may be novel gentle ways to inhibit or eliminate the mucin. Dr. David Morris has used mucolytics—such as bromelain and N-acetyl cysteine to solubilize mucin. In the present review, we aimed to study the regulation of mucin expression by promoter methylation, and drugs that can inhibit mucin, such as boldine, amiloride, naltrexone, dexamethasone, and retinoid acid receptors antagonist. This review also explored some possible pathways, such as inhibition of Na + , Ca2+ channels and induction of DNA methyltransferase along with inhibition of ten-eleven translocation enzymes, which can be good targets to control mucin. Mucins are strong adhesive molecules that play great roles in clinging to cells or cell to cell. Besides, they have been greatly involved in metastasis and also act as disease markers for cancers. Diagnostic markers may have exclusive roles in disease initiation and progression. Therefore, the present review explores various drugs to control and target mucin in various diseases, specifically cancers.
{"title":"Possible Therapeutics for Pseudomyxoma Peritonei: A Rare, Lethal, and the Least Investigated Disease","authors":"Aarifa Nazmeen","doi":"10.1055/s-0043-1769919","DOIUrl":"https://doi.org/10.1055/s-0043-1769919","url":null,"abstract":"Abstract Pseudomyxoma peritonei (PMP) refers to a growth disorder characterized by glycoprotein neoplasm in the peritoneum, where mucin oversecretion occurs. The tumors of the appendix region are well associated with PMP; however, ovarian, colon, stomach, pancreas, and urachus tumors have also been linked to PMP. Other mucinous tumors in the pelvis, paracolic gutters, greater omentum, retrohepatic space, and Treitz ligament can be the reason for PMP. Despite being rare and having a slow growth rate, PMP can be lethal without treatment. It is treated with neoadjuvant chemotherapy with the option of cytoreductive surgery and intraperitoneal chemotherapy. In the current study, we hypothesize that there may be novel gentle ways to inhibit or eliminate the mucin. Dr. David Morris has used mucolytics—such as bromelain and N-acetyl cysteine to solubilize mucin. In the present review, we aimed to study the regulation of mucin expression by promoter methylation, and drugs that can inhibit mucin, such as boldine, amiloride, naltrexone, dexamethasone, and retinoid acid receptors antagonist. This review also explored some possible pathways, such as inhibition of Na + , Ca2+ channels and induction of DNA methyltransferase along with inhibition of ten-eleven translocation enzymes, which can be good targets to control mucin. Mucins are strong adhesive molecules that play great roles in clinging to cells or cell to cell. Besides, they have been greatly involved in metastasis and also act as disease markers for cancers. Diagnostic markers may have exclusive roles in disease initiation and progression. Therefore, the present review explores various drugs to control and target mucin in various diseases, specifically cancers.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"139 - 151"},"PeriodicalIF":0.0,"publicationDate":"2022-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"57981264","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}
L. A. Hidalgo-Grau, N. Ruiz-Edo, O. Estrada-Ferrer, E. M. García-Torralbo, M. del Bas-Rubia, P. Clos-Ferrero, E. Bombuy-Giménez
Abstract Background The ligation of intersphincteric fistula fract (LIFT) technique avoids postoperative anal continence disturbances and preserves quality of life. Methods A total of 70 patients with anal fistula (AF) were treated in the Day Surgery Unit. The LIFT technique was the primary treatment in 63 patients. The other had previously undergone placement of a loose seton (two-step approach). The mean follow-up was 66.8 months. Statistical analysis was performed using contingency tables, the chi-square test, and the Student T-test. Results The use of LIFT was successful in 40 patients (57.1%). However, 6 patients (8.6%) presented persistence of postoperative intersphincteric fistula, being successfully treated by fistulotomy. There were no differences in this technique's success rate between high and low AF ( p = 0.45). The success rate of one-step LIFT, however, was significantly higher ( p = 0.03). No disturbances of continence were observed. Conclusions The LIFT technique has a role in the treatment of AF, is suitable for ambulatory surgery, and has a low complications rate. A two-step approach is not always needed.
{"title":"Ligation of Intersphincteric Fistula Tract (LIFT) for the Treatment of Anal Fistula: A Prospective Observational Study","authors":"L. A. Hidalgo-Grau, N. Ruiz-Edo, O. Estrada-Ferrer, E. M. García-Torralbo, M. del Bas-Rubia, P. Clos-Ferrero, E. Bombuy-Giménez","doi":"10.1055/s-0043-1764195","DOIUrl":"https://doi.org/10.1055/s-0043-1764195","url":null,"abstract":"Abstract Background The ligation of intersphincteric fistula fract (LIFT) technique avoids postoperative anal continence disturbances and preserves quality of life. Methods A total of 70 patients with anal fistula (AF) were treated in the Day Surgery Unit. The LIFT technique was the primary treatment in 63 patients. The other had previously undergone placement of a loose seton (two-step approach). The mean follow-up was 66.8 months. Statistical analysis was performed using contingency tables, the chi-square test, and the Student T-test. Results The use of LIFT was successful in 40 patients (57.1%). However, 6 patients (8.6%) presented persistence of postoperative intersphincteric fistula, being successfully treated by fistulotomy. There were no differences in this technique's success rate between high and low AF ( p = 0.45). The success rate of one-step LIFT, however, was significantly higher ( p = 0.03). No disturbances of continence were observed. Conclusions The LIFT technique has a role in the treatment of AF, is suitable for ambulatory surgery, and has a low complications rate. A two-step approach is not always needed.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"024 - 029"},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45950752","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}
Abstract Objective In the present study, we aimed to examine the treatments and their outcomes in cases with colon injuries after blunt and penetrating abdominal traumas. Materials and Methods Twenty-six patients who underwent a laparotomy and were found to have a colon injury due to blunt abdominal trauma, penetrating stab injury, gunshot injury, and traffic accident were included. All patients were admitted into the emergency outpatient clinic of Gazi Yaşargil Training and Research Hospital General Surgery Clinic between 2016 and 2020. The records of the cases were analyzed retrospectively. Results Colon injuries were detected in 26 cases. All 26 (100%) cases were males with an average age of 29.80 ± 11.4 (range: 17–60) years old. Colon injuries observed during emergency operations included 18 (69.23%) patients with a GSI (gunshot injuries), 3 (11.53%) with penetrating stab injuries, 4 (15.38%) who were a part of traffic accidents and 1 (3.85%) patient with a blunt abdominal trauma. A primary colon repair was performed in 10 patients. Five patients underwent a colon resection and there were end colostomies. Four patients underwent a loop ileostomy after a colon resection and anastomosis. Colon resections with anastomoses were performed in seven patients. The mean hospitalization period was 26 ± 29.28 days. Conclusion Patients should be classified intraoperatively with findings, such as peritoneal contamination, degree of colon injury, duration of the injury, and any accompanying injuries.
{"title":"Our Experience of Emergency Colorectal Injury as a Result of Abdominal Trauma","authors":"I. Taş, Ebral Yiğit","doi":"10.1055/s-0043-1769918","DOIUrl":"https://doi.org/10.1055/s-0043-1769918","url":null,"abstract":"Abstract Objective In the present study, we aimed to examine the treatments and their outcomes in cases with colon injuries after blunt and penetrating abdominal traumas. Materials and Methods Twenty-six patients who underwent a laparotomy and were found to have a colon injury due to blunt abdominal trauma, penetrating stab injury, gunshot injury, and traffic accident were included. All patients were admitted into the emergency outpatient clinic of Gazi Yaşargil Training and Research Hospital General Surgery Clinic between 2016 and 2020. The records of the cases were analyzed retrospectively. Results Colon injuries were detected in 26 cases. All 26 (100%) cases were males with an average age of 29.80 ± 11.4 (range: 17–60) years old. Colon injuries observed during emergency operations included 18 (69.23%) patients with a GSI (gunshot injuries), 3 (11.53%) with penetrating stab injuries, 4 (15.38%) who were a part of traffic accidents and 1 (3.85%) patient with a blunt abdominal trauma. A primary colon repair was performed in 10 patients. Five patients underwent a colon resection and there were end colostomies. Four patients underwent a loop ileostomy after a colon resection and anastomosis. Colon resections with anastomoses were performed in seven patients. The mean hospitalization period was 26 ± 29.28 days. Conclusion Patients should be classified intraoperatively with findings, such as peritoneal contamination, degree of colon injury, duration of the injury, and any accompanying injuries.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"099 - 103"},"PeriodicalIF":0.0,"publicationDate":"2022-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45428420","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}
A. Gomes, João Batista Sampaio Netto, Ricardo de Oliveira Ayres, José Mauro da Silva Rodrigues, Ronaldo Antonio Borghesi
Abstract Introduction Anal examination and videoanoscopy (VA) are rarely performed during colonoscopies. In recent years, there has been a considerable increase in lesions of sexually transmitted anal and rectal infections, but these conditions are not noticed or reported during routine colonoscopy. Objective To raise awareness regarding the fortuitous findings of lesions and sexually transmitted infections (STIs) in colonoscopy exams and to demonstrate that anal examination and VA provide important information and should be routinely performed. Methods We conducted a descriptive retrospective study in 16,132 patients screened by colonoscopy and VA between 2006 and 2018. Among numerous other findings, the presence of anal condylomata and sexually transmitted retitis or perianal dermatitis was observed. The rates of each finding were calculated, and the patients were subdivided by sex and into age groups by blocks of ten years. Results Among the 16,132 colonoscopies performed, 26 cases of condyloma (0.16%) and 50 cases of proctitis or perianal dermatitis suspicious for STI (0.33%) were found. Conclusion Performing anal examination and VA systematically in all routine colonoscopies enabled the identification of numerous anal conditions, including several fortuitous cases of STIs. The study proposes that anal examination and VA should be performed in all routine colonoscopies and, in suspected cases, complementary tests for STIs.
{"title":"Sexually Transmitted Infections Lesions Found during Colonoscopies","authors":"A. Gomes, João Batista Sampaio Netto, Ricardo de Oliveira Ayres, José Mauro da Silva Rodrigues, Ronaldo Antonio Borghesi","doi":"10.1055/s-0043-1769486","DOIUrl":"https://doi.org/10.1055/s-0043-1769486","url":null,"abstract":"Abstract Introduction Anal examination and videoanoscopy (VA) are rarely performed during colonoscopies. In recent years, there has been a considerable increase in lesions of sexually transmitted anal and rectal infections, but these conditions are not noticed or reported during routine colonoscopy. Objective To raise awareness regarding the fortuitous findings of lesions and sexually transmitted infections (STIs) in colonoscopy exams and to demonstrate that anal examination and VA provide important information and should be routinely performed. Methods We conducted a descriptive retrospective study in 16,132 patients screened by colonoscopy and VA between 2006 and 2018. Among numerous other findings, the presence of anal condylomata and sexually transmitted retitis or perianal dermatitis was observed. The rates of each finding were calculated, and the patients were subdivided by sex and into age groups by blocks of ten years. Results Among the 16,132 colonoscopies performed, 26 cases of condyloma (0.16%) and 50 cases of proctitis or perianal dermatitis suspicious for STI (0.33%) were found. Conclusion Performing anal examination and VA systematically in all routine colonoscopies enabled the identification of numerous anal conditions, including several fortuitous cases of STIs. The study proposes that anal examination and VA should be performed in all routine colonoscopies and, in suspected cases, complementary tests for STIs.","PeriodicalId":15408,"journal":{"name":"Journal of Coloproctology","volume":"43 1","pages":"075 - 081"},"PeriodicalIF":0.0,"publicationDate":"2022-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48827202","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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