M. Amini, M. Hashemizadeh, M. Sepehrimanesh, S. L. Poorbaghi, Razieh Naseri Mojarrad, Z. Zardosht
Background: Obesity is becoming a worldwide health problem. Recently, bariatric surgeries are developing to combat with this problem. However, these surgical methods themselves have risks. Objectives: The present study investigated the preventive effect of routine leak test of both gastrojejunal and jejunojejunal anastomoses immediately after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery against post-operative leak by inexperienced surgeons. Methods: In a prospective interventional study, this research enrolled 52 morbid obese patients with LRYGB from September 2014 to October 2016. After anastomoses, methylene blue and air leak tests were performed and the section line and both anastomosis sites for patency and inspected for air and dye leaks were examined. Results: Mean body mass index of patients was 48.84 ± 6.8 kg/m. Twelve patients had positive leak test and the anastomoses were reinforced by additional sutures. All patients were discharged with no leak and no patient had leak during the routine follow-up period. Conclusions: Intraoperative leak test of both gastrojejunal and jejunojejunal anastomoses is a valuable test in the assessment of leak during LRYGB surgery, especially in unskilled surgeons.
{"title":"Clinical Efficacy of Jejunojejunostomy Leak Test Using Methylene Blue During Laparoscopic Roux-en-Y Gastric Bypass on Post-Operative Leak Rate","authors":"M. Amini, M. Hashemizadeh, M. Sepehrimanesh, S. L. Poorbaghi, Razieh Naseri Mojarrad, Z. Zardosht","doi":"10.5812/ACR.77092","DOIUrl":"https://doi.org/10.5812/ACR.77092","url":null,"abstract":"Background: Obesity is becoming a worldwide health problem. Recently, bariatric surgeries are developing to combat with this problem. However, these surgical methods themselves have risks. Objectives: The present study investigated the preventive effect of routine leak test of both gastrojejunal and jejunojejunal anastomoses immediately after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery against post-operative leak by inexperienced surgeons. Methods: In a prospective interventional study, this research enrolled 52 morbid obese patients with LRYGB from September 2014 to October 2016. After anastomoses, methylene blue and air leak tests were performed and the section line and both anastomosis sites for patency and inspected for air and dye leaks were examined. Results: Mean body mass index of patients was 48.84 ± 6.8 kg/m. Twelve patients had positive leak test and the anastomoses were reinforced by additional sutures. All patients were discharged with no leak and no patient had leak during the routine follow-up period. Conclusions: Intraoperative leak test of both gastrojejunal and jejunojejunal anastomoses is a valuable test in the assessment of leak during LRYGB surgery, especially in unskilled surgeons.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73506301","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}
S. Hosseini, Mohammed Abdzaid Akool, Mozhdeh Zamani
Background: In recent years, single-port laparoscopic colectomy (SPLC) has been introduced as a new technique for colorectal surgery. Despite several studies, available results are too sparse to accurately identify differences between SPLC and conventional multiport laparoscopic colectomy (MPLC). In a continuing effort, the aim of this study was to compare these two techniques in colon cancer patients. Methods: 76 patients with colon cancer who underwent either SPLC or MPLC took part in this study. Demographic data and complications such as age, gender, operative time, hospital stay, intra-operative blood volume loss, and internal organ injury were assessed. The patients were followed up for 6 months. Statistical analysis was performed by SPSS software using Student’s t-test, Chi-square test, or Fisher’s exact test. Results: The complications were similar in both SPLC and MPLC groups. Operative time was significantly lower in SPLC (P = 0.003). No significant differences were observed in other factors (P > 0.05). Conclusions: According to studies conducted so far, it seems that the difference in the surgeon’s experience, types of the colorectal diseases, and types of the colorectal resection may affect the outcomes like operative time and hospital stay. Therefore, further coherent investigations with larger datasets are essential for a detailed comparison.
{"title":"Comparative Outcomes Analysis of Single-Port versus Multi-Port Laparoscopic Right Hemicolectomy in Colon Cancer","authors":"S. Hosseini, Mohammed Abdzaid Akool, Mozhdeh Zamani","doi":"10.5812/ACR.80097","DOIUrl":"https://doi.org/10.5812/ACR.80097","url":null,"abstract":"Background: In recent years, single-port laparoscopic colectomy (SPLC) has been introduced as a new technique for colorectal surgery. Despite several studies, available results are too sparse to accurately identify differences between SPLC and conventional multiport laparoscopic colectomy (MPLC). In a continuing effort, the aim of this study was to compare these two techniques in colon cancer patients. Methods: 76 patients with colon cancer who underwent either SPLC or MPLC took part in this study. Demographic data and complications such as age, gender, operative time, hospital stay, intra-operative blood volume loss, and internal organ injury were assessed. The patients were followed up for 6 months. Statistical analysis was performed by SPSS software using Student’s t-test, Chi-square test, or Fisher’s exact test. Results: The complications were similar in both SPLC and MPLC groups. Operative time was significantly lower in SPLC (P = 0.003). No significant differences were observed in other factors (P > 0.05). Conclusions: According to studies conducted so far, it seems that the difference in the surgeon’s experience, types of the colorectal diseases, and types of the colorectal resection may affect the outcomes like operative time and hospital stay. Therefore, further coherent investigations with larger datasets are essential for a detailed comparison.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"110 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76066003","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}
M. Tahamtan, S. Hosseini, Seyyed Hamdollah Mosavat, A. Bananzadeh, Masoomeh Rahimi, H. Khazraei
Background: In this text, the important points of Avicenna’s Canon of Medicine on hemorrhoidal disease and its treatment have been introduced in light of colorectal surgery. Objectives: The aim of this study is to briefly explain the hemorrhoidal disease and its treatment through different sections of Avicenna’s Canon of Medicine. A unique feature of the Canon is careful and precise observations and description of the disorders and diseases. However, the recommended treatment differs from which that used today except in a few diseases. Methods: The most detailed chapter regarding hemorrhoid in Canon of Avicenna, under the title of “Anal disease,” shows rather precise knowledge about anal disease and their surgical treatments in the 11th century. Results and Discussion: Avicenna explained in detail about anal diseases such as perianal abscess, fissure, rectal prolapse, and hemorrhoid in the 17th chapter of the 3rd volume of the Canon. Many herbs were used in anal disease by medieval physicians such asAvicennahadantioxidantandanti-inflammatoryeffects. Thus,theknowledgeof ancientphysiciancanhelpusindevelopingnew therapeutic methods.
{"title":"Concepts of Hemorrhoids and Its Treatment in Avicenna’s Canon of Medicine","authors":"M. Tahamtan, S. Hosseini, Seyyed Hamdollah Mosavat, A. Bananzadeh, Masoomeh Rahimi, H. Khazraei","doi":"10.5812/ACR.62907","DOIUrl":"https://doi.org/10.5812/ACR.62907","url":null,"abstract":"Background: In this text, the important points of Avicenna’s Canon of Medicine on hemorrhoidal disease and its treatment have been introduced in light of colorectal surgery. Objectives: The aim of this study is to briefly explain the hemorrhoidal disease and its treatment through different sections of Avicenna’s Canon of Medicine. A unique feature of the Canon is careful and precise observations and description of the disorders and diseases. However, the recommended treatment differs from which that used today except in a few diseases. Methods: The most detailed chapter regarding hemorrhoid in Canon of Avicenna, under the title of “Anal disease,” shows rather precise knowledge about anal disease and their surgical treatments in the 11th century. Results and Discussion: Avicenna explained in detail about anal diseases such as perianal abscess, fissure, rectal prolapse, and hemorrhoid in the 17th chapter of the 3rd volume of the Canon. Many herbs were used in anal disease by medieval physicians such asAvicennahadantioxidantandanti-inflammatoryeffects. Thus,theknowledgeof ancientphysiciancanhelpusindevelopingnew therapeutic methods.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"59 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85078325","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}
Background: Traditional open hemorrhoidectomy is the most commonly performed operation for the third or fourth degree hemorrhoids in the developing world, despite considerable postoperative pain and bleeding complications. This modification is an attempt to reduce these complications and compare the outcome of both methods. Methods: A prospective, comparative study was conducted in phase I, at Fatima hospital at Baqai Medical University, from March 2009 to August 2011. It was followed by a descriptive case-series in phase II, conducted at different hospitals from September 2011 to August 2017. The inclusion criteria were patients of both genders and all age groups, with third or fourth degree hemorrhoids requiring surgery. The exclusion criteria were patients in between blocks (operated by other surgeons), patients with complicated hemorrhoids, closed hemorrhoidectomy cases, cases operated by residents, and cases lost to follow-up. In phase I, a total of 182 patients were enrolled and randomly allocated to group A or B undergoing triple hemostatic hemorrhoidectomy and traditional open hemorrhoidectomy, respectively; 231 patients were included in phase II (group C) undergoing modified hemorrhoidectomy. The analyzed variables were operative blood loss, operative time, postoperative pain, hospital stay, time to pain-free defecation, and per-operative or postoperative complications. Results: There was significantly more operative blood loss in group B patients. Pain perception was significantly high in group B patients at eight and 24 hours, as well as eighth, 15th, and 30th days. Group B patients also had longer duration of operation and more prolonged pain-free defecation. Both, intra-operative and post-operative complications were higher among the group B. The outcome of phase II (group C) was similar to those of group A. Conclusions: In a limited resource setting, triple hemostatic open hemorrhoidectomy offers potential advantages of less operative blood loss, shorter duration of operation, shortened hospital stay, shorter time to pain free defecation, and less postoperative pain and other complications.
{"title":"Comparative Analysis of Triple Hemostatic Open Hemorrhoidectomy Versus Traditional Open Hemorrhoidectomy","authors":"M. Shamim","doi":"10.5812/acr.67109","DOIUrl":"https://doi.org/10.5812/acr.67109","url":null,"abstract":"Background: Traditional open hemorrhoidectomy is the most commonly performed operation for the third or fourth degree hemorrhoids in the developing world, despite considerable postoperative pain and bleeding complications. This modification is an attempt to reduce these complications and compare the outcome of both methods. Methods: A prospective, comparative study was conducted in phase I, at Fatima hospital at Baqai Medical University, from March 2009 to August 2011. It was followed by a descriptive case-series in phase II, conducted at different hospitals from September 2011 to August 2017. The inclusion criteria were patients of both genders and all age groups, with third or fourth degree hemorrhoids requiring surgery. The exclusion criteria were patients in between blocks (operated by other surgeons), patients with complicated hemorrhoids, closed hemorrhoidectomy cases, cases operated by residents, and cases lost to follow-up. In phase I, a total of 182 patients were enrolled and randomly allocated to group A or B undergoing triple hemostatic hemorrhoidectomy and traditional open hemorrhoidectomy, respectively; 231 patients were included in phase II (group C) undergoing modified hemorrhoidectomy. The analyzed variables were operative blood loss, operative time, postoperative pain, hospital stay, time to pain-free defecation, and per-operative or postoperative complications. Results: There was significantly more operative blood loss in group B patients. Pain perception was significantly high in group B patients at eight and 24 hours, as well as eighth, 15th, and 30th days. Group B patients also had longer duration of operation and more prolonged pain-free defecation. Both, intra-operative and post-operative complications were higher among the group B. The outcome of phase II (group C) was similar to those of group A. Conclusions: In a limited resource setting, triple hemostatic open hemorrhoidectomy offers potential advantages of less operative blood loss, shorter duration of operation, shortened hospital stay, shorter time to pain free defecation, and less postoperative pain and other complications.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87365160","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}
Erfan Mohammadi, D. Qujeq, H. Taheri, K. Hajian-Tilaki
Background: This study aimed at evaluating oxidant and antioxidant markers (including nitrite, nitrate, total antioxidant capacity (TAC), malondialdehyde (MDA), iron, selenium, glutathione peroxidase (GPx), and glutathione reductase (GR) in patients with inflammatory bowel disease (IBD) and compare them with healthy controls. Methods: Serum samples were obtained from 35 patients (19 ulcerative colitis (UC) and 16 Crohn’s disease (CD) in the active phase of the disease) and 30 healthy controls. Serum levels of nitrite and nitrate, TAC, MDA, iron, selenium, glutathione peroxidase, and glutathione reductase were measured. The results were compared between the two groups using independent t-student test. The Pearson’s correlation coefficient (for continuous data) was performed using the SPSS software. Results: Serum levels of nitrite, nitrate, and MDA were significantly higher (P = 0.001) in patients with IBD, while the levels of TAC, trace elements, glutathione peroxidase (GPx), and Glutathione Reductase (GR) levels were lower (P < 0.05) in patients with IBD. However, when females were considered separately, Gpx and GR activities were not significantly different in those with and without IBD. The present results showed that nitrite, MDA, GPx, GR, and Se: MDA ratio had the strongest correlation with disease activity
{"title":"Inappropriate Total Oxidant/Antioxidant Status, Nitric Oxide Oxidation End Products and Trace Element Levels in Patients with Inflammatory Bowel Disease","authors":"Erfan Mohammadi, D. Qujeq, H. Taheri, K. Hajian-Tilaki","doi":"10.5812/acr.64029","DOIUrl":"https://doi.org/10.5812/acr.64029","url":null,"abstract":"Background: This study aimed at evaluating oxidant and antioxidant markers (including nitrite, nitrate, total antioxidant capacity (TAC), malondialdehyde (MDA), iron, selenium, glutathione peroxidase (GPx), and glutathione reductase (GR) in patients with inflammatory bowel disease (IBD) and compare them with healthy controls. Methods: Serum samples were obtained from 35 patients (19 ulcerative colitis (UC) and 16 Crohn’s disease (CD) in the active phase of the disease) and 30 healthy controls. Serum levels of nitrite and nitrate, TAC, MDA, iron, selenium, glutathione peroxidase, and glutathione reductase were measured. The results were compared between the two groups using independent t-student test. The Pearson’s correlation coefficient (for continuous data) was performed using the SPSS software. Results: Serum levels of nitrite, nitrate, and MDA were significantly higher (P = 0.001) in patients with IBD, while the levels of TAC, trace elements, glutathione peroxidase (GPx), and Glutathione Reductase (GR) levels were lower (P < 0.05) in patients with IBD. However, when females were considered separately, Gpx and GR activities were not significantly different in those with and without IBD. The present results showed that nitrite, MDA, GPx, GR, and Se: MDA ratio had the strongest correlation with disease activity","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"418 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79510346","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}
T. Velikova, Z. Spassova, L. M. Milatchkov, D. Panova, E. Todorova, K. Yuzeir, E. Kurteva, D. Kyurkchiev, S. Deredjan, R. Nikolov, I. Altankova, L. M. Vladimirova
Background: Fecal and immunological biomarkers can be used to diagnose and manage patients with Crohn’s disease (CD). Anti tumor necrosis factor (TNF) should be evaluated in addition to biomarkers to determine the response to therapy. Objectives: The current study aimed at following up fecal calprotectin (FC), perinuclear anti neutrophil cytoplasmic antibodies (pANCA), anti Saccharomyces cerevisiae antibodies (ASCA), and anti nuclear antibodies (ANA) in patients with CD on anti-TNF therapy. Methods: A total of 57 patients with CD and the mean age of 40 ± 15 years (ranged: 20 75) were monitored after initiation of anti TNFa treatment. Stool samples were tested for FC (Alegria automated the enzyme linked immunosorbent assay (ELISA) system), and serum samples for ANCA, ANA (indirect immunofluorescence IIF), and ASCA (ELISA) in the beginning and after six months on immunosuppressive therapy plus anti TNFa agents. Results: It was observed that all patients with CD had significantly decreased FC levels after anti TNFa therapy (963.97 mg/kg initially vs. 268.42 mg/kg after treatment; P = 0.043). Moreover, in 75% of patients, FC levels dropped below the cutoff value of 50 mg/kg. Positive for ASCA IgA/IgG were 17/24 tested patients, but no differences were observed regarding the application of anti TNFa therapy. However, the titers of pANCA decreased in four patients after anti TNFa treatment. Conclusions: Initial and follow up measurements of some immunological markers such as FC and pANCA could be of benefit for patients with CD in anti TNF therapy, whereas others such as ANA and ASCA were not useful to monitor the therapy.
{"title":"Dynamics of Some Routine Immunological Parameters During Anti - TNF Therapy in Patients with Crohn’s Disease","authors":"T. Velikova, Z. Spassova, L. M. Milatchkov, D. Panova, E. Todorova, K. Yuzeir, E. Kurteva, D. Kyurkchiev, S. Deredjan, R. Nikolov, I. Altankova, L. M. Vladimirova","doi":"10.5812/ACR.68674","DOIUrl":"https://doi.org/10.5812/ACR.68674","url":null,"abstract":"Background: Fecal and immunological biomarkers can be used to diagnose and manage patients with Crohn’s disease (CD). Anti tumor necrosis factor (TNF) should be evaluated in addition to biomarkers to determine the response to therapy. Objectives: The current study aimed at following up fecal calprotectin (FC), perinuclear anti neutrophil cytoplasmic antibodies (pANCA), anti Saccharomyces cerevisiae antibodies (ASCA), and anti nuclear antibodies (ANA) in patients with CD on anti-TNF therapy. Methods: A total of 57 patients with CD and the mean age of 40 ± 15 years (ranged: 20 75) were monitored after initiation of anti TNFa treatment. Stool samples were tested for FC (Alegria automated the enzyme linked immunosorbent assay (ELISA) system), and serum samples for ANCA, ANA (indirect immunofluorescence IIF), and ASCA (ELISA) in the beginning and after six months on immunosuppressive therapy plus anti TNFa agents. Results: It was observed that all patients with CD had significantly decreased FC levels after anti TNFa therapy (963.97 mg/kg initially vs. 268.42 mg/kg after treatment; P = 0.043). Moreover, in 75% of patients, FC levels dropped below the cutoff value of 50 mg/kg. Positive for ASCA IgA/IgG were 17/24 tested patients, but no differences were observed regarding the application of anti TNFa therapy. However, the titers of pANCA decreased in four patients after anti TNFa treatment. Conclusions: Initial and follow up measurements of some immunological markers such as FC and pANCA could be of benefit for patients with CD in anti TNF therapy, whereas others such as ANA and ASCA were not useful to monitor the therapy.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88191891","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. Ghahramani, Marzie Rezaeian Jahromi, G. Pouladfar, A. Bananzadeh, A. Safarpour, S. Hosseini, Manli Aminshahidi
Background: Determining the rate of bactibilia among patients under going laparoscopic cholecystectomy (LC) and its correla-tions with predisposing factors and postoperative infections, which help evaluate the need for prophylactic antibiotic. Methods: In this prospective study, 85 consecutive patients with uncomplicated cholelithiasis who underwent LC were enrolled from2012to2013. Routinebileculturewasdoneatthetimeof LC.Patientsweredividedinto2groups,1withnegativebilecultureand anotherwithbactibilia. Demographicandlaboratorydatawerecompared. Patientswerefollowedup10daysaftertheirlaparoscopy and 1 month after discharge to monitor the presence of infection. Results: Atotalof 7culturesof bilewerepositiveforbacteria(8.2%). Thepatients’ agewasthesolefactorwithasignificantrelation-ship with the rate of bactobilia (P = 0.016). Within 10 days after surgery, fever and surgical site infection were detected in 10.6% of patients, which was not significantly different in the 2 groups. There were no complications in the 30-day follow-up. Conclusions: Detectingbactobiliawithlowfrequencyandthelackof correlationbetweenbactobiliaandpostoperativeinfectious, complications did not support prescribing prophylactic antibiotic in respective patients. The older age was the sole predisposing factor for the development of bactobilia.
{"title":"Bactobilia Among Patients with Uncomplicated Cholelithiasis Undergoing Laparoscopic Cholecystectomy: The Risk Factors and Effects on Postoperative Infectious Complications","authors":"L. Ghahramani, Marzie Rezaeian Jahromi, G. Pouladfar, A. Bananzadeh, A. Safarpour, S. Hosseini, Manli Aminshahidi","doi":"10.5812/ACR.12795","DOIUrl":"https://doi.org/10.5812/ACR.12795","url":null,"abstract":"Background: Determining the rate of bactibilia among patients under going laparoscopic cholecystectomy (LC) and its correla-tions with predisposing factors and postoperative infections, which help evaluate the need for prophylactic antibiotic. Methods: In this prospective study, 85 consecutive patients with uncomplicated cholelithiasis who underwent LC were enrolled from2012to2013. Routinebileculturewasdoneatthetimeof LC.Patientsweredividedinto2groups,1withnegativebilecultureand anotherwithbactibilia. Demographicandlaboratorydatawerecompared. Patientswerefollowedup10daysaftertheirlaparoscopy and 1 month after discharge to monitor the presence of infection. Results: Atotalof 7culturesof bilewerepositiveforbacteria(8.2%). Thepatients’ agewasthesolefactorwithasignificantrelation-ship with the rate of bactobilia (P = 0.016). Within 10 days after surgery, fever and surgical site infection were detected in 10.6% of patients, which was not significantly different in the 2 groups. There were no complications in the 30-day follow-up. Conclusions: Detectingbactobiliawithlowfrequencyandthelackof correlationbetweenbactobiliaandpostoperativeinfectious, complications did not support prescribing prophylactic antibiotic in respective patients. The older age was the sole predisposing factor for the development of bactobilia.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84798627","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}
Diaphragmatic eventration (DE) or eventration of the diaphragm is characterized by a permanent high position of 1 or rarely both the leaflets of the diaphragm, providing a potential space for the displacement of abdominal viscera on the affected side(s).It is a relatively rare condition with unknown etiology in adults. Prevalence of DE is less than 0.05% of the population, both children and adults, and is more common in males. There is a various presentation for DE and patients are mostly asymptomatic. The diagnosis of DE is vital to avoid certain serious, though rare, complications such as gastric or colon volvulus. Here is the report of an unusual presentation of eventration of the diaphragm with sigmoid colon volvulus presented with complaint of chronic constipation and ‘fear to eat’. Patient was diagnosed in the operating room despite multiple imaging modalities. Eventration of diaphragm and cachexia is a rare association and to the best of authors‘ knowledge, it is not reported in literature. It is hoped that the current case report sensitizes physicians to the unusual presentation of eventration of diaphragm. Plication of Diaphragm, Mediastinal Shift, Sigmoid Volvulus
{"title":"Eventration of Diaphragm with Chronic Constipation: An Unusual Presentation: A Case Report","authors":"A. Porwal, P. Gandhi","doi":"10.5812/ACR.12372","DOIUrl":"https://doi.org/10.5812/ACR.12372","url":null,"abstract":"Diaphragmatic eventration (DE) or eventration of the diaphragm is characterized by a permanent high position of 1 or rarely both the leaflets of the diaphragm, providing a potential space for the displacement of abdominal viscera on the affected side(s).It is a relatively rare condition with unknown etiology in adults. Prevalence of DE is less than 0.05% of the population, both children and adults, and is more common in males. There is a various presentation for DE and patients are mostly asymptomatic. The diagnosis of DE is vital to avoid certain serious, though rare, complications such as gastric or colon volvulus. Here is the report of an unusual presentation of eventration of the diaphragm with sigmoid colon volvulus presented with complaint of chronic constipation and ‘fear to eat’. Patient was diagnosed in the operating room despite multiple imaging modalities. Eventration of diaphragm and cachexia is a rare association and to the best of authors‘ knowledge, it is not reported in literature. It is hoped that the current case report sensitizes physicians to the unusual presentation of eventration of diaphragm. Plication of Diaphragm, Mediastinal Shift, Sigmoid Volvulus","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90505178","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}
Michelle L Cooper, A. Melloy, H. Nabi, S. Ng, C. Gillespie
Objectives: We aimed to assess the surgical outcomes associated with the introduction of a dedicated colorectal service and newly implemented enhanced recovery after surgery (ERAS) programme at Logan Hospital. Methods: A prospective database was created to include all patients admitted to Logan hospital for colorectal resections after the establishment of a dedicated colorectal service with two colorectal surgical society of Australia and New Zealand (CSSANZ) trained colorectalsurgeonsandanERASprogramme. Thedemographics,pathologyandsurgicaloutcomesinthispatientgroupwerecom-pared to a historical retrospective patient cohort from the same hospital with resections performed by general surgeons prior to theintroductionof theERASprogramme. Primaryoutcomesincludedthelengthof stay,readmissionrate,morbidityandmortality. Results: The prospective database included patients from February to November 2015 with a minimum 30 day follow-up (n = 72). The retrospective patient cohort was from January to December 2012 (n = 68). The average length of stay (LOS) reduced from 10.85 daysto5.74days(P=0.037). Thirtydayreadmissionratesdecreasedfrom7.35% to4.17% (P=0.485). Morbidityreducedfrom41.18% to 11.11% (P< 0.001). Mortalityratesof 2.94% preERASandnilpost(P=0.234). Demographicinformation,co-morbiditiesandpathology were comparable. Conclusions: Our results suggest that a dedicated colorectal service with an ERAS program is able to improve surgical outcomes including length of stay, morbidity and mortality. This is in keeping with existing international literature.
{"title":"A Colorectal Unit with an Enhanced Recovery After Surgery (ERAS) Programme Improves Surgical Outcomes in a Major Metropolitan Hospital","authors":"Michelle L Cooper, A. Melloy, H. Nabi, S. Ng, C. Gillespie","doi":"10.5812/ACR.12663","DOIUrl":"https://doi.org/10.5812/ACR.12663","url":null,"abstract":"Objectives: We aimed to assess the surgical outcomes associated with the introduction of a dedicated colorectal service and newly implemented enhanced recovery after surgery (ERAS) programme at Logan Hospital. Methods: A prospective database was created to include all patients admitted to Logan hospital for colorectal resections after the establishment of a dedicated colorectal service with two colorectal surgical society of Australia and New Zealand (CSSANZ) trained colorectalsurgeonsandanERASprogramme. Thedemographics,pathologyandsurgicaloutcomesinthispatientgroupwerecom-pared to a historical retrospective patient cohort from the same hospital with resections performed by general surgeons prior to theintroductionof theERASprogramme. Primaryoutcomesincludedthelengthof stay,readmissionrate,morbidityandmortality. Results: The prospective database included patients from February to November 2015 with a minimum 30 day follow-up (n = 72). The retrospective patient cohort was from January to December 2012 (n = 68). The average length of stay (LOS) reduced from 10.85 daysto5.74days(P=0.037). Thirtydayreadmissionratesdecreasedfrom7.35% to4.17% (P=0.485). Morbidityreducedfrom41.18% to 11.11% (P< 0.001). Mortalityratesof 2.94% preERASandnilpost(P=0.234). Demographicinformation,co-morbiditiesandpathology were comparable. Conclusions: Our results suggest that a dedicated colorectal service with an ERAS program is able to improve surgical outcomes including length of stay, morbidity and mortality. This is in keeping with existing international literature.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"193 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79694991","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}
Mostafa Vaghari Tabari, S. Moein, D. Qujeq, M. Kashifard, J. S. Shirvani, K. Tilaki, G. Farshidfar
Background: Ulcerativecolitisisacommontypeof inflammatoryboweldisease(IBD).Theaimof thepresentstudywastoexamine therelationshipbetweenlipidprofile,especiallyhigh-densitylipoprotein(HDL),andmalondialdehyde(MDA)levelinpatientswith ulcerative colitis. Methods: In this study, 45 patients with ulcerative colitis were selected, 25 of whom were diagnosed with active disease and 20 were in clinical remission. Moreover, 45 healthy subjects were selected as the controls. The status of serum lipid profile and MDA level were measured via precise photometric methods. The obtained data were analyzed, using independent t-test and correlation coefficient test. P < 0.05 was considered statistically significant. Results: Theserumlevelof HDL-Cdecreased,whiletheserumlevelof MDAsignificantlyincreasedinpatientswithulcerativecolitis incomparisonwiththehealthycontrols(P< 0.05). NosignificantcorrelationwasobservedbetweentheMDAlevelandtriglyceride, cholesterol, and LDL-C levels in patients with ulcerative colitis. However, a significant inverse correlation was observed between HDL-C and MDA levels (r, -0.306; P < 0.05). Conclusions: TheinversecorrelationbetweenHDL-CandMDAlevelscanberegardedasanindicatorof theprotectiveroleof HDL-C againstlipidperoxidationinulcerativecolitis. Inpatientswithulcerativecolitis,theserumlevelof HDL-Cdecreasedincomparison with healthy subjects. Therefore, it is necessary to determine the HDL-C level in patients with ulcerative colitis.
{"title":"Evaluation of the Potential Antioxidant Role of High-Density Lipoprotein-Cholesterol (HDL-C) in Patients with Ulcerative Colitis","authors":"Mostafa Vaghari Tabari, S. Moein, D. Qujeq, M. Kashifard, J. S. Shirvani, K. Tilaki, G. Farshidfar","doi":"10.5812/ACR.13699","DOIUrl":"https://doi.org/10.5812/ACR.13699","url":null,"abstract":"Background: Ulcerativecolitisisacommontypeof inflammatoryboweldisease(IBD).Theaimof thepresentstudywastoexamine therelationshipbetweenlipidprofile,especiallyhigh-densitylipoprotein(HDL),andmalondialdehyde(MDA)levelinpatientswith ulcerative colitis. Methods: In this study, 45 patients with ulcerative colitis were selected, 25 of whom were diagnosed with active disease and 20 were in clinical remission. Moreover, 45 healthy subjects were selected as the controls. The status of serum lipid profile and MDA level were measured via precise photometric methods. The obtained data were analyzed, using independent t-test and correlation coefficient test. P < 0.05 was considered statistically significant. Results: Theserumlevelof HDL-Cdecreased,whiletheserumlevelof MDAsignificantlyincreasedinpatientswithulcerativecolitis incomparisonwiththehealthycontrols(P< 0.05). NosignificantcorrelationwasobservedbetweentheMDAlevelandtriglyceride, cholesterol, and LDL-C levels in patients with ulcerative colitis. However, a significant inverse correlation was observed between HDL-C and MDA levels (r, -0.306; P < 0.05). Conclusions: TheinversecorrelationbetweenHDL-CandMDAlevelscanberegardedasanindicatorof theprotectiveroleof HDL-C againstlipidperoxidationinulcerativecolitis. Inpatientswithulcerativecolitis,theserumlevelof HDL-Cdecreasedincomparison with healthy subjects. Therefore, it is necessary to determine the HDL-C level in patients with ulcerative colitis.","PeriodicalId":8370,"journal":{"name":"Annals of Colorectal Research","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74346013","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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