Newswise — Low Anterior Resection Syndrome and Quality of Life After Sphincter-Sparing Rectal Cancer Surgery

A Long-term Longitudinal Follow-up

Pieniowski, Emil H.A., M.D.1,2; Palmer, Gabriella J., M.D., Ph.D.2; Juul, Therese, R.N., M.H.Sc., Ph.D.3; Lagergren, Pernilla, R.N., Ph.D.2; Johar, Asif, M.Sc., B.Sc.(Hons.)2; Emmertsen, Katrine J., M.D., Ph.D.3,4; Nordenvall, Caroline, M.D., Ph.D.2; Abraham-Nordling, Mirna, M.D., Ph.D.

1 Department of Surgery, South General Hospital (Södersjukhuset), Stockholm, Sweden

2 Department of Molecular Medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

3 Department of Surgery, Aarhus University Hospital, Aarhus, Denmark

4 Department of Surgery K, Regional Hospital Randers, Denmark

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 14–20

doi: 10.1097/DCR.0000000000001228

Original Contributions: Colorectal Cancer

BACKGROUND: Despite low anterior resection syndrome being a well-known consequence of sphincter-preserving rectal cancer surgery, the long-term effect on bowel function and quality of life is not fully understood.

 

A Changing Spectrum of Colorectal Cancer Biology With Age

Implications for the Young Patient

Chouhan, Hanumant, M.D.1,2,3; Ferrandon, Sylvain, Ph.D.2; DeVecchio, Jennifer, B.A.2; Kalady, Matthew F., M.D.1,2,3; Church, James M., M.D.1,2

1 Department of Colorectal Surgery, Cleveland Clinic, Cleveland, Ohio

2 Sanford R. Weiss, M.D., Center for Hereditary Colorectal Neoplasia, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio

3 Department of Stem Cell and Regenerative Medicine, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 21–26

doi: 10.1097/DCR.0000000000001188

Original Contributions: Colorectal Cancer

BACKGROUND: The methylator pathway of colorectal carcinogenesis, characterized by CpG island hypermethylation and BRAF mutations, accounts for ≈25% of colorectal cancers. Because these cancers tend to be right sided and because DNA methylation in the right colon increases with age, we expect an increasing proportion of right-sided cancer over time. Conversely, we expect young patients (age <50 y) to have less methylated and fewer right-sided cancers.

 

A Decision Analysis for Rectal-Sparing Familial Adenomatous Polyposis

Total Colectomy With Ileorectal Anastomosis Versus Proctocolectomy With IPAA

Melnitchouk, Nelya, M.D., M.Sc.1,2; Saadat, Lily Victoria, M.D.1; Bleday, Ronald, M.D.1; Goldberg, Joel E., M.D., M.P.H.1,2

1 Department of Surgery, Brigham and Women’s Hospital/Harvard Medical School, Boston, Massachusetts

2 Center for Surgery and Public Health, Boston, Massachusetts

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 27–32

doi: 10.1097/DCR.0000000000001186

Original Contributions: Colorectal Cancer

BACKGROUND: There are different approaches for the surgical management of rectal-sparing familial adenomatous polyposis with variable impacts on both quality of life and survival.

 

Conditional Probability of Survival After Neoadjuvant Chemoradiation and Proctectomy for Rectal Cancer

What Matters and When

Karagkounis, Georgios, M.D.; Liska, David, M.D.; Kalady, Matthew F., M.D.

Department of Colorectal Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 33–39

doi: 10.1097/DCR.0000000000001239

Original Contributions: Colorectal Cancer 

BACKGROUND: Disease-free survival estimated from the time of surgery does not account for the changing likelihood of survival based on time already accrued. Conditional disease-free survival is defined as the probability of remaining disease free after reaching a specific time point without recurrence.

 

Short- and Long-term Outcomes of Minimally Invasive Versus Open Multivisceral Resection for Locally Advanced Colorectal Cancer

Nishikawa, Takeshi, Ph.D.; Nozawa, Hiroaki, M.D., Ph.D.; Kawai, Kazushige, Ph.D.; Sasaki, Kazuhito, M.D., Ph.D.; Otani, Kensuke, Ph.D.; Tanaka, Toshiaki, M.D., Ph.D.; Hata, Keisuke, M.D., Ph.D.; Watanabe, Toshiaki, M.D., Ph.D.

Department of Surgical Oncology, the University of Tokyo, Tokyo, Japan

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 40–46

doi: 10.1097/DCR.0000000000001255

Original Contributions: Colorectal Cancer

BACKGROUND: Colorectal cancer invading the adjacent organs/structures is detected in 5% to 20% of all surgical interventions performed for the management of colorectal cancer.

 

Laparoscopic Ventral Rectopexy Versus Stapled Transanal Rectal Resection for Treatment of Obstructed Defecation in the Elderly

Long-term Results of a Prospective Randomized Study

Madbouly, Khaled M., M.D., Ph.D., F.R.C.S.(Glasg.); Mohii, Ahmed D., M.D.

Department of Surgery, Section of Colon and Rectal Surgery, University of Alexandria, Alexandria, Egypt

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 47–55

doi: 10.1097/DCR.0000000000001256

Original Contributions: Pelvic Floor

 

BACKGROUND: Obstructed defecation is a common complaint in coloproctology. Many anal, abdominal, and laparoscopic procedures are adopted to correct the underlying condition.

 

The Contributions of Internal IntussusceptionIrritable Bowel Syndrome, and Pelvic Floor Dyssynergia to Obstructed Defecation Syndrome

Cavallaro, Paul M., M.D.1; Staller, Kyle, M.D., M.P. H.2; Savitt, Lieba R., N.P.-C., R.N.-C., M.S.N.1; Milch, Holly, N.P.1; Kennedy, Kevin, B.S.1; Weinstein, Milena M., M.D.3; Ricciardi, Rocco, M.D., M.P.H.1; Bordeianou, Liliana G., M.D., M.P.H.1

1 Colorectal Surgery Center, Department of General and Gastrointestinal Surgery, Massachusetts General Hospital, Boston, Massachusetts

2 Digestive Healthcare Center, Department of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts

3 Division of Urogynecology and Pelvic Reconstructive Surgery, Department of Obstetrics & Gynecology, Massachusetts General Hospital, Boston, Massachusetts

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 56–62

doi: 10.1097/DCR.0000000000001250

Original Contributions: Pelvic Floor

BACKGROUND: Recently, there has been a trend toward surgical management of internal intussusceptiondespite an unclear correlation with constipation symptoms.

 

A Quality-of-Life Comparison of Two Fecal Incontinence Phenotypes

Isolated Fecal Incontinence Versus Concurrent Fecal Incontinence With Constipation

Cauley, Christy E., M.D., M.P.H.1; Savitt, Lieba R., N.P.-C., R.N.-C., M.S.N.1; Weinstein, Milena, M.D.2; Wakamatsu, May M., M.D.2; Kunitake, Hiroko, M.D., M.P.H.1; Ricciardi, Rocco, M.D., M.P.H.1; Staller, Kyle, M.D., M.P.H.3; Bordeianou, Liliana, M.D., M.P.H.1

1 Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts

2 Department of Gynecology, Massachusetts General Hospital, Boston, Massachusetts

3 Department of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 63–70

doi: 10.1097/DCR.0000000000001242

Original Contributions: Pelvic Floor

BACKGROUND: Many patients with fecal incontinence report coexisting constipation. This subset of patients has not been well characterized or understood.

 

The Effect of Surgical Training and Operative Approach on Outcomes in Acute Diverticulitis

Should Guidelines Be Revised?

Goldstone, Robert N., M.D.; Cauley, Christy E., M.D., M.P.H.; Chang, David C., Ph.D., M.B.A., M.P.H.; Kunitake, Hiroko, M.D., M.P.H.; Ricciardi, Rocco, M.D., M.P.H.; Bordeianou, Liliana, M.D., M.P.H.

Colorectal Surgery Center, Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 71–78

doi: 10.1097/DCR.0000000000001240

Original Contributions: Socioeconomic

BACKGROUND: Current guidelines accept partial colectomy and primary anastomosis with proximal diversion for select patients with perforated diverticulitis based on low-quality evidence.

 

Emergent Colon Resections

Does Surgeon Specialization Influence Outcomes?

Kulaylat, Audrey S., M.D.1; Pappou, Emmanouil, M.D., Ph.D.2; Philp, Matthew M., M.D.3; Kuritzkes, Benjamin A., M.D.2; Ortenzi, Gail, R.N.1; Hollenbeak, Christopher S., Ph.D.1,4; Choi, Christine, M.D.1; Messaris, Evangelos, M.D., Ph.D.1

1 Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania

2 Division of Colon and Rectal Surgery, Columbia University, New York, New York

3 Division of Colon and Rectal Surgery, Temple University, Philadelphia, Pennsylvania

4 Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, Pennsylvania

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 79–87

doi: 10.1097/DCR.0000000000001230

Original Contributions: Socioeconomic 

BACKGROUND: Relationships between high-volume surgeons and improved postoperative outcomes have been well documented. Colorectal procedures are often performed by general surgeons, particularly in emergent settings, and may form a large component of their practice. The influence of subspecialized training on outcomes after emergent colon surgery, however, is not well described.

 

C-Reactive Protein Values After Colorectal Resection

Can We Discharge a Patient With a C-Reactive Protein Value >100? A Retrospective Cohort Study

Benoit, Olivier, M.D.1; Faron, Mathieu, M.D.1; Margot, Nicolas, M.D.1; Creavin, Ben, M.D.2; Debove, Clotilde, M.D.1; Tiret, Emmanuel, M.D.1; Parc, Yann, M.D., Ph.D.1; Lefevre, Jérémie H., M.D., Ph.D.1

1 Department of General and Digestive Surgery, Hôpital Saint Antoine (AP-HP), Paris VI University, Paris, France

2 Department of Surgery, St Vincent’s University Hospital, Elm Park, Dublin, Ireland

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 88–96

doi: 10.1097/DCR.0000000000001216

Original Contributions: Socioeconomic

BACKGROUND: C-reactive protein is a useful negative predictive test for the development of anastomotic leakage following colorectal surgery. Evolution of procedures (laparoscopy, enhanced recovery program, early discharge, complex redo surgery) may influence C-reactive protein values; however, this is poorly studied to date.

 

Effect of Medicaid Expansion on Colorectal Cancer Screening Rates

Zerhouni, Yasmin A., M.D.1,2; Trinh, Quoc-Dien, M.D.1,3; Lipsitz, Stuart, Sc.D.1; Goldberg, Joel, M.D., M.P.H.1,4; Irani, Jennifer, M.D.4; Bleday, Ronald, M.D.4; Haider, Adil H., M.D., M.P.H.1; Melnitchouk, Nelya, M.D., M.Sc.1,4

1 Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts

2 UCSF East Bay Department of Surgery, Oakland, California

3 Division of Urological Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

4 Section of Colon and Rectal Surgery, Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

Diseases of the Colon & Rectum: January 2019 - Volume 62 - Issue 1 - p 97–103

doi: 10.1097/DCR.0000000000001260

Original Contributions: Socioeconomic

BACKGROUND: Colorectal cancer screening decreases incidence and improves survival. Minorities and low-income patients have lower screening rates. The Affordable Care Act increased insurance coverage for low-income Americans by funding Medicaid expansion. Not all states expanded Medicaid. The effect of Medicaid expansion on colorectal cancer screening is unknown.

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