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Title: Consensus Definitions and Interpretation Templates for Fluoroscopic Imaging of Defecatory Pelvic Floor DisordersProceedings of the Consensus Meeting of the Pelvic Floor Consortium of the American Society of Colon and Rectal Surgeons, the Society of Abdominal Radiology, the International Continence Society, the American Urogynecologic Society, the International Urogynecological Association, and the Society of Gynecologic Surgeons.

Authors: Ian Paquette, M.D. • David Rosman, M.D. • Rania El Sayed, M.D. • Tracy Hull, M.D., Ervin Kocjancic, M.D., Lieschen Quiroz, M.D. • Susan Palmer, M.D., Abbas Shobeiri, M.D., M.B.A., Milena Weinstein, M.D. • Gaurav Khatri, M.D., Liliana Bordeianou, M.D., M.P.H., Members of the Expert Workgroup on Fluoroscopic Imaging of Pelvic Floor Disorders

Description: The Pelvic Floor Disorders Consortium (PFDC) was formed to arrange collaboration between these specialties: colorectal surgeons, urogynecologists, urologists, gynecologists, gastroenterologists, radiologists, physiotherapists, and other advanced care practitioners. The PFDC’s goal is to collaborate to develop and evaluate educational programs, create clinical guidelines and algorithms, and promote overall quality of care in this unique population. Consensus was reached by the PFDC on many relevant technical and reporting considerations of female disorders.


Title: Primary Tumor-Related Complications and Salvage Outcomes in Patients with Metastatic Rectal Cancer and an Untreated Primary Tumor

Authors: Winson J. Tan, M.B.B.S.(Hons.), M.Med, Sujata Patil, Ph.D., Jose G. Guillem, M.D., M.P.H.,  Philip B. Paty, M.D., Martin R. Weiser, M.D.,  Garrett M. Nash, M.D., M.P.H., J. Joshua Smith, M.D., Ph.D., Emmanouil P. Pappou, M.D., Ph.D., Iris H. Wei, M.D., Julio Garcia-Aguilar, M.D., Ph.D.

Description: A significant proportion of patients with metastatic rectal cancer and untreated primary tumor experience primary tumor-related complications. These patients should be followed closely, and preemptive intervention (resection, diversion, or radiation) should be considered if the primary tumor progresses despite systemic therapy. 


Title: Adding Narrow-Band Imaging to Chromoendoscopy for the Evaluation of Tumor Response to Neoadjuvant Therapy in Rectal Cancer

Authors: Mitsuaki Ishioka, M.D., Ph.D.,  Akiko Chino, M.D., Ph.D.,  Daisuke Ide, M.D., Ph.D., Shoichi Saito, M.D., Ph.D.,  Masahiro Igarashi, M.D., Ph.D., Toshiya Nagasaki, M.D., Ph.D., Takashi Akiyoshi, M.D., Ph.D., Satoshi Nagayama, M.D., Ph.D., Yosuke Fukunaga, M.D., Ph.D., Masashi Ueno, M.D., Ph.D., Hiroshi Kawachi, M.D., Ph.D. Noriko Yamamoto, M.D., Ph.D., Junko Fujisaki, M.D., Ph.D., Tsuyoshi Konishi, M.D., Ph.D.

Description: Despite the limited improvement in diagnostic accuracy, adding narrow-band imaging to chromoendoscopy improved inter-rater agreement between the expert and nonexpert endoscopists. Narrow-band imaging is a reliable and promising modality for universal standardization of the diagnosis of clinical complete response. 


Title: Diverticular Disease Epidemiology: Rising Rates of Diverticular Disease Mortality Across  Developing Nations

Authors: Cameron W. Hunt, B.S. • Ruchir Chaturvedi, B.S. • Lev Brown, B.A., Caitlin Stafford, B.S. • Christy E. Cauley, M.D., M.P.H. • Robert N. Goldstone, M.D. Todd D. Francone, M.D., M.P.H. • Hiroko Kunitake, M.D., M.P.H., Liliana Bordeianou, M.D., M.P.H. • Rocco Ricciardi, M.D., M.P.H.

Description: There is considerable variability in diverticular disease mortality across the globe. Developing nations were characterized by rapid increases in diverticular disease mortality and expanding percentages of overweight adults. Public health interventions in developing nations are needed to alter mortality rates from diverticular disease.

Title: Opioid Consumption Patterns After Anorectal Operations: Development of an Institutional Prescribing Guideline

Authors: David C. Meyer, M.D., M.S.1 • Susanna S. Hill, M.D.2 • Janet A. McDade, MSN, ANP, BC.2  Cristina R. Harnsberger, M.D.2 • Jennifer S. Davids, M.D.2 • Paul R. Sturrock, M.D.2 Justin A. Maykel, M.D.2 • Karim Alavi, M.D., M.P.H.2

Description: Opioid prescribing patterns and consumption are widely variable after anorectal operations and appear to be highly dependent on the operation category. It is noteworthy that 63% of opioids prescribed after anorectal operations were unused by the patient and may pose a significant public health risk. Based on the usage patterns observed in this study, prospective studies should be performed to optimize opioid prescribing.


Title: Early Versus Late Preventive Ileostomy Closure Following Colorectal Surgery: Systematic Review and Meta-analysis With Trial Sequential Analysis  of Randomized Controlled Trials

Authors: Zhiqiang Cheng, M.D., Ph.D. • Shuohui Dong, M.D. • Dongsong Bi, M.D., Ph.D.  Yanlei Wang, M.D., Ph.D. • Yong Dai, M.D., Ph.D. • Xiang Zhang, M.D., Ph.D.

Description: In selected patients, early closure of ileostomy after colorectal surgery can be considered, with a lower incidence of postoperative small-bowel obstruction/postoperative ileus and less total operative time, but a relatively high surgical site infection rate.


TitlePerirectal Fascial Anatomy: New Insights Into an Old Problem

Authors:  Sigmar StelznerM.D., Ph.D. Tillmann Heinze, M.D.; Taxiarchis K. Nikolouzakis,  M.D.; Torge Mees, Sören M.D., M.M.I.S., M.H.B.A.; Witzigmann, Helmut M.D., Ph.D.; Wedel, Thilo M.D., Ph.D.2 

DescriptionThis study aimed to perform a comprehensive visualization of perirectal fasciae to facilitate strategies of rectal surgery such as total mesorectal excision, intersphincteric resection, and transanal total mesorectal excision.

Photo: Figure 9


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