Risk Factors for Anal Cancer
Faramarz
Pakravan
Coloproktologisches Center (CPZ) Düsseldorf, Düsseldorf, Germany
author
Katja
Wolff
Coloproktologisches Center (CPZ) Düsseldorf, Düsseldorf, Germany
author
text
article
2014
eng
Background The use of statistical methods to analyze data, regardless of their theoretical assumptions, leads to misinterpretation of the results. Objectives Effective attributes in colorectal cancer relapse were investigated through survival analysis in the present study. Comparison between the results of artificial neural network (ANN) method and Cox proportional hazards (Cox PH) model was the main purpose of this research. Patients and Methods A total of 184 patients with locoregional colorectal cancer, referred to Shahid Faghihi Hospital (Shiraz, Iran) for surgery, were followed in a five-year period for possible relapse during 2003-2011. Disease-free survival was then modeled based on the patients’ attributes, using Cox PH regression and ANN methods. All the attributes effective on disease relapse were investigated by these two methods. Results A total of 114 (62%) males and 70 (38%) females with a median age of 54 (range: 23-84) years old participated in the study. Among them, there were 95 (51.6%) patients with colon cancer and 89 (48.4%) with rectum cancer. In addition, 53 patients relapsed and 131 patients did not present any relapse or missed the follow up (censored data). The results showed that the accuracy rate in prediction was higher for the ANN method than the Cox PH model (78.2% versus 72.7%). In addition, the area under the receiver operating curve (ROC) was also more for the ANN method (0.86 versus 0.74). Five attributes of the patients, including neoadjuvant treatment, perforation and/or obstruction, perineural invasion, stage, and tumor grade, were significant through the Cox HP model. The first five attributes by the ANN method were surgeon, primary tumor site, perforation and/or obstruction, age, and adjuvant treatments. In this study, the order of attributes determined by the ANN method was rather confirmed by the physicians. Conclusions The results showed superiority of the ANN method over the Cox PH model with respect to the area under the ROC and the accuracy rate in prediction. However, this method requires a large data set to learn the relations and cannot distinguish the confounding attributes.
Iranian Journal of Colorectal Research
Shiraz University of Medical Sciences
2783-2430
2
v.
3
no.
2014
0
0
https://colorectalresearch.sums.ac.ir/article_45469_d193c4908485f2983e14c9cf7d601f9b.pdf
dx.doi.org/10.17795/acr-21533
Evaluating the Efficacy of Open Versus Laparoscopic Abdominoperianal Resection in Management of Patients with Low Rectal Cancer
Leila
Ghahramani
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Hesameddin
Eghlimi
Shiraz University of Medical Sciences, Shiraz, IR Iran
author
AliMohammad
Bananzadeh
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Seyed Vahid
Hosseini
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Ahmad
Izadpanah
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Ali Reza
Safarpour
author
Ahmed Mohammed Ali
Al Hurry
Department of Surgery, General Surgeon, Al Hussein Teaching Hospital, Kerbala, Iraq
author
Khairallah
Muzhir Gabash
Department of Surgery, Al-Karama Teaching Hospital Medical College, Wasit University, Wasit, Iraq
author
Fahimeh
Hajhosseini
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Fatemeh
Ganji
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
text
article
2014
eng
Background Abdominoperineal resection (APR) along with permanent colostomy is the standard method of low rectal cancer operation and resection. The laparoscopic APR provides better visualization of pelvic structures compared to the open approach. Disadvantages of the laparoscopic approach have been reported as longer operation duration and requirement of expensive equipment Although this issue has been investigated extensively worldwide, data is limited from Iran. Objectives The aim of this study was to compare short-term outcome of Laparoscopic Abdominoperineal Resection (APR) with open APR in patients with low rectal cancer in Shiraz, southern Iran. Patients and Methods This was a non-randomized controlled trial study performed in Shahid Faghihi Hospital affiliated to Shiraz University of Medical Sciences from 2007 to 2012. We included all patients with rectal cancer who underwent laparoscopic or open APR with permanent colostomy. Both groups were evaluated regarding oncology results. Volume of intraoperative bleeding, short-term complications, operation to diet interval and duration of hospitalization were recorded and further compared between the laparoscopy and open APR groups. Results Overall, 24 patients were included in this study of whom 11 underwent laparoscopy and 13 underwent open APR. The two study groups were comparable regarding age (P = 0.747), gender (P = 0.605), tumor stage (P = 0.116), tumor histopathology grade (P = 0.421) and distance from the anal verge (P = 0.711). The duration of operation was comparable between the groups (P = 0.336). Those who underwent laparoscopy had significantly lower intraoperative bleeding (485.5 ± 139.8 vs. 658.3 ± 183.2; P = 0.024), shorter operation-diet interval (2.27 ± 0.46 vs. 3.15 ± 0.37; P < 0.001) and shorter duration of hospitalization compared to the open APR group (4.09 ± 0.53 vs. 4.76 ± 0.59; P = 0.008). Conclusions Laparoscopic APR is associated with minimal perioperative bleeding, shorter operation-diet interval and shorter durations of hospitalization compared to open approach in patients with low rectal cancer who had not received neoadjuvant chemo radiotherapy. Oncologic results in this operation were comprisable to open procedure because the mesorectal, anus and sphincter complex excision are performed in the same method. . Therefore, laparoscopy could be the method of choice for APR.
Iranian Journal of Colorectal Research
Shiraz University of Medical Sciences
2783-2430
2
v.
3
no.
2014
0
0
https://colorectalresearch.sums.ac.ir/article_45470_8e9a71b5cee213e9f51f756f314bd29d.pdf
dx.doi.org/10.17795/acr-22676
Real Time PCR for Characterization of Enteroinvasive E. coli (EIEC) in Children with Diarrhea in Shiraz
Pejman
Abbasi
Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Mohammad
Kargar
author
Abbas
Doosti
Biotechnology Research Center,Jahrom Branch Islamic Azad University, Shahrekord, IR Iran
author
Jalal
Mardaneh
Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Sadegh
Ghorbani Dalini
Department of Microbiology,Jahrom Branch Islamic Azad University, Jahrom, IR Iran
author
Mohammad Ali
Dehyadegari
Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
text
article
2014
eng
Background Diarrheal disease is still a health problem, especially in developing countries, where it is considered one of the foremost causes of death in children, accounting for approximately two million deaths annually worldwide. Enteroinvasive Escherichia coli (EIEC) is known to cause shigellosis-like symptoms in both adults and children. Objectives The aim of this study was to identify EIEC in children with diarrhea using Real-time PCR assays in Shiraz, Iran. Patients and Methods A total of 285 stool samples were collected from patients with diarrhea in Shiraz, in 2012. Diarrheagenic E. coli (DEC) strains were isolated by standard biochemical analysis. We used Real time PCR and PCR to detect the presence of ipaH gene in EIEC. Susceptibility testing to 18 antimicrobial agents was determined by diffusion methods according to clinical and laboratory standards institute (CLSI, 2011) guidelines. Results In total, 285 stool samples were tested in which 49 (17%) were contaminated with E. coli by biochemical tests. In the present study, EIEC was detected in seven (14.3%) children with diarrhea. Of seven patients, five children were younger than 12 months and two were 13-24 months old. In total, four EIEC strains were isolated from watery diarrhea and three EIEC strains from bloody diarrhea. In the present study, EIEC strain exhibited high frequency of drug resistance to penicillin (100%), trimethoprim/sulfamethoxazole (71%) and tetracycline (71%). Conclusions We reported the first study performed in Shiraz to identify EIEC intestinal pathogens in children with diarrhea. This type of pathogen should be considered when designing preventive strategies for children in Iran.
Iranian Journal of Colorectal Research
Shiraz University of Medical Sciences
2783-2430
2
v.
3
no.
2014
0
0
https://colorectalresearch.sums.ac.ir/article_45471_88223c63f76a049adbb7932ea21b2103.pdf
dx.doi.org/10.17795/acr-22721
Topical Platelet Lysate Hydrogel in Patients With Anal Fissure
Akram
Jamshidzadeh
School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Zeinab
Mardani
School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Leila
Ghahramani
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Soleiman
Mohammadi
School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Seyed Mojtaba
Seyed Raoufi
School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Alireza
Safarpour
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Ahmad
Izadpanah
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Seyed Vahid
Hosseini
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Masoumeh
Rahimi
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
text
article
2014
eng
Background Anal fissure is a painful tear or crack in the distal part of anal canal. It usually involves the epithelium, but in the long term it may extend to the whole anal mucosa. Platelet Lysate (PL) hydrogel is a hemoderivitive pharmaceutical formulation that contains plenty of growth factors. These growth factors can induce tissue regeneration and revascularization as well as fibroblast proliferation. Objectives This study aimed to evaluate the effectiveness of PL hydrogel in the treatment of the anal fissure or retardation of its development. Patients and Methods The patients with chronic and acute anal fissure were randomly divided into groups of A and B. Group A received PL hydrogel and Rectol, while group B received placebo and Rectol. Then, they were followed and evaluated for two weeks. Results Although it was anticipated that platelet growth factors would be effective in anal fissure healing process, no significant difference was observed between the control group and the case group after the treatment. Nevertheless, a significant difference was observed within the two groups after the treatment. Conclusions PL hydrogel does not seem to have beneficial effects compared to the placebo or Rectol on the healing of anal fissure.
Iranian Journal of Colorectal Research
Shiraz University of Medical Sciences
2783-2430
2
v.
3
no.
2014
0
0
https://colorectalresearch.sums.ac.ir/article_45472_5c226bf492b0b73c0f6c302caa55bd28.pdf
dx.doi.org/10.17795/acr-24266
Gastric Gastrointestinal Stromal Tumor (GIST) Incidentally Found After Laparoscopic Sleeve Gastrectomy: A Case Report
Reza
Roshanravan
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Mina
Heidari Esfahani
Department of Pathology, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Sam
Moslemi
author
Seyed Vahid
Hosseini
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Khairallah
Muzhir Gabash
Department of Surgery, Al-Karama Teaching Hospital, Medical College, Wasit University, Wasit, Iraq
author
text
article
2014
eng
Introduction One of unexpected and incidental pathologic reports in endoscopy is Gastrointestinal Stromal Tumor (GIST) with an incidence of 1.5/100000 annually and incidental pathologic finding during bariatric surgery as around 2% herein. Case Presentation We reported a 45-year-old female with morbid obesity for five years scheduled for laparoscopic sleeve gastrectomy. During the operation, no mass was detected and postoperative pathology reported a GIST with positive report of CD117 and negative for S100. Discussion Laparoscopic resection of early stage gastric GIST is a useful approach and has become a proper technique in the recent years.
Iranian Journal of Colorectal Research
Shiraz University of Medical Sciences
2783-2430
2
v.
3
no.
2014
0
0
https://colorectalresearch.sums.ac.ir/article_45473_0ff2e7882fff2ab6b0b29690db80a399.pdf
dx.doi.org/10.17795/acr-24855
Clinical Pathological Analysis of Appendiceal Neoplasms From 4800 Appendectomy Specimens
Massood
Hosseinzadeh
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Mohammad Hossein
Anbardar
Department of Pathology, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Mohammad
Mohammadianpanah
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
author
Behrooz
Ilkhanizadeh
Department of Pathology, Urmia University of Medical Sciences, Urmia, IR Iran
author
text
article
2014
eng
Background Appendiceal Neoplasms are relatively uncommon. Although Carcinoid tumor is the most prevalent tumor of appendix, mucinous tumors and metastatic tumors can also be identified in appendectomy specimens after careful pathologic examination. Objectives The main goal of this study is the evaluation of appendectomy specimens for appendiceal neoplasms and subsequent subtyping of those tumors. Materials and Methods Retrospective assessment of 4800 appendectomy specimens, performed from 2010 to 2014, was done. The specimens were collected from Namazee and Faghihi hospitals, affiliated to Shiraz University of Medical Sciences. The clinical and histopathologic data were collected and analyzed by satisfactory statistical methods. Results The age of patients was 32 years with a male to female ratio of 3:1. The overall incidence of appendiceal neoplasms was 86 in 4800 specimens (1.8%). The most common neoplasm was carcinoid tumor. Others reported tumors were mucinous cyst adenoma, mucocele, mucinous adenocarcinoma, leukemic infiltration, and a case of appendiceal involvement by bladder transitional cell carcinoma. Conclusions Although appendiceal tumors are not as prevalent as colon cancer, careful examination of appendectomy specimens can identify neoplastic processes. Beyond carcinoid tumors and mucinous neoplasms, leukemia lymphoma and other metastatic tumors can involve the appendix.
Iranian Journal of Colorectal Research
Shiraz University of Medical Sciences
2783-2430
2
v.
3
no.
2014
0
0
https://colorectalresearch.sums.ac.ir/article_45474_bb51d5082f9f44b64a416b960c156a88.pdf
dx.doi.org/10.17795/acr-24927
Successfully Treated Pediatric Patient With Megarectum by Vertical Reduction Rectoplasty
Ibrahim
Akkoyun
Department of Pediatric Surgery, Konya Education and Research Hospital, Konya, Turkey
author
text
article
2014
eng
This report represents successful treatment of a seven-year-old boy with megarectum, who complained of intractable constipation and encopresis, by vertical reduction rectoplasty.
Iranian Journal of Colorectal Research
Shiraz University of Medical Sciences
2783-2430
2
v.
3
no.
2014
0
0
https://colorectalresearch.sums.ac.ir/article_45475_554e59a9610857e18ddc66e3e5ed3c77.pdf
dx.doi.org/10.17795/acr-25208