2024-03-28T13:36:48Z
https://colorectalresearch.sums.ac.ir/?_action=export&rf=summon&issue=5439
Iranian Journal of Colorectal Research
Iran. J. Colorectal. Res.
2018
6
4
Preoperative Bowel Preparation with Oral Antibiotics Might Increase Wound Infection in Elective Colorectal Resections
Mahmoud
Aghaei-Afshar
Farzaneh
Mahmoudikordi
Mohammad
Rezazadehkermani
Preoperative bowel preparation was previously strictly done for all patient undergoing colorectal surgeries. With advances in thesurgical techniquesandpatient care, the role of bowel preparation in surgical complications is questioned. In this studywedescribea non-randomized retrospective analysis of 193 patients who underwent left colon and rectal resections in two different hospitals,the preoperative bowel preparation regimens were different in two hospitals. Both regimens contain mechanical preparation withpolyethylene glycol, however, one hospital administered erythromycin and neomycin and the other hospital did not. From 74 patientsreceiving oral antibiotic eight (10.8%) one developedwoundinfection and from 119 patientswhodid not receive oral antibioticthree (2.5%) patient developed wound infection. This difference was statistically significant. Regarding literature review, it is suggestedto omit oral antibiotic from preoperative bowel preparation regimens elective colorectal resections.
Neomycin
Erythromycin
Colectomy
infection
2018
09
01
https://colorectalresearch.sums.ac.ir/article_47176_ff289151946af0b4b4a71c0e8a4b8e84.pdf
Iranian Journal of Colorectal Research
Iran. J. Colorectal. Res.
2018
6
4
A Rare Complication of Stapled Hemorrhoidopexy: Giant Pelvic Hematoma Treated with Super-Selective Percutaneous Angioembolization
Francesco
Ferrara
Paolo
Rigamonti
Giovanni
Damiani
Maurizio
Cariati
Marco
Stella
Introduction: Procedure for prolapsed hemorrhoids (PPH) or hemorrhoidopexy is not free from complications, some of whichhave been described as serious, such as bleeding. This study describes a case of a female patient with post-operative huge pelvichematoma, successfully treated with percutaneous angioembolization.Case Presentation: A 76-year-old female underwent PPH, with no intraoperative complications. Few hours later, the patient showedsigns of acute abdomen. No external rectal bleeding was identified and vital signs were normal. A computerized tomography (CT)-scan showed a giant peri-rectal and retroperitoneal pelvic hematoma, with signs of active bleeding. A subsequent selective arteriographyshowed huge bleeding from superior hemorrhoidal artery, treated with super-selective embolization. The procedure wassuccessful and the patient showed a symptomatic improvement. The subsequent hospital stay was uneventful and she was dischargedon the ninth post-operative day, with no complications. At the 30-day post-discharge follow-up, the patient was completelypain free with no signs of pelvic discomfort. Control CT scan revealed regression of the pelvic hematoma.Conclusions: Severe complications may occur after PPH and one of the most important is local bleeding. In the current case, nosigns of external active bleeding were noted. Prompt diagnosis with CT scan allowed efficacious non-operative treatment with angioembolization,avoiding the need of reoperation for a potential serious complication.
Hemorrhoidopexy
PPH
Bleeding
Hematoma
Angioembolization
2018
09
01
https://colorectalresearch.sums.ac.ir/article_47177_2e79ad058a0c8a655fb65744b6519028.pdf
Iranian Journal of Colorectal Research
Iran. J. Colorectal. Res.
2018
6
4
Strangulated Small Bowel Obstruction in Paracecal Hernia and Laparoscopic Approach: A Case Report and Review of Literature
Stefano
Mandalà
Antonino
Mirabella
Massimo
Lupo
Massimo
Branca
Camillo La
Barbera
Carlo
Szokoll
Vincenzo
Mandalà
Internal hernia (IH) is an infrequent cause of small bowel obstruction, and paracecal hernia (PH) is very rare. The etiology is relatedto congenital or acquired causes. The current report was on the case of a 67-year-old male admitted to surgical emergency departmentfor a small bowel obstruction due to a PH. The patient was taken to theatre and underwent a laparoscopic-assisted procedureof small bowel resection for strangulation. The postoperative course was uneventful. As demonstrated in literature, the most importantdiagnostic tool is contrast-enhanced computedtomography (CT) (when possible with reformatted images). Early diagnosis andprompt surgical intervention is paramount to achieve a good outcome. Laparoscopic approach seems to have an interesting role insuch conditions. A further review of literature was performed to highlight the current “state of art” in diagnostic and therapeuticmanagement, especially with regard to laparoscopic approach, of this rare disease.
Paracecal Hernia
Internal hernia
Small Bowel Obstruction
Strangulation
Laparoscopy
2018
09
01
https://colorectalresearch.sums.ac.ir/article_47178_263046d44a0497225716f407afff5dbd.pdf
Iranian Journal of Colorectal Research
Iran. J. Colorectal. Res.
2018
6
4
Liver Transplantation for Non-Resectable Colorectal Liver Metastases
Ashwin
Rammohan
Improved results following liver transplantation (LT) over the past 20 years have led clinicians to push boundaries and expand itsindications. LT in non-resectable colorectal liver metastases (NCRLM) is being revisited with an aim to radically improve survival.By utilizing new tools for preoperative patient selection, modern operative techniques for LT and an aggressive attitude againstmetastases, long-term survival, and even cure could be expected. This paper reviews the current status of liver transplantation forNCRLM with an eye on the future.
Non-Resectable Colorectal Liver Metastases
Liver Transplantation
Review
2018
09
01
https://colorectalresearch.sums.ac.ir/article_47179_8290e37abcd87feaef4c5864897631d8.pdf
Iranian Journal of Colorectal Research
Iran. J. Colorectal. Res.
2018
6
4
Evaluation and Management of Intractable Constipation in Children
Lusine
Ambartsumyan
Leonel
Rodriguez
Intractable constipation has a negative impact on quality of life and well-being of children. The evaluation includes a thoroughhistory and physical examination with diagnostic testing to rule out metabolic, systemic, anatomic, and neurological etiologies. Inchildren with refractory symptomswhofailed aggressive medical management, colonic transit studies help guide need for invasivetesting. Manometric testing of the anorectum and the colon are recommended to evaluate for enteric neuromuscular compromiseand guide novel medical and surgical therapies. Goals of management are to facilitate colonic emptying, ensure fecal continence,and preserve colonic neuromuscular integrity. Treatments range from aggressive medical therapy with stimulant laxatives thatmodify transit to antegrade continence enemas that facilitate colonic emptying. Surgery, including diverting ostomy and resection,has a limited role and should only be considered in select patients after medical and manometric evaluation. The aim of this articleis to provide an update on the evaluation and management of childhood intractable constipation.
Constipation
children
Refractory
2018
09
01
https://colorectalresearch.sums.ac.ir/article_47180_1ae203fdf320f02a89f4a3a21e0a93ff.pdf
Iranian Journal of Colorectal Research
Iran. J. Colorectal. Res.
2018
6
4
Quality Metrics and Indicators in Colonoscopy
Halim
Bou Daher
Ala
Sharara
Colonoscopy is the preferred method for colorectal cancer screening. However, despite significant advances, the examination remainssubject to limitations and variability amongst different practitioners. This calls for the need for objective quality indicators toensure the optimal use of the modality. Three major priority quality measures have been identified that include adenoma detectionrate (ADR), cecal intubation, and adherence to surveillance guidelines. ADR is the best-studied metric correlating with outcomesincluding post-colonoscopy colon cancer, but has inherent limitations such as the potential for corruptibility. Other importantquality indicators include the quality of bowel preparation and colonoscopy withdrawal time. All these quality measures are interrelatedand an improvement in any of them would help in increasing the power of colonoscopy as a screening tool, as well asdecreasing its economic burden and potentially improving adherence to screening guidelines.
Colonoscopy
Quality Indicator
Quality Metrics
quality
Screening
Colorectal cancer
Polyps
2018
09
01
https://colorectalresearch.sums.ac.ir/article_47181_d47d98b3d5fa80f9ca88a428f53d9424.pdf
Iranian Journal of Colorectal Research
Iran. J. Colorectal. Res.
2018
6
4
Rectal Polyp with Osseous Metaplasia: A Case Report and Review of the Literature
Nitin
Rangrao Gaikwad
Sudhir
Jagdishprasad Gupta
Kirti
Jaiswal
An osseous metaplasia in colonic tissue is extremely rare. The current report presents a case of osseous metaplasia in a hamartomatousrectal polyp in a four-year-old boy, who presented with intermittent rectal bleeding. Though this condition has minimumadverse effects on the prognosis of the patient, awareness of this rare histological variant is of utmost importance.
Polyp
metaplasia
Histopathology
2018
09
01
https://colorectalresearch.sums.ac.ir/article_47182_2ba36264a6e872b14efeff5c8ed69b6d.pdf
Iranian Journal of Colorectal Research
Iran. J. Colorectal. Res.
2018
6
4
EndoTHeF: Endoluminal Treatment of Hemorrhoids with Foam
Maurizio
Ronconi
Silvia
Casiraghi
Mattia
Schieppati
Background: Hemorrhoids are normal anatomical structures, present in individuals from birthandrecognisable even in intrauterinelife. When we talk about haemorrhoids in actual fact we refer to the symptoms caused by haemorrhoids. Currently surgery isconsidered the gold standard in the treatment of hemorrhoids.Objectives: In our work we propose the application of an alternative, outpatient and painless treatment of hemorrhoids usingintraluminal injection of sclerosing foam (EndoTHeF), demonstrating the safety and feseability of this procedure.Methods:We enrolled 615 patients frommay 2008 to september 2018 with proctorragy from second and third degree hemorrhoids.Regular 3-week control examinations for all patients were scheduled. A total of 1427 procedures were carried out, with an average of2.32 sessions per patient.Results: Four hundred seventy six patients were available for follow-up, which lasted on average 12 months. In 83% of the casesproctorragy disappeared as early as after the first session. The analysis of a validity score concerning bleeding, pain level and senseof discomfort reported by patients showed a statistically significant difference (P < 0.0015) between before and after procedure.Conclusions: Hemorrhoidal endosclerosis with foam seems to be an effective and safe method to cure hemorrhoidal pathologiesand seems to offer good results in the short-middle term with acceptable results in terms of patient comfort and overall cost tosociety.
Hemorrhoids
Foam
Endovascular
Sclerosis
Endoscopy
Mininvasive
Outpatient
2018
09
01
https://colorectalresearch.sums.ac.ir/article_47183_6e54e115058890c4fb56ee45c9e6b9c2.pdf