Current management of spontaneous intra-abdominal abscess in Crohn's disease
Publication date: April–June 2018Source: Journal of Coloproctology, Volume 38, Issue 2Author(s): Ana Teresa Pugas Carvalho, Barbara Cathalá Esberard, Andre da Luz MoreiraAbstractCrohn's disease (CD) is a chronic transmural disease process with approximately 10% of patients developing spontaneous intra-abdominal abscess during the first 5 years after the diagnosis. The symptoms are often nonspecific. The treatment modalities include the use of wide-spectrum antibiotics, imaging-guided percutaneous drainage (PD) and surgical drainage with or without resection. The best initial treatment strategy has not been settled contr...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
A case study of ileal metaplasia and neoplasia in a patient with an ileal-rectal anatomosis
Publication date: April–June 2018Source: Journal of Coloproctology, Volume 38, Issue 2Author(s): Beth M. Campbell, David Clark, James Harvey, Andrew ReidAbstractA clear link between ulcerative colitis and the formation of dysplasia and neoplasia has been described. This increased risk remains even after subtotal colectomy and ileo-rectal anastomosis, necessitating life-long surveillance of the remaining ano-rectum. This case study highlights the importance in long-term follow up in this population, including proximal to the anastomosis as dysplastic changes can occur in the distal ileum.ResumoUma ligação clara entre co...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Enterovesical fistula caused by ileal primary adenocarcinoma
ConclusionThe relative inaccessibility of the small bowel and the malignant neoplasms’ non-specific symptoms make an early diagnosis difficult. Discovery of the disease, often only at an advanced stage, results in complications and less effective therapy. The laparoscopic approach might be advantageous and effective in the treatment of advanced small bowel cancer with invasion of adjacent structures.ResumoIntroduçãoAs neoplasias do intestino delgado são entidades raras com apenas 3,2% dos tumores gastrointestinais localizando-se neste segmento. O adenocarcinoma é o segundo tipo histológico mais comum entre as neopla...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Technique and results of the first six cases of anal sphincteroplasty with Deoti's flap for complex anatomical deformity of the perineum
ConclusionsDeoti's surgical flap with sphincteroplasty successfully reconstructs complex anatomical deformities of the perineum. Current questionnaires to assess fecal incontinence may not evaluate properly the anatomical result of the technique, thus we propose a visual scale. In addition, sphincteroplasty with Deoti's flap may have longer-term outcomes in functional results than sphincteroplasty alone.ResumoObjetivosA esfincteroplastia anal com retalho Deoti é um procedimento publicado recentemente para o tratamento de deformidade perineal grave. O objetivo deste estudo é relatar seis pacientes, analisando seus resulta...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
A prospective study of efficacy and safety of rubber band ligation in the treatment of Grade II and III hemorrhoids – a western Indian experience
ConclusionRubber band ligation is a simple, safe and effective method for treating symptomatic second and third degree hemorrhoids as an outpatient procedure. It gives better results for Grade II and single hemorrhoids. Recurrence rate after successful band ligation is low.ResumoBackgroundAs hemorroidas são uma das doenças mais frequentes da região anal, com alta prevalência envolvendo todas as faixas etárias. Existem várias opções de tratamento, sendo que nenhuma é perfeita. A ligadura elástica de hemorroidas é um tratamento conservador que pode ser realizado em ambulatório.ObjetivoO estudo foi realizado para ...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Risk factors for postoperative complications in Crohn disease: analysis of 173 patients
ConclusionsWe described clear associations between age at surgery>40 years and the group others (intestinal perforation, mesenteric ischemia and postoperative complications) and overall postoperative complications in Crohn disease. These results may suggest that surgery does not need to be delayed and, in some cases, should be anticipated.ResumoIntrodução e objetivosVários fatores têm sido estudados como possíveis fatores de risco para complicações pós-operatórias na doença de Crohn. Estas complicações estão associadas a estadias mais prolongadas no hospital e a um aumento da mortalidade. Apesar do debate rela...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Gender-based analysis of the characteristics and outcomes of surgery for anal fistula: analysis of more than 560 cases
ConclusionThe majority of fistula-in-ano in males were posterior and high trans-sphincteric whereas most fistula-in-ano in females were low and anteriorly based. Despite the different characteristics of fistula-in-ano; no significant differences in the rates of fistula recurrence and fecal incontinence between males and females could be recorded.ResumoBackgroundA fístula anal comumente acomete mais os homens que as mulheres. Algumas diferenças nas características da fístula anal entre ambos os sexos têm sido reconhecidas, embora o impacto dessas diferenças nos desfechos da cirurgia para fístula anal ainda seja incer...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Establishing the normal ranges of female and male anal canal and rectal wall vascularity with color Doppler anorectal ultrasonography
ConclusionsBlood supply is highest at upper levels of the anal canal; however, inner structures are better irrigated in men. Moreover, the rectal wall is better irrigated than the mesorectal fat. Establishing normal ranges may permit future comparisons of the studied structures in disease states as well as the hormonal and age related changes.ResumoObjetivoAvaliar vascularização do canal anal, parede retal e gordura mesorretal em homens e mulheres, usando ultrassonografia endorretal com Doppler colorido para estabelecer parâmetros vasculares de normalidade.MétodosEstudo prospectivo transversal incluindo voluntários as...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Effects of biofeedback in the treatment of female fecal incontinence
ConclusionBiofeedback is an effective method for the treatment of fecal incontinence, with increased sphincter strength and improved quality of life.ResumoIntroduçãoA incontinência anal é a perda involuntária de fezes e gases, caracterizada pela incapacidade de manter o controle fisiológico do conteúdo intestinal. Pode interferir negativamente na qualidade de vida dos pacientes. Biofeedback é uma ferramenta terapêutica utilizada no tratamento, através do treinamento dos músculos do assoalho pélvico, a partir de estímulo visual e sonoro.ObjetivoAvaliar os efeitos do biofeedback no tratamento da incontinência a...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Adipose tissue-derived stem cells: a new approach to the treatment of Crohn's disease-associated perianal fistulae
Publication date: Available online 1 May 2018Source: Journal of ColoproctologyAuthor(s): Mónica Maria Ramos Tavares, Laura Elisabete Ribeiro BarbosaAbstractCrohn's disease has an ever-increasing prevalence and incidence, with about 20% of patients developing perianal fistula with significant impact on their quality of life.Despite the medical and surgical treatments currently used, Crohn's-related fistula treatment continues to pose a challenge due to the low rates of efficacy associated with high recurrence rates.Recent clinical trials have shown promising results regarding safety and efficacy of local treatment of this ...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Coloanal intussusception in adults due to lipoma
We present a case wherein the patient had a lipoma of the sigmoid colon that caused an immense prolapse through the anus. Very few cases of coloanal intussusception are reported in adults, and we discuss the diagnostic tools and the management of this rare surgical entity.ResumoA intussuscepção no adulto é uma entidade rara. Mas a intussuscepção colo-anal é uma exceção. Lesões malignas são a causa mais comum de intussuscepção colônica e, neste aspecto, difere da intussuscepção infantil. Apresentamos um caso de lipoma do cólon sigmoide que causou um prolapso imenso através do ânus. Muito poucos casos de in...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Ligation of the intersphincteric fistula tract procedure and its modifications
ConclusionLigation of the intersphincteric fistula tract and its modifications are effective and simple procedures in treating simple anal fistulae, especially high transsphincteric ones. However, more trials should be performed to evaluate its effectiveness regarding complex fistulae.ResumoObjetivoO tratamento de fístulas anais é considerado um desafio devido à natureza diversa dessa doença e suas incontáveis complicações. O procedimento de ligadura do trato da fístula interesfincteriana e suas modificações foi popularizado entre cirurgiões em todo o mundo devido a sua simplicidade e desfechos promissores. O pr...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Colorectal adenocarcinoma staging of patients in a public tertiary hospital in the state of Grande do Sul
ConclusionMost patients treated at this hospital have advanced disease (67%) and come from the emergency department (51%).ResumoIntroduçãoO câncer colorretal tem a segunda maior prevalência e a terceira maior incidência no mundo. A mortalidade está diretamente relacionada ao estágio da doença.ObjetivoAvaliar o estadiamento de pacientes com adenocarcinoma colorretal atendidos pelo Serviço de Coloproctologia do Hospital Nossa Senhora da Conceição (HNSC) entre os anos de 2010 e 2015.MétodoEstudo de prevalência. A coleta de dados foi realizada de forma retrospectiva através de pesquisa no sistema eletrônico do G...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Continence changes following transanal endoscopic microsurgery result from the impact on rectal capacity: clinical and functional evaluation before and after surgical treatment
ConclusionsAfter TEM, a modest impact on anorectal function can be observed. The transient impairment results from loss of rectal capacity and not from impairment of the anal sphincters, being completely resolved 90 days after surgery.ResumoIntroduçãoDescrita em 1983 e de sólida aplicação clínica, o impacto da Microcirurgia Endoscópica Transanal (TEM) sobre a função anorretal permanece pouco conhecido. Os objetivos do presente estudo foram avaliar o impacto da TEM na função anorretal conforme avaliações clínica (Wexner score) e funcional (manometria anorretal) antes e após a cirurgia.MétodoProspectivamente,...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
Surgical treatment of malignant colon polyps
ConclusionsThe persistence of malignancy in the surgical specimen was associated with larger sessile polyps and piecemeal removal. A significant number of patients did not show malignancy in the surgical resection specimen, with more markers being required to better stratify patients.ResumoContextoNa decisão terapêutica do pólipo maligno do cólon diversos fatores preditores de doença residual após a recessão endoscópica norteiam a decisão de vigilância ou intervenção cirúrgica. Esta é uma decisão desafiadora, uma vez que mesmo na presença dos preditores de alto risco usados atualmente, apenas 15% a 30% dos ...
Source: Journal of Coloproctology - July 5, 2018 Category: Gastroenterology Source Type: research
