International journal of colorectal disease
-
Int J Colorectal Dis · May 2017
Meta AnalysisGoshajinkigan for reducing chemotherapy-induced peripheral neuropathy: protocol for a systematic review and meta-analysis.
Chemotherapy-induced peripheral neuropathy (CIPN) is an issue for both cancer patients and specialists, and the number of cases of CIPN is growing with the increasing number of cancer patients worldwide. CIPN is often caused by common anticancer drugs such as taxanes and platinum analogs. These are key drugs for various cancers including colorectal and gastric cancers. However, there are currently no effective drugs to prevent CIPN. Goshajinkigan, a Japanese traditional herbal medicine (Kampo), is a promising drug which is used to treat diabetic neuropathy in Japan. This systematic review will assess the efficacy and safety of Goshajinkigan for reducing CIPN in cancer patients receiving chemotherapy. ⋯ This is a protocol for systematic review and meta-analysis and does not need ethics approval. We will disseminate the findings of this review through publication in a peer-reviewed journal.
-
Int J Colorectal Dis · May 2017
Functional outcome following rectal surgery-predisposing factors for low anterior resection syndrome.
Developments in surgical techniques and neoadjuvant treatment have enabled an increasing proportion of patients with rectal cancer to undergo sphincter-sparing resections. The avoidance of a permanent stoma can come at the cost of poor bowel function which can significantly impact patients' quality of life. The objective of this study was to identify the incidence and risk factors for the development of bowel dysfunction following rectal cancer surgery. ⋯ The use of neoadjuvant radiotherapy (LCCRT) and timing of stoma reversal are risk factors for the development of severe bowel dysfunction. The potential for long-term poor functional results after LCCRT should be discussed with patients and form a part of the decision-making in individual treatment plans. The timing of the ileostomy closure, where safe and feasible, should be performed within 6 months to improve outcome.
-
Int J Colorectal Dis · Apr 2017
The RIPASA score is sensitive and specific for the diagnosis of acute appendicitis in a western population.
The definitive diagnosis of acute appendicitis (AA) requires histopathological examination. Various clinical diagnostic scoring systems attempt to reduce negative appendectomy rates. The most commonly used in Western Europe and the USA is the Alvarado score. The Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score achieves better sensitivity and specificity in Asian and Middle Eastern populations. We aimed to determine the diagnostic accuracy of the RIPASA score in Irish patients with AA. ⋯ The RIPASA score is a useful tool to aid in the diagnosis of acute appendicitis in the Irish population. A score of ≥7.5 provides sensitivity and specificity exceeding that previously documented for the Alvarado score in Western populations. WHAT DOES THIS PAPER ADD TO THE LITERATURE?: This is the first study evaluating the utility of the RIPASA score in predicting acute appendicitis in a Western population. At a value of 7.5, a cut-off score suggestive of appendicitis in the Eastern population, RIPASA demonstrated a high-sensitivity, specificity, positive predictive value and diagnostic accuracy in our cohort and was more accurate than the commonly used Alvarado score.
-
Int J Colorectal Dis · Apr 2017
Diagnosis, treatment, and consequences of anastomotic leakage in colorectal surgery.
The aim of this study was to explore the choice of modality for diagnosis, treatments, and consequences of anastomotic leakage. ⋯ This study demonstrated that one fourth of the CT scans that were executed were initially negative for leakage. Most patients with a grade C leakage will not have an intact anastomosis. An anastomotic leakage leads to significantly more severe postoperative complications, higher rate of reoperations, and higher mortality. An earlier relaparotomy instead of a CT scan and improved postoperative surveillance could possibly reduce the consequences of the anastomotic leakage.
-
Int J Colorectal Dis · Mar 2017
Comparison of three different application routes of butyrate to improve colonic anastomotic strength in rats.
Despite extensive research, anastomotic leakage (AL) remains one of the most dreaded complications after colorectal surgery. Since butyrate enemas are known to enhance anastomotic healing, several administration routes have been explored in this study. ⋯ Butyrate enemas are effective in the enhancement of colonic anastomosis. Enhanced butyrate-based approaches designed to reduce AL in animal models for both proximal and distal anastomoses were not more effective than were butyrate enemas alone. Further research should focus on how exogenous butyrate can improve anastomotic healing after gastrointestinal surgery.