Techniques in coloproctology
-
Meta Analysis Comparative Study
Intracorporeal versus extracorporeal anastomosis in minimally invasive right colectomy: an updated systematic review and meta-analysis.
Minimally invasive colectomy has become the standard for treatment of colonic disease in many centers. Restoration of bowel continuity following resection can be achieved by intracorporeal (IC) or extracorporeal (EC) anastomosis. The aim of this systematic review was to assess the outcomes of IC compared to EC anastomosis in minimally invasive right colectomy. ⋯ IC anastomosis was associated with significantly shorter extraction site incisions, earlier bowel recovery, fewer complications, and lower rates of conversion, AL, SSI, and incisional hernia than has the EC anastomosis.
-
Anastomotic leakage (AL) remains the most challenging complication following colorectal resection. There are several tests that can be used to test anastomotic integrity intraoperatively including air leak testing (ALT) and intraoperative colonoscopy (IOC). Indocyanine green (ICG) can be used to visualise blood supply to the bowel used in the anastomosis. However, there is no consensus internationally regarding routine use and which technique is superior. The aim of this study was to determine which intraoperative anastomotoic leak test (IALT) was most effective in reducing AL. ⋯ This study suggests that intraoperative testing for a good blood supply using ICG may reduce the AL rate following colorectal surgery.
-
Multicenter Study
Sacral neuromodulation for fecal incontinence in Latin America: initial results of a multicenter study.
Sacral neuromodulation (SNM) is a widely used therapeutic option for fecal incontinence (FI). Larger series are mainly from Western countries, while few reports address the results of SNM in less developed or less wealthy countries. The aim of the present study was to evaluate the efficacy of SNM in patients with FI in Latin America. ⋯ Sacral nerve stimulation for FI is safe and efficient, even in less wealthy or less developed countries.
-
The United Kingdom (UK) bowel cancer screening programme has reduced mortality from colorectal cancer (CRC), but poor uptake with stool-based tests and lack of specificity of faecal occult blood testing (FOBT), has prompted investigation for a more suitable screening test. The aim of this study was to investigate the feasibility of a urinary volatile organic compounds (VOC)-based screening tool for CRC. ⋯ CRC was correctly distinguished from adenomas or no bowel pathology using urinary VOC markers, within the bowel screening population. This pilot study demonstrates the potential of this method for CRC detection, with higher test uptake and superior sensitivity than FOBT. In addition, this is the first application of GC-IMS in CRC detection which has shown high test accuracy and usability.
-
Meta Analysis Comparative Study
Laparoscopic vs. robotic rectal cancer surgery and the effect on conversion rates: a meta-analysis of randomized controlled trials and propensity-score-matched studies.
The usage of robotic surgery in rectal cancer is increasing, but there is an ongoing debate as to whether it provides any benefit. The aim of the present study was to determine if robotic surgery results in less conversion to an open operation than laparoscopic rectal cancer surgery. ⋯ Robotic surgery for rectal cancer is associated with reduced conversion to open surgery compared to a laparoscopic approach.