Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
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Comparative Study Observational Study
Complications after laparoscopic and open subtotal colectomy for inflammatory colitis: a case-matched comparison.
The aim of this study was to compare the early postoperative outcome of patients undergoing laparoscopic subtotal colectomy with those undergoing open subtotal colectomy for colitis refractory to medical treatment. ⋯ In patients requiring colectomy for acute severe colitis, laparoscopic surgery reduced blood loss but increased operating time and was not associated with a reduction in early postoperative complications, length of hospital stay or readmission rates.
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Comparative Study
Flexible sigmoidoscopy following a positive faecal occult blood test within a bowel screening programme may reduce the detection of neoplasia.
Colorectal cancer screening using the faecal occult blood test (FOBt) detects a disproportionate number of left-sided tumours. This study aims to examine the theoretical impact on neoplasia detection rates of a sigmoidoscopy-first protocol in FOBt-positive patients undergoing colonoscopy. ⋯ A significant reduction in the detection of both adenomas and cancers would be seen if the sigmoidoscopy-first protocol were to be used following a positive FOBt. Furthermore, a significant proportion of patients would be subjected to two procedures, with considerable implications for both the patient and cost.
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Bowel dysfunction was assessed after low anterior resection with and without neoadjuvant therapy (NT) for rectal cancer using a novel symptom-based scoring system correlated with quality of life. ⋯ Severe bowel dysfunction is a frequent long-term outcome after resection for rectal cancer. Use of NT, regardless of a long- or short-course protocol, and TME (compared with PME) are strong independent risk factors for major LARS.
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Review Meta Analysis
Peritoneal fluid cytokines and matrix metalloproteinases as early markers of anastomotic leakage in colorectal anastomosis: a literature review and meta-analysis.
There has been recent interest in the measurement of peritoneal fluid cytokines in the early postoperative period to help diagnose anastomotic leakage at a preclinical stage. The currently available literature on the early diagnosis of colorectal anastomotic leakage by estimation of drain fluid cytokines or matrix metalloproteinases (MMP) is reviewed. ⋯ Measurement of drain fluid cytokines and MMP has the potential to diagnose colorectal anastomotic leakage at a preclinical stage, but is not yet ready for clinical use. Further research is needed, possibly using IL-6 in combination with other cytokines and MMP as markers.