Abstract:
:Since the early 1900s, skeletal muscle transpositions have been employed for complicated cases of fecal incontinence to augment or replace the anal sphincter. Multiple techniques have evolved that vary with the type and configuration of muscle used in the reconstruction. Transposition of the gluteus maximus muscle was popular in the early stages of development but was replaced by techniques involving transposition of the gracilis muscle. Within the past 16 years, electrical stimulators have been applied to the transposed muscle flaps to create a dynamic reconstruction improving the efficacy of these neosphincters over their static counterparts. However, the stimulated versions are technically demanding with a high rate of morbidity secondary to complications of the multiple components and variations in technique. The stimulator used in this procedure has been removed from the US market, although it is still available in other countries. Currently in the United States, gracilis transposition is still employed in the absence of an electrical stimulator as an adjunct to the artificial bowel sphincter (Acticon Neosphincter, American Medical Systems, Minnetonka, MN), such as in cases of severe muscle loss and congenital atresia. In European countries, the stimulated graciloplasty continues to evolve, leading to expansion of its use in total anorectal reconstruction for anal atresia and after abdominoperineal resection.
journal_name
Clin Colon Rectal Surgjournal_title
Clinics in colon and rectal surgeryauthors
Cera SM,Wexner SDdoi
10.1055/s-2005-864081subject
Has Abstractpub_date
2005-02-01 00:00:00pages
46-54issue
1eissn
1531-0043issn
1530-9681journal_volume
18pub_type
杂志文章abstract::Squamous cell carcinoma of the anus (SCCA) is a rare tumor. However, its incidence has been increasing in men and women over the past 25 years worldwide. Risk factors associated with this cancer are those behaviors that predispose individuals to human papillomavirus (HPV) infection and immunosuppression. Anal cancer i...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0031-1286002
更新日期:2011-09-01 00:00:00
abstract::Advanced primary and recurrent colorectal cancer can be successfully treated by experienced, dedicated centers delivering good outcomes with low mortality and morbidity. Development and implementation of a comprehensive referral pathway is to be encouraged. Multidisciplinary team management is essential in the managem...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1606118
更新日期:2017-11-01 00:00:00
abstract::Rectal bleeding is a common presentation to the colon and rectal surgeon's office. It is important to develop a systematic approach to its evaluation so as not to miss the presence of a malignancy. The possibility of more than one diagnosis contributing to the symptom should always be kept in mind. It may therefore be...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2005-922847
更新日期:2005-11-01 00:00:00
abstract::A multispecialty clinic practice is a common practice arrangement for colorectal surgeons. A practice of this type has a variety of features, both positive and negative. This article explores the location, practice patterns, lifestyles, compensation, and academic opportunities associated with a multispecialty clinic p...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2006-948023
更新日期:2006-08-01 00:00:00
abstract::Surgery is a very complex, changing, and, sometimes, threatening environment. Emotional intelligence is a key skill for surgical leaders. Authoritarian, hierarchical, transactional, transformational, adaptive, situational, and servant-shepherd leadership can all be used in surgical leadership. Patient care must be the...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0040-1709457
更新日期:2020-07-01 00:00:00
abstract::Electronic health records (EHRs) or electronic medical records (EMRs) contain a vast amount of clinical data that can be useful for multiple purposes including research. Disease registries are collections of data in predefined formats for population management, research, and other purposes. There are differences betwe...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1673358
更新日期:2019-01-01 00:00:00
abstract::Parasitic infections are a major worldwide health problem, and they account for millions of infections and deaths each year. Most of the infections as well as the morbidity and mortality from these diseases occur in the developing world in rural regions. However, these diseases have become more common in Western count...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2007-970199
更新日期:2007-02-01 00:00:00
abstract::Advances in the surgical management of rectal cancer have placed the quality of total mesorectal excision (TME) as the major predictor in overall survival. A standardized TME technique along with quality increases the percentage of patients undergoing a complete TME. Quality measurements of TME will place increasing d...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1545066
更新日期:2015-03-01 00:00:00
abstract::Perineal wound complications following abdominoperineal resection (APR) is a common occurrence. Risk factors such as operative technique, preoperative radiation therapy, and indication for surgery (i.e., rectal cancer, anal cancer, or inflammatory bowel disease [IBD]) are strong predictors of these complications. Pati...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2008-1055325
更新日期:2008-02-01 00:00:00
abstract::Functional anorectal disorders include solitary rectal ulcer syndrome, rectocele, nonrelaxing puborectalis syndrome, and descending perineal syndrome. Patients usually present with "constipation," but the clinical picture of these disorders includes rectal pain and bleeding, digitalization, incomplete evacuation, and ...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2005-870892
更新日期:2005-05-01 00:00:00
abstract::Despite the slower learning curve of laparoscopic colectomy and the lack of prospective randomized trials, laparoscopic procedures have repeatedly demonstrated a shortened length of stay, reduction in postoperative ileus, and earlier resumption of diet. However, laparoscopy in inflammatory bowel disease has unique cha...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2006-939528
更新日期:2006-02-01 00:00:00
abstract::Transanal total mesorectal excision (taTME) is a novel technique that has evolved over the years to address the challenges of low rectal cancer surgery by applying the principles and benefits of laparoscopic surgery to more historic transanal techniques. It has been popularized through its use in rectal cancer, but th...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0039-3402781
更新日期:2020-05-01 00:00:00
abstract::Colorectal cancer, which kills more than 50,000 patients every year in the United States and costs more than $6 billion in direct health costs, is a prime target for cancer prevention. Computed tomography colonography (CTC) has emerged as a minimally invasive, structural examination of the entire colon that can comple...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2008-1081001
更新日期:2008-08-01 00:00:00
abstract::Peritoneal surface disease (PSD) has historically been used interchangeably with the term peritoneal carcinomatosis (PC) and has a dismal natural history. A variety of malignant pathologies, including colorectal and appendiceal primary tumors, can disseminate throughout the peritoneal cavity, leading to bowel obstruct...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1642052
更新日期:2018-09-01 00:00:00
abstract::Our understanding of the genetics of colorectal cancer has changed dramatically over recent years. Colorectal cancer can be classified in multiple different ways. Along with the advent of whole-exome sequencing, we have gained an understanding of the scale of the genetic changes found in sporadic colorectal cancer. We...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1602234
更新日期:2018-05-01 00:00:00
abstract::Nodal dissemination in locally advanced rectal cancer occurs mainly in two directions: upward and lateral. Lateral node involvement has been demonstrated; however, lateral lymph node dissection (LLND) is not routinely performed in Western countries and the focus is more on neoadjuvant treatment regimens. The main reas...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1606112
更新日期:2017-11-01 00:00:00
abstract::Lynch syndrome is the familial clustering of colorectal and endometrial cancers. This syndrome is passed in an autosomal dominant fashion within families with defective mismatch repair as the genetic basis for cancer development in these patients. There remains a group of patients who fit clinical diagnostic criteria ...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0032-1313776
更新日期:2012-06-01 00:00:00
abstract::Abdominal wall reconstruction in the digestive tract fistula patient is a complex issue. The authors review the available data and present information regarding the timing of surgery, techniques of abdominal wall reconstruction, hernia repair, and discuss pitfalls associated with the various options. A simple and basi...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0030-1262988
更新日期:2010-09-01 00:00:00
abstract::Hemorrhoid disease is the most common reason patients seek evaluation by a colon and rectal surgeon. The majority of hemorrhoids can be managed nonoperatively with medical management or office-based procedures. The authors review the anatomy, pathophysiology, presentation, and management of hemorrhoids. ...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0031-1272818
更新日期:2011-03-01 00:00:00
abstract::Paradoxical puborectalis contraction and increased perineal descent are two forms of functional constipation presenting as challenging diagnostic and treatment dilemmas to the clinician. In the evaluation of these disorders, the clinician should take special care to exclude anatomic disorders leading to constipation. ...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2008-1075863
更新日期:2008-05-01 00:00:00
abstract::As a result of the obvious benefits of laparoscopic cholecystectomy, minimally invasive techniques have been applied to more complex gastrointestinal procedures, including colorectal resections. The goal in adapting laparoscopic techniques for colorectal surgery is to offer an operation that results in less pain, shor...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2005-916278
更新日期:2005-08-01 00:00:00
abstract::Ulcerative colitis is a chronic inflammatory disease of the colon with an increasing incidence worldwide. The medical management of this disease continues to expand as drugs to induce and maintain remission are sought to avoid the need for colectomy. This article will review the standard of care for the treatment of m...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2004-823066
更新日期:2004-02-01 00:00:00
abstract::The introduction of total mesorectal excision (TME) for rectal cancer has reduced local recurrence rates and improved oncologic outcomes, although complication rates such as anastomotic leak have also been a consequence. With the advent of neoadjuvant therapy for rectal cancer, many are questioning how this developmen...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2007-984863
更新日期:2007-08-01 00:00:00
abstract::Lower gastrointestinal bleeding (LGIB) is a common entity encountered by the surgeon. Though most LGIB stops on its own, familiarity with the diagnoses and their treatments is critical to optimal patient care. Even in 2016, surgery may be required. Advances in imaging have led to an enhanced ability to localize bleedi...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1693439
更新日期:2020-01-01 00:00:00
abstract::Lymphoma involving the colon and rectum is rare and can occur either as primary colorectal lymphoma or as a manifestation of systemic disease. Most patients with primary colorectal lymphoma present with abdominal pain, and obstruction is unusual. Although lesions may be evident on radiographic studies, the findings ar...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2006-942344
更新日期:2006-05-01 00:00:00
abstract::The applicability of laparoscopy to many complex intraabdominal colorectal procedures continues to expand, and has been shown to be feasible and safe in experienced hands. Data are available on the elderly, rectal prolapse, diverticulitis, Hartman's takedown, small bowel obstruction, Crohn's disease, and ulcerative co...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0030-1247857
更新日期:2010-02-01 00:00:00
abstract::Genitourinary structures are at risk of injury during colorectal surgery. The incidence of injury is low; however, the risk is higher in cases involving severe inflammatory or infectious processes, locally advanced or recurrent cancer, previous radiation, and reoperation. Consideration of the anatomical relationship b...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1580629
更新日期:2016-06-01 00:00:00
abstract::Crohn's disease is a complex disease with a varying clinical and anatomical spectrum. One-third of patients with Crohn's will have disease confined to the colon. In this article, the authors review the surgical treatment options for colonic Crohn's disease including the current status of performing segmental colectomy...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0039-1683906
更新日期:2019-07-01 00:00:00
abstract::Colorectal cancer is common in the Western world; ~5% of individuals diagnosed with colorectal cancer have an identifiable inherited genetic predisposition to this malignancy. Genetic testing and rational clinical management recommendations currently exist for the management of individuals with a variety of colorectal...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0029-1242459
更新日期:2009-11-01 00:00:00
abstract::All colorectal operations carry significant associated risk. To facilitate the best outcomes it is essential to perform a comprehensive evaluation of patient risk preoperatively. Once risk factors are identified the appropriate steps must be taken to minimize their effects. The evaluation of the patient can be broken ...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0029-1202870
更新日期:2009-02-01 00:00:00