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 challenges that must be overcome. For the patient with uncomplicated terminal ileal Crohn's disease, there are definite reproducible advantages to a minimally invasive approach. As surgeons gain experience, more complex cases may be attempted laparoscopically with a low threshold to alternate the approach if difficulties are encountered. We will continue to "push the envelope" in patients with complex Crohn's disease to allow more to be done in complex cases. For the patient with Crohn's colitis and ulcerative colitis, the role of a minimally invasive approach is less well defined. In experienced hands, a laparoscopic total colectomy can be performed safely and offers the patient all the advantages seen with laparoscopic segmental resection. Outcomes are likely to improve with better training, techniques, and equipment. As the field of minimally invasive surgery continues to expand, what is being "pushed" today will be routine in the future.
journal_name
Clin Colon Rectal Surgjournal_title
Clinics in colon and rectal surgeryauthors
Marcello PWdoi
10.1055/s-2006-939528subject
Has Abstractpub_date
2006-02-01 00:00:00pages
26-32issue
1eissn
1531-0043issn
1530-9681journal_volume
19pub_type
杂志文章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::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::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::Large bowel obstruction is a common problem with many different causes, the most common being colorectal adenocarcinoma, extracolonic adenocarcinoma, diverticular disease, volvulus, and inflammatory bowel disease. The nature of the obstruction can influence the best management. Historically, treatment of obstruction c...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0032-1329533
更新日期:2012-12-01 00:00:00
abstract::The morbidity and mortality associated with surgical hemorrhage are considerable, particularly when relaparotomy is necessary. This complication can usually be avoided with comprehensive preoperative patient evaluation and meticulous surgical technique. The damage control sequence is a useful surgical strategy when se...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2006-956439
更新日期:2006-11-01 00:00:00
abstract::Colorectal surgery patients frequently suffer from postoperative complications. Patients with complications have been shown to be at higher risk for mortality, poor oncologic outcomes, additional complications, and worse quality of life. Complications are increasingly recognized as markers of quality of care with more...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1584501
更新日期:2016-09-01 00:00:00
abstract::The use of laparoscopy has become widespread across many surgical specialties. Its utility as treatment for colon cancer was initially met with hesitancy due to concern for port site and wound recurrences; however, this was later disproven by large retrospective series. Subsequently, there have been multiple, large, p...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1597317
更新日期:2017-04-01 00:00:00
abstract::The proximity of the colon and rectum to the organs of the urologic system virtually ensures that iatrogenic urologic injuries become a distinct possibility during complex colorectal surgical procedures. An intimate knowledge of urogenital anatomy as well as strategies for identification and repair of potential injuri...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0038-1677026
更新日期:2019-05-01 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::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::Pruritus ani is a common condition with many different potential causes. Because of this, it can be difficult to treat. It is important to identify and eliminate any inciting factors, which are often unintentional consequences of the patient's attempts to alleviate symptoms. If no reversible cause is found, simple mea...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0035-1570391
更新日期:2016-03-01 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::When utilized properly, social media offers several personal and professional benefits for the practicing surgeon, including peer networking, education, e-mentorship, marketing, recruitment, and patient outreach. However, unprofessional online behavior is common among surgeons, and this improper use of social media ca...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1604255
更新日期:2017-09-01 00:00:00
abstract::Clinical research (CR) is a natural corollary to clinical surgery. It gives an investigator the opportunity to critically review their results and develop new strategies. This article covers the critical factors and the important components of a successful CR program. The first and most important step is to build a de...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0034-1376171
更新日期:2014-06-01 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::Professional medical societies serve several functions that may benefit society, the sponsoring medical profession, and individual members. Several professional societies are available for colorectal surgeons to join and participate in. Reasons to join include service, educational offerings, networking, and companions...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0031-1278406
更新日期:2011-06-01 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::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::Diverticular disease affects approximately two thirds of the population over the age of 70. While only a small fraction of these patients will develop diverticulitis, adequate radiological evaluation of diverticulitis and its complications is imperative in determining proper medical and surgical treatment. Clinical ex...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2004-832696
更新日期:2004-08-01 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::Colorectal cancer begins as a polyp that is a benign growth on the mucosal surface of the colon or rectum. Over a period of 5 to 15 years, polyps can degenerate into a cancer, thus invading the colonic wall. Colorectal screening methods are designed to diagnose and remove polyps before they acquire invasive potential ...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1584091
更新日期:2016-12-01 00:00:00
abstract::The evolution over the past 20 years of anal preservation in rectal cancer surgery has been truly remarkable. Intersphincteric resection (ISR) reported by Schiessel in 1994 in Australia has been shown to enable anal preservation even for cancers quite close to the anus. In Japan, ISR via the detachment of the anal can...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0040-1714240
更新日期:2020-11-01 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::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::Diverticular disease is common in the Western world and is a considerable source of morbidity. Many have proposed an association between diverticular disease, its complications, and obesity. We examine this question through a review of the available literature. While it is likely that an association between diverticul...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0031-1295688
更新日期:2011-12-01 00:00:00
abstract::Crohn's disease represents a challenging operative dilemma. The nature of the disease increases the technical complexity of operations, their morbidity, and the likelihood of multiple operations. In this setting, the advantages of laparoscopic surgery, including shorter hospital stays, less adhesion formation, fewer w...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-2007-991033
更新日期:2007-11-01 00:00:00
abstract::A range of topics are covered in this issue dedicated to complex and reoperative colorectal surgery, from radiation-induced surgical problems, to enterocutaneous fistulas and locally advanced or recurrent rectal cancer. Common themes include the importance of operative planning and patient counseling on the expected f...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0036-1580634
更新日期:2016-06-01 00:00:00
abstract::A dynamic evolution is occurring in transanal surgery. Transanal techniques began with intraluminal surgical removal of rectal masses and have progressed to transanal total mesorectal excision (taTME) for rectal cancer. TaTME was first performed in 2009 by Sylla, Rattner, Delgado, and Lacy. This article documents the ...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0039-3402779
更新日期:2020-05-01 00:00:00
abstract::Bladder dysfunction following colorectal surgery may be related to extirpative procedures in the region of the pelvic autonomic plexus. The most common etiology is from autonomic disruption during abdominoperineal or low anterior resections. Contemporary technical modifications have allowed surgeons to achieve oncolog...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章
doi:10.1055/s-0030-1254299
更新日期:2010-06-01 00:00:00
abstract::The incidence of Crohn's disease in the pediatric population is increasing. While pediatric patients with Crohn's disease exhibit many of the characteristics of older patients, there are important differences in the clinical presentation and course of disease that can impact the clinical decisions made during treatmen...
journal_title:Clinics in colon and rectal surgery
pub_type: 杂志文章,评审
doi:10.1055/s-0037-1609022
更新日期:2018-03-01 00:00:00