Abstract:
BACKGROUND:Small bowel adenocarcinoma (SBA) remains a rare entity but occurs at increased frequency in the setting of chronic Crohn's disease (CD). Our aim was to study the presentation, diagnosis and prognosis of SBA in patients undergoing surgery for CD at a single institution. METHODS:We reviewed the medical records of all patients with CD complicated by adenocarcinoma of the small bowel from 2000 to 2017. Descriptive statistics and Kaplan-Meier overall survival estimates were calculated. RESULTS:In total, 22 patients (14 males) with CD (median duration of Crohn's diagnosis 32 years) were diagnosed with SBA and underwent surgical resection (8 isolated small bowel resections, 12 ileocolic resections, and 2 total proctocolectomies). The median patient age at the time of diagnosis was 54 years (range 22-82 years). A total of 17 patients (77%) underwent cross-sectional CT imaging within 3 months of surgery, a cancer diagnosis was suggested in only one patient. In one other patient, SBA was diagnosed preoperatively on endoscopic biopsy of the terminal ileum. The remaining patients were operated on for obstruction (n = 17), abscess or fistulizing disease (n = 2), and sigmoid cancer (n = 1). For these 20 (90%) patients not suspected to have SBA on preoperative assessment, 5 (25%) were diagnosed intraoperatively on frozen section and 15 (75%) were unexpectedly diagnosed postoperatively on final pathology. T staging was characterized by more advanced tumors (T4: 59%, T3: 27%, T2: 9%, and T1: 5%). Nine patients (41%) had nodal involvement and five patients (23%) had hepatic and/or peritoneal carcinomatosis. The 1-, 3-, and 5-year survival estimates for our cohort were 84%, 30%, and 10%, respectively. Median survival was 30.5 months with median follow-up of 23 months (range 6-84 months). CONCLUSIONS:SBA in the setting of CD is most commonly found incidentally after surgical resection for benign indications. As such, any suspicious finding at the time of surgery in a patient with chronic CD should warrant careful investigation with frozen section and/or resection. Prognosis for CD complicated by SBA remains poor even in the modern era.
journal_name
Tech Coloproctoljournal_title
Techniques in coloproctologyauthors
Hussain T,Jeganathan NA,Karagkounis G,Stocchi L,Shawki S,Holubar SD,Gordon I,Hull T,Liska Ddoi
10.1007/s10151-020-02269-8subject
Has Abstractpub_date
2020-10-01 00:00:00pages
1055-1062issue
10eissn
1123-6337issn
1128-045Xpii
10.1007/s10151-020-02269-8journal_volume
24pub_type
杂志文章abstract:BACKGROUND:Anal fissures can cause morbidity in an otherwise healthy young patient. The process of evacuation results in stretching and descent of the anoderm and perineum especially posteriorly. Posterior perineal support may provide counter pressure at the posterior aspect of the pelvic floor, balancing the pressure ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-009-0453-y
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Pouchitis after total rectocolectomy is among the most common complications of patients with ulcerative colitis (UC). However, its frequency is quite rare in patients with familial adenomatous polyposis (FAP). We evaluated the inflammatory and pro-apoptotic activity in endoscopically normal mucosa of the ile...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-008-0395-9
更新日期:2008-03-01 00:00:00
abstract:BACKGROUND:Early detection of colorectal anastomotic leakage (AL) may lead to better outcome. AL may be preceded by change in local metabolism and local ischaemia. Microdialysis of the peritoneal cavity is able to measure these changes in real-time and is minimally invasive. The aim of this prospective cohort study was...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1020-0
更新日期:2014-01-01 00:00:00
abstract::Various transanal and perineal surgical techniques have been described for the treatment of rectourethral fistula (RUF). However, these techniques are poorly suited for complicated fistulas. Here, we present a novel minimally invasive procedure: robotic-assisted laparoscopic segmental resection with rectoanal anastomo...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-012-0913-7
更新日期:2013-10-01 00:00:00
abstract:BACKGROUND:Patient self-report is important in the assessment of the impact of anal incontinence (AI) on quality of life. This study aimed to (1) determine the correlation between total St. Mark's Incontinence Score (SMIS) and a single-item visual analogue scale (VAS) for bother from AI, and (2) determine the correlati...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-015-1397-z
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Doppler-guided hemorrhoidal artery ligation (DGHAL) was described as lower risk and a less painful alternative to hemorrhoidectomy. We report our experience and 5-year follow-up with this procedure. METHODS:Between May 2003 and December 2004, 100 patients with symptomatic Grade II or III hemorrhoids underwe...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0801-6
更新日期:2012-02-01 00:00:00
abstract::Obstructed defecation is one subtype of constipation, and may be due to functional or mechanical causes. Here, we report an unusual cause, never described before, of obstructed defecation due to a large uterine myoma that reverted to normal bowel habits after surgery. The importance of an accurate evaluation of the ca...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-009-0510-6
更新日期:2009-09-01 00:00:00
abstract::The Malone appendicostomy is a novel option for surgical management of faecal incontinence and chronic constipation, by permitting the administration of antegrade colonic enemas for colonic evacuation. We report the case of a 54-year-old female who had undergone abdomino perineal resection for low rectal cancer follow...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-010-0672-2
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Conflicting views regarding the use of ileorectal anastomosis (IRA) in ulcerative colitis (UC) exist and this controversy prompted us to review our experience, especially against the background of the current tendency to choose the ileal pouch-anal procedure (IPAA). METHODS:Thirty-two consecutive patients w...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-006-0286-x
更新日期:2006-10-01 00:00:00
abstract::Hereditary proctalgia is an extremely rare condition characterized by endosonographic evidence of internal anal sphincter (IAS) thickening and specific ultrastructural changes seen at light and electron microscopy (EM). We report the case of a 54-year-old Caribbean woman with severe proctalgia and IAS thickening, trea...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-007-0329-y
更新日期:2007-03-01 00:00:00
abstract::Colonic diverticular disease is extremely common in developed countries. Although the majority of patients with diverticulosis remain asymptomatic, about one-third of the patients manifest the disease with either hemorrhage or inflammation. Diverticulitis may be uncomplicated or complicated by abscess formation, perfo...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0738-9
更新日期:2011-10-01 00:00:00
abstract::Our objective was to report of our first experience with transanal total mesorectal excision (TME) of rectal cancer using single-port equipment, a pure natural orifice transluminal endoscopic surgery (NOTES) procedure, and to discuss the advantages and disadvantages of the technique. A patient with rectal cancer was s...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-012-0882-x
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:The purposes of the study were the long-term evaluation of silicone implants with three-dimensional (3D) anal endosonography and its correlation with anal incontinence. METHODS:Fifteen patients were injected with silicone because of anal incontinence and co-existing internal anal sphincter disruption (n = 8...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-009-0502-6
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate patient factors that affect the progression of anal dysplasia in human immunodeficiency virus (HIV)-positive individuals. METHODS:A retrospective cohort study of HIV-positive adults with human papilloma virus related anal lesions was performed from 2012 to 2017. ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-019-01951-w
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The aim of our study was to assess perineal wound healing in patients with Crohn's disease (CD) who undergo proctectomy or proctocolectomy with end ileostomy and to evaluate the influence of various factors including types of perineal dissection on eventual wound healing. METHODS:Data for patients with CD w...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-017-1695-8
更新日期:2017-09-01 00:00:00
abstract::Anal fistula repair still remains challenging. Up to 30% of fistulas persist after surgery despite many improvements in surgical skills and technique. One major reason for surgical failure is a persistent fistula track or remnants of the fistula epithelium which could not be removed during surgery. To overcome this pr...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0726-0
更新日期:2011-12-01 00:00:00
abstract:BACKGROUND:Ligation of the intersphincteric tract (LIFT), a novel sphincter-saving technique, has been recently described with promising results. Literature data are still scant. In this prospective observational study, we present our experience with this technique. METHODS:Between October 2010 and April 2011, 18 pati...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0779-0
更新日期:2011-12-01 00:00:00
abstract::The currently used technology for transanal excision of rectal neoplasms is diathermy. However, control of bleeding is sometimes difficult. The Harmonic Scalpel provides a "dry" surgical field which facilitates the procedure and allows complete resection of the neoplasm with greater accuracy. ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-008-0427-5
更新日期:2008-09-01 00:00:00
abstract:INTRODUCTION:One in ten patients with rectal cancer presents with synchronous colorectal liver metastases. We present an up-to-date review of the different surgical strategies available for rectal cancer patients with synchronous colorectal liver metastases. METHOD:A literature review of MEDLINE, Cochrane and Google s...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-012-0888-4
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:Colonic resection according to the procedure by Hartmann is considered a fast and safe surgical intervention, which has been used for years, in particular, in emergency situations. METHODS:Using data of a prospective multicentre study on the operative treatment of colorectal carcinoma over the time period f...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10151-004-0164-3
更新日期:2004-11-01 00:00:00
abstract::The purpose of this study was to assess outcome measures and cost-effectiveness of robotic colorectal resections in adult patients with inflammatory bowel disease. The Cochrane Library, PubMed/Medline and Embase databases were reviewed, using the text "robotic(s)" AND ("inflammatory bowel disease" OR "Crohn's" OR "Ulc...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-018-1766-5
更新日期:2018-03-01 00:00:00
abstract:AIM:The aim of this study is to review the time between formation and closure of loop ileostomies following total mesorectal excision in patients with rectal cancer. PATIENTS AND METHODS:A retrospective study of 170 patients who underwent low anterior resection for rectal cancer, between 1990 and 2009. Loop ileostomie...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-010-0628-6
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Management of anal fistula (AF) remains challenging with many controversies. The purpose of this study was to explore current surgical practice in the management of AF with a focus on technical variations among surgeons. METHODS:An online survey was conducted by inviting all surgeons and physicians on the m...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-019-02051-5
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:Oncologic outcomes after complete mesocolic excision (CME) in colon cancer are under investigation. The aim of our study was to compare CME and conventional colectomy (CC) in terms of pathological and oncological outcomes for right colon cancer and to evaluate the impact of lymph node metastasis around the v...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02378-4
更新日期:2021-01-05 00:00:00
abstract:BACKGROUND:The aim of this study was to report the outcomes of sacral neuromodulation (SNM) in chronic pelvic pain (CPP) patients in the Finnish national cohort. METHODS:This was a register-based retrospective study, involving all the centers that provide SNM treatment in Finland. The data of all patients treated with...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02148-2
更新日期:2020-03-01 00:00:00
abstract::The treatment techniques for pilonidal disease are either associated with high recurrence rates or complex procedures. This prospective randomized study compared the outcome of excision and marsupialization technique with sinus excision technique. A total of 40 consecutive patients with limited, chronic pilonidal sinu...
journal_title:Techniques in coloproctology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s101510200037
更新日期:2002-12-01 00:00:00
abstract:BACKGROUND:Technical feasibility of inferior rectal nerve anastomosis to the anterior vagus branch of the perineally transposed antropyloric valve for total anorectal reconstruction has been previously demonstrated in cadavers. To the best of our knowledge, the present study is the first report of using this procedure ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1092-x
更新日期:2014-06-01 00:00:00
abstract::The article Gracilis muscle transposition for treatment. ...
journal_title:Techniques in coloproctology
pub_type: 已发布勘误
doi:10.1007/s10151-019-02044-4
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:Extralevator abdominoperineal excision (ELAPE) probably improves the oncological quality of low rectal cancer surgery, as compared to standard abdominoperineal excision (SAPE), possibly due to lower rates of accidental perioperative bowel perforations and lower rates of circumferential resection margin (CRM)...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-014-1243-8
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Porcine small intestinal submucosa (SIS) is a bioprosthetic collagen material used in the management of various surgical conditions, especially hernia repairs. We studied the effectiveness of porcine SIS Bioprosthetic plug (Surgisis AFP, Cook Biotech Inc., West Lafayette, IN, USA) in the treatment of fistula...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10151-012-0897-3
更新日期:2013-04-01 00:00:00