Abstract:
BACKGROUND:The proposed difficulty scoring system (DSS) may aid in preoperative planning for laparoscopic total mesorectal excision (L-TME) for rectal cancer. METHODS:Fifty-three patients [28 males; 59.0 (31.0-88.0) years of age] treated for rectal cancer at our institution from 2/2011-5/2018 were identified. "Difficult operation" (DO) was defined as the presence of ≥3 factors: operative time ≥320 min, estimated blood loss >250 ml, intraoperative complications, conversion to laparotomy, >2 stapler applications, incomplete TME quality, and/or subjective perceived difficulty. Univariate analysis and multivariate logistic regression model with backward elimination method were used to obtain a DSS which consists of two factors: sex (male = 1 and female = 0) and body mass index (BMI) (≥30 kg/m2 = 1, <30 kg/m2 = 0). RESULTS:In univariate analysis, sex (p = 0.0217), BMI (p = 0.0026), American Society of Anesthesiologists (ASA) score (p = 0.0372), and magnetic resonance imaging transverse diameter (p = 0.0441) correlated to DO. Multivariate analysis revealed that sex and BMI were the most important risk factors for a DO [area under the receiver operating characteristic curve [AUC] = 0.7761, 95% CI = (0.6443-0.9080)]. Male patients with a BMI ≥ 30 kg/m2 were more likely to experience a DO (77.8%). The simplified DSS did not weaken the discriminating power compared to multivariate logistic regression model (AUC 0.7696 vs. 0.7761, p = 0.7387). L-TME with a DSS of 0, 1, and 2 had a DO rate of 10%, 33.3%, and 77.8%, respectively. CONCLUSIONS:A simplified DSS may be used preoperatively in preparation for L-TME.
journal_name
Tech Coloproctoljournal_title
Techniques in coloproctologyauthors
Krizzuk D,Yellinek S,Parlade A,Liang H,Dasilva G,Wexner SDdoi
10.1007/s10151-020-02285-8subject
Has Abstractpub_date
2020-11-01 00:00:00pages
1137-1143issue
11eissn
1123-6337issn
1128-045Xpii
10.1007/s10151-020-02285-8journal_volume
24pub_type
杂志文章abstract:PURPOSE:Introduction of stapled hemorrhoidopexy (SH) brought a radical change in the treatment of haemorrhoidal disease. The aim of this study is to evaluate the results and the complications (early and late) from the use of this technique. METHODS:During the last 6 years (2005-2011), 123 patients underwent a SH in ou...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0739-8
更新日期:2011-10-01 00:00:00
abstract::Haemorrhoidectomy is frequently associated with significant postoperative pain and prolonged hospital stay. New techniques to reduce these problems are constantly under evaluation. Amongst these, LigaSure haemorrhoidectomy is a safe and fast technique that fulfils the requirements of low-complication rate, fast wound ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-009-0530-2
更新日期:2009-12-01 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:The aim of this study is to underscore the incidence of synchronous polyps in patients with colorectal cancer and to emphasise the importance of their perioperative detection and management. PATIENTS AND METHODS:Three hundred and seven patients underwent a potentially curative resection for colorectal cance...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0117-x
更新日期:2004-11-01 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::Advancements in the medical treatment of Crohn's disease have reduced the need for surgery. The indications for surgery include the failure of medical management, especially the persistence or worsening of symptoms in spite of proper treatment and complications of the disease process. These complications include intes...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0728-y
更新日期:2011-10-01 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::This article describes the operative technique that my colleagues and I apply to total mesorectal excision in patients with rectal cancer. A body of data support improvement of short-term outcomes over open resection. Although long-term data remain scarce, several ongoing trials may clarify this deficiency. The approp...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-012-0932-4
更新日期:2013-02-01 00:00:00
abstract:BACKGROUND:The aim of this report is to describe our experience with stapled haemorrhoidopexy as a day surgery procedure. METHODS:From January 2000 to January 2003, a total of 214 patients with third- and fourth-degree haemorrhoids underwent stapled haemorrhoidopexy under spinal anaesthesia. We analysed early postoper...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-003-0029-1
更新日期:2003-10-01 00:00:00
abstract:BACKGROUND:There are different open healing and primary closure approaches for chronic pilonidal sinus (CPD) that differ in principles and extension. AIMS:To compare the results of different closure surgical techniques, we performed a meta-analysis of randomized controlled trials (RCT) comparing: (1) open wide excisio...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,meta分析
doi:10.1007/s10151-014-1149-5
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:Iatrogenic ureteral injury (IUI) following abdominal surgery has a relatively low incidence, but is associated with high risks of morbidity and mortality. Conventional assessment of IUI includes visual inspection and palpation. This is especially challenging during laparoscopic procedures and has translated ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-019-01973-4
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Perineal wound complications are frequently observed after abdominoperineal resection (APR) for rectal cancer, especially in preoperatively irradiated patients. This is the first study to investigate whether local application of gentamicin-impregnated collagen fleece reduces deep perineal wound infection aft...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-008-0440-8
更新日期:2008-12-01 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:Permacol™ collagen paste, an acellular crosslinked porcine dermal collagen matrix suspension, is a new treatment option for anal fistula. Data remain limited, however, and as yet only the results of one case of Crohn's fistula treated with Permacol™ paste has been reported. The aim of this study was to asses...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-019-01932-z
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to investigate the role of confocal laser endomicroscopy (CLE) in the assessment of disease activity in ulcerative colitis (UC). METHODS:Consecutive patients with UC referred to our inflammatory bowel disease unit for colonoscopy were enrolled. Patients without UC were used as cont...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-017-1654-4
更新日期:2017-07-01 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::The purpose of this systematic review was to compare the diagnostic ability of blood markers for colorectal cancer (CRC). A systematic review of the literature for diagnostic blood markers for primary human colorectal cancer over the last 5 years was performed. The primary outcome was to assess the diagnostic ability ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-018-1820-3
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Transanal intersphincteric resection (ISR) was introduced and has been increasingly performed as an ultimate surgical treatment for extremely low rectal cancer. We considered that high quality and less invasive surgery could be achieved if ISR and laparoscopic surgery were combined. METHODS:Between December...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-006-0243-8
更新日期:2006-03-01 00:00:00
abstract:BACKGROUND:Liver metastases from colorectal cancer are treatable and potentially curable when hepatic resection is applied. This paper is to illustrate surgical treatment of metastatic colorectal cancer in China. PATIENTS AND METHODS:Between January 1993 and December 2002, 485 patients with colorectal liver metastases...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10151-004-0109-x
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:This prospective randomized trial was used to compare two different local anesthetic techniques, local perianal anesthesia and pudendal nerve block, used for harmonic scalpel hemorrhoidectomy (HSH). METHODS:A total of 120 patients with grade III or IV hemorrhoids were randomly chosen to perform HSH (60 pati...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10151-010-0614-z
更新日期:2010-11-01 00:00:00
abstract:BACKGROUND:Ileal pouch-anal anastomosis (IPAA) for ulcerative colitis(UC) can be performed as either 2- or 3-stage procedure. IPAA in the elderly has been reported as safe and feasible, but little work to date has assessed outcomes by procedure. The aim of our study was to assess use and short-term outcomes of 2- and 3...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02327-1
更新日期:2020-08-16 00:00:00
abstract:BACKGROUND:Fibre is often recommended as the first-choice treatment but its effects can be uneven. The aim of the study was to compare the clinical efficacy and tolerability of fibre versus lactulose in outpatients with chronic constipation. METHODS:In a prospective randomized crossover trial, patients were randomized...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,随机对照试验
doi:10.1007/s10151-006-0262-5
更新日期:2006-07-01 00:00:00
abstract:BACKGROUND:A prospective randomized trial to assess the cleansing ability and tolerance of bowel preparations for colonoscopy was conducted in a group of 953 patients. METHODS:The bowel cleansing methods were: sennoside calcium, polyethylene glycol (PEG) lavage, oral sodium phosphate (NaP) in one 90-ml dose, oral NaP ...
journal_title:Techniques in coloproctology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/s101510300003
更新日期:2003-04-01 00:00:00
abstract::Hepatic resection for colorectal liver metastases remains the only therapeutic option that improves long-term survival and offers potential cure. By conventional resectability criteria, only a limited number of patients with metastatic disease can be subjected to surgical intervention. In the past decade, better under...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0750-0
更新日期:2011-10-01 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:Foramen needle electrode placement for percutaneous nerve evaluation (PNE) is currently carried out while observing the somatic motor response. This study investigated electrode placement while observing the autonomic as well as the somatic response. METHODS:A consecutive series of ten patients (seven women...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-014-1160-x
更新日期:2014-08-01 00:00:00
abstract:PURPOSE:To compare patient quality of life (QoL) and short-term surgical outcomes between robotic anterior resection (r-AR) and laparoscopic (l-AR) approach. METHODS:Consecutive patients having undergone either robotic or laparoscopic AR for adenocarcinoma were studied. All operations were performed by two surgeons ex...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-017-1631-y
更新日期:2017-05-01 00:00:00
abstract::Intussusception of the appendix is a rare condition. We present the case of a 72-year-old woman with multiple polyps in the colon with an appendix completely intussuscepted into a polyp within the caecum. The clinical features, preoperative diagnosis, classification and treatment of this condition are discussed with r...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0068-2
更新日期:2004-08-01 00:00:00
abstract::Ischemic injury to the bowel is a disease entity that has a wide spectrum of pathological and clinical findings. Patients with chronic ischemia present with colicky abdominal pain, obstructive symptoms and signs of ischemic colonic stricture. We reported the first case of ischemic colitis arising from a superior recta...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0712-6
更新日期:2013-06-01 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