Abstract:
BACKGROUND:In the United States, colorectal cancer (CRC) screening and surveillance is recommended until age 75. However, rates of surgery for CRC are greatest in the elderly, questioning current guidelines. Tumor sidedness is an emerging prognostic marker that may help guide screening and treatment decisions, with specific benefit evaluating CRC anatomic distribution in the elderly. Our objective was to investigate the anatomical distribution of CRC in the elderly and factors associated with right-sidedness. METHODS:The National Cancer Database (2004-2016) was used to identify elderly patients with CRC. Cases were stratified by tumor sidedness and elderly subgroups: 65-74, 75-84, and ≥ 85 years of age, and further categorized by primary site. Multivariate analysis identified factors associated with CRC right-sidedness. The outcomes were CRC sidedness in the elderly, the anatomic distribution by age group, and factors associated with right-sidedness. RESULTS:There were 508,219 colorectal cancer patients aged over 65 years identified, 54% of whom had a right-sided cancer. The right-sided incidence rates by age group were 49% (65-74 years), 58.2% (75-84 years), and 65.9% (≥ 85 years) (p < 0.001). Variables associated with right-sidedness were age (OR 1.032; 95% CI 1.031-1.033; p < 0.001), female sex (OR 1.541; 95% CI 1.522-1.561; p < 0.001), Medicare (OR 1.023, 95% CI 1.003-1.043; p = 0.027), year of diagnosis ≥ 2010 (OR 1.133; 95% CI 1.119-1.147; p < 0.001), tumor size > 5 cm (OR 1.474; 95% CI 1.453-1.495; p < 0.001), pathologic stage IV (OR 1.036; 95% CI 1.012-1.060; p = 0.003). CONCLUSIONS:We found higher rates of right-sided colon cancer in the 75 and above age group. This is a population who would benefit greatly from a high-quality and complete colonoscopy for early diagnosis. As screening and surveillance for this age group are not currently recommended, our findings question the lack of universal recommendation of colonoscopy in patients over 75 years old. Guidelines for CRC screening and surveillance should consider the colon cancer right-shift in the elderly population. Based on these results, we recommend thorough assessment of the proximal colon in the elderly.
journal_name
Tech Coloproctoljournal_title
Techniques in coloproctologyauthors
Reif de Paula T,Simon HL,Profeta da Luz MM,Keller DSdoi
10.1007/s10151-020-02329-zsubject
Has Abstractpub_date
2020-08-27 00:00:00eissn
1123-6337issn
1128-045Xpii
10.1007/s10151-020-02329-zpub_type
杂志文章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:BACKGROUND:Pelvic exenteration remains a viable and effective treatment option for the management of locally advanced or recurrent pelvic malignancy. The aim of this study was to present an early experience of robotic multivisceral resection of pelvic malignancy, and to compare this experience with similar series throu...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-020-02290-x
更新日期:2020-11-01 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::We report a new method of performing single-port laparoscopic surgery for appendiceal mucocele. The key points of our technique are placing a 3/4 circumferential skin incision with multiple radial splits on the confine of the umbilicus, use of a "home-made" multichannel port system, and trimming the skin incision stra...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-011-0695-3
更新日期:2011-09-01 00:00:00
abstract::Turnbull and Cutait described abdominoperineal pull-through followed by delayed coloanal anastomosis (DCA) in 1961. DCA could reduce anastomotic leaks, pelvic morbidity and use of stomas. Strong evidence about its clinical benefits is still lacking. This systematic review examined the clinical outcomes of DCA for the ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-014-1132-1
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:Various sequelae which might lead to reintervention have been described after stapled rectal mucosectomy for hemorrhoids. One potential treatment modality for persistent complaints after stapled hemorrhoidopexy (SHP) or stapling for rectocele is the so-called agraffectomy (removal of the retained staples). T...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-011-0704-6
更新日期:2011-09-01 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::Despite improvements in medical therapy, the annual high mortality rate from end-stage heart failure continues. Although cardiac transplantation is a successful treatment for these patients, the shortage of donor hearts has led surgeons to seek other options. Ventricular assist device (VAD) technology is applied to a ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-007-0365-7
更新日期:2007-09-01 00:00:00
abstract:INTRODUCTION:Colorectal transport in idiopathic fecal incontinence has scarcely been studied, and it remains to be investigated in patients with fecal incontinence and anal sphincter lesion. The aim of the present study was to compare colorectal transport during defecation in patients with idiopathic fecal incontinence...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-010-0652-6
更新日期:2011-03-01 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::Anal fissure management has rapidly progressed in the last 15 years as our understanding of fissure pathophysiology has developed. All methods of treatment aim to reduce the anal sphincter spasm associated with chronic anal fissures. Surgical techniques have been used for over 100 years with success. Lateral internal ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-007-0355-9
更新日期:2007-09-01 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::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::Stapled hemorrhoidopexy is an alternative method to conventional surgical procedures for third-degree hemorrhoids. It has many advantages such as less pain, faster recovery and earlier return to work. Nevertheless, many reports mentioned the persistence of postoperative pain, hemorrhage, recurrence, sphincter injury, ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-005-0236-z
更新日期:2005-12-01 00:00:00
abstract::Retained rectal foreign body is not an uncommon condition, but reliable epidemiological data are not available. The diagnosis and management can present a significant challenge due to delayed presentation and the reluctance of the patients to provide details of the incident. The aim of the clinical evaluation is to id...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-012-0899-1
更新日期:2013-02-01 00:00:00
abstract::There is still no clear consensus about surgical treatment of anal fistulas. Fistulotomy or fistulectomy and primary sphincter reconstruction is still regarded with skepticism. The aim of this systematic review was to evaluate the evidence in the literature supporting the use of this technique in the treatment of comp...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
doi:10.1007/s10151-015-1323-4
更新日期:2015-07-01 00:00:00
abstract:PURPOSE:This study was performed to determine impact of open and hand-assisted colorectal resection on surgical site infection (SSI) rates. METHODS:National Surgical Quality Improvement Project data from 2006 to 2008 were supplemented with an institutional review board-approved chart review. Primary endpoint was SSI r...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1066-z
更新日期:2014-04-01 00:00:00
abstract:BACKGROUND:Epidemiological studies in Western countries have documented an increase of hospitalizations for acute diverticulitis (AD) but Italian evidence is scarce. The aim of the present study was to analyse the trend in hospitalization for AD, including in-hospital mortality, in Italy from 2008 to 2015. METHODS:Thr...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-018-1840-z
更新日期:2018-08-01 00:00:00
abstract:BACKGROUND:In theory, perioperative detection of lymph nodes with the injection of isosulfan blue dye should provide lymph road mapping (LRM) able to direct the resection. However, there is no supporting evidence for this theory in cases of colon cancer. We reanalysed all operative reports using the sentinel lymph node...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-010-0603-2
更新日期:2010-09-01 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: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: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:BACKGROUND:Anastomotic leak after rectal surgery is reported in 9% (range 3-28%) of patients. The aim of our study was to evaluate the effectiveness of endosponge therapy for anastomotic. Endpoints were the rate of restored continuity and the functional bowel outcome after anastomotic leakage. METHODS:This was a multi...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,多中心研究
doi:10.1007/s10151-019-02007-9
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Achieving full recovery after colorectal cancer surgery means a return to normal physical and psychological health and to a normal social life. Recovery data focusses on time to discharge rather than longer term functionality including return to work (RTW). We aim to assess return to normal holistic function...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-014-1232-y
更新日期:2014-12-01 00:00:00
abstract::We describe obliteration of the rectal lumen during stapled haemorrhoidopexy in a patient with marked mucosal prolapse. The complication was recognised immediately and continuity was restored by performing a limited Delorme's procedure. The possible cause of this complication is explored and serves as a reminder that ...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-007-0382-6
更新日期:2007-12-01 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::Recto-urinary, recto-vaginal and ileo-anal pouch-associated fistulae are rare yet a significant clinical problem due to their profound impact on patients' quality of life and are a challenge to repair. In this report, we describe repair of these complex fistulae using a modified trans-sphincteric posterior sagittal ap...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-012-0917-3
更新日期:2014-02-01 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:In Western countries, the incidence of acute diverticulitis (AD) is increasing. Patients with uncomplicated diverticulitis can undergo a standard antibiotic treatment in an outpatient setting. The aim of this systematic review was to assess the safety and efficacy of the management of acute diverticulitis in...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,meta分析
doi:10.1007/s10151-018-1919-6
更新日期:2019-02-01 00:00:00
abstract::Prolapse is a common complication in patients with a transverse loop colostomy. In most cases, the prolapse can be managed conservatively awaiting time for closure eventually. However, loop stoma may also be intentionally permanent or the patient may be too fragile to have the colostomy closed and in these cases a lap...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-004-0051-y
更新日期:2004-03-01 00:00:00