Abstract：
PURPOSE:Ileal pouch-anal anastomosis (IPAA) has been established as the procedure of choice for patients who require excision of the colon and rectum for familial adenomatous polyposis and ulcerative colitis. The requirement for proximal stomal diversion in IPAA is controversial. OBJECTIVES:To compare post-operative outcomes following IPAA with and without proximal diversion. METHODS:Computerised literature search, of Ovid MEDLINE and EMBASE. Full-text comparative studies published between 1992 and 2019, in English language and on adult patients. Ileal pouch-anal anastomosis with or without proximal stomal diversion following proctocolectomy. Outcome measures were anastomotic leak, anastomosis strictures, re-operations, pouch failure, intra-abdominal sepsis, small bowel obstruction/ileus and mortality. RESULTS:Five hundred and forty-six studies were screened. Fourteen relevant studies included 4973 cases (1832 patients with no stomas vs 3141 with stomas). Anastomotic strictures (p ≤ 0.0001 OR 0.40; 95% CI (0.26-0.62)) and pouch failures (p = 0.003 OR 0.54; 95% CI (0.36-0.82)) were higher in diverted than non-diverted patients. Re-operation was more frequently required in non-diverted patients (p = 0.02 OR 2.51; 95% CI (1.12-5.59)). Heterogeneity was low in 5 out of 7 variables. CONCLUSION:In selected patients, diversion-free IPAA is a safe procedure associated with lower anastomotic stricture and pouch failure rates than diverted IPAA. This appears to occur at the expense of a higher re-operation rate. An RCT is required to help define the selection criteria.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Khan K,Manzoor T,Khan S,Hartley JEdoi
10.1007/s00384-020-03814-5subject
Has Abstractpub_date
2021-01-04 00:00:00eissn
0179-1958issn
1432-1262pii
10.1007/s00384-020-03814-5pub_type
杂志文章,评审abstract：:Continence following the gracilis stimulated neosphincter reconstruction after total rectal excision is inferior to that obtained in the presence of an intact anal canal. We describe a modification of the alpha loop in which the tendon is brought through the belly of the gracilis muscle. The results in three patients ...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/BF00292246
更新日期：1994-01-01 00:00:00
abstract：PURPOSE:Functional constipation in children and adolescents is a common and invalidating condition. In a minority of patients, symptoms persist despite optimal conservative therapy. The aim of this study was to evaluate whether the short-term effects of sacral neuromodulation (SNM) in children and adolescents with cons...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-016-2604-8
更新日期：2016-08-01 00:00:00
abstract：INTRODUCTION:Intestinal adenosquamous carcinoma (ASC) is a rare colorectal neoplasm frequently occurring at onset as a locally advanced disease with distant metastases. The liver is the most common site of metastasis, followed by the peritoneum and the lung. Cutaneous metastases from usual colorectal adenocarcinoma occ...
journal_title：International journal of colorectal disease
pub_type：
doi：10.1007/s00384-019-03464-2
更新日期：2020-02-01 00:00:00
abstract：AIMS:This study assesses the value of endorectal ultrasound (ERUS)-directed biopsy in detecting local recurrence of rectal cancer. METHODS:We reviewed the records of patients undergoing ERUS by a single surgeon for surveillance after treatment of rectal adenocarcinoma. Lesions suggestive of local recurrence underwent ...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-005-0785-7
更新日期：2006-04-01 00:00:00
abstract：PURPOSE:For rectal neuroendocrine tumors (NETs) ≤ 10 mm, endoscopic resection is a standard treatment. However, there is no consensus whether additional surgery should be performed for patients at risk of lymph node metastasis (LNM) after endoscopic resection. The purpose of this study was to analyze the results of end...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-020-03826-1
更新日期：2021-01-02 00:00:00
abstract：BACKGROUND AND AIMS:Anastomotic dehiscence following colorectal surgery is a significant cause of morbidity and mortality. Phenytoin has wound-healing promoting and collagenase inhibitory effects. This study assessed these effects on healing of experimental colonic anastomoses in a rat model. MATERIALS AND METHODS:Nin...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-003-0533-9
更新日期：2004-05-01 00:00:00
abstract：INTRODUCTION:A simple quality of life questionnaire was designed to triage patients with faecal incontinence to the most appropriate level of support, investigation and treatment. METHOD:A questionnaire was developed to include a 'symptom' score, similar in content to St Mark's questionnaire and a 'bothersome' score. ...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-009-0769-0
更新日期：2009-10-01 00:00:00
abstract：BACKGROUND:Laparoscopic resection for the cure of rectal cancer is still a matter of debate. Laparoscopic approach is more complex and with a long learning curve, which may results in an increase in morbidity and mortality. This study aimed to retrospectively analyze the impact of laparoscopic resection for rectal canc...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-009-0789-9
更新日期：2009-12-01 00:00:00
abstract：:Division of the inferior mesenteric artery flush with the aorta (high tie) allows a tension-free anastomosis in distal colorectal resections but may also diminish the blood supply. Tissue oxygen tension was measured proximal to the resection margin before and after either low or high division of the inferior mesenteri...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/BF00337583
更新日期：1995-01-01 00:00:00
abstract：PURPOSE:There is scant data assessing the consequences of staging restorative proctocolectomy for ulcerative colitis. The aim of the study is to compare outcomes of initial vs. staged restorative proctocolectomy. METHODS:Patients completing restorative proctocolectomy, including ileostomy reversal, during 2006-2012 we...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-017-2836-2
更新日期：2017-08-01 00:00:00
abstract：BACKGROUND AND AIMS:Reduced fibrinolytic activity of the peritoneum seems to be the main cause of postoperative adhesions. This prospective randomized trial compared the peritoneal fibrinolytic activity between laparoscopic and conventional colorectal resection. METHODS:Parietal peritoneal biopsy specimens were taken ...
journal_title：International journal of colorectal disease
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s00384-002-0391-x
更新日期：2002-11-01 00:00:00
abstract：BACKGROUND:Gastrointestinal cancers belong to the most important causes of cancer death in the Western world. Because cure can be achieved only by complete surgical removal of the tumor, and most patients have metastasis at the time point of diagnosis, the majority of patients receive chemotherapy. DISCUSSION:Indicati...
journal_title：International journal of colorectal disease
pub_type： 杂志文章,评审
doi：10.1007/s00384-003-0496-x
更新日期：2003-11-01 00:00:00
abstract：BACKGROUND:Incomplete polyp resection (IPR) is recognized as a risk factor for interval colorectal cancer (ICC), and is, therefore, an important issue in polypectomy. Cold snare polypectomy (CSP) is a procedure that does not involve electrocautery and has no burn effect. Therefore, there is the possibility that the ris...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-019-03347-6
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND AND AIMS:Pancreatic stellate cells (PSCs) play a key role in the development of pancreatic fibrosis. The molecular mechanisms underlying their activation in response to profibrogenic mediators, however, are largely unknown. Extending previous studies on the transcriptional regulation of PSC activation, we ha...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-003-0565-1
更新日期：2004-09-01 00:00:00
abstract：PURPOSE:Secondary non-response to infliximab (IFX) in patients with Crohn's disease (CD) is so common that prediction of non-response is required to adopt the optimal therapy for an individual patient. METHODS:The clinical model was constructed in a training cohort. Clinical features, serological parameters, and genet...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-020-03679-8
更新日期：2020-11-01 00:00:00
abstract：:Compartment syndrome has been reported in a few cases after prolonged surgery with patients in leg supports. A recent case in our hospital (57-year-old man undergoing cystourethrectomy because of cancer) made us interested in the problem. This case together with six from the literature are analysed. Moreover, the firs...
journal_title：International journal of colorectal disease
pub_type： 杂志文章,评审
doi：10.1007/BF00496140
更新日期：1990-02-01 00:00:00
abstract：PURPOSE:Deterioration of anorectal function after long-course preoperative chemoradiotherapy combined with surgery for rectal cancer is poorly defined. We conducted a prospective study to evaluate the acute and long term effects of preoperative chemoradiotherapy on anorectal function and quality of life of the patients...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-009-0807-y
更新日期：2010-02-01 00:00:00
abstract：PURPOSE:No consensus exists regarding the use of preoperative bowel preparation for patients undergoing a low anterior resection (LAR). Several comparative studies show similar outcomes when a single time enema (STE) is compared with mechanical bowel preparation (MBP). It is hypothesized that STE is comparable with MBP...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-020-03651-6
更新日期：2020-10-01 00:00:00
abstract：BACKGROUND AND AIMS:We investigated expression of E-cadherin, beta-catenin, and c-erbB-2 in gastric cancer to identify molecular factor(s) relevant to development of liver metastasis, which is a frequent cause of mortality in gastric cancer patients. PATIENTS AND METHODS:We analyzed by immunohistochemistry and compare...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-002-0427-2
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to identify clinical and pathological parameters to improve prediction of disease-free survival (DFS) and overall survival (OS) in patients treated with neoadjuvant chemoradiotherapy for rectal cancer. METHODS:Between July 1995 and May 2007, 148 patients with primary rectal ade...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-009-0682-6
更新日期：2009-07-01 00:00:00
abstract：PURPOSE:Malignant bowel obstruction is a complication of colorectal carcinoma or metastasis from other carcinoma, and it causes significant damage on the condition of elderly patients; however, the self-expandable metallic stents (SEMSs) have been effectively used either for palliation or for bridging to the surgical p...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-017-2946-x
更新日期：2018-02-01 00:00:00
abstract：PURPOSE:There is strong evidence supporting the importance of the volume-outcome relationship with respect to lung and pancreatic cancers. This relationship for rectal cancer surgery however remains unclear. We review the currently available literature to assess the evidence base for volume outcome in relation to recta...
journal_title：International journal of colorectal disease
pub_type： 杂志文章,评审
doi：10.1007/s00384-010-1019-1
更新日期：2010-12-01 00:00:00
abstract：BACKGROUND:Ostomies are being placed in 35 % of patients after colorectal cancer surgery. As decision-making regarding colorectal surgery is challenging in the older patients, it is important to have insight in the potential impact due to ostomies. METHODS:An internet-based survey was sent to all members with register...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-016-2665-8
更新日期：2017-01-01 00:00:00
abstract：PURPOSE:Surgical site infections (SSI) cause excess morbidity and mortality in modern surgery. Several different approaches to reduce the incidence of SSI have been investigated with variable results. METHOD:This is to our knowledge the first systematic randomized evaluation in patients undergoing laparotomy in viscer...
journal_title：International journal of colorectal disease
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00384-010-0884-y
更新日期：2010-05-01 00:00:00
abstract：OBJECTIVE:For colorectal screening patients a mean gain of life time was previously calculated of about 30-50 days. Different recommendations for recognising at-risk groups and defining surveillance intervals after an initial finding of colorectal adenomas have been published. However, no benefit-risk analysis regardin...
journal_title：International journal of colorectal disease
pub_type： 杂志文章,meta分析
doi：10.1007/s00384-006-0252-0
更新日期：2007-08-01 00:00:00
abstract：PURPOSE:Although some studies have reported differences in clinicopathological features between left- and right-sided advanced colorectal cancer (CRC), there are few reports regarding early-stage disease. In this study, we aimed to compare the clinicopathological features of left- and right-sided T1 CRC. METHODS:Subje...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-020-03668-x
更新日期：2020-10-01 00:00:00
abstract：BACKGROUND AND AIMS:Colonic diverticulitis shows a high recurrence rate, but the role of faecal markers in predicting recurrence is unknown. The aim of this study was to investigate the role of faecal calprotectin (FC) in predicting recurrence of diverticulitis. PATIENTS/METHODS:A prospective cohort study was performe...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-014-1884-0
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND AND AIM:Concurrent definitive treatment of underlying fistulas from infected anal glands at the time when the anorectal abscesses are drained is controversial as this is associated with a higher incidence of faecal incontinence, failure and recurrence. This meta-analysis was conducted to determine the merits...
journal_title：International journal of colorectal disease
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s00384-005-0060-y
更新日期：2006-09-01 00:00:00
abstract：PURPOSE:A temporary loop stoma is often created after laparoscopic colorectal cancer surgery. Peristomal adhesions may make stoma closure into a complicated operation. We demonstrated how to place the SurgiWrap® adhesion barrier film and evaluated the peristomal adhesion severity and feasibility of stoma closure. METH...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-018-03229-3
更新日期：2019-03-01 00:00:00
abstract：PURPOSE:The purposes of this study were to assess the working definition of a colorectal anastomotic leak among colorectal surgeons and to survey the current approach to investigation and management of a patient with a suspected anastomotic leak. METHODS:Online survey consisting of nine questions regarding the definit...
journal_title：International journal of colorectal disease
pub_type： 杂志文章
doi：10.1007/s00384-013-1640-x
更新日期：2013-07-01 00:00:00
