International journal of colorectal disease
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Int J Colorectal Dis · Feb 2018
Randomized Controlled Trial Multicenter Study Comparative StudyNon-inferiority multicenter prospective randomized controlled study of rectal cancer T2-T3s (superficial) N0, M0 undergoing neoadjuvant treatment and local excision (TEM) vs total mesorectal excision (TME).
The standard treatment of rectal adenocarcinoma is total mesorectal excision (TME), in many cases requires a temporary or permanent stoma. TME is associated with high morbidity and genitourinary alterations. Transanal endoscopic microsurgery (TEM) allows access to tumors up to 20 cm from the anal verge, achieves minimal postoperative morbidity and mortality rates, and does not require an ostomy. The treatment of T2, N0, and M0 cancers remains controversial. Preoperative chemoradiotherapy (CRT) in association with TEM reduces local recurrence and increases survival. The TAU-TEM study aims to demonstrate the non-inferiority of the oncological outcomes and the improvement in morbidity and quality of life achieved with TEM compared with TME. ⋯ This study aims to demonstrate the preservation of the rectum after preoperative CRT and TEM in rectal cancer stages T2-3s, N0, M0 and to determine the ability of this strategy to avoid the need for radical surgery (TME).
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Int J Colorectal Dis · Jan 2018
Comparative StudySurgical and oncological outcomes after complete mesocolic excision in right-sided colon cancer compared with conventional surgery: a retrospective, single-institution study.
The aim of the study was whether complete mesocolic excision (CME) with central vascular ligation (CVL) is associated with a survival benefit compared with traditional procedure in right-sided colon cancer. ⋯ Surgical standardization of CME with CVL for right-sided colon cancer is associated with better staging and prognosis, particularly in UICC stage II and III. This study shows that CME is safe and reproducible with acceptable morbidity.
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Int J Colorectal Dis · Dec 2017
Observational StudyProcalcitonin and C-reactive protein as early markers of postoperative intra-abdominal infection in patients operated on colorectal cancer.
The aim of this study was to evaluate the accuracy of serum procalcitonin (PCT) and C-reactive protein (CRP) for early diagnosis of postoperative intra-abdominal infections (PIAI) after elective surgery for colorectal cancer. ⋯ PCT and CRP serum levels are associated with the appearance of PIAI after colorectal cancer surgery, although the positive predictive values were low for both PCT and CRP. However, the negative predictive values were high.
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Int J Colorectal Dis · Dec 2017
Low risk of complications in patients with first-time acute uncomplicated diverticulitis.
First-time acute uncomplicated diverticulitis (AUD) has been considered to have an increased risk of complication, but the level of evidence is low. The aim of the present study was to evaluate the risk of complications in patients with first-time AUD and in patients with a history of diverticulitis. ⋯ The risk for development of complications is low in AUD with no difference between patients with first-time or recurrent diverticulitis. This result strengthens existing evidence on the benign disease course of AUD.
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Int J Colorectal Dis · Dec 2017
Randomized Controlled Trial Multicenter StudyPredictive factors on CT imaging for progression of uncomplicated into complicated acute diverticulitis.
Since outpatient treatment and omitting antibiotics for uncomplicated acute colonic diverticulitis have been proven to be safe in the majority of patients, selection of patients that may not be suited for this treatment strategy becomes an important topic. The aim of this study is to identify computed tomography (CT) imaging predictors for a complicated disease course of initially uncomplicated acute diverticulitis. ⋯ Fluid collections and to a lesser extent the length of the inflamed colon segment may serve as predictive factors on initial CT for a complicated disease course in patients with uncomplicated acute colonic diverticulitis. These findings may aid in the selection of patients not suitable for outpatient treatment and treatment without antibiotics.