Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
-
J. Gastrointest. Surg. · Mar 2012
ReviewPostoperative adjuvant chemotherapy for stage II colorectal cancer: a systematic review of 12 randomized controlled trials.
The impact of postoperative adjuvant chemotherapy on the oncological outcomes for stage II colorectal cancer remains controversial. ⋯ Postoperative adjuvant chemotherapy for stage II colorectal cancer appears to be associated with improved 5-year overall survival and 5-year disease-free survival, and reduction in risk of recurrence.
-
J. Gastrointest. Surg. · Mar 2012
Comparative StudyLaparoscopic ventral rectopexy for internal rectal prolapse using biological mesh: postoperative and short-term functional results.
Laparoscopic ventral mesh rectopexy is a novel procedure to correct internal and external rectal prolapse. Several authors have shown that this approach is safe and improves obstructive defaecation symptoms and faecal incontinence, without inducing new-onset constipation, possible after posterior rectopexy. Over the last decade, as for other procedures, biological meshes are used to correct pelvic floor disorders. Literature data are scant. In this study, we present our experience with this procedure using biological mesh. ⋯ Laparoscopic ventral mesh rectopexy using biological mesh for internal rectal prolapse is safe and effective in ameliorating symptoms of obstructed defaecation and faecal incontinence.
-
J. Gastrointest. Surg. · Mar 2012
Comparative StudyClinical significance of indefinite for dysplasia on pouch biopsy in patients with underlying inflammatory bowel disease.
"Indefinite for dysplasia" (IND) on pouch mucosal biopsy is occasionally reported during routine histopathological evaluation. The natural history and implication of this histologic entity in ileal pouch-anal anastomosis (IPAA) has not been studied. ⋯ Subsequent dysplasia was uncommon in pouch patients with IND. Natural history of pouch IND warrants further long-term investigation.
-
J. Gastrointest. Surg. · Mar 2012
Comparative StudyInternal hernia after gastric bypass: a new and simplified technique for laparoscopic primary closure of the mesenteric defects.
Bowel obstruction due to internal hernia is a well-known complication of laparoscopic Roux-en-Y gastric bypass (LRGB). Increasing evidence supports primary closing of the mesenteric defects, but controversy continues about surgical technique of systematic closure. This paper reviews our experience with internal hernia after LRGB and describes a new method of preemptive closure of the mesenteric defects. ⋯ Internal hernia should be ruled out in patients with previous LRGB and abdominal pain. Our technique for primary closing of the mesenteric defects seems to be safe and is so far promising.
-
J. Gastrointest. Surg. · Feb 2012
Randomized Controlled TrialP.O.P.A. study: prevention of postoperative abdominal adhesions by icodextrin 4% solution after laparotomy for adhesive small bowel obstruction. A prospective randomized controlled trial.
Adhesive small bowel obstruction (ASBO) is an important cause of hospital admission, is associated with significant morbidity and mortality, and therefore is a substantial burden for healthcare systems worldwide. Icodextrin 4% solution (Adept, Shire Pharmaceuticals, UK) is a high-molecular-weight a-1,4 glucose polymer approved in Europe for use as intraoperative lavage and postoperative instillation to reduce the occurrence of post-surgery intra-abdominal adhesions. The present clinical study aimed to evaluate the safety and effectiveness of icodextrin 4% in decreasing the incidence, extent, and severity of adhesions in patients after abdominal surgery for ASBO. ⋯ The data resulting from this RCT showed that the use of icodextrin 4% solution in ASBO is safe and reduces intra-abdominal adhesion formation and the risk of re-obstruction.