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Minimally invasive surgery for rectal cancer: Are we there yet?

World Journal of Gastroenterology 2011年第7期17卷 862-866页

作者： bradley J champagne Rohit Makhija Division of Colorectal Surgery University Hospitals Case Medical Center Cleveland OH 44106United States Laparoscopic Colorectal Fellow University Hospitals Case Medical Center Cleveland OH 44106 United States

Laparoscopic colon surgery for select cancers is slowly evolving as the standard of care but minimally invasive approaches for rectal cancer have been viewed with significant skepticism. This procedure has been performed by select surgeons at specialized centers and concerns over local recurrence, sexual dysfunction and appropriate training measures have further hindered widespread acceptance. Data for laparoscopic rectal resection now supports its continued implementation and widespread usage by expeienced surgeons for select patients. The current controversies regarding technical approaches have created ambiguity amongst opinion leaders and are also addressed in this review.

关键词：直肠癌手术性功能障碍培训措施腹腔镜切除术医生结肠

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Impact of a Pharmacist Implemented Protocol on Overall Use of Alvimopan （Entereg） and Length of Stay in Laparoscopic Colorectal Surgeries

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Journal of Pharmacy and Pharmacology 2016年第10期4卷 521-525页

作者： Halle M. Orlinski Rachana R. Patel bradley J. champagne Joseph A. Trunzo Karen L. Kier University Hospitals St. John Medical Center Westlake Ohio 44145 USA

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Endoscopy and polyps-diagnostic and therapeutic advances in management

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World Journal of Gastroenterology 2013年第27期19卷 4277-4288页

作者： Scott R Steele Eric K Johnson bradley champagne Brad Davis Sang Lee David Rivadeneira Howard Ross Dana A Hayden Justin A Maykel Department of Surgery Madigan Army Medical CenterMadigan Health SystemTacoma Division of Colon and Rectal Surgery Case Western Reserve Medical Center Department of Surgery University of Cincinnati Division of Colon and Rectal Surgery Weill Cornell Medical College Department of Surgery Huntington Hospital/North Shore-LIJ Health System Department of Surgery Riverview Plaza Riverview Medical CenterRed Bank Department of Surgery Loyola University Health System Division of Colon and Rectal Surgery University of Massachusetts Memorial Medical Center

Despite multiple efforts aimed at early detection through screening, colon cancer remains the third leading cause of cancer-related deaths in the United States, with an estimated 51000 deaths during 2013 alone. The goal remains to identify and remove benign neoplastic polyps prior to becoming invasive cancers. Polypoid lesions of the colon vary widely from hyperplastic, hamartomatous and inflammatory to neoplastic adenomatous growths. Although these lesions are all benign, they are common, with up to one-quarter of patients over 60 years old will develop pre-malignant adenomatous polyps. Colonoscopy is the most effective screening tool to detect polyps and colon cancer, although several studies have demonstrated missed polyp rates from 6%-29%, largely due to variations in polyp size. This number can be as high as 40%, even with advanced (> 1 cm) adenomas. Other factors including sub-optimal bowel preparation, experience of the endoscopist, and patient anatomical variations all affect the detection rate. Additional challenges in decision-making exist when dealing with more advanced, and typically larger, polyps that have traditionally required formal resection. In this brief review, we will explore the recent advances in polyp detection and therapeutic options.

关键词： Polyps Endoscopy Colonoscopy Endoscopic submucosal dissection Endoscopic mucosal resection Quality Combined endoscopic-laparoscopic resection Combined laparoscopic-endoscopic resection Combined endoscopic-laparoscopic surgery

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