检索结果-南通市图书馆

Colorectal polyps and polyposis syndromes

Gastroenterology Report 2014年第1期2卷 1-15页

作者： Noam Shussman steven d.wexner department of Colorectal Surgery Cleveland Clinic FloridaWestonFLUSA

A polyp is defined as any mass protruding into the lumen of a hollow viscus.Colorectal polyps may be classified by their macroscopic appearance as sessile(flat,arising directly from the mucosal layer)or pedunculated(extending from the mucosa through a fibrovascular stalk).Colorectal polyps may also be histologically classified as neoplastic or as non-neoplastic(hyperplastic,hamartomatous,or inflammatory).The neoplastic polyps are of primary importance because they harbor a malignant potential,which represents a stage in the development of colorectal cancer.For this reason,it is essential to identify these polyps at a sufficiently early stage,when a simple outpatient procedure to remove them can interrupt the development of colorectal cancer and prevent disease and death.When invasive carcinoma arises in a polyp,careful consideration must be given to ensuring the adequacy of treatment.Although most neoplastic polyps do not evolve into cancer,it is well accepted that the majority of colorectal carcinomas evolve from adenomatous polyps;the sequence of events leading to this transformation is referred to as the adenoma-to-carcinoma sequence.The presence of a systemic process that promotes the development of multiple gastro-intestinal polyps is termed‘polyposis’.Hereditary gastro-intestinal polyposis syndromes account for approximately 1%of all cases of colorectal cancer and are associated with a broad spectrum of extra-colonic tumors.Early detection and accurate classification of these syndromes are essential,in order to initiate a surveillance program for the early detection of cancer.Several polyposis syndromes have been described,each having its own genetic basis and characteristic polyp distribution,clinical presentation,and malignancy risk.diagnostic modalities and treatment options for neoplastic polyps-as well as the most prevalent polyposis syndromes-are reviewed below.

关键词： colonic polyps polyposis screening

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

COVId-19疫情期间胃肠外科实践策略

引用

Gastroenterology Report 2020年第3期8卷 175-176,I0001页

作者： steven d.wexner department of Colorectal Surgery Cleveland Clinic FloridaWestonFLUSA

The entire focus of the world has rapidly shifted to the COVId-19 pandemic.Virtually all headlines in print and visual lay media,as well as lead articles in peer-reviewed scientific journals,delve into COVId-19-related issues.Within the world of surgery,information sharing amongst surgeons has helped to define best practices.The rapidity with which this high volume of information is being shared is attestation to the seemingly infinite need for opinions,answers,and especially data.In the absence of a significant body of high-quality data,among the various publications are a plethora of guidelines from organizations,societies,and individual surgical groups.Realizing the dearth of evidence upon which to formulate guidelines,the various publications have included either personal or institutional experiences often in the form of registries or databases or expert consensus-based guidelines[1-5].The manuscript in this edition of Gastroenterology Report by Ke and coworkers[6]offers guidance from,in the authors’words,‘the front-line Chinese GI surgeons’to help the rest of the world to deal with COVId-19.The authors included a myriad of useful information including overall strategies based upon the local establishment of a task force,risk stratification of patients,recommendations for infection prevention in the department of surgical gastroenterology,recommendations for the management of both gastrointestinal(GI)surgery and endoscopy,reflections on perioperative infection-control measures,post-discharge follow-up,and considerations relative to adjuvant chemotherapy.

关键词：实践策略 prevention COV

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

结直肠癌微创手术的重新评价与思考

引用

Gastroenterology Report 2017年第1期5卷 1-10,I0001页

作者： Mahmoud Abu Gazala steven d.wexner department of Colorectal Surgery Cleveland Clinic FloridaWestonFLUSA

纵观整个外科史,外科医师一直在努力优化外科术式,减少手术创伤。过去30年间,随着新技术和新术式的开展,结直肠微创手术取得了巨大的进展。腹腔镜手术已显示出等同于甚至优于开放术式的治疗效果。而且,腹腔镜手术已经突破了传统的界限,... 详细信息

纵观整个外科史,外科医师一直在努力优化外科术式,减少手术创伤。过去30年间,随着新技术和新术式的开展,结直肠微创手术取得了巨大的进展。腹腔镜手术已显示出等同于甚至优于开放术式的治疗效果。而且,腹腔镜手术已经突破了传统的界限,衍生出单孔腹腔镜、经自然腔道内镜手术及机器人手术等新的微创术式。本文回顾了微创手术的发展历程,并对目前各种结直肠微创术式进行了评价。

关键词：结肠癌直肠癌微创手术腹腔镜机器人手术经肛全直肠系膜切除术经自然腔道标本取出

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

使用球囊扩张器取出结肠镜检查过程中掉落的AmpliEYE

引用

Gastroenterology Report 2019年第2期7卷 139-140,I0002页

作者： Jihui Li Luke Blake steven d.wexner department of General Surgery Paris Community HospitalParisILUSA department of Colorectal Surgery Cleveland Clinic FloridaWestonFLUSA

AmplifEYE can increase the detection rate of adenomatous polyps and stabilize the mucosa for easy biopsy and polypectomy.But it can also become a foreign body when it is dislodged during the procedure.We report a case... 详细信息

关键词： colonoscopy AmplifEYE foreign-body retrieval balloon dila

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Postoperative ileus in colorectal surgery:is there any difference between laparoscopic and open surgery?

引用

Gastroenterology Report 2013年第2期1卷 138-143页

作者： Mehdi Fesharakizadeh diana Taheri Shahaboddin dolatkhah steven d.wexner Faculty of Medicine Islamic Azad UniversityNajaf Abad BranchIsfahanIran department of Colorectal Surgery Cleveland Clinic FloridaWestonFloridaUSA department of Pathology Faculty of MedicineIsfahan University of Medical SciencesIsfahanIran Medical student Faculty of MedicineIsfahan University of Medical SciencesIsfahanIran

Background:Postoperative ileus is a major complication of patients undergoing abdominal surgery.The purpose of this study was to determine the effects of operative time and the method of surgery on postoperative ileus.Methods:After institutional review board approval,121 patients were studied in two groups.Group 1 consisted of 86 patients with colorectal cancers and Group 2 included 35 patients with diverticulitis.Various surgical procedures were performed in both groups.In all patients,the nasogastric(NG)tube was removed after termination of surgery.Clear liquids were offered commencing on the first postoperative day,followed by a regular diet as tolerated.GI-1 was the postoperative time to toleration of clear liquids,whereas GI-2 was the postoperative time to first bowel movement or flatus and toleration of a regular diet.Statistical analysis was performed using a linear regression model by disease with the first bowel movement or flatus as the dependent variable and operative time and category as explanatory variables.Results:Vomiting after oral feeding occurred in 18(20.9%)patients with cancer and in 7(20.0%)patients with diverticular disease.An NG tube was reinserted in 13(15.1%)patients in the cancer group and in 3(8.6%)patients in the diverticular disease group.In patients with cancer,the duration of operation was associated with GI-2(P=0.011),whereas in patients with diverticulitis,the duration of operation was associated with GI-1(P=0.001)and GI-2(P=0.044).In the diverticulitis group,a significant relationship was found between GI-2 and operative category(P=0.03).Conclusion:Longer operations led to more prolonged postoperative ileus after both laparoscopy and laparotomy,regardless of malignant or benign pathology.In anticipation of and/or following longer operations,surgeons should consider measures to shorten postoperative ileus.

关键词： outcomes postoperative complication colorectal surgery laparoscopic surgery open surgery ileus

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

再次括约肌成形术:效果能长久吗?

引用

Gastroenterology Report 2016年第1期4卷 39-42,I0002页

作者： Kwangdae Hong Giovanna dasilva John T.dollerschell david Maron steven d.wexner department of Colorectal Surgery Cleveland Clinic FloridaWestonFLUSA

目的:本研究旨在调查再次括约肌成形术(RS)患者的长期结局。方法:利用一个前瞻性数据库对1988年11月至2011年12月间接受RS手术的排便失禁患者进行回顾性分析。通过问卷和电话调查进行克利夫兰临床排便失禁评分(CCFFIS,0分最佳,20分最差... 详细信息

目的:本研究旨在调查再次括约肌成形术(RS)患者的长期结局。方法:利用一个前瞻性数据库对1988年11月至2011年12月间接受RS手术的排便失禁患者进行回顾性分析。通过问卷和电话调查进行克利夫兰临床排便失禁评分(CCFFIS,0分最佳,20分最差)和排便失禁生活质量评分(FIQoL,4.1分最佳,1分最差)。手术成功定义为截至末次随访未进一步行排便手术、无造口且CCFFIS评分<9。计量资料的比较采用Wilxoxon和Mann-Whitney U检验。采用双元逻辑回归分析来确定手术成功的预测因素。结果:84例患者接受RS手术,其中56例(66.7%)获得74月的中位随访(12-283月)。末次随访时,平均CCFFIS评分由16.563.7下降至11.966.6(P<0.001)。12例(21.4%)患者接受后续便秘手术,3例(5.4%)进行了永久性造口,判定为手术失败。随访结束时,18例(32.1%)患者CCFFIS评分<9,16例获得长期成功。24例患者接受了FIQoL评分,平均2.6分(1.04.1分)。术后CCFFIS评分与FIQoL显著负相关(Spearman相关系数为0.854,P<0.001)。逻辑回归分析并没有发现任何预测RS成功的临床参数。结论:基于我们的成功标准,RS手术的长期成功率(中位随访时间74月)并不理想。

关键词：排便失禁再次括约肌成形术长期结局

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

aTME:走向繁荣还是中途夭折?

引用

Gastroenterology Report 2020年第1期8卷 1-4,I0001页

作者： Liang Kang Patricia Sylla Sam Atallah Massaki Ito steven d.wexner Jian-Ping Wang department of Colorectal Surgery Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesThe Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongP.R.China division of Colon and Rectal Surgery Department of SurgeryIcahn School of Medicine at Mount SinaiNew YorkNYUSA The College of Medicine Endo-Surgical Center of FloridaDepartment of Colorectal SurgeryFlorida HospitalOrlandoFLUSA Colorectal and Pelvic Surgery division Department of Surgical OncologyNational Cancer Center Hospital EastKashiwaChibaJapan department of Colorectal Surgery Cleveland Clinic FloridaWestonFLUSA

Since Sylla et al.[1]introduced transanal total mesorectal excision(taTME)in 2010,there has been rapid global uptake of this approach,predicated upon the postulated advantage of improved visualization of and access to the deep pelvic anatomy.This approach has been proposed for locally adries have demonstrated the procedural safety and short-and long-term oncologic adequacy of taTME in carefully selected patients,when performed by experienced high-volume taTME surgeons[1–7].

关键词： anatomy carefully experienced

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Surgical outcomes and their relation to the number of prior episodes of diverticulitis

引用

Gastroenterology Report 2013年第1期1卷 64-69页

作者： Shota Takano Cesar Reategui Giovanna da Silva david J.Maron steven d.wexner Eric G.Weiss department of Colorectal Surgery Cleveland Clinic FloridaWestonFLUSA

Purpose:We aimed to investigate the relationship between the number of prior episodes of diverticulitis and outcomes of sigmoid colectomy.Methods:After institutional review board approval,a retrospective review was undertaken based on records of patients who underwent sigmoid resection with anastomosis for diverticulitis between 4 May 2007 and 29 February 2012.Patients were divided into two groups:0–3 attacks(group 1)and4 attacks(group 2).Statistical analyses were performed to determine whether the groups differed on demographic,intra-operative and postoperative variables.Results:We identified 247 patients who underwent sigmoid colectomy for diverticulitis(45 open,202 laparoscopic).The two groups did not differ significantly in age,gender,American Society of Anesthesiologists score,past surgical history,body mass index,length of stay,use of a stoma or number of prior hospitalizations for diverticulitis.Group 1 had a higher rate of abscesses(30.6 vs 6.8%,Pd fistulas(19.4 vs 0.9%,Pd higher rates of postoperative complications(45.8 vs 23.3%,Pd conversion(17.1 vs 4.4%,P=0.0091).The most common surgical complications in groups 1 and 2 were wound infection(35 vs 10)and ileus(20 vs 8).Based on multivariate regression analysis,4 attacks were independently correlated with a lower complication rate(odds ratio=0.512,95%confidence interval=0.266–0.987,P=0.046).Conclusions:Patients who had4 previous attacks of diverticulitis had fewer postoperative complications.

关键词： diverticulitis sigmoidectomy numbers of prior attacks

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

New Therapies for Fecal Incontinence

New Therapies for Fecal Incontinence

引用

2006·中国（南京）肛肠外科国际论坛

作者： steven d.wexner Cleveland Clinic Florida

＜正＞Patients with severe fecal incontinence unresponsive to conservative measures can be divided into 2 broad categories of surgical approach.The first group includes those patients with an identifiable anatomic sphincter defect who can expect 40-60%long-term surgical success rate with overlapping sphincteroplasty. The absence of pudendal neuropathy yields the best outcome in these patients.The second group includes

关键词：

来源： cnki会议评论

在线全文

cnki会议

学校读者我要写书评

暂无评论

A consensus document on bowel preparation prior to colonoscopy

A consensus document on bowel preparation prior to colonosco...

引用

2006·中国（南京）肛肠外科国际论坛

作者： steven d.wexner david E.Beck Todd H.Baron Robert d.Fanelli Neil Hyman Kevin Wasco Task Force Chair ASCRS ASGE SAGES

＜正＞Colonoscopy is the current standard method for evaluation of the colon.diagnostic accuracy and therapeutic safety of colonoscopy depends on the quality of the colonic cleansing or preparation.The ideal preparation for colonoscopy would reliably empty the colon of all fecal material in a rapid fashion with no gross or histologic alteration of the colonic mucosa.The preparation would also not cause any patient discomfort

关键词：

来源： cnki会议评论

在线全文

cnki会议

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：