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Racial differences in the anatomical distribution of colorectal cancer:a study of differences between American and Chinese patients

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World Journal of Gastroenterology 2003年第4期9卷 721-725页

作者： San-HuaQing Kai-YunRao Hui-YongJiang stevend.wexner NanFangHospital FirstMilitaryMedicalUniversityGuangzhou510515GuangdongProvinceChina DepartmentofColorectalSurgery ClevelandClinicFloridaWestonFlorida33308USA

AIM: To compare the racial differences of anatomical distribution of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution between patients from America (white) and China (oriental).METHODS: Data was collected from 690 consecutive patients in Cleveland Clinic Florida, U.S.A. and 870consecutive patients in Nan Fang Hospital affiliated to the First Military Medical University, China over the past 11years from 1990 to 2000. All patients had colorectal adenocarcinoma diagnosed by histology and underwent ***: The anatomical subsite distribution of tumor,age and gender were significantly different between white and oriental patients. Lesions in the proximal colon (P＜0.001) were found in 36.3 % of white vs 26.0 % of oriental patients and cancers located in the distal colon and rectum in 63.7 % of white and 74 % of oriental patients (P＜0.001). There was a trend towards the redistribution from distal colon and rectum to proximal colon in white males over time, especially in older patients (＞80 years).No significant change of anatomical distribution occurred in white women and Oriental patients. The mean age at diagnosis was 69.0 years in white patients and 48.3 years in Oriental patients (P＜0.001).CONCLUSION: This is the first study comparing the anatomical distribution of colorectal cancers in whites and Chinese patients. White Americans have a higher risk of proximal CRC and this risk increased with time. The proportion of white males with CRC also increased with *** patients were more likely to have distal CRC and developed the disease at a significantly earlier age than white patients. These findings have enhanced our understanding of the disease process of colorectal cancer in these two races.

关键词： Asian Continental Ancestry Group European Continental Ancestry Group Adenocarcinoma Adult Age Distribution Aged Aged, 80 and over China Colonic Neoplasms Colorectal Neoplasms Comparative Study Female Humans Male Middle Aged Rectal Neoplasms Retrospective Studies United States

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结直肠外科肛门直肠手术学 1-1

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丛书名：结直肠肛门手术技巧系列丛书

2014年

作者： stevend.wexner JamesW.Fleshman

本书是包含了腹部及肛门直肠目前所有外科手术的教科书。本书所有的章节均由国际著名专家撰写，并且使用了创新的编写形式。其中有一些技术仍有争议，作者描述了其个人的经验和方法，且按照一个比较规范的格式来编写手术方法，特别是某... 详细信息

ISBN: (纸本)9787308136679

本书是包含了腹部及肛门直肠目前所有外科手术的教科书。本书所有的章节均由国际著名专家撰写，并且使用了创新的编写形式。其中有一些技术仍有争议，作者描述了其个人的经验和方法，且按照一个比较规范的格式来编写手术方法，特别是某些技术需要非常详细、中袋地描述术前准备或术后管理等内容。

关键词：外科手术肛门疾病直肠疾病结肠疾病

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直肠癌手术后的肠道重建

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中国实用外科杂志 2005年第3期25卷 178-180页

作者： stevend.wexner 王汉涛傅传刚 DepartmentofColoreetalSurgeryClevelandClinicFlorida WestonFLUSA33331 不详

1 概述直肠癌仍然是美国和其他发达国家重要的公共健康问题.据美国国立癌症研究所统计,2003年美国有42000例新发直肠癌病例[1].……

关键词：直肠癌手术后肠道新发重建公共健康病例美国发达国家统计

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Treatment strategies in obstructed defecation and fecal incontinence

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World Journal of Gastroenterology 2006年第20期12卷 3168-3173页

作者： Marat Khaikin Steven D wexner Department of Colorectal Surgery Cleveland Clinic Florida WestonFL 33331United States

Obstructed defecation （OD） and fecal incontinence （FI） are challenging clinical problems, which are commonly encountered in the practice of colorectal surgeons and gastroenterologists. These disorders sodally and psychologically distress patients and greatly impair their quality of life. The underlying anatomical and pathophysiological changes are complex, often incompletely understood and cannot always be determined. As a consequence, many medical, surgical, and behavioral approaches have been described, with no panacea. Over the past decade, advances in an understanding of these disorders together with rational and similar methods of evaluation in anorectal physiology laboratories （ARP）, radiology studies, and new surgical techniques have led to promising results. In this brief review, we discuss treatment strategies and recent updates on clinical and therapeutic aspects of obstructed defecation and fecal incontinence.

关键词： Obstructed defecation Fecal incontinence Treatment

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Idiopathic fistula-in-ano

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World Journal of Gastroenterology 2011年第28期17卷 3277-3285页

作者： Sherief Shawki Steven D wexner Department of Colorectal Surgery Cleveland Clinic Florida Department of Surgery Suez Canal University

Fistula-in-ano is the most common form of perineal ***,a fistula includes an internal opening,a track,and an external *** external opening might acutely appear following infection and/or an abscess,or more insiduously in a chronic *** includes control of infection,assessment of the fistulous track in relation to the anal sphincter muscle,and finally,definitive treatment of the *** was the most commonly used mode of management,but concerns about post-fistulotomy incontinence prompted the use of sphincter preserving techniques such as advancement flaps,fibrin glue,collagen fistula plug,ligation of the intersphincteric fistula track,and stem *** descriptive and comparative studies have evaluated these different techniques with variable *** lack of consistent results,level I evidence,or long-term follow-up,as well as the heterogeneity of fistula pathology has prevented a definitive treatment *** article will review the most commonly available modalities and techniques for managing idiopathic fistula-in-ano.

关键词： Anal fistula Seton Fistulotomy Advancement flap Fibrin glue Fistula plug

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Re-appraisal and consideration of minimally invasive surgery in colorectal cancer

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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

Throughout history,surgeons have been on a quest to refine the surgical treatment options for their patients and to minimize operative *** the last three decades,there have been tremendous advances in the field of minimally invasive colorectal surgery,with an explosion of different technologies and approaches offered to treat well-known *** surgery has been shown to be equal or superior to open *** boundaries of laparoscopy have been pushed further,in the form of single-incision laparoscopy,natural-orifice transluminal endoscopic surgery and *** paper critically reviews the pathway of development of minimally invasive surgery,and appraises the different minimally invasive colorectal surgical approaches available to date.

关键词： colon cancer rectal cancer minimally invasive surgery laparoscopy robotic surgery transanal total mesorectal excision natural-orifice specimen extraction

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Current status of laparoscopy for the treatment of rectal cancer

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World Journal of Gastroenterology 2014年第41期20卷 15125-15134页

作者： Noam Shussman Steven D wexner Department of Colorectal Surgery Cleveland Clinic Florida

Surgery for rectal cancer in complex and entails many *** the laparoscopic approach in general and specific to colon cancer has been long proven to have short term benefits and to be oncologically safe,it is still a debatable topic for rectal *** attempt to benefit rectal cancer patients with the known advantages of the laparoscopic approach while not compromising their oncologic outcome has led to the conduction of many studies during the past *** we describe our technique for laparoscopic proctectomy and assess the current literature dealing with short term outcomes,immediate oncologic measures(such as lymph node yield and specimen quality) and long term oncologic outcomes of laparoscopic rectal cancer *** also briefly evaluate the evolving issues of robotic assisted rectal cancer surgery and the current innovations and trends in the minimally invasive approach to rectal cancer surgery.

关键词： Laparoscopy Rectal cancer Minimally invasive surgery Oncological outcomes Short term benefits

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Strategies for the management of gastrointestinal surgery in the COVID-19 pandemic

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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 *** all headlines in print and visual lay media,as well as lead articles in peer-reviewed scientific journals,delve into COVID-19-related *** the world of surgery,information sharing amongst surgeons has helped to define best *** rapidity with which this high volume of information is being shared is attestation to the seemingly infinite need for opinions,answers,and especially *** 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 *** 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 *** 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

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Neutropenic enterocolitis

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World Journal of Gastroenterology 2017年第1期23卷 42-47页

作者： Fabio G Rodrigues Giovanna Dasilva Steven D wexner Department of Colorectal Surgery Cleveland Clinic FloridaWestonFL 33331United States

Neutropenic colitis is a severe condition usually affecting immunocompromised patients. Its exact pathogenesis is not completely understood. The main elements in disease onset appear to be intestinal mucosal injury together with neutropenia and the weakened immune system of the afflicted patients. These initial conditions lead to intestinal edema, engorged vessels, and a disrupted mucosal surface, which becomes more vulnerable to bacterial intramural invasion. Chemotherapeutic agents can cause direct mucosal injury (mucositis) or can predispose to distension and necrosis, thereby altering intestinal motility. This article aims to review current concepts regarding neutropenic colitis’ pathogenesis, diagnosis, and management.

关键词： Neutropenic enterocolitis Neutropenic colitis Immunocompromise Intestinal mucosal injury Neutropenia Intestinal edema Intramural invasion Pathogenesis

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Retrieval of dislodged AmplifEYE using balloon dilator during colonoscopy

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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 *** it can also become a foreign body when it is dislodged during the *** report a case of dislodged AmplifE... 详细信息

关键词： colonoscopy AmplifEYE foreign-body retrieval balloon dila

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