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Colonic pouch confers better Bowel Function and similar postoperative outcomes compared to straight anastomosis for low rectal cancer

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World Journal of Gastrointestinal Surgery 2021年第3期13卷 303-314页

作者： Zhen-Zhou Chen Yi-Dan Li Wang Huang Ning-Hui Chai Zheng-Qiang Wei Department of Gastrointestinal Surgery The First Affiliated Hospital of Chongqing Medical UniversityChongqing 400000China Department of Cardiology The Second Affiliated Hospital of Chongqing Medical UniversityChongqing 400000China

BACKGROUND With advancements in laparoscopic technology and the wide application of linear staplers,sphincter-saving procedures are increasingly performed for low rectal cancer.However,sphincter-saving procedures have led to the emergence of a unique clinical disorder termed anterior rectal resection syndrome.Colonic pouch anastomosis improves the quality of life of patients with rectal cancer>7 cm from the anal margin.But whether colonic pouch anastomosis can reduce the incidence of rectal resection syndrome in patients with low rectal cancer is unknown.AIM To compare postoperative and oncological outcomes and Bowel Function of straight and colonic pouch anal anastomoses after resection of low rectal cancer.METHODS We conducted a retrospective study of 72 patients with low rectal cancer who underwent sphincter-saving procedures with either straight or colonic pouch anastomoses.functional evaluations were completed preoperatively and at 1,6,and 12 mo postoperatively.We also compared perioperative and oncological outcomes between two groups that had undergone low or ultralow anterior rectal resection.RESULTS There were no significant differences in mean operating time,blood loss,time to first passage of flatus and excrement,and duration of hospital stay between the colonic pouch and straight anastomosis groups.The incidence of anastomotic leakage following colonic pouch construction was lower(11.4%vs 16.2%)but not significantly different than that of straight anastomosis.Patients with colonic pouch construction had lower postoperative low anterior resection syndrome scores than the straight anastomosis group,suggesting better Bowel Function(preoperative:4.71 vs 3.89,P=0.43;1 mo after surgery:34.2 vs 34.7,P=0.59;6 mo after surgery:22.70 vs 29.0,P<0.05;12 mo after surgery:15.5 vs 19.5,P=0.01).The overall recurrence and metastasis rates were similar(4.3%and 11.4%,respectively).CONCLUSION Colonic pouch anastomosis is a safe and effective procedure for colorectal reconstruction after low and ultralow rectal resections.

关键词： Low rectal cancer Colonic pouch Rectal resection syndrome Low anterior rectal resection Bowel Function Surgery

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Bowel Function and quality of life after minimally invasive colectomy with D3 lymphadenectomy for right-sided colon adenocarcinoma

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World Journal of Gastroenterology 2020年第33期26卷 4972-4982页

作者： Ki-Myung Lee Se-Jin Baek Jung-Myun Kwak Jin Kim Seon-Hahn Kim Department of Surgery Korea University College of MedicineSeoul 02841South Korea

BACKGROUND Changes in Bowel Function after right-sided colectomy are not well understood compared to those associated with left-sided colectomy or rectal resection.In particular,there are concerns about Bowel Function after right-sided colectomy with complete mesocolic excision,which has become popular in the West.AIM To evaluate the functional outcomes of patients who underwent right-sided colectomy with D3 lymphadenectomy for colon cancer.METHODS functional data from patients who underwent minimally invasive right-sided colectomy for colon cancer from October 2017 to September 2018 were prospectively collected.functional outcomes were evaluated preoperatively and at 3,6,12,and 18 mo postoperatively.RESULTS Prior to surgery,57 patients answered the questionnaire,and 47 responded at three months,52 at 6 mo,52 at 12 mo,and 25 at 18 mo postoperatively.Most scales of quality of life and Bowel Function improved significantly over time.Urgency persisted to a high degree throughout the period without a significant change over time.The use of medications for defecation was about 10%over the entire period.Gas(P=0.023)and fecal frequency(Pbowel dysfunction group(P=0.028)was more common among patients taking medication.At six months,resected bowel and colon lengths were significantly different as a risk factor between the dysfunction group and the no dysfunction group[odd ratio(OR):1.095,P=0.026;OR:1.147,P=0.031,respectively]in univariate analysis,but not in multivariate analysis.CONCLUSION Despite D3 lymphadenectomy,most bowel symptoms improved over time after right-sided colectomy using a minimally invasive approach,and continuous medication was needed in only approximately 10%of patients.

关键词： Colonic neoplasm Right colectomy Bowel Function D3 lymphadenectomy Complete mesocolic excision Quality of life

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Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection:A randomized controlled trial

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World Journal of Gastrointestinal Surgery 2023年第7期15卷 1474-1484页

作者： Yuan-Tao Hou Yuan-Yuan Pan Lei Wan Wen-Sheng Zhao Ying Luo Qi Yan Yi Zhang Wei-Xin Zhang Yun-Chang Mo Lu-Ping Huang Qin-Xue Dai Dan-Yun Jia Ai-Ming Yang Hai-Yan An An-Shi Wu Ming Tian Jian-Qiao Fang Jun-Lu Wang Yi Feng Department of Anesthesiology Peking University People’s HospitalBeijing 100044China Department of Anesthesiology First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Department of Anesthesiology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of Pain Medicine Zhejiang Chinese Medicine and Western Medicine Integrated HospitalHangzhou 310003Zhejiang ProvinceChina Department of Anesthesiology Beijing Chaoyang HospitalCapital Medical UniversityBeijing 100020China Department of Anesthesiology The First Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou 310003Zhejiang ProvinceChina Key Laboratory of Acupuncture and Neurology of Zhejiang Province Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Pain Medicine Peking University People’s HospitalBeijing 100044China Key Laboratory for Neuroscience Ministry of Education/National Health Commission of ChinaPeking UniversityBeijing 100083China

BACKGROUND Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery.The effects of transcutaneous electrical acupoint stimulation(TEAS)remain unclear.AIM To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.METHODS Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive:(1)TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery,plus two 30-min daily sessions for 3 consecutive days after surgery(perioperative TEAS group);(2)Preoperative and intraoperative TEAS only;(3)Preoperative and postoperative TEAS only;or(4)Sham stimulation.The primary outcome was the time from the end of surgery to the first bowel sound.RESULTS In total,441 patients were randomized;405 patients(58.4±10.2 years of age;247 males)received the planned surgery.The time to the first bowel sounds did not differ among the four groups(P=0.90;log-rank test).On postoperative day 1,the rest pain scores differed significantly among the four groups(P=0.04;Kruskal–Wallis test).Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group(1.4±1.2)than in the sham sti-mulation group(1.7±1.1;P=0.04).Surgical complications did not differ among the four groups.CONCLUSION TEAS provided analgesic effects in adult patients undergoing major abdominal surgery,and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

关键词： Analgesia Bowel Function Colorectal resection Gastrectomy Postoperative pain Transcutaneous electrical acupoint stimulation

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Efficacy of a Kiwifruit Extract (PhenActiv^TM) on Gastrointestinal Tract function: A Randomised Double-Blind Placebo-Controlled Study

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Food and Nutrition Sciences 2023年第12期14卷 1281-1295页

作者： David Briskey Alistair Rowan Mallard Amanda Rao RDC Clinical Brisbane Australia School of Human Movement and Nutrition Sciences The University of Queensland Brisbane Australia School of Medicine University of Sydney Sydney Australia

Objective: Gastrointestinal (GI) discomfort is experienced by millions of people every day. This study aimed to evaluate the effect of PhenActivTM, a novel green kiwifruit extract, on gastrointestinal tract (GIT) function in otherwise healthy adults. Methods: 41 healthy adults with mild GI discomfort were enrolled in this double-blind, randomized, placebo-controlled study. Participants were randomized to either take 3.0 g/day of PhenActivTM or a placebo for 6 weeks. Interviews were conducted at baseline, week 3 and week 6, with participants completing questionnaires regarding GI symptoms. Frequency of bowel movements was self-recorded daily. Results: There were no differences in daily and weekly defecation frequency and stool characteristics in either group. The active and placebo groups significantly improve GSRS scores (p , only the active group had a significant improvement in the IBSSS and PAC-QOL scores (p TM for 6 weeks did not improve defecation frequency or stool composition in healthy adults, but did improve perceived symptoms of GIT function, including symptoms of functional GIT disorders, IBS and constipation. The product was well tolerated and future trials investigating higher doses with more participants and/or a different population would be beneficial.

关键词： Kiwifruit Extract Gastrointestinal Tract function Stool Gastrointestinal Health Bowel Function Defecation Frequency

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Spinal Cord Stimulation for Refractary Neuropathic Pain and Its Action on the Neurovegetative Systems

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Journal of Biomedical Science and Engineering 2019年第9期12卷 443-450页

作者： Sara S.Pedrao Gabriela R.Lauretti Caio C.M.S.Matias Raquel de Oliveira Carlos A.F.Trindade School of Medicine of Ribeirao Preto University of Sao PauloSao PauloBrazil

BACKGROUND: Spinal Cord Stimulation (SCS) has been used for chronic refractory pain, however its effectivity on neurovegetative systems has not been evaluated to data. OBJECTIVES: The study was conducted to evaluate the effect of SCS in patients suffering from refractory neuropathic pain, related to analgesia, quality of life and neurovegetative actions on the digestive and urinary tracts. Fifteen patients acted as their own control related to all evaluations. P bowel transit and urinary function, as improved overall analgesia and decreased daily rescue analgesic (p bowel activity and urinary function.

关键词： Spinal Cord Stimulation Bowel Function Bladder function Neurovegetative Actions

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