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Ileocolonic mucormycosis in adult immunocompromised patients:A surgeon's perspective

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World Journal of Gastroenterology 2010年第9期16卷 1165-1170页

作者： Oswens Siu-Hung Lo Wai-Lun Law Division of colorectal Surgery Department of SurgeryUniversity of Hong Kong Medical CentreQueen Mary Hospital

We report three cases of ileocolic mucormycosis in adult immunocompromised patients presenting as acute *** patients underwent laparotomy but two of them died from multiorgan failure before the diagnoses were *** diagnosis of gastrointestinal mucormycosis is rarely suspected,and antemortem diagnosis is made in only 25%-50% of *** cases illustrate the difficulty encountered by surgeons in managing acute abdomen in neutropenic patients with hematological *** management of colonic mucormycosis in the published literature is also reviewed.

关键词： Gastrointestinal mucormycosis Colon Immunocompromised Surgery

Animal models of human colorectal cancer:Current status, uses and limitations

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World Journal of Gastroenterology 2015年第41期21卷 11854-11861页

作者： Vijay K Mittal Jasneet Singh Bhullar Kumar Jayant department of Surgery Providence Hospital and Medical Centers department of colorectal Surgery University of MinnesotaMN 55114 United States

AIM: To make orthotopic colon cancer murine modelsa more clearly understood subject. The orthotopic tumor models have been found to be more relevant in replicating the human disease process as compared to heterotopic models, many techniques for making orthotopic colorectal murine models have been ***: We evaluated the current literature for various reported orthotopic colon cancer models to understand their techniques, advantages and limitations. An extensive literature review was performed by searching the National Library of Medicine Database(Pub Med) using Me SH terms animal model; colon cancer; orthotopic model; murine model. Twenty studies related to colon cancer orthotopic xenograft model were evaluated in detail and discussed here. RESULTS: The detailed analysis of all relevant reports on orthotopic model showed tumor take rate between 42%-100%. While models using the enema technique and minimally invasive technique have reported development of tumor from mucosa with tumor take rate between 87%-100% with metastasis in 76%-90%.CONCLUSION: Over the years, the increased understanding of the murine models of human colon cancer has resulted in the development of various models. Each reported model has some limitations. These latest models have opened up new doors for continuing cancer research for not only understanding the colon cancer pathogenesis but also aid in the development of newer chemotherapeutic drugs as they mimic the human disease closely.

关键词： Murine model Colon cancer Colon cancer murine mode

Severe rectal burn induced by hot normal saline enema:a case report

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Gastroenterology Report 2022年第1期10卷 638-640页

作者： Xiaoming Zhu Siyuan Jiang Chen Wang Haifeng Gong Wei Zhang department of colorectal Surgery Changhai HospitalShanghaiP.R.China

Case report A 44-year-old woman was admitted to our emergency room with a diagnose of rectal burn due to an accidental hot normal saline enema before oophorocystectomy in a local hospital 8 days *** reported hypogastralgia and burning pain on the buttocks immediately when the enema was *** enema was stopped instantly and she was treated with fasting,antibiotics,glucocorticoids,and parenteral nutrition for a ***,the above symptoms did not resolve.

关键词： admitted rectal stopped

Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer

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World Journal of Gastroenterology 2024年第23期30卷 2991-3004页

作者： Li-Qun Cai Da-Qing Yang Rong-Jian Wang He Huang Yi-Xiong Shi department of colorectal and Anal Surgery Whenzhou Central HospitalWenzhou 325000Zhejiang ProvinceChina department of colorectal and Anorectal Surgery The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina

BACKGROUND colorectal cancer significantly impacts global health,with unplanned reoperations post-surgery being key determinants of patient *** predictive models for these reoperations lack precision in integrating complex clinical *** To develop and validate a machine learning model for predicting unplanned reoperation risk in colorectal cancer *** Data of patients treated for colorectal cancer(n=2044)at the First Affiliated Hospital of Wenzhou Medical University and Wenzhou Central Hospital from March 2020 to March 2022 were retrospectively *** were divided into an experimental group(n=60)and a control group(n=1984)according to unplanned reoperation *** were also divided into a training group and a validation group(7:3 ratio).We used three different machine learning methods to screen characteristic variables.A nomogram was created based on multifactor logistic regression,and the model performance was assessed using receiver operating characteristic curve,calibration curve,Hosmer-Lemeshow test,and decision curve *** risk scores of the two groups were calculated and compared to validate the *** More patients in the experimental group were≥60 years old,male,and had a history of hypertension,laparotomy,and hypoproteinemia,compared to the control *** logistic regression analysis confirmed the following as independent risk factors for unplanned reoperation(Pcolorectal cancer,which can improve tr

关键词： colorectal cancer Postoperative unplanned reoperation Unplanned reoperation Clinical validation Nomogram Machine learning models

Midterm outcome of stapled transanal rectal resection for obstructed defecation syndrome:A single-institution experience in China

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World Journal of Gastroenterology 2013年第38期19卷 6472-6478页

作者： Bin Zhang Jian-Hua Ding Yu-Juan Zhao Meng Zhang Shu-Hui Yin Ying-Ying Feng Ke Zhao department of colorectal Surgery the Second Artillery General Hospital department of Laboratory Medicine the Second Artillery General Hospital

AIM:To assess midterm results of stapled transanal rectal resection(STARR)for obstructed defecation syndrome(ODS)and predictive factors for ***:From May 2007 to May 2009,75 female patients underwent STARR and were included in the present *** and postoperative workup consisted of standardized interview and physical examination including proctoscopy,colonoscopy,anorectal manometry,and *** and functional results were assessed by standardized questionnaires for the assessment of constipation constipation scoring system(CSS),Longo’s ODS score,and symptom severity score(SSS),incontinence Wexner incontinence score(WS),quality of life Patient Assessment of Constipation-Quality of Life Questionnaire(PAC-QOL),and patient satisfaction visual analog scale(VAS).Data were collected prospectively at baseline,12 and 30 ***:The median follow-up was 30 mo(range,30-46 mo).Late postoperative complications occurred in 11(14.7%)*** of these patients required procedure-related reintervention(one diverticulectomy and two excision of staple granuloma).Although the recurrence rate was 10.7%,constipation scores(CSS,ODS score and SSS)significantly improved after STARR(P<0.0001).Significant reduction in ODS symptoms was matched by an improvement in the PAC-QOL and VAS(P<0.0001),and the satisfaction index was excellent in 25(33.3%)patients,good in 23(30.7%),fairly good in 14(18.7%),and poor in 13(17.3%).Nevertheless,the WS increased after STARR(P=0.0169).Incontinence was present or deteriorated in 8(10.7%)patients;6(8%)of whom were new *** analysis revealed that the occurrence of fecal incontinence(preoperative,postoperative or new-onset incontinence;P=0.028,0.000,and 0.007,respectively)was associated with the success of the ***:STARR is an acceptable procedure for the surgical correction of ***,its impact on symptomatic recurrence and postoperative incontinence may be problematic.

关键词： colorectal surgery Constipation Stapled transanal rectal resection

Conservative approach to the acute management of a large mesenteric cyst

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World Journal of Clinical Cases 2017年第9期5卷 360-363页

作者： Billy C Leung Ruth Sankey Matteo Fronza Mohamed Maatouk department of General and colorectal Surgery Milton Keynes HospitalEaglestone

Mesenteric cysts are rare, benign gastrointestinal cystic lesions, which are often non-troublesome and present as an incidental radiological finding. However, surgery is often performed in the acute setting to remove lesions that are symptomatic. This report highlights the case of a large, symptomatic mesenteric cyst managed successfully with initial conservative measures followed by planned elective surgery. A 44-year-old female presented with a four-day history of generalised abdominal pain associated with distension, fever, diarrhoea and vomiting. Computer tomography revealed a large(21.7 cm × 11.8 cm × 14 cm) mesenteric cyst within the left abdomen cavity. She was admitted and treated conservatively with intravenous fluids and antibiotics for four days, which lead to complete symptom resolution. Follow-up at intervals of one and three months revealed no return of symptoms. An elective laparotomy and excision of the mesenteric cyst was then scheduled and performed safely at nine months after the initial presentation. Compared to acute surgery, acute conservative management followed by planned elective resection of a symptomatic mesenteric cyst may prove safer. The withholding of an immediate operation may potentially avoid unnecessary operative risk and should be considered in patients without obstructive and peritonitic symptoms. Our case demonstrated the safe use of initial conservative management followed by planned elective surgery of a mesenteric cyst found in the acute setting, which was symptomatic but was not obstructive or causing peritonitic symptoms.

关键词： Conservative management Acute setting Mesenteric cysts Elective operation

Treatment of hemorrhoids: A survey of surgical practice in Australia and New Zealand

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World Journal of Clinical Cases 2019年第22期7卷 3742-3750页

作者： George E Fowler Javariah Siddiqui Assad Zahid Christopher John Young department of colorectal Surgery Royal Devon and Exeter NHS Foundation TrustExeter EX25DWUnited Kingdom department of colorectal Surgery Royal Prince Alfred HospitalNewtown 2042NSWAustralia

BACKGROUND Hemorrhoidal disease is the most common anorectal *** can be classified as external or internal,according to their relation to the dentate *** hemorrhoids originate below the dentate line and are managed conservatively unless the patient cannot keep the perianal region clean,or they cause significant *** hemorrhoids originate above the dentate line and can be managed according to the graded degree of prolapse,as described by ***,low-grade internal hemorrhoids are effectively treated conservatively,by non-operative measures,while high-grade internal hemorrhoids warrant procedural *** To determine the application of clinical practice guidelines for the current management of hemorrhoids and colorectal surgeon consensus in Australia and New *** An online survey was distributed to 206 colorectal surgeons in Australia and New Zealand using 17 guideline-based hypothetical clinical *** There were 82 respondents(40%)to 17 guideline-based ***(53%)reached consensus,of which only 1(6%)disagreed with the *** was based on low quality evidence for the management of acutely thrombosed external *** were 8 scenarios which showed community equipoise(47%)and they were equally divided for agreeing or disagreeing with the *** topics were based on low and moderate levels of *** included the initial management of grade I internal hemorrhoids,grade III internal hemorrhoids when initial management had failed and the patient had recognised risks factors for septic complications;and finally,the decision-making when considering patient preferences,including a prompt return to work,or minimal post-operative *** Although there are areas of consensus in the management of hemorrhoids,there are many areas of community equipoise which would benefit from further research.

关键词： Hemorrhoids Clinical practice guidelines Survey Consensus

Stem cell therapy:light in the tunnel for penetrating Crohn’s disease

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Gastroenterology Report 2023年第1期11卷 78-87页

作者： Nan Lan Xianrui Wu Bo Shen Center for Inflammatory Bowel disease Columbia University Irving Medical Center/NewYork Presbyterian HospitalNew YorkNYUSA department of colorectal Surgery The 6th Hospital of Sun Yat-Sen UniversityGuangzhouGuangdongP.R.China

Patients with Crohn’s disease frequently suffer from fistula resulting from adverse sequelae of persistent complicated active disease or surgical *** affects a patient’s quality of life and is directly associated with the need for surgical *** of fistula can be made through CT enterography,MR enterography,gastrograffin-based imaging,and transanal *** for fistula mainly consists of medication,endoscopic procedures,and *** are emerging approaches under current investigation,such as stem cell *** results showed a decent response in patients with perianal and rectovaginal fistula with minimal side *** investigation is still needed for other internal fistula.

关键词： Crohn’s disease fistula perianal disease stem cells therapy

Male gender is associated with an increased risk of anastomotic leak in rectal cancer patients after total mesorectal excision

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Gastroenterology Report 2018年第2期6卷 137-143,I0003页

作者： Jian-ping Wang and Ping Lan Chi Zhou Xian-rui Wu Xuan-hui Liu Yu-feng Chen Jia Ke Xiao-wen He Xiao-sheng He Tuo Hu Yi-feng Zou Xiao-bin Zheng Hua-shan Liu Jian-cong Hu Xiao-jian Wu Jian-ping Wang Ping Lan department of colorectal Surgery the Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesGuangzhouGuangdong 510065China

Background:The impact of a patient’s gender on the development of anastomotic leak(AL)in rectal cancer patients following total mesorectal excision(TME)remains *** aim of this study was to evaluate the association between patients’gender and the risk of ***:All rectal cancer patients following TME with a primary anastomosis during the study period from 2010 to 2014 were *** of the post-operative AL incidence rate between male and female patients were ***:Of all patients examined(n¼956),587(61.4%)were males and 369(38.6%)were *** patients were more likely to have a history of smoking and drinking alcohol,but less likely to have a history of abdominal surgery compared to female patients.A higher incidence rate of pre-operative bowel obstruction and larger tumor volume in male patients was observed in our *** all the patients,81(8.5%)developed post-operative *** male patients(n¼62,10.6%)suffered from AL than females(n¼19,5.1%)(P¼0.003).Multivariate logistic regression analyses confirmed the association between male gender and AL[odds ratio(OR):2.41,95%confidence interval(CI):1.37–4.23,P¼0.002].Similar results were also obtained in patients who underwent laparoscopic TME(OR:2.11,95%CI:1.15–3.89,P¼0.016).Conclusions:Male patents were found to have an increased risk for AL following TME with a primary anastomosis.A temporary protecting stoma may help to protect the anastomosis and lessen the risk for AL especially in male patients.

关键词： rectal cancer anastomotic leak gender risk factor total mesorectal excision primary anastomosis