PURPOSE: The purpose of our study was to determine the clinical and CT predictors recurrent disease after a first episode diverticulitis that successfully managed nonoperatively. METHODS: We retrospectively analyzed 954 consecutive patients who presented institution with from 2002 2008. Patients were identified International Classification Diseases, 9th Revision/Current Procedural Terminology codes. excluded if they had subsequent colectomy based on attack (n = 81), or between 2008 not their...

It should be recognized that these guidelines not deemed inclusive of all proper methods care or exclusive reasonably directed to obtaining the same results. The ultimate judgment regarding propriety any specific procedure must made by physician in light circumstances presented individual patient.

PURPOSE: The role of laparoscopic surgery in treatment patients with diverticulitis is unclear. A retrospective comparison conventional for chronic was performed to assess morbidity, recovery from surgery, and cost. METHODS: Records undergoing elective resection uncomplicated 1992 1994 at a single institution were reviewed. Laparoscopic involved complete intracorporeal dissection, bowel division, anastomosis extracorporeal placement an anvil. RESULTS: Sigmoid left colon resections...

Recent studies have suggested that a subset of patients with Crohn's colitis may favorable outcome after ileal pouch-anal anastomosis and advocated elective in selected disease. We not offered to known disease, but because the overlap clinical presentation ulcerative indeterminate colitis, some receiving an are subsequently found review our experience these identify potential preoperative predictors ultimate pouch failure.Patients final diagnosis disease were identified from registry. These...

This study retrospectively evaluated 288 patients who had undergone ileal pouch-anal anastomosis to determine the incidence of perineal complications and relate these findings pathologic diagnosis, with goal specifically clarifying appropriate surgical management indeterminate colitis. Of patients, 235 (82 percent) a diagnosis chronic ulcerative colitis, 18 (6 6 (2 Crohn's disease, 29 (10 familial polyposis. All occurred at least months after closure stoma required operative therapy. 9...

PURPOSE: Indications for operative intervention in the treatment of diverticulitis have become unclear. We hypothesized that surgical has decreased resulting proportionately more complicated cases (free perforation and/or abscess). METHODS: conducted a retrospective analysis patients with diverticular disease Nationwide Inpatient Sample from 1991 through 2005. used diagnostic codes to identify all patient discharges and then determined proportion diverticulitis, perforated disease, abscess,...

Pathology Pathogenesis Clinical features/differential diagnosis Radiology/endscopy Acute diverticulitis Complications Medical management Surgical treatment Right-sided diverticular disease.

In Brief OBJECTIVE: To assess the development of anal cancer in women diagnosed with a human papillomavirus–related cervical, vulvar, or vaginal neoplasm. METHODS: Using data from National Cancer Institute's Surveillance, Epidemiology and End Results program 1973 through 2007, 189,206 cases either situ invasive neoplasm were followed for 138,553,519 person-years subsequent primary cancer. Standardized incidence ratios calculated observed number cancers compared those expected based on age-,...

PURPOSE: Our purpose was to study the effect of unilateral pudendal neuropathy on results anal sphincter repair. METHOD: Fifteen female patients who underwent external repair for fecal incontinence were studied. In all instances, result obstetric delivery injury. Anal manometry and neurophysiologic investigations document defects performed in patients. Sphincter using an overlapping suture technique. RESULTS: All had anterior defects. Seven (47 percent) neuropathy: six (85 neuropathy, one...

This study was undertaken to identify clinical characteristics, natural history, and results of medical surgical treatment anal fissures in Crohn's disease.This is a retrospective review patients with disease fissure.Of the 56 patients, 49 (84 percent) had symptomatic fissures. Fissures were most commonly (66 located posterior midline, 18 (32 multiple healed one-half treated medically. Factors predictive successful included male gender, painless fissure, acute fissure. Of 15 10 (67...

PURPOSE: Inadequate initial differentiation between ulcerative colitis and Crohn's disease may lead to a diagnosis of indeterminate colitis. Construction an ileoanal pouch in these patients result significant morbidity failure when the ultimate is disease. METHOD: We prospectively studied 543 with idiopathic inflammatory bowel determine whether patient's pathologic changed time how it affected outcome. RESULTS: Preoperative was 499 patients, 42 2 patients. Prior colectomy performed 58...

PURPOSE: The aim of this study was to understand better the cause and predictability pouch failure requiring rediversion after ileal pouch-anal anastomosis assess ultimate outcome patients in a large series who required rediversion. METHODS: Data from 460 completing at one institution were recorded both prospectively accumulated registry patient medical records. RESULTS: Of patients, 21 (4.6 percent) underwent Five these subsequently had successful restoration continuity, leaving permanent...

In selected individuals requiring emergency colon resection, intraoperative colonic lavage with primary anastomosis represents a safe alternative to staged reconstruction. This procedure achieves excellent mechanical preparation of the colon, facilitates anastomosis, and avoids disadvantages associated multistaged operations. At our institution, 25 patients urgent segmental resection left have undergone lavage. Primary without fecal diversion has been performed in 21 these patients....

PURPOSE: A notable increase in-hospital admissions for Clostridium difficile colitis has occurred in the United States. In this paper we evaluate changes epidemiology of a subset hospitalized patients with inflammatory bowel diseases. METHODS: retrospective cohort analysis was conducted all disease Nationwide Inpatient Sample, 20 percent stratified random sample national hospital discharge abstracts from 1993 through 2003. Using standard diagnostic codes, identified yearly difficile, other...

To evaluate women's sexual function, self-esteem, body image, and health-related quality of life after colorectal surgery.Current literature lacks prospective studies that female sexuality/quality surgery using validated instruments.Sexual general health patients undergoing were evaluated preoperatively, at 6 12 months surgery, the Female Sexual Function Index, Rosenberg Self-Esteem scale, Body Image scale SF-36, respectively.Ninety-three women with a mean age 43.0 +/- 11.6 years old...

To develop and evaluate an objective method of technical skills assessment for graduating subspecialists in colorectal (CR) surgery-the Colorectal Objective Structured Assessment Technical Skill (COSATS).It may be reasonable the public to assume that surgeons certified as competent have had their assessed. However, skill, despite being hallmark a surgeon, is not directly assessed at time certification by surgical boards.A procedure-based, multistation examination was developed reflect sample...

To implement the Colorectal Objective Structured Assessment of Technical skill (COSATS) into American Board Colon and Rectal Surgery (ABCRS) certification build evidence validity for interpretation scores this high stakes assessment tool.Currently, technical is not a formal component board certification. With demands surgical specialties, documenting competence in at time with valid tool ideal.In September 2014, COSATS was mandatory ABCRS Seventy candidates took examination, their...

Approximately half of Crohn's patients require intestinal resection, and many need repeat resections.The purpose this study was to evaluate the increased risk clinical anastomotic leak in with a history previous resection undergoing anastomosis for disease.This retrospective analysis prospectively collected departmental data 100% capture.The conducted at department colorectal surgery tertiary care teaching hospital between July 2007 March 2016.A cohort consecutive disease who were treated...

Hand-assisted laparoscopic colectomy is thought to facilitate colonic mobilization while maintaining the benefits of surgery. Although previous studies hand-assisted have focused on segmental resection, use restorative proctocolectomy has not been investigated. This study evaluated effectiveness approach compared with a conventional method in patients undergoing proctocolectomy.From prospective database, consecutive series were identified and results compared. Twenty-three patients,...

Obstetric trauma and excessive defecatory straining with perineal descent may lead to pudendal neuropathy bilateral increase in nerve terminal motor latencies (PNTML). We have frequently observed unilateral prolongation of PNTML. Diagnostic therapeutic implications are discussed.Records 174 patients referred pelvic floor laboratory for anorectal manometry PNTML testing were reviewed. Computerized was performed using dynamic pressure analysis, determined a (St. Mark's) electrode.No response...

Carcinoma of the colon that arises in patients with Crohn's disease is being reported increasing frequency. To help clarify nature this association, records 25 and colorectal carcinoma seen from 1957 through 1989 were reviewed. One patient had leiomyosarcoma rectum, two onset after diagnosis treatment carcinoma. Therefore, 22 available for complete retrospective analysis. The median age at was 37 years (range, 15-67 years), 54.5 32-76 years). duration symptoms preceding discovery 18.5 0-32...