Search Our Scientific Publications & Authors

J Crohns Colitis 2019 Apr 16. Epub 2019 Apr 16.

Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background And Aims: Although the incidence of inflammatory bowel disease (IBD) is increasing in Asia, data on long-term epidemiologic trends are limited. We performed a 30-year longitudinal study to investigate temporal trends in the epidemiology of Crohn's disease (CD) and ulcerative colitis (UC) in Seoul, Korea.

Methods: This population-based study included 1431 IBD patients (418 CD, 1013 UC) diagnosed between 1986 and 2015 in the Songpa-Kangdong district of Seoul, Korea. Read More

Syst Rev 2019 Apr 15;8(1):95. Epub 2019 Apr 15.

Clinical Epidemiology Program, The University of Ottawa, Ottawa, Canada.

Background: Development of fistula-in-ano following incision and drainage (I&D) of anorectal abscesses occurs in over 30% of patients. It is associated with significant patient morbidity and societal cost. The use of antibiotics following drainage is controversial, with randomized controlled trials reporting opposing conclusions regarding their influence on the rate of fistula formation. Read More

ANZ J Surg 2019 Apr 9. Epub 2019 Apr 9.

Department of Surgery, Saint-Antoine Hospital, AP-HP, Sorbonne University, Paris, France.

Background: Delayed coloanal anastomosis (DCAA) may be used in patients with complex rectal conditions, such as chronic pelvic sepsis, low recto-vaginal and recto-vesical fistula; however, limited data are available. The aim is to report the morbidity and functional results of DCAA in redo rectal surgery.

Methods: All patients undergoing DCAA between January 2014 and August 2017 were retrospectively included. Read More

Mol Clin Oncol 2019 May 5;10(5):487-491. Epub 2019 Mar 5.

Musculoskeletal Oncology Service, Osaka International Cancer Institute, Osaka, Osaka 541-8567, Japan.

Chordoma is a rare tumor that originates from the notochord. Half of chordomas involve the sacral region. Surgery is considered to be the standard treatment for sacral chordoma. Read More

BMJ Case Rep 2019 Mar 31;12(3). Epub 2019 Mar 31.

Urology, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK.

An 80-year-old man with history of prostate cancer successfully treated with brachytherapy was initially thought to have Fournier's gangrene until imaging detected a rectoprostatic fistula. Although this is known to be a rare complication of prostate brachytherapy, in this case the aetiology was a new primary rectal adenocarcinoma. It was not possible to catheterise per urethra owing to the fistula, so he was fitted with suprapubic catheter, and underwent palliative loop colostomy. Read More

Oncol Lett 2019 Apr 19;17(4):3777-3782. Epub 2019 Feb 19.

Department of Colorectal Anal Surgery, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510655, P.R. China.

Application value of nursing intervention combined with early nutritional support treatment in preventive stoma reversion of low rectal cancer was explored. Ninety-two cases of low rectal cancer patients undergoing preventive stoma reversion from January 2014 to December 2016 were retrospectively analyzed. All the patients had closed fistula 3 months after neostomy. Read More

Ann Surg 2019 May;269(5):815-826

Department of Colorectal Surgery, Cleveland Clinic Foundation, Cleveland, OH.

Background Information: We aimed to compare prospectively the complications and functional outcome of patients undergoing a J-Pouch (JP) or a side-to-end anastomosis (SE) for treatment of low rectal cancer at a 2-year time point after resection for rectal cancer.

Methods: A multicenter study was conducted on patients with low rectal cancer who were randomized to receive either a JP or SE and were followed for 24 months utilizing SF-12 and FACT-C surveys to evaluate the quality of life (QOL). Fecal incontinence was evaluated using the Fecal Incontinence Severity Index (FISI). Read More

ANZ J Surg 2019 Mar 28. Epub 2019 Mar 28.

Faculty of Health and Medical Science, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia.

Background: There is no consensus about the optimal management of the rectal stump after an emergency subtotal colectomy in patients with acute severe ulcerative colitis (ASUC). The aim was to perform a systematic review of the published literature on the surgical and medical management of the rectal stump after an emergency (sub) total colectomy in patients with ASUC.

Methods: The following databases were searched, MEDLINE (PubMed), EMBASE and OVID SP, from January 1993 to March 2018. Read More

World J Gastroenterol 2019 Mar;25(11):1421-1431

Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China.

Background: Obstructed defecation syndrome (ODS) is a widespread disease in the world. Rectocele is the most common cause of ODS in females. Multiple procedures have been performed to treat rectocele and no procedure has been accepted as the gold-standard procedure. Read More

JSLS 2019 Jan-Mar;23(1)

Department of Surgery, Iwate Medical University School of Medicine, Iwate Japan.

Background: Anastomotic leakage during laparoscopic low anterior resection (Lap-LAR) for rectal cancer remains challenging for colorectal surgeons. Firing linear staplers multiple times has been reported as a risk factor for iatrogenic anastomotic leakage. Our institute usually performs rectal transection using 2 planned stapler fires followed by anastomosis with the double-stapling technique. Read More

Gan To Kagaku Ryoho 2019 Mar;46(3):598-600

Dept. of Surgery, Matsubara Tokushukai Hospital.

A 76-year-old man visited our hospital with complaints of appetite loss and diarrhea. Abdominal computed tomography (CT)showed a large transverse colon tumor at the splenic flexure and a gastrocolic fistula. Upper gastrointestinal series and gastroscopy demonstrated a type 2 tumor in the transverse colon and a gastrocolic fistula as the scope was inserted into the transverse colon. Read More

Dan Med J 2019 Apr;66(4)

Introduction: Ligation of the intersphincteric fistula tract (LIFT) to treat transsphincteric fistulae has yielded varied but promising results. However, it has been shown that long-term follow-up (> 250 days) is vital to obtain the correct surgical outcome. Here, we present the long-term results of patients undergoing the LIFT procedure at Herlev Hospital, Denmark. Read More

J Pediatr Surg 2019 Mar 1. Epub 2019 Mar 1.

Department of Pediatric Surgery and the Research Institute, Nationwide Children's Hospital, Columbus, OH.

Purpose: The purpose of this study was to identify factors associated with attaining fecal continence in children with anorectal malformations (ARM).

Methods: We performed a multi-institutional cohort study of children born with ARM in 2007-2011 who had spinal and sacral imaging. Questions from the Baylor Social Continence Scale were used to assess fecal continence at the age of ≥4 years. Read More

Colorectal Dis 2019 Mar 21. Epub 2019 Mar 21.

Department of Gastroenterology, University Hospital of Rennes, Pontchaillou, France.

Aim: To compare the rate of failure of radiofrequency thermocoagulation for anal fistula with that of rectal advancement flap in a case-matched study.

Method: Patients who underwent radiofrequency treatment were compared with age- and sex-matched patients with Crohn's disease (CD) who underwent a rectal flap procedure. Fistula features, general characteristics and the main clinical events were recorded in a prospective database. Read More

J Pediatr Surg 2019 Feb 28. Epub 2019 Feb 28.

Center for Colorectal and Pelvic Reconstruction-Nationwide Children's Hospital, Columbus, OH 43205, USA.

Purpose: A complication of the surgical management of anorectal malformations (ARMs) is a retained remnant of the original fistula (ROOF) formerly called a posterior urethral diverticulum (PUD). A ROOF may have multiple presentations or may be incidentally discovered during the work-up of ARM after previous surgery. We sought to define the entity and the surgical indications for excision of a ROOF when found. Read More

Rev Prat 2018 Mar;68(3):249-252

Service de proctologie médico-chirurgicale, groupe hospitalier Paris-Saint-Joseph, Paris, France.

Diagn Pathol 2019 Mar 13;14(1):22. Epub 2019 Mar 13.

Department of Radiology, Maisonneuve-Rosemont Hospital, 5415 Boulevard de L'Assomption, Montreal, QC, Canada.

Background: Malakoplakia is a chronic inflammatory disease characterized by tissue infiltrates of large granular macrophages containing distinctive intracytoplasmic inclusions termed Michaelis-Gutmann (MG) bodies. The genitourinary system is the most commonly involved site, followed by the gastrointestinal tract. Malakoplakia may occur as a complication of primary or secondary immunosuppression and, therefore, renal transplant recipients are at risk. Read More

J Urol 2019 Jan 29:101097JU0000000000000087. Epub 2019 Jan 29.

Department of Urology, Lahey Hospital and Medical Center , Burlington , Massachusetts.

Purpose: We report multi-institutional outcomes in patients who underwent urethroplasty with a rectal mucosa graft.

Materials And Methods: We used the TURNS (Trauma and Urologic Reconstructive Network of Surgeons) database to identify patients who underwent urethral reconstruction with transanal harvest of a rectal mucosa graft. We reviewed preoperative demographics, stricture etiology, previous management and patient outcomes. Read More

J Med Case Rep 2019 Mar 7;13(1):80. Epub 2019 Mar 7.

Department of Surgery, St Elizabeth Catholic General Hospital, Shisong, P.O Box 8, Kumbo - Nso, Bui Division, Northwestern Region, Cameroon.

Background: A case is reported of innocuous intestinal obstruction requiring surgical intervention that was confirmed to be Crohn's disease histopathologically in a resource-constrained rural mission hospital in Cameroon.

Case Presentation: A 70-year man of Kumbo origin from Northwest region of Cameroon with a history of crampy right lower-quadrant abdominal pain, non-bloody, non-mucoid diarrhea alternating with constipation presented to my institution. Abdominal examination of the patient revealed an ill-defined mass in the right iliac fossa and visible peristalsis. Read More

Dis Colon Rectum 2019 Apr;62(4):395-396

Icahn School of Medicine at Mount Sinai, Division of Colon and Rectal Surgery, New York, New York.

ANZ J Surg 2019 Mar 6. Epub 2019 Mar 6.

Department of Urology, John Hunter Hospital, Newcastle, New South Wales, Australia.

Best Pract Res Clin Obstet Gynaecol 2019 Jan 29. Epub 2019 Jan 29.

Department of Obstetrics and Gynecology, Hospital CHR Liège, University of Liège, Boulevard du 12eme de Ligne,1, 4000, Liège, Belgium. Electronic address:

The surgical management of bowel endometriosis is a real challenge. In addition to the fact that only symptomatic patients should undergo surgery, no consensus has been approved in the literature. Among the surgical techniques, the surgeon has to choose between rectal shaving, disc excision, or segmental colorectal resection. Read More

Drugs Today (Barc) 2019 Feb;55(2):95-105

Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy; IBD Center, Department of Gastroenterology, Humanitas Research Hospital, Rozzano, Milan, Italy.

Despite significant advances in medical and surgical therapy for perianal fistulas in Crohn's disease (CD), treatment results are still modest, and a specific need for more effective therapies is a reality. Darvadstrocel is composed of expanded human allogeneic mesenchymal adult stem cells extracted from adipose tissue and constitutes the first stem cell therapy for perianal fistulizing CD to receive approval from the European Medicines Agency (EMA). This therapy is injected in both internal and external openings, as well as inside the fistula tracks, to induce fistula healing. Read More

J Surg Case Rep 2019 Feb 14;2019(2):rjy351. Epub 2019 Feb 14.

General Surgery Department, Gaziosmanpasa University, Tokat, Turkey.

Leiomyoma of the anal canal originating from the internal anal sphincter is an extremely rare clinical entity. Generally, it does not produce any clinical signs unless it is large enough to cause obstruction, discomfort, bleeding or pain. The diagnosis is often made incidentally during rectal examination due to other perianal disease or check-up. Read More

Med Sci Monit 2019 Feb 20;25:1350-1354. Epub 2019 Feb 20.

Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China (mainland).

BACKGROUND The ligation of the inter-sphincteric fistula tract plus bioprosthetic anal fistula plug (LIFT-plug) is a new procedure in the treatment of trans-sphincteric perianal fistulas. The aim of this study was to evaluate its long-term outcomes. MATERIAL AND METHODS Clinical data of 78 patients with trans-sphincteric perianal fistula who were managed by the LIFT-plug technique between March 2014 to October 2016 were analyzed retrospectively. Read More

Tech Coloproctol 2019 Feb 16. Epub 2019 Feb 16.

Department of General Surgery, University of Rome Tor Vergata, Policlinico Tor Vergata, Rome, Italy.

Background: This study aims to investigate functional results and recurrence rate after stapled transanal rectal resection (STARR) for rectocele associated with obstructive defection syndrome (ODS).

Methods: A study was conducted on patients with ODS symptoms associated with symptomatic rectocele ≥ 3 cm on dynamic defecography who had STARR at our institution between 01/2007 and 12/2015. Data were prospectively collected and analyzed. Read More

Am J Surg 2019 Jan 31. Epub 2019 Jan 31.

Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alberta, Canada. Electronic address:

Background: Treatment of anorectal abscesses continues to revolve around early surgical drainage and control of perianal sepsis. Yet even with prompt drainage, abscess recurrence and postoperative fistula formation rates are as high as 40% within 12 months. These complications are thought to be associated with inadequate drainage, elevated bacterial load, or a noncryptoglandular etiology of disease. Read More

Gastroenterology 2019 Feb 14. Epub 2019 Feb 14.

Department of Surgery, Pelvic Floor Unit, Aarhus University Hospital, Aarhus, Denmark.

Background And Aims: Perianal fistulas are common in patients with Crohn´s disease (CD). Injections of cultured autologous and allogeneic adipose tissue-derived stem cells have been shown to heal CD-associated fistulas. Unfortunately, this treatment is time-consuming and expensive. Read More

Gan To Kagaku Ryoho 2019 Jan;46(1):88-90

Dept. of Surgery, Yao Tokushukai General Hospital.

An 81-year old man with a perirectal abscess was referred in May 2017 by another hospital. We observed swelling in the anal region at the 4 o'clock position and performed incisional drainage. Although this alleviated the pain and inflammation in the anal region, the irritation recurred in early June. Read More

J Urol 2019 03;201(3):435

Eur Radiol 2019 Feb 7. Epub 2019 Feb 7.

Department of Pediatrics and Pediatric Neuropsychiatry, Sapienza University of Rome, Policlinico Umberto I Hospital, Viale del Policlinico, 155, 00161, Rome, Italy.

Objectives: To identify differences between two cohorts of adult and pediatric patients affected by Crohn's disease (CD), with regard to lesion location in the small intestine and colon-rectum, lesion activity, and prevalence of perianal disease (PD), using MRI as the main diagnostic tool.

Methods: We retrospectively reviewed 350 consecutive MRI examinations performed between 2013 and 2016 in outpatients or inpatients with histologically proven CD, monitored by the Gastroenterology and Pediatric Units of our Hospital. The magnetic resonance enterography (MRE) protocol for adult and pediatric CD patients routinely includes evaluation of nine different intestinal segments (from jejunum to rectum) and of the anal canal. Read More

Ultrasound Int Open 2019 Jan 5;5(1):E34-E51. Epub 2019 Feb 5.

Department of Surgery, Haukeland University Hospital and Department of Clinical Medicine, University of Bergen, Bergen, Norway.

This article represents part 3 of the EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound (GIUS). It provides an overview of the examination techniques recommended by experts in the field of endorectal/endoanal ultrasound (ERUS/EAUS), as well as perineal ultrasound (PNUS). The most important indications are rectal tumors and inflammatory diseases like fistula and abscesses in patients with or without inflammatory bowel disease (IBD). Read More

Surg Case Rep 2019 Jan 31;5(1):14. Epub 2019 Jan 31.

Department of Surgery, Saitama Medical Center, Jichi Medical University, 1-847 Amanuma-cho, Omiya-ku, Saitamashi, Saitamaken, 330-8503, Japan.

Background: Bevacizumab is an anti-angiogenesis agent used to treat patients with metastatic colorectal cancer and is associated with a variety of complications. We present a patient with rectal cancer who developed a delayed anastomotic leak more than 5 years after undergoing low anterior resection.

Case Report: A 78-year-old man with hematochezia was diagnosed with two synchronous rectal cancers 7 years prior to presentation. Read More

World J Surg 2019 Jan 31. Epub 2019 Jan 31.

Indus Super Specialty Hospital, Mohali, India.

Aim: Several studies have evaluated the efficacy of preoperative MRI in fistula-in-ano. However, the evaluation of MRI after fistula-in-ano surgery has never been done. The aim was to evaluate the utility of MRI in postoperative period after fistula-in-ano surgery. Read More

BMC Res Notes 2019 Jan 29;12(1):66. Epub 2019 Jan 29.

Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

Objective: The aim of this study was to determine the accuracy of three-dimensional endoanal ultrasound scan (3D-EAUS) in the pre-operative assessment of fistula-in-ano in identifying the fistula tract and comparing with findings at surgery in a South Asian cohort. A retrospective analysis of 87 patients with suspected fistula-in-ano who underwent pre-operative 3D-EAUS between January 2009 and January 2016 was carried out. All patients subsequently had surgical exploration under anaesthesia (EUA), irrespective of 3D-EAUS findings. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2453-2455

Dept. of Gastroenterological Surgery, Saitama Cancer Center.

Few cases of recurrent colorectal carcinomas were treated non-surgically and cured. Here, we report 3 such cases. Case No. Read More

Gan To Kagaku Ryoho 2018 Dec;45(13):2006-2008

Dept. of Surgery, Kanmon Medical Center.

A 45-year-old man presented with the chief complaint of anal discomfort to a previous doctor. The symptoms remained after undergoing seton surgery following the diagnosis of intermuscular anal fistula. CT showed a tumor that was 3 cm in diameter on the right wall of the rectum, and he received a diagnosis of neuroendocrine carcinoma(NEC)based on a biopsy. Read More

J Indian Assoc Pediatr Surg 2019 Jan-Mar;24(1):45-51

Department of Pediatric Surgery, All India Institute of Medical Sciences, New Delhi, India.

Aim: This study aims to evaluate the need of Redo pull-through (Re PT) procedures for Hirschsprung's disease (HD) and suggest preventive strategies.

Materials And Methods: Patients who underwent redo procedures for HD from 1980 to 2016 by a single surgeon were retrospectively reviewed.

Results: Of 167 patients operated for HD, 32 underwent Re PT; 7 were previously operated by the same surgeon, while 25 were referred from outside. Read More

Am J Gastroenterol 2019 Jan 18. Epub 2019 Jan 18.

Department of Gastroenterology, Daping Hospital, Research Institute of Surgery, Army Medical University (Third Military Medical University), Chongqing, China.

J Laparoendosc Adv Surg Tech A 2019 Jan 24. Epub 2019 Jan 24.

Department of General Surgery and Oncological Surgery, Advanced Laparoscopic and Bariatric Surgery Center, Policlinico San Marco, Zingonia (BG), Italy.

Background: Colorectal cancer, one of the most common tumor- and cancer-related deaths worldwide, requires a multidisciplinary management including neoadjuvant chemoradiotherapy and surgery. Laparoscopic surgery for rectal cancer is gaining popularity due to its safety profile and good oncological results, if performed by experienced surgeons in specialized centers. This study describes our 10 years experience in minimally invasive rectal cancer surgery. Read More

Inflamm Bowel Dis 2019 Jan 18. Epub 2019 Jan 18.

Division ofPediatric Surgery, Mayo Clinic, Rochester Minnesota, USA.

Background: Restorative proctocolectomy and ileal pouch anal anastomosis (IPAA) has become the procedures of choice for restoration of intestinal continuity in ulcerative colitis or familial adenomatous polyposis. This systematic review aims to assess short-term postoperative and long-term functional outcomes in pediatric patients undergoing IPAA.

Methods: A literature search was performed for all publications of pediatric IPAA in which short- and long-term outcomes were reported. Read More

Dis Colon Rectum 2019 May;62(5):615-622

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.

Background: Management of transsphincteric cryptoglandular fistulas remains a challenging problem and the optimal surgical approach remains elusive. Mesenchymal stem cells, increasingly being utilized for perianal Crohn's disease, offer a novel therapy to treat cryptoglandular fistulas.

Objectives: This study aimed to determine safety and feasibility of using an autologous mesenchymal stem cell-coated fistula plug in patients with transsphincteric cryptoglandular fistulas. Read More

J Contemp Brachytherapy 2018 Dec 28;10(6):510-515. Epub 2018 Dec 28.

Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

Purpose: To determine risk factors for fistula formation after interstitial brachytherapy (ISBT) in patients with advanced gynecologic cancers.

Material And Methods: We performed an Institutional Review Board (IRB) approved retrospective review of 44 patients treated with transperineal template-based ISBT from 2011 to 2017 at a major metropolitan county and university health system. All patients were treated with image-guided high-dose-rate ISBT. Read More

Dis Colon Rectum 2019 02;62(2):e8

Garg Fistula Research Institute, Panchkula, Haryana, India.

J Urol 2019 02;201(2):222

Rev Col Bras Cir 2019 Jan 7;45(6):e1998. Epub 2019 Jan 7.

Universidade Federal de Minas Gerais, Faculdade de Medicina, Hospital das Clínicas, Instituto Alfa de Gastroenterologia, Grupo de Coloproctologia, Belo Horizonte, MG, Brasil.

Objective: to evaluate the factors associated with non-closure of protective ileostomy after anterior resection of the rectum with total mesorectum excision for rectal cancer, the morbidity associated with the closure of ileostomies and the rate of permanent ileostomy in patients with rectal adenocarcinoma.

Methods: we conducted a retrospective study with 174 consecutive patients diagnosed with rectal tumors, of whom 92 underwent anterior resection of the rectum with coloanal or colorectal anastomosis and protective ileostomy, with curative intent. We carried out a multivariate analysis to determine the factors associated with definite permanence of the stoma, as well as studied the morbidity of patients who underwent bowel continuity restoration. Read More

Ayu 2018 Jan-Mar;39(1):2-8

Department of Shalyatantra, AIIA, New Delhi, India.

Background: In Ayurveda, is considered as one of the grave disease by due to more recurrence rate. is para-surgical procedure which is found more effective in the management of fistula-in-ano. is routinely prepared with (latex), powder and . Read More

JAAPA 2019 Jan;32(1):1-7

Yasmine Hubbard is a surgical PA at St. Peter's Health Partners and Affiliated Hospitals in Albany and Troy, N.Y. Denise Rizzolo is an associate professor in the School of Nursing at Kean University in Union, N.J., and an assistant clinical professor in the Pace Completion Program in the Department of Physician Assistant Studies in New York City. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Anorectal pain is common but often misdiagnosed, and patients may suffer in silence if they are too uncomfortable discussing the topic with their healthcare provider. This article reviews rectal anatomy and the signs and symptoms of several common anorectal conditions and how to manage them. Read More

Clin Exp Immunol 2019 Apr 9;196(1):123-138. Epub 2019 Jan 9.

IBD Unit, Presidio Columbus, Fondazione Policlinico Universitario A. Gemelli IRCCS Università Cattolica del Sacro Cuore, Rome, Italy.

Collaboration between gastroenterologists and rheumatologists is recommended for the correct management of patients with associated spondyloarthritis (SpA) and inflammatory bowel disease (IBD). We aimed to establish the appropriateness of several red flags for a prompt specialist referral. A systematic review of the literature was performed using the GRADE method to describe the prevalence of co-existing IBD-SpA and the diagnostic accuracy of red flags proposed by a steering committee. Read More