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1. Simultaneous pelvic exenteration and liver resection for primary rectal cancer with synchronous liver metastases: results from the PelvEx Collaborative

Author: Kelly, M. E., Aalbers, A. G. J., Abdul Aziz, N., Abecasis, N., Abraham‐Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Burger, J. W. A., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo‐Marulanda, A., Chan, K. K. L., Chang, G. J., Chew, M. H., Chong, P. C., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique‐Navascues, J. M., Espin‐Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia‐Granero, E., Garcia‐Sabrido, J. L., Gentilini, L., George, M. L., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Hagemans, J. A. W., Hanchanale, V., Harji, D. P., Helewa, R. M., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kiran, R. P., Kim, H., Kim, H. J., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kristensen, H. Ø., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Margues, C. F. S., Martling, A., Meijerink, W. J. H. J., Merkel, S., Mehta, A. M., McArthur, D. R., McDermott, F. D., McGrath, J. S., Malde, S., Mirnezami, A., Monson, J. R. T., Morton, J. R., Mullaney, T. G., Negoi, I., Neto, J. W. M., Nguyen, B., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., O’Connell, P. R., O’Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., van Ramshorst, G. H., Rasheed, S., Rasmussen, P. C., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Rutten, H. J. T., Ryan, É. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Hellawell, G., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sørensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Sumrien, H., Sutton, P. A., Swartking, T., Taylor, C., Tekkis, P. P., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., Vasquez‐Jimenez, W., Verhoef, C., Vizzielli, G., Voogt, E. L. K., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Wheeler, J. M. D., Wild, J., Wilson, M., de Wilt, J. H. W., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., van Zoggel, D., Winter, D. C., Kelly, M. E., Aalbers, A. G. J., Abdul Aziz, N., Abecasis, N., Abraham‐nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Burger, J. W. A., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo‐marulanda, A., Chan, K. K. L., Chang, G. J., Chew, M. H., Chong, P. C., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique‐navascues, J. M., Espin‐basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia‐granero, E., Garcia‐sabrido, J. L., Gentilini, L., George, M. L., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Hagemans, J. A. W., Hanchanale, V., Harji, D. P., Helewa, R. M., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kiran, R. P., Kim, H., Kim, H. J., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kristensen, H. Ø., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Margues, C. F. S., Martling, A., Meijerink, W. J. H. J., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Monson, J. R. T., Morton, J. R., Mullaney, T. G., Negoi, I., Neto, J. W. M., Nguyen, B., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., O’Connell, P. R., O’Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., van Ramshorst, G. H., Rasheed, S., Rasmussen, P. C., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Rutten, H. J. T., Ryan, É. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Hellawell, G., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sørensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Sumrien, H., Sutton, P. A., Swartking, T., Taylor, C., Tekkis, P. P., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., Vasquez‐jimenez, W., Verhoef, C., Vizzielli, G., Voogt, E. L. K., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Wheeler, J. M. D., Wild, J., Wilson, M., de Wilt, J. H. W., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., van Zoggel, D., Winter, D. C., Kelly, ME, Aalbers, AGJ, Aziz, NA, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, KK, Aziz, O, Baker, RP, Bali, M, Baseckas, G, Bebington, B, Bednarski, BK, Beets, GL, Berg, PL, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, AB, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, JWA, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, KKL, Chew, GJH, Chong, PC, Christensen, HK, Clouston, H, Codd, M, Coffins, D, Colquhoun, AJ, Corr, A, Coscia, M, Coyne, PE, Creavin, B, Croner, RS, Damjanovic, L, Daniels, R, Davies, M, Davies, RJ, Delaney, CP, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, EJ, Duff, M, Eglinton, T, Enrique-Navascues, JM, Espin-Basany, E, Evans, MD, Fearnhead, NS, Flatmark, K, Fleming, F, Frizelle, FA, Gallego, MA, Garcia-Granero, E, Garcia-Sabrido, JL, Gentilini, L, George, ML, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, DA, Hagemans, JAW, Hanchanale, V, Harji, DP, Helewa, RM, Heriot, AG, Hochman, D, Hohenberger, W, Holm, T, Hompes, R, Jenkins, JT, Kaffenberger, S, Kandaswamy, GV, Kapur, S, Kanemitsu, Y, Kelley, SR, Keller, DS, Khan, MS, Kiran, RP, Kim, H, Kim, HJ, Koh, CE, Kok, NFM, Kokelaar, R, Kontovounisios, C, Kristensen, HO, Kroon, HM, Kusters, M, Lago, V, Larsen, SG, Larson, DW, Law, WL, Laurberg, S, Lee, PJ, Limbert, M, Lydrup, ML, Lyons, A, Lynch, AC, Mantyh, C, Mathis, KL, Margues, CFS, Martling, A, Meijerink, WJHJ, Merkel, S, Mehta, AM, McArthur, DR, McDermott, FD, McGrath, JS, Malde, S, Mimezami, A, Monson, JRT, Morton, JR, Mullaney, TG, Negoi, I, Neto, JWM, Nguyen, B, Nielsen, MB, Nieuwenhuijzen, GAP, Nilsson, PJ, O'Connell, PR, O'Dwyer, ST, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, AC, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, RW, van Ramshorst, GH, Rasheed, S, Rasmussen, PC, Regenbogen, SE, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, HJT, Ryan, EJ, Safar, B, Sagar, PM, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, AMP, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Hellawell, G, Shida, D, Simpson, A, Smart, NJ, Smart, P, Smith, JJ, Solbakken, AM, Solomon, MJ, Sorensen, MM, Steele, SR, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, NA, Sumrien, H, Sutton, PA, Swanking, T, Taylor, C, Tekkis, PP, Teras, J, Thurairaja, R, Toh, EL, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, JJ, Turner, WH, Tuynman, JB, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, ELK, Uehara, K, Wakeman, C, Warner, S, Wasmuth, HH, Weber, K, Weiser, MR, Wheeler, JMD, Wild, J, Wilson, M, de Wilt, JHW, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, RN, van Zoggel, D, Winter, DC, Surgery, CCA - Cancer Treatment and quality of life, and Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: Male, medicine.medical_specialty, Adolescent, Colorectal cancer, survival outcomes, medicine.medical_treatment, surgical outcome, surgical outcomes, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 03 medical and health sciences, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Interquartile range, medicine, Humans, liver metastasi, Rectal cancer, Retrospective Studies, Pelvic exenteration, business.industry, Rectal Neoplasms, Mortality rate, Liver Neoplasms, Gastroenterology, Postoperative complication, Perioperative, medicine.disease, Surgery, Pelvic Exenteration, liver metastasis, Treatment Outcome, 030220 oncology & carcinogenesis, international collaboration, Resection margin, 030211 gastroenterology & hepatology, Hepatectomy, Neoplasm Recurrence, Local, business
Abstract: Aim: At presentation, 15–20% of patients with rectal cancer already have synchronous liver metastases. The aim of this study was to determine the surgical and survival outcomes in patients with advanced rectal cancer who underwent combined pelvic exenteration and liver (oligometastatic) resection. Method: Data from 20 international institutions that performed simultaneous pelvic exenteration and liver resection between 2007 and 2017 were accumulated. Primarily, we examined perioperative outcomes, morbidity and mortality. We also assessed the impact that margin status had on survival. Results: Of 128 patients, 72 (56.2%) were men with a median age of 60 years [interquartile range (IQR) 15 years]. The median size of the liver oligometastatic deposits was 2 cm (IQR 1.8 cm). The median duration of surgery was 406 min (IQR 240 min), with a median blood loss of 1090 ml (IQR 2010 ml). A negative resection margin (R0 resection) was achieved in 73.5% of pelvic exenterations and 66.4% of liver resections. The 30-day mortality rate was 1.6%, and 32% of patients had a major postoperative complication. The 5-year overall survival for patients in whom an R0 resection of both primary and metastatic disease was achieved was 54.6% compared with 20% for those with an R1/R2 resection (P = 0.006). Conclusion: Simultaneous pelvic exenteration and liver resection is feasible, with acceptable morbidity and mortality. Simultaneous resection should only be performed where an R0 resection of both pelvic and hepatic disease is anticipated.
Published: 2020

2. Management strategies for patients with advanced rectal cancer and liver metastases using modified Delphi methodology: results from the PelvEx Collaborative

Author: Kelly M. E., Agj A., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K. K., Aziz O., Baker R. P., Bali M., Baseckas G., Bebington B., Bednarski B. K., Beets G. L., Berg P. L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Jwa B., Burling D., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Kkl C., Chang G. J., Chew M. H., Chong P., Christensen H. K., Clouston H., Codd M., Collins D., Colquhoun A. J., Corr A., Coscia M., Coyne P. E., Creavin B., Croner R. S., Damjanovic L., Daniels I. R., Davies M., Davies R. J., Delaney C. P., de Wilt J., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Duff M., Eglinton T., Enrique-Navascues J. M., Espin-Basany E., Evans M. D., Fearnhead N. S., Flatmark K., Fleming F., Frizelle F. A., Gallego M. A., Garcia-Granero E., Garcia-Sabrido J. L., Gentilini L., George M. L., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D. A., Jaw H., Hanchanale V., Harji D. P., Helewa R. M., Heriot A. G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J. T., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kelley S. R., Keller D. S., Khan M. S., Kiran R. P., Kim H., Kim H. J., Koh C. E., Nfm K., Kokelaar R., Kontovounisios C., Kristensen H. O., Kroon H. M., Kusters M., Lago V., Larsen S. G., Larson D. W., Law W. L., Laurberg S., Lee P. J., Limbert M., Lydrup M. L., Lyons A., Lynch A. C., Mantyh C., Mathis K. L., Cfs M., Martling A., Wjhj M., Merkel S., Mehta A. M., McArthur D. R., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Jrt M., Morton J. R., Mullaney T. G., Negoi I., Jwm N., Nguyen B., Nielsen M. B., Gap N., Nilsson P. J., O'Connell P. R., O'Dwyer S. T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A. C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R. W., Rasheed S., Rasmussen P. C., Regenbogen S. E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Hjt R., Ryan E. J., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Amp S., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shellawell G., Shida D., Simpson A., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sorensen M. M., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Sumrien H., Sutton P. A., Swartking T., Taylor C., Tekkis P. P., Teras J., Thurairaja R., Toh E. L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., van Ramshorst G., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Elk V., Uehara K., Wakeman C., Warrier S., Wasmuth H. H., Weber K., Weiser M. R., Jmd W., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R. N., Winter D. C., Rottoli M, Poggioli G, Kelly, M. E., Agj, A., Abdul Aziz, N., Abecasis, N., Abraham-Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Jwa, B., Burling, D., Campain, N., Carvalhal, S., Castro, L., Caycedo-Marulanda, A., Kkl, C., Chang, G. J., Chew, M. H., Chong, P., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., de Wilt, J., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique-Navascues, J. M., Espin-Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Jaw, H., Hanchanale, V., Harji, D. P., Helewa, R. M., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kiran, R. P., Kim, H., Kim, H. J., Koh, C. E., Nfm, K., Kokelaar, R., Kontovounisios, C., Kristensen, H. O., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Cfs, M., Martling, A., Wjhj, M., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Jrt, M., Morton, J. R., Mullaney, T. G., Negoi, I., Jwm, N., Nguyen, B., Nielsen, M. B., Gap, N., Nilsson, P. J., O'Connell, P. R., O'Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., Rasheed, S., Rasmussen, P. C., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Hjt, R., Ryan, E. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Amp, S., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Shellawell, G., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Sumrien, H., Sutton, P. A., Swartking, T., Taylor, C., Tekkis, P. P., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., van Ramshorst, G., van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Vizzielli, G., Elk, V., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Jmd, W., Wild, J., Wilson, M., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., Winter, D. C., and Academic Medical Center
Subjects: Liver metastasisSurvival Outcome, medicine.medical_specialty, survival outcomes, Colorectal cancer, surgical outcome, medicine.medical_treatment, Delphi method, Rectum, Disease, surgical outcomes, 03 medical and health sciences, Liver disease, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Hepatectomy, Humans, Medicine, liver metastasi, Rectal cancer, Neoplasm Staging, Pelvic exenteration, Rectal Neoplasms, business.industry, General surgery, Liver Neoplasms, Gastroenterology, Induction chemotherapy, medicine.disease, liver metastasis, medicine.anatomical_structure, 030220 oncology & carcinogenesis, international collaboration, 030211 gastroenterology & hepatology, business
Abstract: Aim: A total of 15–20% of patients with rectal cancer have liver metastases on presentation. The management of these patients is controversial. Heterogeneity in management strategies is considerable, with management often being dependent on local resources and available expertise. Method: Members of the PelvEx Collaborative were invited to participate in the generation of a consensus statement on the optimal management of patients with advanced rectal cancer with liver involvement. Fifteen statements were created for topical discussion on diagnostic and management issues. Panellists were asked to vote on statements and anonymous feedback was given. A collaborative meeting was used to discuss any nuances and clarify any obscurity. Consensus was considered when > 85% agreement on a statement was achieved. Results: A total of 135 participants were involved in the final round of the Delphi questionnaire. Nine of the 15 statements reached consensus regarding the management of patients with advanced rectal cancer and oligometastatic liver disease. Routine use of liver MRI was not recommended for patients with locally advanced rectal cancer, unless there was concern for metastatic disease on initial computed tomography staging scan. Induction chemotherapy was advocated as first-line treatment in those with synchronous liver metastases in locally advanced rectal cancer. In the presence of symptomatic primary disease, a diverting stoma may be required to facilitate induction chemotherapy. Overall, only one-quarter of the panellists would consider simultaneous pelvic exenteration and liver resection. Conclusion: This Delphi process highlights the diverse treatment of advanced rectal cancer with liver metastases and provides recommendations from an experienced international group regarding the multidisciplinary management approach.
Published: 2020

3. The impact of the COVID-19 pandemic on the Management of Locally Advanced Primary/Recurrent Rectal Cancer

Author: Chok A. Y., Kontovounisios C., Rasheed S., Kelly M. E., Agj A., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K. K., Aziz O., Baker R. P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B. K., Beets G. L., Berg P. L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Jwa B., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Kkl C., Chang G. J., Chang M., Chew M. H., Chong P., Christensen H. K., Clouston H., Codd M., Collins D., Colquhoun A. J., Corr A., Coscia M., Cosimelli M., Coyne P. E., Creavin B., Croner R. S., Damjanovic L., Daniels I. R., Davies M., Davies R. J., Delaney C. P., Jhw D. W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Duff M., Eglinton T., Enrique-Navascues J. M., Espin-Basany E., Evans M. D., Fearnhead N. S., Flatmark K., Fleming F., Frizelle F. A., Gallego M. A., Garcia-Granero E., Garcia-Sabrido J. L., Gentilini L., George M. L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D. A., Jaw H., Hanchanale V., Harji D. P., Helewa R. M., Hellawell G., Heriot A. G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J. T., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kelley S. R., Keller D. S., Khan M. S., Kim H., Kim H. J., Koh C. E., Nfm K., Kokelaar R., Kristensen H. O., Kroon H. M., Kusters M., Lago V., Larsen S. G., Larson D. W., Law W. L., Laurberg S., Lee P. J., Limbert M., Lydrup M. L., Lyons A., Lynch A. C., Mantyh C., Mathis K. L., Cfs M., Martling A., Wjhj M., Merkel S., Mehta A. M., McArthur D. R., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Jrt M., Morton J. R., Mullaney T. G., Negoi I., Jwm N., Ng J. L., Nguyen B., Nielsen M. B., Gap N., Nilsson P. J., Oliver A., O'Dwyer S. T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A. C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R. W., Rasmussen P. C., Rausa E., Regenbogen S. E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Hjt R., Ryan E. J., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Amp S., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shida D., Simpson A., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sorensen M. M., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Swartling T., Sumrien H., Sutton P. A., Swartking T., Tan E. J., Taylor C., Teras J., Thurairaja R., Toh E. L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., van Ramshorst G. H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Elk V., Uehara K., Wakeman C., Warrier S., Wasmuth H. H., Weber K., Weiser M. R., Jmd W., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R. N., Zappa M. A., Winter D. C., Tekkis P. P., Chok A.Y., Kontovounisios C., Rasheed S., Kelly M.E., Agj A., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K.K., Aziz O., Baker R.P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B.K., Beets G.L., Berg P.L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A.B., Brunner M., Buchwald P., Bui A., Burgess A., Jwa B., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Kkl C., Chang G.J., Chang M., Chew M.H., Chong P., Christensen H.K., Clouston H., Codd M., Collins D., Colquhoun A.J., Corr A., Coscia M., Cosimelli M., Coyne P.E., Creavin B., Croner R.S., Damjanovic L., Daniels I.R., Davies M., Davies R.J., Delaney C.P., Jhw D.W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E.J., Duff M., Eglinton T., Enrique-Navascues J.M., Espin-Basany E., Evans M.D., Fearnhead N.S., Flatmark K., Fleming F., Frizelle F.A., Gallego M.A., Garcia-Granero E., Garcia-Sabrido J.L., Gentilini L., George M.L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D.A., Jaw H., Hanchanale V., Harji D.P., Helewa R.M., Hellawell G., Heriot A.G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J.T., Kaffenberger S., Kandaswamy G.V., Kapur S., Kanemitsu Y., Kelley S.R., Keller D.S., Khan M.S., Kim H., Kim H.J., Koh C.E., Nfm K., Kokelaar R., Kristensen H.O., Kroon H.M., Kusters M., Lago V., Larsen S.G., Larson D.W., Law W.L., Laurberg S., Lee P.J., Limbert M., Lydrup M.L., Lyons A., Lynch A.C., Mantyh C., Mathis K.L., Cfs M., Martling A., Wjhj M., Merkel S., Mehta A.M., McArthur D.R., McDermott F.D., McGrath J.S., Malde S., Mirnezami A., Jrt M., Morton J.R., Mullaney T.G., Negoi I., Jwm N., Ng J.L., Nguyen B., Nielsen M.B., Gap N., Nilsson P.J., Oliver A., O'Dwyer S.T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A.C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R.W., Rasmussen P.C., Rausa E., Regenbogen S.E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Hjt R., Ryan E.J., Safar B., Sagar P.M., Sahai A., Saklani A., Sammour T., Sayyed R., Amp S., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shida D., Simpson A., Smart N.J., Smart P., Smith J.J., Solbakken A.M., Solomon M.J., Sorensen M.M., Steele S.R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N.A., Swartling T., Sumrien H., Sutton P.A., Swartking T., Tan E.J., Taylor C., Teras J., Thurairaja R., Toh E.L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J.J., Turner W.H., Tuynman J.B., van Ramshorst G.H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Elk V., Uehara K., Wakeman C., Warrier S., Wasmuth H.H., Weber K., Weiser M.R., Jmd W., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R.N., Zappa M.A., Winter D.C., Tekkis P.P., Chok, A. Y., Kontovounisios, C., Rasheed, S., Kelly, M. E., Agj, A., Abdul Aziz, N., Abecasis, N., Abraham-Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bedford, M., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Jwa, B., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo-Marulanda, A., Kkl, C., Chang, G. J., Chang, M., Chew, M. H., Chong, P., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Cosimelli, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Jhw, D. W., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique-Navascues, J. M., Espin-Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., George, V., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Jaw, H., Hanchanale, V., Harji, D. P., Helewa, R. M., Hellawell, G., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kim, H., Kim, H. J., Koh, C. E., Nfm, K., Kokelaar, R., Kristensen, H. O., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Cfs, M., Martling, A., Wjhj, M., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Jrt, M., Morton, J. R., Mullaney, T. G., Negoi, I., Jwm, N., Ng, J. L., Nguyen, B., Nielsen, M. B., Gap, N., Nilsson, P. J., Oliver, A., O'Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., Rasmussen, P. C., Rausa, E., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Hjt, R., Ryan, E. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Amp, S., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Swartling, T., Sumrien, H., Sutton, P. A., Swartking, T., Tan, E. J., Taylor, C., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., van Ramshorst, G. H., van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Vizzielli, G., Elk, V., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Jmd, W., Wild, J., Wilson, M., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., Zappa, M. A., Winter, D. C., Tekkis, P. P., and Surgery
Subjects: Oncology, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Locally advanced, MEDLINE, Comorbidity, COVID-19 - advanced - recurrent - primary - rectal cancer, SDG 3 - Good Health and Well-being, Internal medicine, Pandemic, Correspondence, medicine, Combined Modality Therapy, Humans, General, Pandemics, Recurrent Rectal Cancer, Neoplasm Staging, business.industry, Rectal Neoplasms, SARS-CoV-2, COVID-19, medicine.disease, Neoplasm staging, Surgery, Neoplasm Recurrence, Local, business
Published: 2020

4. Predicting outcomes of pelvic exenteration using machine learning

Author: Dudurych I., Kelly M. E., Aalbers A. G. J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K. K., Aziz O., Baker R. P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B. K., Beets G. L., Berg P. L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A. B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J. W. A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Chan K. K. L., Chang G. J., Chew M. H., Chok A. K., Chong P., Christensen H. K., Clouston H., Codd M., Collins D., Colquhoun A. J., Corr A., Coscia M., Coyne P. E., Creavin B., Croner R. S., Damjanovic L., Daniels I. R., Davies M., Davies R. J., Delaney C. P., Wilt J. H. W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E. J., Duff M., Eglinton T., Enrique-Navascues J. M., Espin-Basany E., Evans M. D., Fearnhead N. S., Flatmark K., Fleming F., Frizelle F. A., Gallego M. A., Garcia-Granero E., Garcia-Sabrido J. L., Gentilini L., George M. L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D. A., Hagemans J. A. W., Hanchanale V., Harji D. P., Helewa R. M., Heriot A. G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J. T., Kaffenberger S., Kandaswamy G. V., Kapur S., Kanemitsu Y., Kelley S. R., Keller D. S., Khan M. S., Kiran R. P., Kim H., Kim H. J., Koh C. E., Kok N. F. M., Kokelaar R., Kontovounisios C., Kristensen H. O., Kroon H. M., Kusters M., Lago V., Larsen S. G., Larson D. W., Law W. L., Laurberg S., Lee P. J., Limbert M., Lydrup M. L., Lyons A., Lynch A. C., Mantyh C., Mathis K. L., Margues C. F. S., Martling A., Meijerink W. J. H. J., Merkel S., Mehta A. M., McArthur D. R., McDermott F. D., McGrath J. S., Malde S., Mirnezami A., Monson J. R. T., Morton J. R., Mullaney T. G., Negoi I., Neto J. W. M., Nguyen B., Nielsen M. B., Nieuwenhuijzen G. A. P., Nilsson P. J., Oliver A., O'Connell P. R., O'Dwyer S. T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A. C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R. W., Rasheed S., Rasmussen P. C., Regenbogen S. E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H. J. T., Ryan E. J., Safar B., Sagar P. M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A. M. P., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shellawell G., Shida D., Simpson A., Smart N. J., Smart P., Smith J. J., Solbakken A. M., Solomon M. J., Sorensen M. M., Steele S. R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N. A., Swartling T., Sumrien H., Sutton P. A., Swartking T., Tan E. J., Taylor C., Tekkis P. P., Teras J., Thurairaja R., Toh E. L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J. J., Turner W. H., Tuynman J. B., van Ramshorst G. H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Voogt E. L. K., Uehara K., Wakeman C., Warrier S., Wasmuth H. H., Weber K., Weiser M. R., Wheeler J. M. D., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R. N., Winter D. C., Dudurych I., Kelly M.E., Aalbers A.G.J., Abdul Aziz N., Abecasis N., Abraham-Nordling M., Akiyoshi T., Alberda W., Albert M., Andric M., Angenete E., Antoniou A., Auer R., Austin K.K., Aziz O., Baker R.P., Bali M., Baseckas G., Bebington B., Bedford M., Bednarski B.K., Beets G.L., Berg P.L., Beynon J., Biondo S., Boyle K., Bordeianou L., Bremers A.B., Brunner M., Buchwald P., Bui A., Burgess A., Burger J.W.A., Burling D., Burns E., Campain N., Carvalhal S., Castro L., Caycedo-Marulanda A., Chan K.K.L., Chang G.J., Chew M.H., Chok A.K., Chong P., Christensen H.K., Clouston H., Codd M., Collins D., Colquhoun A.J., Corr A., Coscia M., Coyne P.E., Creavin B., Croner R.S., Damjanovic L., Daniels I.R., Davies M., Davies R.J., Delaney C.P., Wilt J.H.W., Denost Q., Deutsch C., Dietz D., Domingo S., Dozois E.J., Duff M., Eglinton T., Enrique-Navascues J.M., Espin-Basany E., Evans M.D., Fearnhead N.S., Flatmark K., Fleming F., Frizelle F.A., Gallego M.A., Garcia-Granero E., Garcia-Sabrido J.L., Gentilini L., George M.L., George V., Ghouti L., Giner F., Ginther N., Glynn R., Golda T., Griffiths B., Harris D.A., Hagemans J.A.W., Hanchanale V., Harji D.P., Helewa R.M., Heriot A.G., Hochman D., Hohenberger W., Holm T., Hompes R., Jenkins J.T., Kaffenberger S., Kandaswamy G.V., Kapur S., Kanemitsu Y., Kelley S.R., Keller D.S., Khan M.S., Kiran R.P., Kim H., Kim H.J., Koh C.E., Kok N.F.M., Kokelaar R., Kontovounisios C., Kristensen H.O., Kroon H.M., Kusters M., Lago V., Larsen S.G., Larson D.W., Law W.L., Laurberg S., Lee P.J., Limbert M., Lydrup M.L., Lyons A., Lynch A.C., Mantyh C., Mathis K.L., Margues C.F.S., Martling A., Meijerink W.J.H.J., Merkel S., Mehta A.M., McArthur D.R., McDermott F.D., McGrath J.S., Malde S., Mirnezami A., Monson J.R.T., Morton J.R., Mullaney T.G., Negoi I., Neto J.W.M., Nguyen B., Nielsen M.B., Nieuwenhuijzen G.A.P., Nilsson P.J., Oliver A., O'Connell P.R., O'Dwyer S.T., Palmer G., Pappou E., Park J., Patsouras D., Pellino G., Peterson A.C., Poggioli G., Proud D., Quinn M., Quyn A., Radwan R.W., Rasheed S., Rasmussen P.C., Regenbogen S.E., Renehan A., Rocha R., Rochester M., Rohila J., Rothbarth J., Rottoli M., Roxburgh C., Rutten H.J.T., Ryan E.J., Safar B., Sagar P.M., Sahai A., Saklani A., Sammour T., Sayyed R., Schizas A.M.P., Schwarzkopf E., Scripcariu V., Selvasekar C., Shaikh I., Shellawell G., Shida D., Simpson A., Smart N.J., Smart P., Smith J.J., Solbakken A.M., Solomon M.J., Sorensen M.M., Steele S.R., Steffens D., Stitzenberg K., Stocchi L., Stylianides N.A., Swartling T., Sumrien H., Sutton P.A., Swartking T., Tan E.J., Taylor C., Tekkis P.P., Teras J., Thurairaja R., Toh E.L., Tsarkov P., Tsukada Y., Tsukamoto S., Tuech J.J., Turner W.H., Tuynman J.B., van Ramshorst G.H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Vizzielli G., Voogt E.L.K., Uehara K., Wakeman C., Warrier S., Wasmuth H.H., Weber K., Weiser M.R., Wheeler J.M.D., Wild J., Wilson M., Wolthuis A., Yano H., Yip B., Yip J., Yoo R.N., Winter D.C., Surgery, Dudurych, I., Kelly, M. E., Aalbers, A. G. J., Abdul Aziz, N., Abecasis, N., Abraham-Nordling, M., Akiyoshi, T., Alberda, W., Albert, M., Andric, M., Angenete, E., Antoniou, A., Auer, R., Austin, K. K., Aziz, O., Baker, R. P., Bali, M., Baseckas, G., Bebington, B., Bedford, M., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Boyle, K., Bordeianou, L., Bremers, A. B., Brunner, M., Buchwald, P., Bui, A., Burgess, A., Burger, J. W. A., Burling, D., Burns, E., Campain, N., Carvalhal, S., Castro, L., Caycedo-Marulanda, A., Chan, K. K. L., Chang, G. J., Chew, M. H., Chok, A. K., Chong, P., Christensen, H. K., Clouston, H., Codd, M., Collins, D., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Croner, R. S., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Delaney, C. P., Wilt, J. H. W., Denost, Q., Deutsch, C., Dietz, D., Domingo, S., Dozois, E. J., Duff, M., Eglinton, T., Enrique-Navascues, J. M., Espin-Basany, E., Evans, M. D., Fearnhead, N. S., Flatmark, K., Fleming, F., Frizelle, F. A., Gallego, M. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., George, V., Ghouti, L., Giner, F., Ginther, N., Glynn, R., Golda, T., Griffiths, B., Harris, D. A., Hagemans, J. A. W., Hanchanale, V., Harji, D. P., Helewa, R. M., Heriot, A. G., Hochman, D., Hohenberger, W., Holm, T., Hompes, R., Jenkins, J. T., Kaffenberger, S., Kandaswamy, G. V., Kapur, S., Kanemitsu, Y., Kelley, S. R., Keller, D. S., Khan, M. S., Kiran, R. P., Kim, H., Kim, H. J., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kristensen, H. O., Kroon, H. M., Kusters, M., Lago, V., Larsen, S. G., Larson, D. W., Law, W. L., Laurberg, S., Lee, P. J., Limbert, M., Lydrup, M. L., Lyons, A., Lynch, A. C., Mantyh, C., Mathis, K. L., Margues, C. F. S., Martling, A., Meijerink, W. J. H. J., Merkel, S., Mehta, A. M., Mcarthur, D. R., Mcdermott, F. D., Mcgrath, J. S., Malde, S., Mirnezami, A., Monson, J. R. T., Morton, J. R., Mullaney, T. G., Negoi, I., Neto, J. W. M., Nguyen, B., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., Oliver, A., O'Connell, P. R., O'Dwyer, S. T., Palmer, G., Pappou, E., Park, J., Patsouras, D., Pellino, G., Peterson, A. C., Poggioli, G., Proud, D., Quinn, M., Quyn, A., Radwan, R. W., Rasheed, S., Rasmussen, P. C., Regenbogen, S. E., Renehan, A., Rocha, R., Rochester, M., Rohila, J., Rothbarth, J., Rottoli, M., Roxburgh, C., Rutten, H. J. T., Ryan, E. J., Safar, B., Sagar, P. M., Sahai, A., Saklani, A., Sammour, T., Sayyed, R., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V., Selvasekar, C., Shaikh, I., Shellawell, G., Shida, D., Simpson, A., Smart, N. J., Smart, P., Smith, J. J., Solbakken, A. M., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stitzenberg, K., Stocchi, L., Stylianides, N. A., Swartling, T., Sumrien, H., Sutton, P. A., Swartking, T., Tan, E. J., Taylor, C., Tekkis, P. P., Teras, J., Thurairaja, R., Toh, E. L., Tsarkov, P., Tsukada, Y., Tsukamoto, S., Tuech, J. J., Turner, W. H., Tuynman, J. B., van Ramshorst, G. H., van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Vizzielli, G., Voogt, E. L. K., Uehara, K., Wakeman, C., Warrier, S., Wasmuth, H. H., Weber, K., Weiser, M. R., Wheeler, J. M. D., Wild, J., Wilson, M., Wolthuis, A., Yano, H., Yip, B., Yip, J., Yoo, R. N., and Winter, D. C.
Subjects: Artificial intelligence, medicine.medical_treatment, Machine learning, computer.software_genre, Logistic regression, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], SDG 3 - Good Health and Well-being, Medicine, Humans, Pelvic exenteration, Receiver operating characteristic, Artificial neural network, business.industry, Rectal Neoplasms, Deep learning, Gastroenterology, Prognosis, pelvic exenteration, Support vector machine, machine learning, Test set, colorectal surgery, Neoplasm Recurrence, Local, business, computer, Predictive modelling, artificial neural network
Abstract: Aim: We aim to compare machine learning with neural network performance in predicting R0 resection (R0), length of stay >14days (LOS), major complication rates at 30days postoperatively (COMP) and survival greater than 1 year (SURV) for patients having pelvic exenteration for locally advanced and recurrent rectal cancer. Method: A deep learning computer was built and the programming environment was established. The PelvEx Collaborative database was used which contains anonymized data on patients who underwent pelvic exenteration for locally advanced or locally recurrent colorectal cancer between 2004 and 2014. Logistic regression, a support vector machine and an artificial neural network (ANN) were trained. Twenty per cent of the data were used as a test set for calculating prediction accuracy for R0, LOS, COMP and SURV. Model performance was measured by plotting receiver operating characteristic (ROC) curves and calculating the area under the ROC curve (AUROC). Results: Machine learning models and ANNs were trained on 1147 cases. The AUROC for all outcome predictions ranged from 0.608 to 0.793 indicating modest to moderate predictive ability. The models performed best at predicting LOS >14days with an AUROC of 0.793 using preoperative and operative data. Visualized logistic regression model weights indicate a varying impact of variables on the outcome in question. Conclusion: This paper highlights the potential for predictive modelling of large international databases. Current data allow moderate predictive ability of both complex ANNs and more classic methods.
Published: 2020

5. Surgical and Survival Outcomes Following Pelvic Exenteration for Locally Advanced Primary Rectal Cancer Results From an International Collaboration

Author: Kelly ME, Glynn R, Aalbers AGJ, Alberda W, Antoniou A, Austin KK, Beets GL, Beynon J, Bosman SJ, Brunner M, Buchler MW, Burger JWA, Campain N, Christensen HK, Codd M, Coscia M, Colquhoun A, Daniels I, Davies RJ, de Wilt JHW, Deutsch C, Dietz D, Eglinton T, Fearnhead N, Frizelle FA, Garcia-Sabrido JL, George M, Gentilini L, Harris DA, Harji D, Herriot AG, Hohenberger W, Jenkins JT, Kanemitsu Y, Karen Kar Loen C, Kim H, Koh CE, Kok N, Kontovounisios C, Kulu Y, Law WL, Laurberg S, Le GN, Lydrup ML, Lynch AC, Martling A, Meijerink J, Merkel S, McDermott FD, McGrath J, Nielsen MB, Nieuwenhuijzen GAP, Nordling MA, Northover JMA, O’Connell PR, Patsouras D, Poggioli G, Radwan RW, Rasheed S, Rasmussen PC, Rutten HJT, Sagar PM, Schizas A, Shida D, Smart N, Solomon MJ, Stocchi L, Tekkis PP, Tsukamoto S, Turner W, Tuynman J, Ulrich A, van Leeuwenhoek A, van Ramshorst GH, Vasquez-Jimenez W, Verhoef C, Versteegen M, Wakeman C, Warrier S, Yip J, Winter DC., Kelly ME, Glynn R, Aalbers AGJ, Alberda W, Antoniou A, Austin KK, Beets GL, Beynon J, Bosman SJ, Brunner M, Buchler MW, Burger JWA, Campain N, Christensen HK, Codd M, Coscia M, Colquhoun A, Daniels I, Davies RJ, de Wilt JHW, Deutsch C, Dietz D, Eglinton T, Fearnhead N, Frizelle FA, Garcia-Sabrido JL, George M, Gentilini L, Harris DA, Harji D, Herriot AG, Hohenberger W, Jenkins JT, Kanemitsu Y, Karen Kar Loen C, Kim H, Koh CE, Kok N, Kontovounisios C, Kulu Y, Law WL, Laurberg S, Le GN, Lydrup ML, Lynch AC, Martling A, Meijerink J, Merkel S, McDermott FD, McGrath J, Nielsen MB, Nieuwenhuijzen GAP, Nordling MA, Northover JMA, O’Connell PR, Patsouras D, Poggioli G, Radwan RW, Rasheed S, Rasmussen PC, Rutten HJT, Sagar PM, Schizas A, Shida D, Smart N, Solomon MJ, Stocchi L, Tekkis PP, Tsukamoto S, Turner W, Tuynman J, Ulrich A, van Leeuwenhoek A, van Ramshorst GH, Vasquez-Jimenez W, Verhoef C, Versteegen M, Wakeman C, Warrier S, Yip J, Winter DC., and Surgery
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Colorectal cancer, medicine.medical_treatment, International Cooperation, Cohort Studies, 03 medical and health sciences, Young Adult, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, All institutes and research themes of the Radboud University Medical Center, international collaboration, locally advanced, rectal cancer, surgical outcomes, survival outcomes, SDG 3 - Good Health and Well-being, Clinical endpoint, Medicine, Humans, Survival rate, Neoadjuvant therapy, Aged, Neoplasm Staging, Retrospective Studies, Aged, 80 and over, Pelvic exenteration, business.industry, Rectal Neoplasms, Retrospective cohort study, Middle Aged, medicine.disease, Prognosis, Total mesorectal excision, Surgery, Pelvic Exenteration, Survival Rate, Treatment Outcome, 030220 oncology & carcinogenesis, Resection margin, 030211 gastroenterology & hepatology, Female, business
Abstract: Objective: The aim of the study was to analyze data from an international collaboration, and ascertain prognostic indicators that inform clinical decision-making and practices regarding the role of pelvic exenteration for locally advanced primary rectal cancer (LARC). Background: With improved national screening programs fewer patients present with LARC. Despite this, select cohorts of patients require pelvic exenteration. To date, the majority of outcome data are from single-center series. Methods: Anonymized data from 14 countries on patients who had pelvic exenteration for LARC between 2004 and 2014 were accumulated. The primary endpoint was overall survival. The impact of resection margin, nodal status, bone resection, and use of neoadjuvant therapy (before exenteration) on survival was evaluated using multivariable analysis. Results: Of 1291 patients, 778 (60.3%) were male with a median (range) age of 63 (18–90) years; 78.1% received neoadjuvant therapy. Bone resection en bloc was performed in 8.2% of patients (n¼ 106), and 22.6% (n¼ 292) had resection combined with flap reconstruction. Negative resection margin (R0 resection) was achieved in 79.9%. The 30-day postoperative mortality was 1.5%. The median overall survival following R0, R1, and R2 resection was 43, 21, and 10 months (P < 0.001) with a 3-year survival of 56.4%, 29.6%, and 8.1%, respectively (P < 0.001); 37.8% of patients experienced one or more major complication. Neoadjuvant therapy increased the risk of 30-day morbidity (P < 0.012). Multivariable analysis identified resection margin and nodal status as significant determinants of overall survival (other than advanced age). Conclusions: Attainment of negative resection margins (R0) is the key to survival. Neoadjuvant therapy may improve survival; however, it does so at the increased risk of postoperative morbidity.
Published: 2019

6. Sacral Nerve Modulation Has No Effect on the Postprandial Response in Irritable Bowel Syndrome

Author: Fassov J, Liao D, Brock C, Lundby L, Laurberg S, and Krogh K
Subjects: irritable bowel syndrome, sacral nerve modulation, postprandial response, gastrocolic response, sacral nerve stimulation, lcsh:Diseases of the digestive system. Gastroenterology, lcsh:RC799-869
Abstract: Janne Fassov,1 Donghua Liao,2 Christina Brock,3 Lilli Lundby,4 Søren Laurberg,4 Klaus Krogh1 1Department Of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; 2GIOME Academia, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; 3Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Faculty of Health Sciences Aalborg University, Aalborg, Denmark; 4Department of Surgery, Aarhus University Hospital, Aarhus, DenmarkCorrespondence: Janne FassovDepartment of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N 8200, DenmarkTel +45 26756602Email janfas@rm.dkPurpose: Irritable bowel syndrome is a common gastrointestinal disorder with a global prevalence of approximately 11%. Onset or worsening of symptoms following digestion is one of the characteristics of the condition. The present study aimed at evaluating the postprandial sensory and motor response before and after treatment with sacral nerve modulation.Patients and Methods: Twenty-one irritable bowel syndrome patients, 12 diarrhea-predominant and 9 mixed, were eligible for a 6-week sacral nerve modulation test period. Patients were investigated with multimodal impedance planimetry including a standardized meal at baseline and at the end of 2 weeks of suprasensory stimulation embedded in the 6-week sacral nerve modulation period.Results: There was no statistical significant difference in the sensory response to heat or cold before and after sacral nerve modulation, p> 0.05. At baseline, wall tension increased after the meal (mean 124.79 [range 82.5 to 237.3] mmHg.mm before the meal, mean 207.76 [range, 143.5 to 429] mmHg.mm after the meal), p=0.048 indicating a postprandial response. During sacral nerve modulation, the postprandial increase in wall tension did not reach statistical significance (mean 86.79 [range 28.8 to 204.5] mmHg.mm before the meal, mean 159.71 [range 71.3 to 270.8] mmHg.mm after the meal), p=0.277. However, there was no statistically significant difference between the postprandial wall tension at baseline and during sacral nerve modulation, p=0.489. Likewise, we found no difference between pressure or stretch ratio at baseline and during sacral nerve modulation, p> 0.05.Conclusion: Sacral nerve modulation does not exert its positive treatments effects in diarrhea-predominant and mixed irritable bowel syndrome through a modulation of the postprandial response.Keywords: sacral nerve stimulation, sacral nerve modulation, postprandial response, gastrocolic response, irritable bowel syndrome
Published: 2020

7. Perioperative management and anaesthetic considerations in pelvic exenterations using Delphi methodology: results from the PelvEx Collaborative

Author: PelvEx Collaborative, [missing], Chok, A Y, Oliver, A, Rasheed, S, Tan, E J, Kelly, M E, Aalbers, A G J, Abdul Aziz, N, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, K K, Aziz, O, Baker, R P, Bali, M, Baseckas, G, Bebington, B, Bedford, M, Bednarski, B K, Beets, G L, Berg, P L, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, A B, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, J W A, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, K K L, Chang, G J, Chew, M H, Chong, P, Christensen, H K, Clouston, H, Codd, M, Collins, D, Colquhoun, A J, Corr, A, Coscia, M, Coyne, P E, Creavin, B, Croner, R S, Damjanovic, L, Daniels, I R, Davies, M, Davies, R J, Delaney, C P, de Wilt, J H W, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, E J, Duff, M, Eglinton, T, Enrique-Navascues, J M, Espin-Basany, E, Evans, M D, Fearnhead, N S, Flatmark, K, Fleming, F, Frizelle, F A, Gallego, M A, Garcia-Granero, E, Garcia-Sabrido, J L, Gentilini, L, George, M L, George, V, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, D A, Hagemans, J A W, Hanchanale, V, Harji, D P, Helewa, R M, Hellawell, G, Heriot, A G, Hochman, D, Hohenberger, W, Holm, T, Holmström, A, Hompes, R, Jenkins, J T, Kaffenberger, S, Kandaswamy, G V, Kapur, S, Kanemitsu, Y, Kelley, S R, Keller, D S, Khan, M S, Kim, H, Kim, H J, Koh, C E, Kok, N F M, Kokelaar, R, Kontovounisios, C, Kristensen, H Ø, Kroon, H M, Kusters, M, Lago, V, Larsen, S G, Larson, D W, Law, W L, Laurberg, S, Lee, P J, Limbert, M, Lydrup, M L, Lyons, A, Lynch, A C, Mantyh, C, Mathis, K L, Margues, C F S, Martling, A, Meijerink, W J H J, Merkel, S, Mehta, A M, McArthur, D R, McDermott, F D, McGrath, J S, Malde, S, Mirnezami, A, Monson, J R T, Morton, J R, Mullaney, T G, Negoi, I, Neto, J W M, Nguyen, B, Nielsen, M B, Nieuwenhuijzen, G A P, Nilsson, P J, O’Dwyer, S T, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, A C, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, R W, Rasmussen, P C, Rausa, E, Regenbogen, S E, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, H J T, Ryan, É J, Safar, B, Sagar, P M, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, A M P, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Shida, D, Simpson, A, Smart, N J, Smart, P, Smith, J J, Solbakken, A M, Solomon, M J, Sørensen, M M, Steele, S R, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, N A, Swartling, T, Sumrien, H, Sutton, P A, Swartking, T, Taylor, C, Teras, J, Thurairaja, R, Toh, E L, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, J J, Turner, W H, Tuynman, J B, van Ramshorst, Gabriëlle, Zoggel, D van, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, E L K, Uehara, K, Wakeman, C, Warrier, S, Wasmuth, H H, Weber, K, Weiser, M R, Wheeler, J M D, Wild, J, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, R N, Winter, D C, Tekkis, P P, Surgery, Chok, A Y, Oliver, A, Rasheed, S, Tan, E J, Kelly, M E, Aalbers, A G J, Abdul Aziz, N, Abecasis, N, Abraham-Nordling, M, Akiyoshi, T, Alberda, W, Albert, M, Andric, M, Angenete, E, Antoniou, A, Auer, R, Austin, K K, Aziz, O, Baker, R P, Bali, M, Baseckas, G, Bebington, B, Bedford, M, Bednarski, B K, Beets, G L, Berg, P L, Beynon, J, Biondo, S, Boyle, K, Bordeianou, L, Bremers, A B, Brunner, M, Buchwald, P, Bui, A, Burgess, A, Burger, J W A, Burling, D, Burns, E, Campain, N, Carvalhal, S, Castro, L, Caycedo-Marulanda, A, Chan, K K L, Chang, G J, Chew, M H, Chong, P, Christensen, H K, Clouston, H, Codd, M, Collins, D, Colquhoun, A J, Corr, A, Coscia, M, Coyne, P E, Creavin, B, Croner, R S, Damjanovic, L, Daniels, I R, Davies, M, Davies, R J, Delaney, C P, de Wilt, J H W, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, E J, Duff, M, Eglinton, T, Enrique-Navascues, J M, Espin-Basany, E, Evans, M D, Fearnhead, N S, Flatmark, K, Fleming, F, Frizelle, F A, Gallego, M A, Garcia-Granero, E, Garcia-Sabrido, J L, Gentilini, L, George, M L, George, V, Ghouti, L, Giner, F, Ginther, N, Glynn, R, Golda, T, Griffiths, B, Harris, D A, Hagemans, J A W, Hanchanale, V, Harji, D P, Helewa, R M, Hellawell, G, Heriot, A G, Hochman, D, Hohenberger, W, Holm, T, Holmström, A, Hompes, R, Jenkins, J T, Kaffenberger, S, Kandaswamy, G V, Kapur, S, Kanemitsu, Y, Kelley, S R, Keller, D S, Khan, M S, Kim, H, Kim, H J, Koh, C E, Kok, N F M, Kokelaar, R, Kontovounisios, C, Kristensen, H Ø, Kroon, H M, Kusters, M, Lago, V, Larsen, S G, Larson, D W, Law, W L, Laurberg, S, Lee, P J, Limbert, M, Lydrup, M L, Lyons, A, Lynch, A C, Mantyh, C, Mathis, K L, Margues, C F S, Martling, A, Meijerink, W J H J, Merkel, S, Mehta, A M, McArthur, D R, McDermott, F D, McGrath, J S, Malde, S, Mirnezami, A, Monson, J R T, Morton, J R, Mullaney, T G, Negoi, I, Neto, J W M, Nguyen, B, Nielsen, M B, Nieuwenhuijzen, G A P, Nilsson, P J, O’Dwyer, S T, Palmer, G, Pappou, E, Park, J, Patsouras, D, Pellino, G, Peterson, A C, Poggioli, G, Proud, D, Quinn, M, Quyn, A, Radwan, R W, Rasmussen, P C, Rausa, E, Regenbogen, S E, Renehan, A, Rocha, R, Rochester, M, Rohila, J, Rothbarth, J, Rottoli, M, Roxburgh, C, Rutten, H J T, Ryan, É J, Safar, B, Sagar, P M, Sahai, A, Saklani, A, Sammour, T, Sayyed, R, Schizas, A M P, Schwarzkopf, E, Scripcariu, V, Selvasekar, C, Shaikh, I, Shida, D, Simpson, A, Smart, N J, Smart, P, Smith, J J, Solbakken, A M, Solomon, M J, Sørensen, M M, Steele, S R, Steffens, D, Stitzenberg, K, Stocchi, L, Stylianides, N A, Swartling, T, Sumrien, H, Sutton, P A, Swartking, T, Taylor, C, Teras, J, Thurairaja, R, Toh, E L, Tsarkov, P, Tsukada, Y, Tsukamoto, S, Tuech, J J, Turner, W H, Tuynman, J B, Ramshorst, G H van, Zoggel, D van, Vasquez-Jimenez, W, Verhoef, C, Vizzielli, G, Voogt, E L K, Uehara, K, Wakeman, C, Warrier, S, Wasmuth, H H, Weber, K, Weiser, M R, Wheeler, J M D, Wild, J, Wilson, M, Wolthuis, A, Yano, H, Yip, B, Yip, J, Yoo, R N, Winter, D C, Tekkis, P P, Mcarthur, D R, Mcdermott, F D, Mcgrath, J S, Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Faculteit FHML Centraal, Health Services Research, RS: CAPHRI - R1 - Ageing and Long-Term Care, RS: FdR IC Goederenrecht, School Office GROW, and Amsterdam Gastroenterology Endocrinology Metabolism
Subjects: BLOOD-TRANSFUSION, CARDIAC RISK, AcademicSubjects/MED00910, medicine.medical_treatment, Delphi method, Computer-assisted web interviewing, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, 030202 anesthesiology, Multidisciplinary approach, Medicine and Health Sciences, Medicine, humans, RISK, COMPLICATIONS, Perioperative management - anaesthetic - pelvic exenterations - rectal cancer - Delphi - PelvEx Collaborative, Manchester Cancer Research Centre, General Medicine, SYSTEMIC INFLAMMATORY RESPONSE, 030220 oncology & carcinogenesis, Original Article, Medical emergency, EPIDURAL-ANESTHESIA, AcademicSubjects/MED00010, Life Sciences & Biomedicine, Consensus, ENHANCED RECOVERY, Best practice, education, MEDLINE, patient care team/organization & administration, 03 medical and health sciences, anesthetics, Humans, MAJOR ABDOMINAL-SURGERY, METAANALYSIS, RECTAL-CANCER, Anesthetics, Patient Care Team, Science & Technology, Pelvic exenteration, business.industry, ResearchInstitutes_Networks_Beacons/mcrc, MORTALITY, LONG-TERM SURVIVAL, Perioperative, COMPARTMENT SYNDROME, medicine.disease, pelvic exenteration, Pelvic Exenteration, Subject-matter expert, consensus, Surgery, business
Abstract: Background The multidisciplinary perioperative and anaesthetic management of patients undergoing pelvic exenteration is essential for good surgical outcomes. No clear guidelines have been established, and there is wide variation in clinical practice internationally. This consensus statement consolidates clinical experience and best practice collectively, and systematically addresses key domains in the perioperative and anaesthetic management. Methods The modified Delphi methodology was used to achieve consensus from the PelvEx Collaborative. The process included one round of online questionnaire involving controlled feedback and structured participant response, two rounds of editing, and one round of web-based voting. It was held from December 2019 to February 2020. Consensus was defined as more than 80 per cent agreement, whereas less than 80 per cent agreement indicated low consensus. Results The final consensus document contained 47 voted statements, across six key domains of perioperative and anaesthetic management in pelvic exenteration, comprising preoperative assessment and preparation, anaesthetic considerations, perioperative management, anticipating possible massive haemorrhage, stress response and postoperative critical care, and pain management. Consensus recommendations were developed, based on consensus agreement achieved on 34 statements. Conclusion The perioperative and anaesthetic management of patients undergoing pelvic exenteration is best accomplished by a dedicated multidisciplinary team with relevant domain expertise in the setting of a specialized tertiary unit. This consensus statement has addressed key domains within the framework of current perioperative and anaesthetic management among patients undergoing pelvic exenteration, with an international perspective, to guide clinical practice, and has outlined areas for future clinical research., The PelvEx Collaborative consensus statement systematically addresses the perioperative and anaesthetic management of patients undergoing pelvic exenteration (PE). Using the modified Delphi methodology, recommendations across six key clinical domains comprising preoperative assessment and preparation, anaesthetic considerations, perioperative management, anticipating possible massive haemorrhage, stress response and postoperative critical care, and pain management were developed. pelvic exenteratio and recommendation
Published: 2021

8. Changing outcomes following pelvic exenteration for locally advanced and recurrent rectal cancer

Author: Kelly, M. E., Aalbers, A. G. J., Aziz, N. Abdul, Abraham-Nordling, M., Alberda, W., Antoniou, A., Austin, K. K., Baker, R., Bali, M., Baseckas, G., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Bordeianou, L., Brunner, M., Buchwald, P., Burger, J. W. A., Burling, D., Campain, N., Chan, K. K. L., Chang, G., Chew, M. H., Chong, P. C., Christensen, H. K., Codd, M., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., de Wilt, J. H. W., Denost, Q., Deutsch, C., Dietz, D., Dozois, E. J., Duff, M., Eglinton, T., Evans, M., Evans, M. D., Fearnhead, N. S., Frizelle, F. A., Garcia-Granero, E., Garcia-Sabrido, J. L., Gentilini, L., George, M. L., Glynn, R., Golda, T., Griffiths, B., Hagemans, J. A. W., Harji, D. P., Harris, D. A., Heriot, A. A. G., Hohenberger, W., Holm, T., Jenkins, J. T., Kanemitsu, Y., Kapur, S., Keller, D. S., Kelley, S. R., Kim, H., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kusters, M., Larson, D. W., Laurberg, S., Law, W. L., Lee, P., Lydrup, M. L., Lynch, A. C., Martling, A., Mathis, K. L., Meijerink, W. J. H. J., Mentha, A. M., Merkel, S., McDermott, F. D., McGrath, J. S., Mihailo, A., Mirnezami, A., Morton, J. R., Mullaney, T. G., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., O'Connell, P. R., Palmer, G., Patsouras, D., Pellino, G., Poggioli, G., Quinn, M., Quyn, A., Radwan, R. W., Rasheed, S., Rasmussen, P. C., Rocha, R., Rothbarth, J., Roxburgh, C., Rutten, H. J. T., Ryan, E., Sagar, P. M., Sammour, T., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V, Shaikh, I, Shida, D., Simpson, A., Smart, N. J., Smith, J., Solomon, M. J., Sorensen, M. M., Steele, S. R., Steffens, D., Stocchi, L., Stylianides, N. A., Taylor, C., Tekkis, P. P., Tsukamoto, S., Turner, W. H., Tuynman, J. B., van Ramshorst, Gabriëlle, van Zoggel, D., Vasquez-Jimenez, W., Verhoef, C., Verstegen, M., Wakeman, C., Warrier, S., Wasmuth, H. H., Weiser, M. R., Wheeler, J. M. D., Wild, J., Winter, D. C., Yip, J., Kelly, M. E., Aalbers, A. G. J., Aziz, N. Abdul, Abraham‐Nordling, M., Alberda, W., Antoniou, A., Austin, K. K., Baker, R., Bali, M., Baseckas, G., Bednarski, B. K., Beets, G. L., Berg, P. L., Beynon, J., Biondo, S., Bordeianou, L., Brunner, M., Buchwald, P., Burger, J. W. A., Burling, D., Campain, N., Chan, K. K. L., Chang, G., Chew, M. H., Chong, P. C., Christensen, H. K., Codd, M., Colquhoun, A. J., Corr, A., Coscia, M., Coyne, P. E., Creavin, B., Damjanovic, L., Daniels, I. R., Davies, M., Davies, R. J., Wilt, J. H. W., Denost, Q., Deutsch, C., Dietz, D., Dozois, E. J., Duff, M., Eglinton, T., Evans, M., Evans, M.D., Fearnhead, N. S., Frizelle, F. A., Garcia‐Granero, E., Garcia‐Sabrido, J. L., Gentilini, L., George, M. L., Glynn, R., Golda, T., Griffiths, B., Hagemans, J. A.W., Harji, D. P., Harris, D. A., Heriot, A. A. G., Hohenberger, W., Holm, T., Jenkins, J. T., Kanemitsu, Y., Kapur, S., Keller, D. S., Kelley, S. R., Kim, H., Koh, C. E., Kok, N. F. M., Kokelaar, R., Kontovounisios, C., Kusters, M., Larson, D. W., Laurberg, S., Law, W. L., Lee, P., Lydrup, M. L., Lynch, A. C., Martling, A., Mathis, K. L., Meijerink, W. J. H. J., Mentha, A. M., Merkel, S., McDermott, F. D., McGrath, J. S., Mihailo, A., Mirnezami, A., Morton, J. R., Mullaney, T. G., Nielsen, M. B., Nieuwenhuijzen, G. A. P., Nilsson, P. J., O'Connell, P. R., Palmer, G., Patsouras, D., Pellino, G., Poggioli, G., Quinn, M., Quyn, A., Radwan, R. W., Rasheed, S., Rasmussen, P. C., Rocha, R., Rothbarth, J., Roxburgh, C., Rutten, H. J. T., Ryan, É., Sagar, P. M., Sammour, T., Schizas, A. M. P., Schwarzkopf, E., Scripcariu, V., Shaikh, I., Shida, D., Simpson, A., Smart, N. J., Smith, J., Solomon, M. J., Sørensen, M.M., Steele, S. R., Steffens, D., Stocchi, L., Stylianides, N. 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Subjects: Male, Blood transfusion, Colorectal cancer, medicine.medical_treatment, Surgical Flaps, COLORECTAL-CANCER, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], Postoperative Complications, Retrospective Studie, Medicine and Health Sciences, Mortality rate, General Medicine, Middle Aged, Treatment Outcome, medicine.anatomical_structure, HOSPITAL VOLUME, SURVIVAL, Original Article, Female, Life Sciences & Biomedicine, Human, medicine.medical_specialty, lcsh:Surgery, Rectum, Subgroup analysis, SDG 3 - Good Health and Well-being, medicine, Humans, Blood Transfusion, Retrospective Studies, Aged, Science & Technology, Pelvic exenteration, Rectal Neoplasms, business.industry, MORTALITY, PelvEx Collaborative, Retrospective cohort study, Original Articles, lcsh:RD1-811, Length of Stay, medicine.disease, SURGEON VOLUME, Pelvic Exenteration, Surgery, Surgical Flap, Postoperative Complication, Neoplasm Recurrence, Local, business, Complication
Abstract: Contains fulltext : 215764.pdf (Publisher’s version ) (Open Access) Background: Pelvic exenteration for locally advanced rectal cancer (LARC) and locally recurrent rectal cancer (LRRC) is technically challenging but increasingly performed in specialist centres. The aim of this study was to compare outcomes of exenteration over time. Methods: This was a multicentre retrospective study of patients who underwent exenteration for LARC and LRRC between 2004 and 2015. Surgical outcomes, including rate of bone resection, flap reconstruction, margin status and transfusion rates, were examined. Outcomes between higher- and lower-volume centres were also evaluated. Results: Some 2472 patients underwent pelvic exenteration for LARC and LRRC across 26 institutions. For LARC, rates of bone resection or flap reconstruction increased from 2004 to 2015, from 3.5 to 12.8 per cent, and from 12.0 to 29.4 per cent respectively. Fewer units of intraoperative blood were transfused over this interval (median 4 to 2 units; P = 0.040). Subgroup analysis showed that bone resection and flap reconstruction rates increased in lower- and higher-volume centres. R0 resection rates significantly increased in low-volume centres but not in high-volume centres over time (low-volume: from 62.5 to 80.0 per cent, P = 0.001; high-volume: from 83.5 to 88.4 per cent, P = 0.660). For LRRC, no significant trends over time were observed for bone resection or flap reconstruction rates. The median number of units of intraoperative blood transfused decreased from 5 to 2.5 units (P < 0.001). R0 resection rates did not increase in either low-volume (from 51.7 to 60.4 per cent; P = 0.610) or higher-volume (from 48.6 to 65.5 per cent; P = 0.100) centres. No significant differences in length of hospital stay, 30-day complication, reintervention or mortality rates were observed over time. Conclusion: Radical resection, bone resection and flap reconstruction rates were performed more frequently over time, while transfusion requirements decreased.
Published: 2019

9. The impact of stapling technique and surgeon specialism on anastomotic failure after right-sided colorectal resection: an international multicentre, prospective audit

Author: Glasbey, Jc, Nepogodiev, D, Battersby, N, Bhangu, A, El-Hussuna, A, Frasson, M, Singh, B, Vennix, S, Zmora, O, Pinkney, T, Chaudhri, S, Bemelman, W, Christensen, P, D'Hoore, A, Laurberg, S, Morton, D, Rubbini, M, Vaizey, C, Mehta, S, Ives, N, Magill, L, Perry, R, Sheward, N, Cillo, M, Estefania, D, Patron Uriburu, J, Ruiz, H, Salomon, M, Makhmudov, A, Selnyahina, L, Varabei, A, Vizhynis, Y, Claeys, D, Defoort, B, Muysoms, F, Pletinckx, P, Vergucht, V, Debergh, I, Feryn, T, Reusens, H, Nachtergaele, M, Francart, D, Jehaes, C, Markiewicz, S, Monami, B, Weerts, J, Bouckaert, W, Houben, B, Knol, J, Sergeant, G, Vangertruyden, G, Haeck, L, Lange, C, Sommeling, C, Vindevoghel, K, Castro, S, De Bruyn, H, Huyghe, M, De Wolf, E, Reynders, D, de Buck van Overstraeten, A, Wolthuis, A, Delibegovic, S, Christiani, A, Marchiori, M Jr, Rocha de Moraes, C, Tercioti, V Jr, Arabadjieva, E, Bulanov, D, Dardanov, D, Stoyanov, V, Yonkov, A, Angelov, K, Maslyankov, S, Sokolov, M, Todorov, G, Toshev, S, Georgiev, Y, Karashmalakov, A, Zafirov, G, Wang, X, Condic, D, Kraljik, D, Mrkovic, H, Pavkovic, V, Raguž, K, Bencurik, V, Holášková, E, Skrovina, M, Farkašová, M, Grolich, T, Kala, Z, Antos, F, Pruchova, V, Sotona, O, Chobola, M, Dusek, T, Ferko, A, Örhalmi, J, Hoch, J, Kocian, P, Martinek, L, Bernstein, I, Gotschalck Sunesen, K, Leunbach, J, Thorlacius-Ussing, O, Uth Oveson, A, Dahl Chirstensen, S, Gamez, V, Oeting, M, Schou Loeve, U, Ugianskis, A, Jessen, M, Krarup, P, Linde, K, Mirza, Q, Overgaard Stovring, J, Erritzøe, L, Loft Jakobsen, H, Lykke, J, Palmgren Colov, E, Husted Madsen, A, Linde Friis, T, Amstrup Funder, J, Dich, R, Kjaer, S, Rasmussen, S, Schlesinger, N, Dilling Kjaer, M, Qvist, N, Khalid, A, Ali, G, Hadi, S, Rosell Walker, L, Kivelä, A, Lehtonen, T, Lepistö, A, Scheinin, T, Siironen, P, Kössi, J, Kuusanmäki, P, Tomminen, T, Turunen, A, Rautio, T, Vierimaa, M, Huhtinen, H, Karvonen, J, Lavonius, M, Rantala, A, Varpe, P, Cotte, E, Francois, Y, Glehen, O, 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J., Gallardo Herrera, A. 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I., Malik, A., Pitt, J., Aryal, K., El-Hadi, A., Lal, R., Pal, A., Velchuru, V., Oliveira Cunha, M., Thomas, M., Bains, S., Boyle, K., Miller, A., Norwood, M., Yeung, J., Goian, L., Gurjar, S., Saghir, W., Sengupta, N., Stewart-Parker, E., Bailey, S., Khalil, T., Lawes, D., Nikolaou, S., Omar, G., Church, R., Muthiah, B., Garrett, W., Marsh, P., Obeid, N., Chandler, S., Coyne, P., Evans, M., Hunt, L., Lim, J., Oliphant, Z., Papworth, E., Weaver, H., Cuiñas Leon, K., Williams, G., Hernon, J., Kapur, S., Moosvi, R., Shaikh, I., Swafe, L., Aslam, M., Evans, J., Ihedioha, U., Kang, P., Merchant, J., Hompes, R., Middleton, R., Broomfield, A., Crutten-Wood, D., Foster, J., Nash, G., Akhtar, M., Boshnaq, M., Eldesouky, S., Mangam, S., Rabie, M., Ahmed, J., Khan, J., Ming Goh, N., Shamali, A., Stefan, S., Thompson, C., Amin, A., Docherty, J., Lim, M., Walker, K., Watson, A., Hossack, M., Mackenzie, N., Paraoan, M., Alam, N., Daniels, I., Narang, S., Pathak, S., Smart, N., Al-Qaddo, A., Codd, R., Rutka, O., Bronder, C., Crighton, I., Davies, E., Raymond, T., Bookless, L., Griffiths, B., Plusa, S., Carlson, G., Harrison, R., Lees, N., Mason, C., Quayle, J., Branagan, G., Broadhurst, J., Chave, H., Sleight, S., Awad, F., Cruickshank, N., Joy, H., Boereboom, C., Daliya, P., Dhillon, A., Watson, N., Watson, R., Artioukh, D., Gokul, K., Javed, M., Kong, R., Sutton, J., Faiz, O., Jenkins, I., Leo, C. A., Samaranayake, S. F., Warusavitarne, J., Arya, S., Bhan, C., Mukhtar, H., Oshowo, A., Wilson, J., Duff, S., Fatayer, T., Mbuvi, J., Sharma, A., Cornish, J., Davies, L., Harries, R., Morris, C., Torkington, J., Knight, J., Lai, C., Shihab, O., Tzivanakis, A., Hussain, A., Luke, D., Padwick, R., Torrance, A., Tsiamis, A., Dawson, P., Balfour, A., Brady, R., Mander, J., Paterson, H., Chandratreya, N., Chu, H., Cutting, J., Vernon, S., Wai Ho, C., Andreani, S., Patel, H., Warner, M., Yan Qi Tan, J., Iqbal, A., Khan, A., Perrin, K., Raza, A., Tan, S., Meyer, Jérémy, Graduate School, TOBB ETÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, TOBB ETU, Faculty of Medicine, Department of Surgical Sciences, and Demirbaş, Sezai
Subjects: Crohn’s disease, Male, Leak, Surgi-cal technique, anastomotic leak, Bowel anastomosis, colorectal cancer, Crohn's disease, epidemiology, international, oversewn, stapler, surgery, surgical technique, Colorectal cancer, medicine.medical_treatment, 030230 surgery, Colon/surgery, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Epidemiology, Prospective Studies, Treatment Failure, Young adult, Prospective cohort study, Colectomy, Aged, 80 and over, General Surgery/statistics & numerical data, Medical Audit, ddc:617, Anastomosis, Surgical, Gastroenterology, Middle Aged, Colorectal Neoplasms/surgery, Colorectal surgery, 030220 oncology & carcinogenesis, Female, Colectomy/adverse effects, Colorectal Neoplasms, Anastomotic Leak/etiology, Adult, medicine.medical_specialty, Adolescent, Colon, bowel anastomosis, Colorectal Surgery/statistics & numerical data, Anastomosis, NO, Young Adult, 03 medical and health sciences, Surgical Stapling, medicine, Humans, Aged, ta3126, business.industry, Anastomosis, Surgical/adverse effects, Surgical Stapling/adverse effects, Bowel anastomosi, medicine.disease, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], General Surgery, business, Colorectal Surgery
Abstract: AIM: There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure.METHOD: Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic resection to this prospective, observational, international, multicentre study. Patients undergoing stapled, side-to-side ileocolic anastomoses were identified and multilevel, multivariable logistic regression analyses were performed to explore factors associated with anastomotic leak.RESULTS: One thousand three hundred and forty-seven patients were included from 200 centres in 32 countries. The overall anastomotic leak rate was 8.3%. Upon multivariate analysis there was no difference in leak rate with use of a cutting stapler for apical closure compared with a noncutting stapler (8.4% vs 8.0%, OR 0.91, 95% CI 0.54-1.53, P = 0.72). Oversewing of the apical staple line, whether in the cutting group (7.9% vs 9.7%, OR 0.87, 95% CI 0.52-1.46, P = 0.60) or noncutting group (8.9% vs 5.7%, OR 1.40, 95% CI 0.46-4.23, P = 0.55) also conferred no benefit in terms of reducing leak rates. Surgeons reporting to be general surgeons had a significantly higher leak rate than those reporting to be colorectal surgeons (12.1% vs 7.3%, OR 1.65, 95% CI 1.04-2.64, P = 0.04).CONCLUSION: This study did not identify any difference in anastomotic leak rates according to the type of stapling device used to close the apical aspect. In addition, oversewing of the anastomotic staple lines appears to confer no benefit in terms of reducing leak rates. Although general surgeons operated on patients with more high-risk characteristics than colorectal surgeons, a higher leak rate for general surgeons which remained after risk adjustment needs further exploration.
Published: 2018

10. Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

Author: Dich Grandt, S, El-Hussuna, A, Frasson, M, Singh, B, Gallo, G, Pata, F, Negoi, I, Pinkney, T, Zmora, O, Bhangu, A, Battersby, N, Chaudhri, S, Nepogodiev, D, Vennix, S, Glasbey, J, Minaya, A, Basso, L, Pukuotukai, M, Kelly, Me, Sánchez Guillén, L, Pellino, G, Buchs, N, Morton, D, Bemelman, W, Christensen, P, D'Hoore, A, Laurberg, S, Rubbini, M, Vaizey, C, Magill, L, Perry, R, Sheward, N, Mortensen, Rn, Cillo, M, Estefania, D, Patron Uriburu, J, Ruiz, H, Salomon, M, Makhmudov, A, Selnyahina, L, Varabei, A, Vizhynis, Y, Claeys, D, Defoort, B, Muysoms, F, Pletinckx, P, Vergucht, V, Debergh, I, Feryn, T, Reusens, H, Francart, D, Jehaes, C, Markiewicz, S, Monami, B, Weerts, J, Bouckaert, W, Houben, B, Knol, J, Sergeant, G, Vangertruyden, G, Haeck, L, Lange, C, Sommeling, C, Vindevoghel, K, Castro, S, De Bruyn, H, Huyghe, M, De Wolf, E, Reynders, D, de Buck van Overstraeten, A, Wolthuis, A, Delibegovic, S, Christiani, A, Marchiori, M Jr, Rocha de Moraes, C, Tercioti, V Jr, Arabadjieva, E, Bulanov, D, Dardanov, D, Stoyanov, V, Yonkov, A, Angelov, K, Maslyankov, S, Sokolov, M, Todorov, G, Toshev, S, Georgiev, Y, Karashmalakov, A, Zafirov, G, Wang, X, Condic, D, Kraljik, D, Mrkovic, H, Pavkovic, V, Raguž, K, Bencurik, V, Holášková, E, Skrovina, M, Farkašová, M, Grolich, T, Kala, Z, Antos, F, Pruchova, V, Sotona, O, Chobola, M, Dusek, T, Ferko, A, Örhalmi, J, Hoch, J, Kocian, P, Martinek, L, Bernstein, I, Gotschalck Sunesen, K, Leunbach, J, Thorlacius-Ussing, O, Uth Oveson, A, Dahl Chirstensen, S, Gamez, V, Oeting, M, Schou Loeve, U, Ugianskis, A, Jessen, M, Krarup, Pm, Linde, K, Mirza, Q, Overgaard Stovring, J, Erritzøe, L, Loft Jakobsen, H, Lykke, J, Palmgren Colov, E, Husted Madsen, A, Linde Friis, T, Amstrup Funder, J, Dich, R, Kjær, S, Rasmussen, S, Schlesinger, N, Dilling Kjaer, M, Qvist, N, Khalid, A, Ali, G, Hadi, S, Rosell Walker, L, Kivelä, A, Lehtonen, T, Lepistö, A, Scheinin, T, Siironen, P, Kössi, J, Kuusanmäki, P, Tomminen, T, Turunen, A, 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H, Kettelhack, C, Kirchhoff, P, Oertli, D, Weixler, B, Aytac, B, Leventoglu, S, Mentes, B, Yuksel, O, Demirbas, S, Busra Ozkan, B, Selçuk Özbalci, G, Sungurtekin, U, Gülcü, B, Ozturk, E, Yilmazlar, T, Challand, C, Fearnhead, N, Hubbard, R, Kumar, S, Arthur, J, Barben, C, Skaife, P, Slawik, S, Williams, M, Zammit, M, Barker, J, French, J, Sarantitis, I, Slawinski, C, Clifford, R, Eardley, N, Johnson, M, Mcfaul, C, Vimalachandran, D, Allan, S, Bell, A, Oates, E, Shanmugam, V, Brigic, A, Halls, M, Pucher, P, Stubbs, B, Agarwal, T, Chopada, A, Mallappa, S, Pathmarajah, M, Sugden, C, Brown, C, Macdonald, E, Mckay, A, Richards, J, Robertson, A, Kaushal, M, Patel, P, Tezas, S, Touqan, N, Ayaani, S, Marimuthu, K, Piramanayagam, B, Vourvachis, M, Iqbal, N, Korsgen, S, Seretis, C, Shariff, U, Arnold, S, Chan, H, Clark, E, Fernandes, R, Moran, B, Bajwa, A, Mcarthur, D, Cao, K, Cunha, P, Pardoe, H, Quddus, A, Theodoropoulou, K, Bolln, C, Denys, G, Gillespie, M, Manimaran, N, Reidy, J, Malik, Ai, Malik, A, Pitt, J, Aryal, K, El Hadi, A, Lal, R, Pal, A, Velchuru, V, Oliveira Cunha, M, Thomas, M, Bains, S, Boyle, K, Miller, A, Norwood, M, Yeung, J, Goian, L, Gurjar, S, Saghir, W, Sengupta, N, Stewart Parker, E, Bailey, S, Khalil, T, Lawes, D, Nikolaou, S, Omar, G, Church, R, Muthiah, B, Garrett, W, Marsh, P, Obeid, N, Chandler, S, Coyne, P, Evans, M, Hunt, L, Lim, J, Oliphant, Z, Papworth, E, Weaver, H, Cuiñas Leon, K, Williams, G, Hernon, J, Kapur, S, Moosvi, R, Shaikh, I, Swafe, L, Aslam, M, Evans, J, Ihedioha, U, Kang, P, Merchant, J, Hompes, R, Middleton, R, Broomfield, A, Crutten Wood, D, Foster, J, Nash, G, Akhtar, M, Boshnaq, M, Eldesouky, S, Mangam, S, Rabie, M, Ahmed, J, Khan, J, Ming Goh, N, Shamali, A, Stefan, S, Thompson, C, Amin, A, Docherty, J, Lim, M, Walker, K, Watson, A, Hossack, M, Mackenzie, N, Paraoan, M, Alam, N, Daniels, I, Narang, S, Pathak, S, Smart, N, Al Qaddo, A, Codd, R, Rutka, O, Bronder, C, Crighton, I, Davies, E, Raymond, T, Bookless, L, Griffiths, B, Plusa, S, Carlson, G, Harrison, R, Lees, N, Mason, C, Quayle, J, Branagan, G, Broadhurst, J, Chave, H, Sleight, S, Awad, F, Cruickshank, N, Joy, H, Boereboom, C, Daliya, P, Dhillon, A, Watson, N, Watson, R, Artioukh, D, Gokul, K, Javed, M, Kong, R, Sutton, J, Faiz, O, Jenkins, I, Leo, Ca, Samaranayake, Sf, Warusavitarne, J, Arya, S, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Duff, S, Fatayer, T, Mbuvi, J, Sharma, A, Cornish, J, Davies, L, Harries, R, Morris, C, Torkington, J, Knight, J, Lai, C, Shihab, O, Tzivanakis, A, Hussain, A, Luke, D, Padwick, R, Torrance, A, Tsiamis, A, Dawson, P, Balfour, A, Brady, R, Mander, J, Paterson, H, Chandratreya, N, Chu, H, Cutting, J, Vernon, S, Wai Ho, C, Andreani, S, Patel, H, Warner, M, Tan, Yq, Iqbal, A, Khan, A, Perrin, K, Raza, A, and S Tan, And
Subjects: Crohn’s disease, medicine.medical_specialty, Complications, Colorectal cancer, SURGERY, medicine.medical_treatment, Bowel resection, Disease, Inflammatory bowel disease, NO, COLORECTAL-CANCER, 03 medical and health sciences, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], MORBIDITY, 0302 clinical medicine, Medicine, Crohn’s disease, Colon cancer, Complications, Length of stay, Bowel resection, Right hemicolectomy, DIVERTICULAR-DISEASE, Colon cancer, Length of stay, Right hemicolectomy, colon cancer, complications, length of stay, bowel resection, right hemicolectomy, PREOPERATIVE OPTIMIZATION, RISK, Crohn's disease, ddc:617, business.industry, medicine.disease, 3126 Surgery, anesthesiology, intensive care, radiology, digestive system diseases, Surgery, 030220 oncology & carcinogenesis, 3121 General medicine, internal medicine and other clinical medicine, Diverticular disease, Prospective Study, 030211 gastroenterology & hepatology, SMOKING, business, Complication, Hospital stay, INFLAMMATORY-BOWEL-DISEASE
Abstract: BACKGROUND: Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIM: To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODS: This is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTS: Three hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSION: Patients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complications' rate was not different between the two groups.
Published: 2019

11. Pelvic Exenteration for Advanced Nonrectal Pelvic Malignancy

Author: Kelly ME, Ryan E ´ J, Aalbers AGJ, Abdul Aziz N, Abraham-Nordling M, Alberda W, Antoniou A, Austin KK, Baker R, Bali M, Baseckas G, Bednarski BK, Beets GL, Berg PL, Beynon J, Biondo S, Bordeianou L, Bremers AB, Brunner M, Buchwald P, Burger JWA, Burling D, Campain N, Chan KKL, Chang GJ, Chew MH, C Chong P, Christensen HK, Codd M, Colquhoun AJ, Corr A, Coscia M, Coyne PE, Creavin B, Damjanovic L, Daniels IR, Davies M, Davies RJ, deWilt JHW, Denost Q, Deutsch C, Dietz D, Domingo S, Dozois EJ, Duff M, Eglinton T, Evans MD, Fearnhead NS, Frizelle FA, Garcia-Granero E, Garcia-Sabrido JL, GentiliniL, George ML, Glynn R, Golda T, Griffiths B, Harris DA, Evans M, Hagemans JAW, Harji DP, Heriot AG, HohenbergerW, Holm T, Humphries E, Jansson-Palmer G, Jenkins JT, Kapur S, Kanemitsu Y, Kelley SR, Keller DS, Kim H, Koh CE, Kok NFM, Kokelaar R, Kontovounisios C, Kroon H, Kusters M, Lago V, Larson DW, Law WL, Laurberg S, Lee P, Lydrup ML, Lynch AC, Mathis KL, Martling A, Meijerink WJHJ, Merkel S, Mehta AM, McDermott FD, McGrath JS, Mihailo A, Mirnezami A, Morton JR, Mullaney TG, Nielsen MB, Nieuwenhuijzen GAP, Nilsson PJ, O’Connell PR, Palmer G, Patsouras D, Pellino G, Poggioli G, Quinn M, Quyn A, Radwan RW, Rasheed S, Rasmussen PC, Rocha R, Rothbarth J, Roxburgh C, Rutten HJT, Sagar PM, Sammour T, Schizas AMP, Schwarzkopf E, Scripcariu V, Shaikh I, Shida D, Simpson A, Smart NJ, Smith JJ, Solomon MJ, Sørensen MM, Steele SR, Steffens D, Stocchi L, Stylianides NA, Tekkis PP, Taylor C, Tsukamoto S, Turner WH, Tuynman JB, vanRamshorst GH, van Zoggel D, Vasquez-JimenezW, Verhoef C, WakemanC, Warrier S, Wasmuth HH, Weiser MR, Wheeler JMD, Wild J, Yip J, Winter DC., Gilberto Poggioli, Kelly, Me, Ryan, E ´ J, Aalbers, Agj, Abdul Aziz, N, Abraham-Nordling, M, Alberda, W, Antoniou, A, Austin, Kk, Baker, R, Bali, M, Baseckas, G, Bednarski, Bk, Beets, Gl, Berg, Pl, Beynon, J, Biondo, S, Bordeianou, L, Bremers, Ab, Brunner, M, Buchwald, P, Burger, Jwa, Burling, D, Campain, N, Chan, Kkl, Chang, Gj, Chew, Mh, C Chong, P, Christensen, Hk, Codd, M, Colquhoun, Aj, Corr, A, Coscia, M, Coyne, Pe, Creavin, B, Damjanovic, L, Daniels, Ir, Davies, M, Davies, Rj, Dewilt, Jhw, Denost, Q, Deutsch, C, Dietz, D, Domingo, S, Dozois, Ej, Duff, M, Eglinton, T, Evans, Md, Fearnhead, N, Frizelle, Fa, Garcia-Granero, E, Garcia-Sabrido, Jl, Gentilinil, George, Ml, Glynn, R, Golda, T, Griffiths, B, Harris, Da, Evans, M, Hagemans, Jaw, Harji, Dp, Heriot, Ag, Hohenbergerw, Holm, T, Humphries, E, Jansson-Palmer, G, Jenkins, Jt, Kapur, S, Kanemitsu, Y, Kelley, Sr, Keller, D, Kim, H, Koh, Ce, Kok, Nfm, Kokelaar, R, Kontovounisios, C, Kroon, H, Kusters, M, Lago, V, Larson, Dw, Law, Wl, Laurberg, S, Lee, P, Lydrup, Ml, Lynch, Ac, Mathis, Kl, Martling, A, Meijerink, Wjhj, Merkel, S, Mehta, Am, Mcdermott, Fd, Mcgrath, J, Mihailo, A, Mirnezami, A, Morton, Jr, Mullaney, Tg, Nielsen, Mb, Nieuwenhuijzen, Gap, Nilsson, Pj, O’Connell, Pr, Palmer, G, Patsouras, D, Pellino, G, Poggioli, G, Quinn, M, Quyn, A, Radwan, Rw, Rasheed, S, Rasmussen, Pc, Rocha, R, Rothbarth, J, Roxburgh, C, Rutten, Hjt, Sagar, Pm, Sammour, T, Schizas, Amp, Schwarzkopf, E, Scripcariu, V, Shaikh, I, Shida, D, Simpson, A, Smart, Nj, Smith, Jj, Solomon, Mj, Sørensen, Mm, Steele, Sr, Steffens, D, Stocchi, L, Stylianides, Na, Tekkis, Pp, Taylor, C, Tsukamoto, S, Turner, Wh, Tuynman, Jb, Vanramshorst, Gh, van Zoggel, D, Vasquez-JimenezW, Verhoef, C, Wakemanc, Warrier, S, Wasmuth, Hh, Weiser, Mr, Wheeler, Jmd, Wild, J, Yip, J, and Winter, Dc.
Subjects: Pelvic Neoplasm, Databases, Factual, medicine.medical_treatment, Tertiary Care Center, Kaplan-Meier Estimate, Cohort Studies, Tertiary Care Centers, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Retrospective Studie, Cause of Death, Pelvic Neoplasms, Neoadjuvant therapy, Cervical cancer, Aged, 80 and over, Mortality rate, Middle Aged, Prognosis, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Female, Survival Analysi, Human, medicine.medical_specialty, Prognosi, Malignancy, Risk Assessment, Disease-Free Survival, 03 medical and health sciences, SDG 3 - Good Health and Well-being, medicine, Humans, Neoplasm Invasiveness, Survival analysis, Proportional Hazards Models, Retrospective Studies, Aged, Neoplasm Staging, Neoplasm Invasivene, Pelvic exenteration, business.industry, medicine.disease, Survival Analysis, Surgery, Pelvic Exenteration, Proportional Hazards Model, Cohort Studie, Neoplasm Recurrence, Local, Ovarian cancer, business
Abstract: Item does not contain fulltext OBJECTIVE: To determine factors associated with outcomes following pelvic exenteration for advanced nonrectal pelvic malignancy. BACKGROUND: The PelvEx Collaborative provides large volume data from specialist centers to ascertain factors associated with improved outcomes. METHODS: Consecutive patients who underwent pelvic exenteration for nonrectal pelvic malignancy between 2006 and 2017 were identified from 22 tertiary centers. Patient demographics, neoadjuvant therapy, histopathological assessment, length of stay, 30-day major complication/mortality rate were recorded.The primary endpoints were factors associated with survival. The secondary endpoints included the difference in margin rates across the cohorts, impact of neoadjuvant treatment on survival, associated morbidity, and mortality. RESULTS: One thousand two hundred ninety-three patients were identified. 40.4% (n = 523) had gynecological malignancies (endometrial, ovarian, cervical, and vaginal), 35.7% (n = 462) urological (bladder), 18.1% (n = 234) anal, and 5.7% had sarcoma (n = 74).The median age across the cohort was 63 years (range, 23-85). The median 30-day mortality rate was 1.7%, with the highest rates occurring following exenteration for recurrent sarcoma or locally advanced cervical cancer (3.3% each). The median length of hospital stay was 17.5 days. 34.5% of patients experienced a major complication, with highest rate occurring in those having salvage surgery for anal cancer.Multivariable analysis showed R0 resection was the main factor associated with long-term survival. The 3-year overall-survival rate for R0 resection was 48% for endometrial malignancy, 40.6% for ovarian, 49.4% for cervical, 43.8% for vaginal, 59% for bladder, 48.3% for anal, and 48.1% for sarcoma. CONCLUSION: Pelvic exenteration remains an important treatment in selected patients with advanced or recurrent nonrectal pelvic malignancy. The range in 3-year overall survival following R0 resection (40%-59%) reflects the diversity of tumor types.
Published: 2019

12. International consensus definition of low anterior resection syndrome

Author: Keane, C, Fearnhead, NS, Bordeianou, L, Christensen, P, Espin Basany, E, Laurberg, S, Mellgren, A, Messick, C, Orangio, GR, Verjee, A, Wing, K, Bissett, I, An, V, Bryant, A, Byrne, C, Chen, T, Clark, D, Croft, S, Dinning, P, Gladman, M, Heriot, A, Kariappa, S, Keck, J, Lubowski, D, Khera, A, Kirkwood, K, Petersen, D, Sloots, K, Totten, B, Weston, M, Andersen, P, Bachmann, C, Barht, H, Emmertsen, K, Faaborg, P, Gögenur, I, Ingerslev, P, Isaksen, D, Iversen, H, Iversen, L, Jacobsen, K, Jansen, T, Jocobsen, I, Juul, T, Kjær, D, Krogh, K, Majgaard, M, Mynster, A, Neuenschwander, A, Nielsen, C, Nielsen, M, Nielsen, R, Nielsen, T, Olsen, J, Poulsen, B, Rahr, H, Snedker, B, Sørensen, G, Stolzenburg, T, Vaabengaard, P, Acheson, A, Andreyev, J, Bach, S, Battersby, N, Bradbury, J, Brown, S, Cecil, T, Chapman, M, Chapman, S, Chave, H, Cook, T, Cuffy, L, Davies, J, Dawson, C, Dixon, J, Duff, S, Edwards, C, Geh, I, Hamilton, C, Hancock, L, Harji, D, Hill, J, Holtham, S, Jenkins, J, Johnston, R, Kapur, S, Maxwell‐Armstrong, C, McArthur, D, Moran, B, Norton, C, Nugent, K, Pateman, L, Perston, Y, Rockall, T, Sagar, P, Saunders, M, Sebag‐Montefiore, D, Senapati, A, Singh, B, Skaife, P, Smart, N, Sykes, H, Taylor, C, Thorpe, G, Tierney, G, Voyce, S, Walsh, C, Warren, O, Wheeler, J, Woodward, A, Winter, D, Abbott, S, Beban, V, Bennett, M, Chadwick, T, Collinson, R, Corbett, S, Dennett, E, Eglinton, T, Fraser, A, Glue, J, Hohaia, D, Menzi, E, O’Connor, M, Stevenson, D, Wells, C, Wolyncewicz, S, Woodfield, J, Bence, K, Boutros, M, Brueseke, M, DeKorte, J, Floruta, C, Francone, T, Frederick, F, Grasso, J, Gurland, B, Higgins, K, Hull, T, Keller, D, Laffan, A, Lovett, S, Marlatt, J, McAdams, D, McCarthy, C, Milch, H, Natale, S, Pappou, E, Paquette, I, Pulskamp, S, Rich, M, Savitt, L, Shafi, M, Steele, S, Stein, S, Tolbert, M, Varma, M, Vogler, S, Vuong, T, Wells, K, Wexner, S, Wo, J, Wright, J, Wunderlich, C, Campbell, K, Lim, M, Moug, S, Oliphant, R, Araujo‐Ferreiro, M, Ballester, C, Belen‐Bueno, A, Blanco‐Colino, R, Carrillo‐Moreno, J, Castillo, J, Codina‐Cazador, A, Enriquez‐Navascuez, JM, Gallego‐García, M, Jerez, J, Jimenez, LM, Labaka‐Aretaga, I, Martin‐Fernández, M, Martinez‐Sanchez, C, Muñoz, A, Paniagua‐Cayetano, G, Pascual‐Damieta, M, de la Portilla, F, Ramirez, L, Sanchez‐García, C, Vaquer‐Casas, G, Vico‐García, E, Vigorita, V, Adams, R, Cornish, J, Davies, M, Evans, M, Torkington, J, and Turner, J
Abstract: Aim: Low anterior resection syndrome (LARS) is pragmatically defined as disordered bowel function after rectal resection leading to a detriment in quality of life. This broad characterization does not allow for precise estimates of prevalence. The LARS score was designed as a simple tool for clinical evaluation of LARS. Although the LARS score has good clinical utility, it may not capture all important aspects that patients may experience. The aim of this collaboration was to develop an international consensus definition of LARS that encompasses all aspects of the condition and is informed by all stakeholders. Method: This international patient–provider initiative used an online Delphi survey, regional patient consultation meetings, and an international consensus meeting. Three expert groups participated: patients, surgeons and other health professionals from five regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in three languages (English, Spanish, and Danish). The primary outcome measured was the priorities for the definition of LARS. Results: Three hundred twenty-five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96% and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to eight symptoms and eight consequences that capture essential aspects of the syndrome. Sampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this. Conclusion: This is the first definition of LARS developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of LARS. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in LARS over time and with intervention.
Published: 2020

13. MethCORR modelling of methylomes from formalin-fixed paraffin-embedded tissue enables characterization and prognostication of colorectal cancer

Author: Mattesen, T.B., Rasmussen, M.H., Sandoval, J., Ongen, H., Árnadóttir, S.S., Gladov, J., Martínez Cardús, Anna, Castro de Moura, Manuel, Madsen, A.H., Laurberg, S., Dermitzakis, E.T., Esteller, M., Andersen, C.L., Bramsen, J.B., and Universitat Autònoma de Barcelona
Subjects: 0301 basic medicine, Male, Tissue Fixation, Quantitative genetics, Colorectal cancer, General Physics and Astronomy, Datasets as Topic, Metastasis, chemistry.chemical_compound, Epigenome, 0302 clinical medicine, Gene expression, Intestinal Mucosa, lcsh:Science, Multidisciplinary, Paraffin Embedding, Methylation, Middle Aged, Prognosis, Gene Expression Regulation, Neoplastic, 030220 oncology & carcinogenesis, DNA methylation, Female, Colorectal Neoplasms, Formalin fixed paraffin embedded, Pronòstic mèdic, Colon, Science, Computational biology, Biology, Risk Assessment, General Biochemistry, Genetics and Molecular Biology, Disease-Free Survival, 03 medical and health sciences, Càncer colorectal, Formaldehyde, medicine, Genètica quantitativa, Biomarkers, Tumor, Humans, Aged, Models, Genetic, Gene Expression Profiling, Rectum, Microsatellite instability, General Chemistry, DNA Methylation, medicine.disease, 030104 developmental biology, chemistry, lcsh:Q, Neoplasm Recurrence, Local, DNA
Abstract: Transcriptional characterization and classification has potential to resolve the inter-tumor heterogeneity of colorectal cancer and improve patient management. Yet, robust transcriptional profiling is difficult using formalin-fixed, paraffin-embedded (FFPE) samples, which complicates testing in clinical and archival material. We present MethCORR, an approach that allows uniform molecular characterization and classification of fresh-frozen and FFPE samples. MethCORR identifies genome-wide correlations between RNA expression and DNA methylation in fresh-frozen samples. This information is used to infer gene expression information in FFPE samples from their methylation profiles. MethCORR is here applied to methylation profiles from 877 fresh-frozen/FFPE samples and comparative analysis identifies the same two subtypes in four independent cohorts. Furthermore, subtype-specific prognostic biomarkers that better predicts relapse-free survival (HR = 2.66, 95%CI [1.67–4.22], P value
Published: 2020

14. International consensus definition of low anterior resection syndrome

Author: Keane, C, Fearnhead, NS, Bordeianou, LG, Christensen, Peter, Basany, EE, Laurberg, S, Portilla de Juan, Fernando de la, Bissett, IP, Universidad de Sevilla. Departamento de Cirugía, Auckland Medical Research Foundation (AMRF), Auckland Medical Research Foundation Ruth Spencer Fellowship, Bowel Disease Research Foundation (BDRF), Danish Cancer Society, American Society of Colon and Rectal Surgeons (ASCRS), Association of Coloproctology of Great Britain and Ireland (ACPGBI), Auckland Medical Research Foundation, BDRF, Colon and Rectal Surgery Section of the Royal Australasian College of Surgeons (RACS), Colorectal Surgical Society of Australia and New Zealand (CSSANZ), ESCP, European Society of Coloproctology (ESCP), and Royal Society of Medicine (RSM) Section of Coloproctology
Subjects: Patient reported, Patient-reported, Low anterior resection syndrome, Rectal resection, Consensus definition
Abstract: Background Low anterior resection syndrome (LARS) is pragmatically defined as disordered bowel function after rectal resection leading to a detriment in quality of life. This broad characterization does not allow for precise estimates of prevalence. The LARS score was designed as a simple tool for clinical evaluation of LARS. Although the LARS score has good clinical utility, it may not capture all important aspects that patients may experience. The aim of this collaboration was to develop an international consensus definition of LARS that encompasses all aspects of the condition and is informed by all stakeholders. Methods This international patient-provider initiative used an online Delphi survey, regional patient consultation meetings and an international consensus meeting. Three expert groups participated: patients, surgeons and other health professionals from five regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in three languages (English, Spanish and Danish). The primary outcome measured was the priorities for the definition of LARS. Results Three hundred and twenty-five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96% and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to eight symptoms and eight consequences that capture essential aspects of the syndrome. Sampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this. Conclusions This is the first definition of LARS developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of LARS. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in LARS over time and with intervention.
Published: 2020

15. Publisher Correction: MethCORR modelling of methylomes from formalin-fixed paraffin-embedded tissue enables characterization and prognostication of colorectal cancer

Author: Mattesen TB, Rasmussen MH, Sandoval J, Ongen H, Árnadóttir SS, Gladov J, Martinez-Cardus A, de Moura MC, Madsen AH, Laurberg S, Dermitzakis ET, Esteller M, Andersen CL, and Bramsen JB
Abstract: An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Published: 2020

16. Predictors for Anastomotic Leak, Postoperative Complications, and Mortality After Right Colectomy for Cancer: Results From an International Snapshot Audit

Author: Gallo, G., Pata, F., Vennix, S., Laurberg, S., Morton, D., Rubbini, M., Vaizey, C., Magill, L., Perry, R., Sheward, N., Hervas, D., Cillo, M., Estefania, D., Uriburu, J.P., Ruiz, H., Solomon, M., Makhmudov, A., Selnyahina, L., Varabei, A., Vizhynis, Y., Claeys, D., Defoort, B., Muysoms, F., Pletinckx, P., Vergucht, V., Debergh, I., Feryn, T., Reusens, H., Nachtergaele, M., Francart, D., Jehaes, C., Markiewicz, S., Monami, B., Weerts, J., Houben, B., Haeck, L., Lange, C., Sommeling, C., Vindevoghel, K., Castro, S., De Bruyn, H., Huyghe, M., De Wolf, E., Reynders, D., D'Hoore, A., De Buck Van Overstraeten, A., Wolthuis, A., Delibegovic, S., Christiani, A., Marchiori, M., Jr., De Moraes, C.R., Tercioti, V., Jr., Arabadjieva, E., Bulanov, D., Dardanov, D., Stoyanov, V., Yonkov, A., Angelov, K., Maslyankov, S., Sokolov, M., Todorov, G., Toshev, S., Georgiev, Y., Karashmalakov, A., Zafirov, G., Wang, X., Condic, D., Kraljik, D., Mrkovic, H., Pavkovic, V., Raguž, K., Bencurik, V., Holášková, E., Skrovina, M., Farkašová, M., Grolich, T., Kala, Z., Antos, F., Pruchova, V., Sotona, O., Chobola, M., Dusek, T., Ferko, A., Örhalmi, J., Hoch, J., Kocian, P., Martinek, L., Bernstein, I., Sunesen, K.G., Leunbach, J., Thorlacius-Ussing, O., Oveson, A.U., Christensen, P., Chirstensen, S.D., Gamez, V., Oeting, M., Loeve, U.S., Ugianskis, A., Jessen, M., Krarup, P., Linde, K., Mirza, Q., Stovring, J.O., Erritzøe, L., Jakobsen, H.L., Lykke, J., Colov, E.P., Madsen, A.H., Friis, T.L., Funder, J.A., Dich, R., Kjar, S., Rasmussen, S., Schlesinger, N., Kjaer, M.D., Qvist, N., Khalid, A., Ali, G., El-Hussuna, A., Hadi, S., Walker, L.R., Kivelä, A., Lehtonen, T., Lepistö, A., Scheinin, T., Siironen, P., Kössi, J., Kuusanmäki, P., Tomminen, T., Turunen, A., Rautio, T., Vierimaa, M., Huhtinen, H., Karvonen, J., Lavonius, M., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Kepenekian, V., Passot, G., Maggiori, L., Manceau, G., Panis, Y., Gout, M., Rullier, E., Van Geluwe, B., Chafai, N., Lefevre, J., Parc, Y., Tire, E., Couette, C., Duchalais, E., Agha, A., Hornberger, M., Hungbauer, A., Iesalnieks, I., Weindl, I., Crescenti, F., Keller, M., Kolodziejski, N., Scherer, R., Sterzing, D., Bock, B., Boehm, G., El-Magd, M., Krones, C., Niewiera, M., Buhr, J., Cordesmeyer, S., Hoffmann, M., Krückemeier, K., Vogel, T., Schön, M., Baral, J., Lukoschek, T., Münch, S., Pullig, F., Horisberger, K., Kienle, P., Magdeburg, J., Post, S., Batzalexis, K., Germanos, S., Agalianos, C., Dervenis, C., Gouvas, N., Kanavidis, P., Kottikias, A., Katsoulis, I., Korkolis, D., Plataniotis, G., Sakorafas, G., Akrida, I., Argentou, M., Kollatos, C., Lampropoulos, C., Tsochatzis, S., Besznyák, I., Bursics, A., Egyed, T., Papp, G., Svastics, I., Atladottir, J., Möller, P., Sigurdsson, H., Stefánsson, T., Valsdottir, E., Andrews, E., Foley, N., Hechtl, D., Majeed, M., McCourt, M., Hanly, A., Hyland, J., Martin, S., O'Connell, R., Winter, D., Connelly, T., Joyce, W., Wrafter, P., Berkovitz, R., Avital, S., Yahia, I.H., Herman, N., Shpitz, B., White, I., Lishtzinsky, Y., Tsherniak, A., Wasserberg, N., Horesh, N., Keler, U., Pery, R., Shapiro, R., Zmora, O., Tulchinsky, H., Badran, B., Dayan, K., Iskhakov, A., Lecaros, J., Nabih, N., Angrima, I., Bardini, R., Pizzolato, E., Tonello, M., Arces, F., Balestri, R., Ceccarelli, C., Prosperi, V., Rossi, E., Giannini, I., Vincenti, L., Di Candido, F., Di Iena, M., Guglielmi, A., Iambrenghi, O., Marsanic, P., Mellano, A., Muratore, A., Annecchiarico, M., Bencini, L., Bonapasta, S., Coratti, A., Guerra, F., Asteria, C., Boccia, L., Gerard, L., Pascariello, A., Manca, G., Marino, F., Casaril, A., Inama, M., Moretto, G., Bacchelli, C., Carvello, M., Mariani, N., Montorsi, M., Spinelli, A., Romairone, E., Scabini, S., Belli, A., Bianco, F., De Franciscis, S., Romano, G.M., Delrio, P., Pace, U., Rega, D., Sassaroli, C., Scala, D., De Luca, R., Ruggieri, E., Elbetti, C., Garzi, A., Romoli, L., Scatizzi, M., Vannucchi, A., Curletti, G., Durante, V., Galleano, R., Mariani, F., Reggiani, L., Bellomo, R., Infantino, A., Franceschilli, L., Sileri, P., Clementi, I., Coletta, D., La Torre, F., Mingoli, A., Velluti, F., Di Giacomo, A., Fiorot, A., Massani, M., Padoan, L., Ruffolo, C., Caruso, S., Franceschini, F., Laessig, R., Monaci, I., Rontini, M., De Nardi, P., Lemma, M., Rosati, R., Tamburini, A., De Luca, M., Sartori, A., Benevento, A., Bottini, C., Ferrari, C., Tessera, G., Pellino, G., Selvaggi, F., Lanzani, A., Romano, F., Sgroi, G., Steccanella, F., Turati, L., Yamamoto, T., Ancans, G., Gerkis, S., Leja, M., Pcolkins, A., Sivins, A., Latkauskas, T., Lizdenis, P., Saladžinskas, Ž., Švagždys, S., Tamelis, A., Razbadauskas, A., Sokolovas, M., Dulskas, A., Samalavicius, N., Jotautas, V., Mikalauskas, S., Poskus, E., Poskus, T., Strupas, K., Camenzuli, C., Cini, C., Predrag, A., Psaila, J., Spiteri, N., Bemelman, W., Buskens, C., De Groof, J., Gooszen, J., Tanis, P., Belgers, E., Davids, P., Furnee, E., Postma, E., Pronk, A., Smakman, N., Clermonts, S., Zimmerman, D., Omloo, J., Van Der Zaag, E., Van Duijvendijk, P., Wassenaar, E., Bruijninckx, M., De Graff, E., Doornebosch, P., Tetteroo, G., Vermaas, M., Iordens, G., Knops, S., Toorenvliet, B., Van Westereenen, E., Boerma, E., Coene, P., Van Der Harst, E., Van Der Pool, A., Raber, M., Melenhorst, J., De Castro, S., Gerhards, M., Arron, M., Bremers, A., De Wilt, H., Ferenschild, F., Yauw, S., Cense, H., Demirkiran, A., Hunfeld, M., Mulder, I., Nonner, J., Swank, H., Van Wagensveld, B., Bolmers, M., Briel, J., Van Geloven, N., Van Rossem, C., Klemann, V., Konsten, J., Leenders, B., Schok, T., Bleeker, W., Gidwani, A., Lawther, R., Loughlin, P., Skelly, B., Spence, R., Brun, M., Helgeland, M., Ignjatovic, D., Øresland, T., Peyman, Y., Backe, I.F., Sjo, O.H., Nesbakken, A., Tandberg-Eriksen, M., Cais, A., Traland, J.H., Herikstad, R., Kørner, H., Lauvland, N., Jajtner, D., Kabiesz, W., Rak, M., Gmerek, L., Horbacka, K., Horst, N., Krokowicz, P., Kwiatkowski, A., Pasnik, K., Karcz, P., Romaniszyn, M., Rusek, T., Walega, P., Czarencki, R., Obuszko, Z., Sitarska, M., Wojciech, W., Zawadzki, M., Amado, S., Clara, P., Couceiro, A., Malaquias, R., Rama, N., Almeida, A., Barbosa, E., Cernadas, E., Duarte, A., Silva, P., Costa, S., Insua, C.M., Pereira, J., Pereira, C., Sacchetti, M., Ferreira, R.A.M., Pinto, B.C., Sousa, P.J.V., Oliveira, A., Cardoso, R., Carlos, S., Corte-Real, J., Pereira, P.M., Souto, R., Carneiro, C., Marinho, R., Nunes, V., Rocha, R., Sousa, M., Leite, J., Melo, F., Pimentel, J., Ventura, L., Nova, C.V., Copǎescu, C., Bintintan, V., Ciuce, C., Dindelegan, G., Scurtu, R., Seicean, R., Domansky, N., Karachun, A., Moiseenko, A., Pelipas, Y., Petrov, A., Pravosudov, I., Aiupov, R., Akmalov, Y., Parfenov, A., Suleymanov, N., Tarasov, N., Jumabaev, H., Mamedli, Z., Rasulov, A., Aliev, I., Chernikovskiy, I., Kochnev, V., Komyak, K., Smirnov, A., Achkasov, S., Bolikhov, K., Shelygin, Y., Sushkov, O., Zapolskiy, A., Gvozdenovic, M., Jovanovic, D., Lausevic, Z., Cvetković, D., Maravić, M., Milovanovic, B., Stojakovic, N., Tripković, I., Mihajlovic, D., Nestorovic, M., Pecic, V., Petrovic, D., Stanojevic, G., Barisic, G., Dimitrijevic, I., Krivokapic, Z., Markovic, V., Popovic, M., Aleksic, A., Dabic, D., Kostic, I., Milojkovic, A., Perunicic, V., Dragana, R., Lukic, D., Petrovic, T., Radovanovic, Z., Cuk, V., Kenic, M., Kovacevic, B., Krdzic, I., Korcek, J., Rems, M., Toplak, J., Escarrâ, J., Barrionuevo, M.G., Golda, T., Moreno, E.K., Martin, C.Z., Laso, C.A., Cumplido, P., Padin, H., Fons, J.B., Hernández-Lizoain, J., Martinez-Ortega, P., Molina-Fernández, M., Sánchez-Justicia, C., Solanas, J.A.G., De Laspra, E.C.D., Elia-Guedea, M., Gallego, E., Ramirez, J., Chaves, J.A., González, P.D., Elosua, T., Sahagún, J., Frade, A.T., Conde, J.A., Castrillo, E., Maag, R.D., Maderuelo, V., Saldarriaga, L., Cao, I.A., Varela, X.F., Fernández, S.N., Calvo, A.P., Álvarez, S.V., Sierra, I.B., Lozano, R., Márquez, M., Porcel, O., Menendez, P., Hevia, M.F., Sigüenzo, L.F., Toscano, M.J., Fortuny, A.L., Trujillo, J.O., Espi, A., Garcia-Botello, S., Martín-Arévalo, J., Moro-Valdezate, D., Pla-Martí, V., Blanco-Antona, F., Abrisqueta, J., Canovas, N.I., Mompean, J.L., Ripoll, D.E., Gonzalez, S.M., Parodi, J., López, A.F., Fernández, M.R., Valls, J.C., De Zarate, L.O., Ribas, R., Sabia, D., Viso, L., Gonçalves, S.A., Egea, M.J.G., Damieta, M.P., Pera, M., Ruiz, S.S., Bernal, J., Landete, F., Ais, G., Alonso, E., Lucia, J.A., Boscá, A., Deusa, S., Del Caño, J.G., Viciano, V., García-Armengol, J., Roig, J., Blas, J., Escartin, J., Fatás, J., Fernando, J., Ferrer, R., Pacheco, R.A., Flórez, L.G., Gijón, M.M., Díez, J.O., Garcia, L.S., Teixido, F.A., Ojo, C.B., Berzosa, J.B., Moure, S.L., Sierra, J.E., Fermiñán, A., Herrerias, F., Rufas, M., Viñas, J., Codina-Cazador, A., Farrés, R., Gómez, N., Julià, D., Planellas, P., López, J., Luna, A., Maristany, C., Duyos, A.M., Puértolas, N., Moral, M.A., Serra-Aracil, X., Coello, P.C., Gómez, D., Carton, C., Miguel, A., Pascual, F.R., Cerrato, X.V., Muñoz, R.Z., Cervera-Aldama, J., González, J.G., Ramos-Prada, J., Santamaría-Olabarrieta, M., Urigüen-Echeverría, A., Alcover, R.C., Soria, J.E., Rodriguez, E.F., Hernandis, J., Ibañez, V.M., De La Torre Gonzalez, F., Huerga, D., Viejo, E.P., Rivera, A., Ucar, E.R., Garcia-Septiem, J., Jiménez, V., Miramón, J.J., Rodriquez, J.R., Alvarez, V.R., Garcea, A., Ponchietti, L., Borda, N., Enriquez-Navascues, J., Saralegui, Y., Molina, G.F., Nogues, E., Méndez, A.R., Castellano, C.R., Quesada, Y.S., Gallego, M., Pascual, I., Perez, I., San Andrés, B., Villanueva, F., Alonso, J., Cagigas, C., Castillo, J., Gómez, M., Martín-Parra, J., Ballester, M.M., Franco, E.P., Aledo, V.S., Navarro, G.V., Rodriquez, E.C., De Chaves, P.G., Hernandez, G., Alvarez, A.P., Sanchez, A.S., Garcia, F.C.B., Roque, J.G.A., Aria, F.L.R., Del Valle Ruiz, S.R., De La Villa, G.S., Compañ, A., Marín, A.G., Nofuentes, C., Micó, F.O., Auladell, V.P., Carrasco, M., Perez, C.D., Gálvez-Pastor, S., Garcia, I.N., Perez, A.S., Enjuto, D., Bujalance, F.M., Marcelin, N., Pérez, M., García, R.S., Cabrera, A., De La Portilla, F., Diaz-Pavon, J., Jimenez-Rodriguez, R., Vazquez-Monchul, J., González, J.D., Pérez, R.G., Castellano, J.R., De La Rua, J.R., Toral, B.C., Alustiza, J.E., Fernández, L., Ramirez, J.R., Ramos, J.S., Alias, D., Garcia-Olmo, D., Guadalajara, H., Herreros, M., Pacheco, P., Del Castillo Díez, F., Pinto, F.L., Alegre, J.M., Ortega, I., Antonio, A.P.N., Caro, A., Escuder, J., Feliu, F., Millan, M., Company, R.A., Caregnato, A.F., Trujillo, R.L., Carrillo, R.R., Carmona, M.R., Alonso, N., Zafra, D.A., Candia, B.A.A., Pascual, J.B., Flores, C.P., Montero, J.A., Clavijo, M.A., Garcia, J., Tocino, J.S., Alcazar, C., Navarro, D.C., Romero, J.F., Riveiro, M.R., Romero, M., Arencibia, B., Esclapez, P., Frasson, M., García-Granero, E., Granero, P., Herrera, A.B.G., Diaz, L., Tordera, E.M.T., Fernandez, F.M., Rodriguez, E.N., Arenal, J., Citores, M., Marcos, J., Sánchez, J., Tinoco, C., Espin, E., Granero, A.G., Gomez, L.J., Garcia, J.S., Vallribera, F., Folkesson, J., Sköldberg, F., Bergman, K., Borgström, E., Frey, J., Silfverberg, A., Söderholm, M., Nygren, J., Segelman, J., Gustafsson, D., Lagerqvist, A., Papp, A., Pelczar, M., Abraham-Nordling, M., Ahlberg, M., Sjovall, A., Tengstrom, J., Hagman, K., Chabok, A., Ezra, E., Nikberg, M., Smedh, K., Tiselius, C., Al-Naimi, N., Dao Duc, M., Meyer, J., Mormont, M., Ris, F., Prevost, G., Villiger, P., Hoffmann, H., Kettelhack, C., Kirchhoff, P., Oertli, D., Weixler, B., Aytac, B., Leventoglu, S., Mentes, B., Yuksel, O., Demirbas, S., Ozkan, B.B., Özbalci, G.S., Sungurtekin, Uğur, Gülcü, B., Ozturk, E., Yilmazlar, T., Challand, C., Fearnhead, N., Hubbard, R., Kumar, S., Arthur, J., Barben, C., Skaife, P., Slawik, S., Williams, M., Zammit, M., Barker, J., French, J., Sarantitis, I., Slawinski, C., Clifford, R., Eardley, N., Johnson, M., McFaul, C., Vimalachandran, D., Allan, S., Bell, A., Oates, E., Shanmugam, V., Brigic, A., Halls, M., Pucher, P., Stubbs, B., Agarwal, T., Chopada, A., Mallappa, S., Pathmarajah, M., Sugden, C., Brown, C., Macdonald, E., Mckay, A., Richards, J., Robertson, A., Kaushal, M., Patel, P., Tezas, S., Touqan, N., Ayaani, S., Marimuthu, K., Piramanayagam, B., Vourvachis, M., Iqbal, N., Korsgen, S., Seretis, C., Shariff, U., Arnold, S., Battersby, N.J., Chan, H., Clark, E., Fernandes, R., Moran, S., Bajwa, A., McArthur, D., Cao, K., Cunha, P., Pardoe, H., Quddus, A., Theodoropoulou, K., Bolln, C., Denys, G., Gillespie, M., Manimaran, N., Reidy, J., Malik, A., Pitt, J., Aryal, K., El-Hadi, A., Lal, R., Pal, A., Velchuru, V., Chaudhri, S., Cunha, M.O., Singh, B., Thomas, M., Bains, S., Boyle, K., Miller, A., Norwood, M., Yeung, J., Goian, L., Gurjar, S., Saghir, W., Sengupta, N., Stewart-Parker, E., Bailey, S., Khalil, T., Lawes, D., Nikolaou, S., Omar, G., Church, R., Muthiah, B., Garrett, W., Marsh, P., Obeid, N., Chandler, S., Coyne, P., Evans, M., Hunt, L., Lim, J., Oliphant, Z., Papworth, E., Weaver, H., Leon, K.C., Williams, G., Hernon, J., Kapur, S., Moosvi, R., Shaikh, I., Swafe, L., Aslam, M., Evans, J., Ihedioha, U., Kang, P., Merchant, J., Hompes, R., Middleton, R., Broomfield, A., Crutten-Wood, D., Foster, J., Nash, G., Akhtar, M., Boshnaq, M., Eldesouky, S., Mangam, S., Rabie, M., Ahmed, J., Khan, J., Goh, N.M., Shamali, A., Stefan, S., Nepogodiev, D., Pinkney, T.D., Thompson, C., Amin, A., Docherty, J., Lim, M., Walker, K., Watson, A., Hossack, M., Mackenzie, N., Paraoan, M., Alam, N., Daniels, I., Narang, S., Pathak, S., Smart, N., Al-Qaddo, A., Codd, R., Rutka, O., Bronder, C., Crighton, I., Davies, E., Raymond, T., Bookless, L., Griffiths, B., Plusa, S., Carlson, G., Harrison, R., Lees, N., Mason, C., Quayle, J., Branagan, G., Broadhurst, J., Chave, H., Sleight, S., Awad, F., Bhangu, A., Cruickshank, N., Joy, H., Boereboom, C., Daliya, P., Dhillon, A., Watson, N., Watson, R., Artioukh, D., Gokul, K., Javed, M., Kong, R., Sutton, J., Faiz, O., Jenkins, I., Leo, C., Samaranayake, F., Warusavitarne, J., Arya, S., Bhan, C., Mukhtar, H., Oshowo, A., Wilson, J., Duff, S., Fatayer, T., Mbuvi, J., Sharma, A., Cornish, J., Davies, L., Harries, R., Morris, C., Torkington, J., Knight, J., Lai, C., Shihab, O., Tzivanakis, A., Hussain, A., Luke, D., Padwick, R., Torrance, A., Tsiamis, A., Dawson, P., Balfour, A., Brady, R., Mander, J., Paterson, H., Chandratreya, N., Chu, H., Cutting, J., Vernon, S., Ho, C.W., Andreani, S., Patel, H., Warner, M., Tan, J.Y.Q., Iqbal, A., Khan, A., Perrin, K., Raza, A., Tan, S., European Society of Coloproctology Collaborating Group Collaborators, Group, ESCP Cohort Studies Sub-Committee, ESCP Research Committee, Logistical Support and Data Collection, Analysis, Investigators, Radiology and nuclear medicine, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Surgery, MUMC+: MA Heelkunde (9), Graduate School, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Cancer Treatment and Quality of Life, Neurology, and Center for Evidence Based Education
Subjects: Male, Leak, Conference Paper, adverse event, ileostomy, non-smoker, 0302 clinical medicine, middle aged, antibiotic therapy, 80 and over, antibiotic agent, postoperative complication, emergency surgery, Colectomy, cecum, Aged, 80 and over, OUTCOMES, adult, COLON-CANCER, Gastroenterology, operation duration, clinical trial, General Medicine, cohort analysis, laparoscopic surgery, ureter injury, Survival Rate, aged, risk factor, 030220 oncology & carcinogenesis, Cohort, kidney injury, 030211 gastroenterology & hepatology, Colonic Neoplasms/mortality, anastomosis leakage, liver injury, prospective study, medicine.medical_specialty, SURGICAL STRESS, ELECTIVE RIGHT, surgical infection, 03 medical and health sciences, Humans, human, Aged, clinical audit, sex ratio, major clinical study, mortality, hemicolectomy, multicenter study, RISK-FACTORS, observational study, Complication, Anastomotic leak, Colon cancer, Postoperative outcome, Right colectomy, general surgery, surgical mortality, SURGERY, very elderly, morbidity, Anastomotic Leak, mortality rate, open surgery, Cohort Studies, Postoperative Complications, gallbladder disease, LAPAROSCOPY, Risk Factors, Neoplasms, cancer mortality, Laparoscopy, Prospective cohort study, colon resection, Medical Audit, medicine.diagnostic_test, Mortality rate, colon tumor, Middle Aged, female, colon cancer, Right Colectomy, Colonic Neoplasms, ileum, surgical stapling, Female, cancer surgery, Colectomy/adverse effects, duodenum injury, small intestine resection, RESECTION, reoperation, Anastomosis, NO, MORBIDITY, medicine, operative blood loss, LS7_4, percutaneous drainage, business.industry, suture technique, Surgery, blood vessel injury, peroperative complication, elective surgery, Anastomotic Leak/epidemiology, pathology, business
Abstract: A right hemicolectomy is among the most commonly performed operations for colon cancer, but modern high-quality, multination data addressing the morbidity and mortality rates are lacking.This study reports the morbidity and mortality rates for right-sided colon cancer and identifies predictors for unfavorable short-term outcome after right hemicolectomy.This was a snapshot observational prospective study.The study was conducted as a multicenter international study.The 2015 European Society of Coloproctology snapshot study was a prospective multicenter international series that included all patients undergoing elective or emergency right hemicolectomy or ileocecal resection over a 2-month period in early 2015. This is a subanalysis of the colon cancer cohort of patients.Predictors for anastomotic leak and 30-day postoperative morbidity and mortality were assessed using multivariable mixed-effect logistic regression models after variables selection with the Lasso method.Of the 2515 included patients, an anastomosis was performed in 97.2% (n = 2444), handsewn in 38.5% (n = 940) and stapled in 61.5% (n = 1504) cases. The overall anastomotic leak rate was 7.4% (180/2444), 30-day morbidity was 38.0% (n = 956), and mortality was 2.6% (n = 66). Patients with anastomotic leak had a significantly increased mortality rate (10.6% vs 1.6% no-leak patients; p0.001). At multivariable analysis the following variables were associated with anastomotic leak: longer duration of surgery (OR = 1.007 per min; p = 0.0037), open approach (OR = 1.9; p = 0.0037), and stapled anastomosis (OR = 1.5; p = 0.041).This is an observational study, and therefore selection bias could be present. For this reason, a multivariable logistic regression model was performed, trying to correct possible confounding factors.Anastomotic leak after oncologic right hemicolectomy is a frequent complication, and it is associated with increased mortality. The key contributing surgical factors for anastomotic leak were anastomotic technique, surgical approach, and duration of surgery. See Video Abstract at http://links.lww.com/DCR/B165. PREDICTORES DE FUGA ANASTOMóTICA, COMPLICACIONES POSTOPERATORIAS Y MORTALIDAD DESPUéS DE LA COLECTOMíA DERECHA POR CáNCER: RESULTADOS DE UNA AUDITORíA INTERNACIONAL DE CORTO PLAZO: La hemicolectomía derecha se encuentra entre las operaciones más frecuentemente realizadas para cáncer de colon, pero faltan datos modernos multinacionales de alta calidad, que aborden las tasas de morbilidad y mortalidad.Reportar la tasa de morbilidad y mortalidad para cáncer de colon del lado derecho, e identificar predictores de resultados desfavorables a corto plazo, después de la hemicolectomía derecha.Estudio prospectivo observacional de corto plazo.Estudio multicéntrico internacional.El estudio de corto plazo de la Sociedad Europea de Coloproctología de 2015, fue una serie prospectiva multicéntrica internacional, que incluyó a todos los pacientes sometidos a hemicolectomía derecha electiva, de emergencia o resección ileocecal, por un período de dos meses y a principios de 2015. Este es un subanálisis, cohorte de pacientes con cáncer de colon.Los predictores de fuga anastomótica, morbilidad y mortalidad postoperatorias a los 30 días, se evaluaron usando modelos de regresión logística de efectos multivariables mixtos, después de la selección de variables con el método Lasso.De los 2,515 pacientes incluidos, se realizó una anastomosis en el 97,2% (n = 2,444); sutura manual en 38.5% (n = 940) y por engrapadora en 61.5% (n = 1504) casos. La tasa global de fuga anastomótica fue del 7,4% (180/2,444), morbilidad a los 30 días fue del 38,0% (n = 956) y la mortalidad fue del 2,6% (n = 66). Los pacientes con fuga anastomótica tuvieron una tasa de mortalidad significativamente mayor (10,6% frente al 1,6% de pacientes sin fuga, p0,001). En el análisis multivariable, las siguientes variables se asociaron con la fuga anastomótica: mayor duración de la cirugía (OR 1.007 por minuto, p = 0.0037), abordaje abierto (OR 1.9, p = 0.0037) y anastomosis por engrapadora (OR 1.5, p = 0.041).Este es un estudio observacional y por lo tanto podría estar presente el sesgo de selección. Por esta razón, se realizó un modelo de regresión logística multivariable, tratando de corregir posibles factores de confusión.La fuga anastomótica después de la hemicolectomía derecha oncológica, es una complicación frecuente y asociada a mayor mortalidad. Los factores quirúrgicos clave que contribuyeron a la fuga anastomótica, fueron la técnica anastomótica, abordaje quirúrgico y duración de la cirugía. Consulte Video Resumen en http://links.lww.com/DCR/B165. (Traducción-Dr. Fidel Ruiz Healy).
Published: 2020

17. Risk factors for unfavourable postoperative outcome in patients with Crohn's disease undergoing right hemicolectomy or ileocaecal resection. An international audit by ESCP and S-ECCO

Author: El-Hussuna, A., Pinkney, T., Zmora, O., Frasson, M., Bhangu, A., Battersby, N., Chaudhri, S., Nepogodiev, D., Singh, B., Vennix, S., Altomare, D., Bemelman, W., Christensen, P., D'Hoore, A., Laurberg, S., Morton, D., Rubbini, M., Vaizey, C., Magill, L., Perry, R., Sheward, N., Nørmark Mortensen, Rikke, El-Hussuna, Alaa, Cillo, M., Estefania, D., Patron Uriburu, J., Ruiz, H., Salomon, M., Makhmudov, A., Selnyahina, L., Varabei, A., Vizhynis, Y., Claeys, D., Defoort, B., Muysoms, F., Pletinckx, P., Vergucht, V., Debergh, I., Feryn, T., Reusens, H., Nachtergaele, M., Francart, D., Jehaes, C., Markiewicz, S., Monami, B., Weerts, J., Bouckaert, W., Houben, B., Knol, J., Sergeant, G., Vangertruyden, G., Haeck, L., Lange, C., Sommeling, C., Vindevoghel, K., Castro, S., De Bruyn, H., Huyghe, M., De Wolf, E., Reynders, D., de Buck van Overstraeten, A., Wolthuis, A., Delibegovic, S., Christiani, A., Marchiori, M., Rocha de Moraes, C., Tercioti, V., Arabadjieva, E., Bulanov, D., Dardanov, D., Stoyanov, V., Yonkov, A., Angelov, K., Maslyankov, S., Sokolov, M., Todorov, G., Toshev, S., Georgiev, Y., Karashmalakov, A., Zafirov, G., Wang, X., Condic, D., Kraljik, D., Mrkovic, H., Pavkovic, V., Raguž, K., Bencurik, V., Holášková, E., Skrovina, M., Farkašová, M., Grolich, T., Kala, Z., Antos, F., Pruchova, V., Sotona, O., Chobola, M., Dusek, T., Ferko, A., Örhalmi, J., Hoch, J., Kocian, P., Martinek, L., Bernstein, I., Gotschalck Sunesen, K., Leunbach, J., Thorlacius-Ussing, O., Uth Oveson, A., Dahl Chirstensen, S., Gamez, V., Oeting, M., Schou Loeve, U., Ugianskis, A., Jessen, M., Krarup, P. M., Linde, K., Mirza, Q., Overgaard Stovring, J., Erritzøe, L., Loft Jakobsen, H., Lykke, J., Palmgren Colov, E., Husted Madsen, A., Linde Friis, T., Amstrup Funder, J., Dich, R., Kjær, S., Rasmussen, S., Schlesinger, N., Dilling Kjaer, M., Qvist, N., Khalid, A., Ali, G., Hadi, S., Rosell Walker, L., Kivelä, A., Lehtonen, T., Lepistö, A., Scheinin, T., Siironen, P., Kössi, J., Kuusanmäki, P., Tomminen, T., Turunen, A., Rautio, T., Vierimaa, M., Huhtinen, H., Karvonen, J., Lavonius, M., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Kepenekian, V., Passot, G., Maggiori, L., Manceau, G., Panis, Y., Gout, M., Rullier, E., van Geluwe, B., Chafai, N., Lefevre, J. H., Parc, Y., Tiret, E., Couette, C., Duchalais, E., Agha, A., Hornberger, M., Hungbauer, A., Iesalnieks, I., Weindl, I., Crescenti, F., Keller, M., Kolodziejski, N., Scherer, R., Sterzing, D., Bock, B., Boehm, G., El-Magd, M., Krones, C., Niewiera, M., Buhr, J., Cordesmeyer, S., Hoffmann, M., Krückemeier, K., Vogel, T., Schön, M., Baral, J., Lukoschek, T., Münch, S., Pullig, F., Horisberger, K., Kienle, P., Magdeburg, J., Post, S., Batzalexis, K., Germanos, S., Agalianos, C., Dervenis, C., Gouvas, N., Kanavidis, P., Kottikias, A., Katsoulis, I. E., Korkolis, D., Plataniotis, G., Sakorafas, G., Akrida, I., Argentou, M., Kollatos, C., Lampropoulos, C., Tsochatzis, S., Besznyák, I., Bursics, A., Egyed, T., Papp, G., Svastics, I., Atladottir, J., Möller, P., Sigurdsson, H., Stefánsson, T., Valsdottir, E., Andrews, E., Foley, N., Hechtl, D., Majeed, M., Mccourt, M., Hanly, A., Hyland, J., Martin, S., O'Connell, P. R., Winter, D., Connelly, T., Joyce, W., Wrafter, P., Berkovitz, R., Avital, S., Haj Yahia, I., Hermann, N., Shpitz, B., White, I., Lishtzinsky, Y., Tsherniak, A., Wasserberg, N., Horesh, N., Keler, U., Pery, R., Shapiro, R., Tulchinsky, H., Badran, B., Dayan, K., Iskhakov, A., Lecaros, J., Nabih, N., Angriman, I., Bardini, R., Pizzolato, E., Tonello, M., Arces, F., Balestri, R., Ceccarelli, C., Prosperi, V., Rossi, E., Giannini, I., Vincenti, L., Altomare, D. F., Di Candido, F., Di Iena, M., Guglielmi, A., Caputi-Iambrenghi, O., Marsanic, P., Mellano, A., Muratore, A., Annecchiarico, M., Bencini, L., Amore Bonapasta, S., Coratti, A., Guerra, F., Asteria, C. R., Boccia, L., Gerard, L., Pascariello, A., Manca, G., Marino, F., Casaril, A., Inama, M., Moretto, G., Bacchelli, C., Carvello, M., Mariani, N., Montorsi, M., Spinelli, A., Romairone, E., Scabini, S., Belli, A., Bianco, F., De Franciscis, S., Maria Romano, G., Delrio, P., Pace, U., Rega, D., Sassaroli, C., Scala, D., De Luca, R., Ruggieri, E., Elbetti, C., Garzi, A., Romoli, L., Scatizzi, M., Vannucchi, A., Curletti, G., Durante, V., Galleano, R., Mariani, F., Reggiani, L., Bellomo, R., Infantino, A., Franceschilli, L., Sileri, P., Clementi, I., Coletta, D., La Torre, F., Mingoli, A., Velluti, F., Di Giacomo, A., Fiorot, A., Massani, M., Padoan, L., Ruffolo, C., Caruso, S., Franceschini, F., Laessig, R., Monaci, I., Rontini, M., De Nardi, P., Elmore, U., Lemma, M., Rosati, R., Tamburini, A., De Luca, M., Sartori, A., Benevento, A., Bottini, C., Ferrari, C. C., Pata, F., Tessera, G., Pellino, G., Selvaggi, F., Lanzani, A., Romano, F., Sgroi, G., Steccanella, F., Turati, L., Yamamoto, T., Ancans, G., Gerkis, S., Leja, M., Pcolkins, A., Sivins, A., Latkauskas, T., Lizdenis, P., Saladžinskas, Å½., Švagždys, S., Tamelis, A., Razbadauskas, A., Sokolovas, M., Dulskas, A., Samalavicius, N., Jotautas, V., Mikalauskas, S., Poskus, E., Poskus, T., Strupas, K., Camenzuli, C., Cini, C., Predrag, A., Psaila, J., Spiteri, N., Buskens, C., de Groof, E. J., Gooszen, J., Tanis, P., Belgers, E., Davids, P., Furnee, E., Postma, E., Pronk, A., Smakman, N., Clermonts, S., Zimmerman, D., Omloo, J., van der Zaag, E., van Duijvendijk, P., Wassenaar, E., Bruijninckx, M., de Graff, E., Doornebosch, P., Tetteroo, G., Vermaas, M., Iordens, G., Knops, S., Toorenvliet, B., van Westereenen, H. L., Boerma, E., Coene, P., van der Harst, E., Van Der Pool, A., Raber, M., Melenhorst, J., de Castro, S., Gerhards, M., Arron, M., Bremers, A., de Wilt, H., Ferenschild, F., Yauw, S., Cense, H., Demirkiran, A., Hunfeld, M., Mulder, I., Nonner, J., Swank, H., van Wagensveld, B., Bolmers, M., Briel, J., van Geloven, A., van Rossem, C., Klemann, V., Konsten, J., Leenders, B., Schok, T., Bleeker, W., Gidwani, A., Lawther, R., Loughlin, P., Skelly, B., Spence, R., Brun, M., Helgeland, M., Ignjatovic, D., Øresland, T., Yousefi, P., Flåten Backe, I., Helmer Sjo, O., Nesbakken, A., Tandberg-Eriksen, M., Cais, A., Hallvard Træland, J., Herikstad, R., Kørner, H., Lauvland, N., Jajtner, D., Kabiesz, W., Rak, M., Gmerek, L., Horbacka, K., Horst, N., Krokowicz, P., Kwiatkowski, A., Pasnik, K., Karcz, P., Romaniszyn, M., Rusek, T., Walega, P., Czarencki, R., Obuszko, Z., Sitarska, M., Wojciech, W., Zawadzki, M., Amado, S., Clara, P., Couceiro, A., Malaquias, R., Rama, N., Almeida, A., Barbosa, E., Cernadas, E., Duarte, A., Silva, P., Costa, S., Martinez Insua, C., Pereira, J., Pereira, C., Sacchetti, M., Carvalho Pinto, B., Jorge Vieira Sousa, P., Marques, R., Oliveira, A., Cardoso, R., Carlos, S., Corte-Real, J., Moniz Pereira, P., Souto, R., Carneiro, C., Marinho, R., Nunes, V., Rocha, R., Sousa, M., Leite, J., Melo, F., Pimentel, J., Ventura, L., Vila Nova, C., Copaescu, C., Bintintan, V., Ciuce, C., Dindelegan, G., Scurtu, R., Seicean, R., Domansky, N., Karachun, A., Moiseenko, A., Pelipas, Y., Petrov, A., Pravosudov, I., Aiupov, R., Akmalov, Y., Parfenov, A., Suleymanov, N., Tarasov, N., Jumabaev, H., Mamedli, Z., Rasulov, A., Aliev, I., Chernikovskiy, I., Kochnev, V., Komyak, K., Smirnov, A., Achkasov, S., Bolikhov, K., Shelygin, Y., Sushkov, O., Zapolskiy, A., Gvozdenovic, M., Jovanovic, D., Lausevic, Z., Cvetkovic, D., Maravic, M., Milovanovic, B., Stojakovic, N., Tripkovic, I., Mihajlovic, D., Nestorovic, M., Pecic, V., Petrovic, D., Stanojevic, G., Barisic, G., Dimitrijevic, I., Krivokapic, Z., Markovic, V., Popovic, M., Aleksic, A., Dabic, D., Kostic, I., Milojkovic, A., Perunicic, V., Lukic, D., Petrovic, T., Radovanovic, D., Radovanovic, Z., Cuk, V. M., Cuk, V. V., Kenic, M., Kovacevic, B., Krdzic, I., Korcek, J., Rems, M., Toplak, J., Escarrâ, J., Gil Barrionuevo, M., Golda, T., Kreisler Moreno, E., Zerpa Martin, C., Álvarez Laso, C., Cumplido, P., Padin, H., Baixauli Fons, J., Hernández-Lizoain, J., Martinez-Ortega, P., Molina-Fernández, M., Sánchez-Justicia, C., Antonio Gracia Solanas, J., Córdoba Díaz de Laspra, E., Echazarreta-Gallego, E., Elia-Guedea, M., Ramirez, J., Arredondo Chaves, J., Diez González, P., Elosua, T., Sahagún, J., Turienzo Frade, A., Álvarez Conde, J., Castrillo, E., Diaz Maag, R., Maderuelo, V., Saldarriaga, L., Aldrey Cao, I., Fernández Varela, X., Núñez Fernández, S., Parajó Calvo, A., Villar Álvarez, S., Blesa Sierra, I., Lozano, R., Márquez, M., Porcel, O., Menendez, P., Fernández Hevia, M., Flores Sigüenza, L., Jimenez Toscano, M., Lacy Fortuny, A., Ordoñez Trujillo, J., Espi, A., Garcia-Botello, S., Martín-Arévalo, J., Moro- Valdezate, D., Pla-Martí, V., Blanco-Antona, F., Abrisqueta, J., Ibañez Canovas, N., Lujan Mompean, J., Escolá Ripoll, D., Martinez Gonzalez, S., Parodi, J., Fernández López, A., Ramos Fernández, M., Castellvi Valls, J., Ortiz de Zarate, L., Ribas, R., Sabia, D., Viso, L., Alonso Gonçalves, S., José Gil Egea, M., Pascual Damieta, M., Pera, M., Salvans Ruiz, S., Bernal, J., Landete, F., Ais, G., Etreros, J., Aguiló Lucia, J., Boscá, A., Deusa, S., García del Caño, J., Viciano, V., García-Armengol, J., Roig, J., Blas, J., Escartin, J., Fatás, J., Fernando, J., Ferrer, R., Arias Pacheco, R., García Flórez, L., Moreno Gijón, M., Otero Díez, J., Solar Garcia, L., Aguilar Teixido, F., Balaguer Ojo, C., Bargallo Berzosa, J., Lamas Moure, S., Enrique Sierra, J., Fermiñán, A., Herrerias, F., Rufas, M., Viñas, J., Codina-Cazador, A., Farrés, R., Gómez, N., Julià, D., Planellas, P., López, J., Luna, A., Maristany, C., Muñoz Duyos, A., Puértolas, N., Alcantara Moral, M., Serra-Aracil, X., Concheiro Coello, P., Gómez, D., Carton, C., Miguel, A., Reoyo Pascual, F., Valero Cerrato, X., Zambrano Muñoz, R., Cervera-Aldama, J., García González, J., Ramos-Prada, J., Santamaría-Olabarrieta, M., Urigüen-Echeverría, A., Coves Alcover, R., Espinosa Soria, J., Fernandez Rodriguez, E., Hernandis Villalba, J., Maturana Ibañez, V., De la Torre Gonzalez, F., Huerga, D., Pérez Viejo, E., Rivera, A., Ruiz Ucar, E., Garcia-Septiem, J., Jiménez, V., Jiménez Miramón, J., Ramons Rodriquez, J., Rodriguez Alvarez, V., Garcea, A., Ponchietti, L., Borda, N., Enriquez-Navascues, J., Saralegui, Y., Febles Molina, G., Nogues, E., Rodríguez Méndez, Ã., Roque Castellano, C., Sosa Quesada, Y., Alvarez-Gallego, M., Pascual, I., Rubio-Perez, I., Diaz-San Andrés, B., Tone-Villanueva, F., Alonso, J., Cagigas, C., Castillo, J., Gómez, M., Martín-Parra, J., Mengual Ballester, M., Pellicer Franco, E., Soria Aledo, V., Valero Navarro, G., Caballero Rodríguez, E., Gonzalez De Chaves, P., Hernandez, G., Perez Alvarez, A., Soto Sanchez, A., Cesar Becerra Garcia, F., Guillermo Alonso Roque, J., López Rodríguez Arias, F., Del Valle Ruiz, S. R., Sánchez De La Villa, G., Compañ, A., García Marín, A., Nofuentes, C., Orts Micó, F., Pérez Auladell, V., Carrasco, M., Duque Perez, C., Gálvez-Pastor, S., Navarro Garcia, I., Sanchez Perez, A., Enjuto, D., Manuel Bujalance, F., Marcelin, N., Pérez, M., Serrano García, R., Cabrera, A., de la Portilla, F., Diaz-Pavon, J., Jimenez-Rodriguez, R., Vazquez-Monchul, J., Daza González, J., Gómez Pérez, R., Rivera Castellano, J., Roldán de la Rua, J., Errasti Alustiza, J., Fernandez, L., Romeo Ramirez, J., Sardon Ramos, J., Cermeño Toral, B., Alias, D., Garcia-Olmo, D., Guadalajara, H., Herreros, M., Pacheco, P., del Castillo Díez, F., Lima Pinto, F., Martínez Alegre, J., Ortega, I., Picardo Nieto Antonio, A., Caro, A., Escuder, J., Feliu, F., Millan, M., Alos Company, R., Frangi Caregnato, A., Lozoya Trujillo, R., Rodríguez Carrillo, R., Ruiz Carmona, M., Alonso, N., Ambrona Zafra, D., Amilka Ayala Candia, B., Bonnin Pascual, J., Pineño Flores, C., Alcazar Montero, J., Angoso Clavijo, M., Garcia, J., Sanchez Tocino, J., Gómez- Alcazar, C., Costa-Navarro, D., Ferri-Romero, J., Rey-Riveiro, M., Romero-Simó, M., Arencibia, B., Esclapez, P., García-Granero, E., Granero, P., Medina Fernández, F. J., Gallardo Herrera, A. B., Diaz López, C., Navarro Rodriguez, E., Torres Tordera, E., Arenal, J., Citores, M., Marcos, J., Sánchez, J., Tinoco, C., Espin, E., Garcia Granero, A., Jimenez Gomez, L., Sanchez Garcia, J., Vallribera, F., Folkesson, J., Sköldberg, F., Bergman, K., Borgström, E., Frey, J., Silfverberg, A., Söderholm, M., Nygren, J., Segelman, J., Gustafsson, D., Lagerqvist, A., Papp, A., Pelczar, M., Abraham-Nordling, M., Ahlberg, M., Sjovall, A., Tengstrom, J., Hagman, K., Chabok, A., Ezra, E., Nikberg, M., Smedh, K., Tiselius, C., Al-Naimi, N., Dao Duc, M., Meyer, J., Mormont, M., Ris, F., Prevost, G., Villiger, P., Hoffmann, H., Kettelhack, C., Kirchhoff, P., Oertli, D., Weixler, B., Aytac, B., Leventoglu, S., Mentes, B., Yuksel, O., Demirbas, S., Busra Ozkan, B., Selçuk Özbalci, G., Sungurtekin, U., Gülcü, B., Ozturk, E., Yilmazlar, T., Challand, C., Fearnhead, N., Hubbard, R., Kumar, S., Arthur, J., Barben, C., Skaife, P., Slawik, S., Williams, M., Zammit, M., Barker, J., French, J., Sarantitis, I., Slawinski, C., Clifford, R., Eardley, N., Johnson, M., Mcfaul, C., Vimalachandran, D., Allan, S., Bell, A., Oates, E., Shanmugam, V., Brigic, A., Halls, M., Pucher, P., Stubbs, B., Agarwal, T., Chopada, A., Mallappa, S., Pathmarajah, M., Sugden, C., Brown, C., Macdonald, E., Mckay, A., Richards, J., Robertson, A., Kaushal, M., Patel, P., Tezas, S., Touqan, N., Ayaani, S., Marimuthu, K., Piramanayagam, B., Vourvachis, M., Iqbal, N., Korsgen, S., Seretis, C., Shariff, U., Arnold, S., Chan, H., Clark, E., Fernandes, R., Moran, B., Bajwa, A., Mcarthur, D., Cao, K., Cunha, P., Pardoe, H., Quddus, A., Theodoropoulou, K., Bolln, C., Denys, G., Gillespie, M., Manimaran, N., Reidy, J., Malik, A. 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Mallappa, S, Pathmarajah, M, Sugden, C, Brown, C, Macdonald, E, Mckay, A, Richards, J, Robertson, A, Kaushal, M, Patel, P, Tezas, S, Touqan, N, Ayaani, S, Marimuthu, K, Piramanayagam, B, Vourvachis, M, Iqbal, N, Korsgen, S, Seretis, C, Shariff, U, Arnold, S, Chan, H, Clark, E, Fernandes, R, Moran, B, Bajwa, A, Mcarthur, D, Cao, K, Cunha, P, Pardoe, H, Quddus, A, Theodoropoulou, K, Bolln, C, Denys, G, Gillespie, M, Manimaran, N, Reidy, J, Malik, Ai, Malik, A, Pitt, J, Aryal, K, El-Hadi, A, Lal, R, Pal, A, Velchuru, V, Oliveira Cunha, M, Thomas, M, Bains, S, Boyle, K, Miller, A, Norwood, M, Yeung, J, Goian, L, Gurjar, S, Saghir, W, Sengupta, N, Stewart-Parker, E, Bailey, S, Khalil, T, Lawes, D, Nikolaou, S, Omar, G, Church, R, Muthiah, B, Garrett, W, Marsh, P, Obeid, N, Chandler, S, Coyne, P, Evans, M, Hunt, L, Lim, J, Oliphant, Z, Papworth, E, Weaver, H, Cuiñas Leon, K, Williams, G, Hernon, J, Kapur, S, Moosvi, R, Shaikh, I, Swafe, L, Aslam, M, Evans, J, Ihedioha, U, Kang, P, Merchant, J, Hompes, R, Middleton, R, Broomfield, A, Crutten-Wood, D, Foster, J, Nash, G, Akhtar, M, Boshnaq, M, Eldesouky, S, Mangam, S, Rabie, M, Ahmed, J, Khan, J, Ming Goh, N, Shamali, A, Stefan, S, Thompson, C, Amin, A, Docherty, J, Lim, M, Walker, K, Watson, A, Hossack, M, Mackenzie, N, Paraoan, M, Alam, N, Daniels, I, Narang, S, Pathak, S, Smart, N, Al-Qaddo, A, Codd, R, Rutka, O, Bronder, C, Crighton, I, Davies, E, Raymond, T, Bookless, L, Griffiths, B, Plusa, S, Carlson, G, Harrison, R, Lees, N, Mason, C, Quayle, J, Branagan, G, Broadhurst, J, Chave, H, Sleight, S, Awad, F, Cruickshank, N, Joy, H, Boereboom, C, Daliya, P, Dhillon, A, Watson, N, Watson, R, Artioukh, D, Gokul, K, Javed, M, Kong, R, Sutton, J, Faiz, O, Jenkins, I, Leo, Ca, Samaranayake, Sf, Warusavitarne, J, Arya, S, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Duff, S, Fatayer, T, Mbuvi, J, Sharma, A, Cornish, J, Davies, L, Harries, R, Morris, C, Torkington, J, Knight, J, Lai, C, Shihab, O, Tzivanakis, A, Hussain, A, Luke, D, Padwick, R, Torrance, A, Tsiamis, A, Dawson, P, Balfour, A, Brady, R, Mander, J, Paterson, H, Chandratreya, N, Chu, H, Cutting, J, Vernon, S, Wai Ho, C, Andreani, S, Patel, H, Warner, M, Yan Qi Tan, J, Iqbal, A, Khan, A, Perrin, K, Raza, A, Tan, S., and 2015 European Society of Coloproctology collaborating, Group
Subjects: creatinine blood level, adverse event, Disease, open surgery, surgery, 0302 clinical medicine, hospital readmission, postoperative complication, resection, Crohn's disease, Resection, Surgery, outcome, parenteral nutrition, postoperative complications, C reactive protein, adult, Gastroenterology, creatinine, Crohn disease, cohort analysis, female, priority journal, risk factor, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, abdominal abscess, anastomosis leakage, prospective study, medicine.medical_specialty, side to side anastomosis, surgical infection, reoperation, Anastomosis, Article, NO, 03 medical and health sciences, intestine resection, length of stay, male, medicine, intraoperative period, follow up, ileocecal resection, controlled study, human, Adverse effect, outcome assessment, preoperative period, ta3126, business.industry, Postoperative complication, Odds ratio, medicine.disease, surgical margin, major clinical study, Confidence interval, hemicolectomy, Parenteral nutrition, protein blood level, business, abscess drainage
Abstract: Aim: Patient- and disease-related factors, as well as operation technique, all have the potential to impact on postoperative outcome in Crohn's disease. The available evidence is based on small series and often displays conflicting results. The aim was to investigate the effect of preoperative and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery for Crohn's disease. Method: This was an international prospective snapshot audit including consecutive patients undergoing right hemicolectomy or ileocaecal resection. The study analysed a subset of patients who underwent surgery for Crohn's disease. The primary outcome measure was the overall Clavien–Dindo postoperative complication rate. The key secondary outcomes were anastomotic leak, reoperation, surgical site infection and length of stay in hospital. Multivariable binary logistic regression analyses were used to produce odds ratios and 95% confidence intervals. Results: In all, 375 resections in 375 patients were included. The median age was 37 and 57.1% were women. In multivariate analyses, postoperative complications were associated with preoperative parenteral nutrition (OR 2.36, 95% CI 1.10–4.97), urgent/expedited surgical intervention (OR 2.00, 95% CI 1.13–3.55) and unplanned intra-operative adverse events (OR 2.30, 95% CI 1.20–4.45). The postoperative length of stay in hospital was prolonged in patients who received preoperative parenteral nutrition (OR 31, 95% CI 1.08–1.61) and those who had urgent/expedited operations (OR 1.21, 95% CI 1.07–1.37). Conclusion: Preoperative parenteral nutritional support, urgent/expedited operation and unplanned intra-operative adverse events were associated with unfavourable postoperative outcome. Enhanced preoperative optimization and improved planning of operation pathways and timings may improve outcomes for patients. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland
Published: 2018

18. Minimally invasive surgery techniques in pelvic exenteration: a systematic and meta-analysis review

Author: Srinivasaiah N., Shekleton F., Kelly M. E., Harji D., Malietzis G., Askari A., Aalbers A. G. J., Alberda W., Antoniou A., Austin K. K., Beets G. L., Berg P. L., Beynon J., Bosman S. J., Brunner M., Burger J. W. A., Campain N., Christensen H. K., Coscia M., Colquhoun A. J., Coyne P., Daniels I. R., Davies R. J., de Wilt J. H. W., Denost Q., Deutsch C., Dietz D., Duff M., Eglinton T., Fearnhead N., Frizelle F. A., Garcia-Sabrido J. L., George M. L., Gentilini L., Griffiths B., Harris D. A., Evans M., Heriot A. G., Hohenberger W., Hoe C. M., Holm T., Kanemitsu Y., Chan K. K. L., Kim H., Koh C. E., Kok N. F., Kontovounisios C., Law W. L., Laurberg S., Lee P., Lydrup M. L., Lynch A. C., Martling A., Meijerink J., Mentha A., Merkel S., McDermott F. D., McGrath J. S., Nielsen M. B., Nieuwenhuijzen G. A. P., Nilsson P. J., Abraham-Nordling M., O'Connell P. R., Patsouras D., Poggioli G., Radwan R. W., Rasheed S., Rasmussen P. C., Rothbarth J., Rutten H. J. T., Sagar P. M., Schizas A. M. P., Shida D., Smart N. J., Solomon M. J., Sorensen M. M., Stocchi L., Tekkis P. P., Tsukamoto S., Turner W. H., Tuynman J. B., van Ramshorst G. H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Verstegen M., Wakeman C., Warrier S., Yip J., Winter D. C., Jenkins J. T., Srinivasaiah N., Shekleton F., Kelly M.E., Harji D., Malietzis G., Askari A., Aalbers A.G.J., Alberda W., Antoniou A., Austin K.K., Beets G.L., Berg P.L., Beynon J., Bosman S.J., Brunner M., Burger J.W.A., Campain N., Christensen H.K., Coscia M., Colquhoun A.J., Coyne P., Daniels I.R., Davies R.J., de Wilt J.H.W., Denost Q., Deutsch C., Dietz D., Duff M., Eglinton T., Fearnhead N., Frizelle F.A., Garcia-Sabrido J.L., George M.L., Gentilini L., Griffiths B., Harris D.A., Evans M., Heriot A.G., Hohenberger W., Hoe C.M., Holm T., Kanemitsu Y., Chan K.K.L., Kim H., Koh C.E., Kok N.F., Kontovounisios C., Law W.L., Laurberg S., Lee P., Lydrup M.L., Lynch A.C., Martling A., Meijerink J., Mentha A., Merkel S., McDermott F.D., McGrath J.S., Nielsen M.B., Nieuwenhuijzen G.A.P., Nilsson P.J., Abraham-Nordling M., O'Connell P.R., Patsouras D., Poggioli G., Radwan R.W., Rasheed S., Rasmussen P.C., Rothbarth J., Rutten H.J.T., Sagar P.M., Schizas A.M.P., Shida D., Smart N.J., Solomon M.J., Sorensen M.M., Stocchi L., Tekkis P.P., Tsukamoto S., Turner W.H., Tuynman J.B., van Ramshorst G.H., van Zoggel D., Vasquez-Jimenez W., Verhoef C., Verstegen M., Wakeman C., Warrier S., Yip J., Winter D.C., and Jenkins J.T.
Subjects: Laparoscopic surgery, medicine.medical_specialty, medicine.medical_treatment, 03 medical and health sciences, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Minimally invasive surgery, Surgical complication, medicine, Humans, Minimally Invasive Surgical Procedures, Pelvic Neoplasms, Robotic surgery, Neoplasm Staging, Surgical outcome, Pelvic exenteration, business.industry, Patient Selection, Mortality rate, Minimally Invasive Surgical Procedure, Surgery, Outcome and Process Assessment, Health Care, 030220 oncology & carcinogenesis, Relative risk, Meta-analysis, Cohort, 030211 gastroenterology & hepatology, business, Human
Abstract: BACKGROUND: Pelvic exenteration is potentially curative for locally advanced and recurrent pelvic cancers. Evolving technology has facilitated the use of minimally invasive surgical (MIS) techniques in selected cases. We aimed to compare outcomes between open and MIS pelvic exenteration.METHODS: A review of comparative studies was performed. Firstly, we evaluated the differences in surgical techniques with respect to operative time, blood loss, and margin status. Secondly, we assessed differences in 30-day morbidity and mortality rates, and length of hospital stay.RESULTS: Four studies that directly compared open and MIS exenteration were included. Analysis was performed on 170 patients; 78.1% (n = 133) had open pelvic exenteration, while 21.8% (n = 37) had a MIS exenteration. The median age for open exenteration was 57.7 years versus 63 years for MIS exenteration. Even though the operative time for MIS exenteration was 83 min longer (p CONCLUSION: MIS exenteration can be performed in highly selective cases, where there is favourable patient anatomy and tumour characteristics. When feasible, it is associated with reduced intra-operative blood loss, shorter length of hospital stay, and reduced morbidity.
Published: 2018

19. Safety of primary anastomosis following emergency left sided colorectal resection: an international, multi-centre prospective audit

Author: Sánchez-Guillén, L, Nepogodiev, D, Sivrikoz, E, van Elst, T, Minaya, A, Pata, F, Glasbey, J, Pinkney, T, Bhangu, A, El-Hussuna, A, Buchs, N, Buskens, C, Chaudri, S, Frasson, M, Gallo, G, Morton, D, Negoi, I, Singh, B, Zmora, O, Perry, R, Magill, L, Altomare, D, Bemelman, W, Brown, S, Denost, Q, Knowles, C, Laurberg, S, Lefèvre, J, Möeslein, G, Vaizey, C, Bilali, S, Bilali, V, Salomon, M, Cillo, M, Estefania, D, Patron Uriburu, J, Ruiz, H, Farina, P, Carballo, F, Guckenheimer, S, Proud, D, Brouwer, R, Bui, A, Nguyen, B, Smart, P, Warwick, A, Theodore, J, Herbst, F, Birsan, T, Dauser, B, Ghaffari, S, Hartig, N, Stift, A, Argeny, S, Unger, L, Strouhal, R, Heuberger, A, Varabei, A, Lahodzich, N, Makhmudov, A, Selniahina, L, Feryn, T, Leupe, T, Maes, L, Reynvoet, E, Van Langenhove, K, Nachtergaele, M, Monami, B, Francart, D, Jehaes, C, Markiewicz, S, Weerts, J, Van Belle, K, Bomans, B, Cavenaile, V, Nijs, Y, Vertruyen, M, Pletinckx, P, Claeys, D, Defoort, B, Muysoms, F, Van Cleven, S, Lange, C, Vindevoghel, K, Wolthuis, A, Todorovic, M, Dabic, S, Kenjic, B, Lovric, S, Vidovic, J, Delibegovic, S, Mehmedovic, Z, Christiano, A, Lombardi, B, Marchiori, M Jr, Tercioti, V Jr, Dardanov, D, Petkov, P, Simonova, L, Yonkov, A, Zhivkov, E, Maslyankov, S, Pavlov, V, Sokolov, M, Todorov, G, Stoyanov, V, Batashki, I, Iarumov, N, Lozev, I, Moshev, B, Slavchev, M, Atanasov, B, Belev, N, Krstev, P, Penkov, R, Šantak, G, Ćosić, J, Previšić, A, Vukušić, L, Zukanović, G, Zelić, M, Kršul, D, Lekić Vitlov, V, Mendrila, D, Orhalmi, J, Dusek, T, Maly, O, Paral, J, Sotona, O, Skrovina, M, Bencurik, V, Machackova, M, Kala, Z, Farkašová, M, Grolich, T, Procházka, V, Hoch, J, Kocian, P, Martinek, L, Antos, F, Pruchova, V, Ceccotti, A, Madsbøll, T, Straarup, D, Uth Ovesen, A, Christensen, P, Bondeven, P, Edling, P, Elfeki, H, Alexandrovich Gameza, V, Michelsen Bach, S, Zheltiakova, I, Krarup, Pm, Krogh, A, Rolff, Hc, Lykke, J, Juvik, Af, Lóven, Hhk, Marckman, M, Osterkamp, Jtf, Madsen, Ah, Worsøe, J, Ugianskis, A, Kjaer, Md, Youn Cho Lee, B, Khalid, A, Kristensen, Mh, El Sorogy, M, Elgeidie, A, Elhemaly, M, Elnakeeb, A, Elrefai, M, Shalaby, M, Emile, S, Omar, W, Sakr, A, Thabet, W, Awny, S, Metwally, I, Refky, B, Shams, N, Zuhdy, M, Lepistö, A, Keränen, I, Kivelä, A, Lehtonen, T, Siironen, P, Rautio, T, Ahonen-Siirtola, M, Klintrup, K, Paarnio, K, Takala, H, Hyöty, M, Haukijärvi, E, Kotaluoto, Sm, Lehto, K, Tomminen, T, Huhtinen, H, Carpelan, A, Karvonen, J, Rantala, A, Varpe, P, Cotte, E, Francois, Y, Glehen, O, Passot, G, D'Alessandro, A, Chouillard, E, Etienne, Jc, Ghilles, E, Vinson-Bonnet, B, Germain, A, Ayav, A, Bresler, L, Chevalier, R, Didailler, R, Rullier, E, Tiret, E, Chafai, N, Lefevre, J, Parc, Y, Sielezneff, I, Mege, D, Lakkis, Z, Barussaud, M, Krones, C, Bock, B, Webler, R, Baral, J, Lang, T, Münch, S, Pullig, F, Schön, M, Hinz, S, Becker, T, Möller, T, Richter, F, Schafmayer, C, Hardt, J, Kienle, P, Crescenti, F, Ahmad, M, Soleiman, Y, Papaconstantinou, I, Gklavas, A, Nastos, K, Theodosopoulos, T, Vezakis, A, Stamou, K, Saridaki, A, Xynos, E, Paraskakis, S, Zervakis, N, Skroubis, G, Amanatidis, T, Germanos, S, Maroulis, I, Papadopoulos, G, Dimitriou, N, Alexandrou, A, Felekouras, E, Griniatsos, J, Karavokyros, I, Papadopoulos, A, Chouliaras, C, Ioannidis, P, Katsounis, D, Kefalou, E, Katsoulis, I, Balalis, D, Manatakis, D, Tzovaras, G, Baloyiannis, I, Mamaloudis, I, Lázár, G, Ábraham, S, Paszt, A, Simonka, Z, Zaránd, A, Baranyai, Z, Ferreira, G, Harsányi, L, Ónody, P, Banky, B, Burány, Á, Lakatos, M, Marton, J, Solymosi, A, Besznyák, I, Bursics, A, Papp, G, Saftics, G, Svastics, I, Valsdottir, E, Atladottir, J, Jonsson, T, Moller, P, Sigurdsson, H, Gupta, Sk, Gupta, S, Kaul, N, Mohan, S, Sharma, G, Wani, R, Chowdri, N, Khan, M, Mehraj, A, Parray, F, Coveney, A, Burke, J, Deasy, J, El-Masry, S, Mcnamara, D, Khan, Mf, Cahill, R, Faul, E, Mulsow, J, Shields, C, Kelly, Me, Bass, G, Martin, St, O'Connell, R, Ryan, E, Connelly, T, Ahmad, G, Bukhari, W, Cooke, F, Gold Deutch, R, Haim, N, Lavy, R, Moscovici, A, Shussman, N, Gefen, R, Marom, G, Pikarsky, A, Weiss, D, Avital, S, Hermann, N, Raguan, B, Slavin, M, White, I, Wasserberg, N, Arieli, H, Gurevich, N, Freund, Mr, Dorot, S, Halfteck, G, Reissman, P, Yair, E, Eden, Y, Pery, R, Tulchinsky, H, Weizman, A, Agresta, F, Curinga, R, Finotti, E, Savino, G, Verza, La, Asteria, Cr, Boccia, L, Pascariello, A, Tamini, N, Bugatti, A, Gianotti, L, Totis, M, Vincenti, L, Andriola, V, Giannini, I, Travaglio, E, Balestri, R, Buccianti, P, Roffi, N, Rossi, E, Urbani, L, Mellano, A, Cinquegrana, A, Lauretta, A, Belluco, C, Mistrangelo, M, Allaix, Me, Arolfo, S, Morino, M, Testa, V, Delrio, P, Pace, U, Rega, D, Scala, D, Clerico, G, Cornaglia, S, Realis Luc, A, Trompetto, M, Ugolini, G, Antonacci, N, Fabbri, S, Montroni, I, Zattoni, D, D'Urbano, C, Cornelli, A, Viti, M, Inama, M, Bacchion, M, Casaril, A, Impellizzeri, H, Moretto, G, Spinelli, A, Carvello, M, David, G, Di Candido, F, Sacchi, M, Frontali, A, Ceriani, V, Molteni, M, Rosati, R, Aleotti, F, Elmore, U, Lemma, M, Vignali, A, Scabini, S, Casoni Pattacini, G, Luzzi, A, Romairone, E, Marino, F, Lorusso, D, Pezzolla, F, Colombo, F, Baldi, C, Foschi, D, Sampietro, G, Sorrentino, L, Di Saverio, S, Birindelli, A, Segalini, E, Spacca, D, Romano, Gm, Belli, A, Bianco, F, De Franciscis, S, Falato, A, Muratore, A, Marsanic, P, Grimaldi, S, Castaldo, N, Ciolli, Mg, Picarella, P, Porfidia, R, Tugnoli, G, Bondurri, A, Cavallo, D, Maffioli, A, Pertusati, A, Pulighe, F, Balestra, F, De Nisco, C, Podda, M, Opocher, E, Longhi, M, Mariani, Nm, Maroni, N, Pisani Ceretti, A, Galleano, R, Aonzo, P, Curletti, G, Reggiani, L, Marconi, M, Del Prete, L, Oldani, M, Pappalardo, R, L S, Zaccone, Scatizzi, M, Baraghini, M, Cantafio, S, Feroci, F, Giani, I, Tutino, R, Cocorullo, G, Gulotta, G, Licari, L, Salamone, G, Sileri, P, Saraceno, F, La Torre, F, Chirletti, P, Coletta, D, De Toma, G, Mingoli, A, Papandrea, M, De Luca, E, Sacco, R, Sammarco, G, Vescio, G, Tonini, V, Bianchini, S, Cervellera, M, Vaccari, S, Cracco, N, Barugola, G, Bertocchi, E, Rossini, R, Ruffo, G, Sartori, A, Clemente, N, De Luca, M, De Luca, A, Scaffidi, G, Lorenzon, L, Balducci, G, Bocchetti, T, Ferri, M, Mercantini, P, Bauce, S, Benevento, A, Bottini, C, Crapa, Pr, Rubbini, M, Anania, G, Carcoforo, P, Cavallesco, G, Feo, C, Yamamoto, T, Sivins, A, Ancans, G, Gerkis, S, Lunis, R, Pcolkins, A, Venskutonis, D, Bradulskis, S, Dainius, E, Subocius, A, Vencius, J, Zeromskas, P, Eismiontas, V, Nutautiene, V, Simcikas, D, Tamosiunas, A, Svagzdys, S, Latkauskas, T, Lizdenis, P, Saladzinskas, Z, Tamelis, A, Dulskas, A, Kuliavas, J, Samalavicius, Ne, Poskus, T, Jotautas, V, Mikalauskas, S, Poskus, E, Strupas, K, Zakaria, A, Lah, Nn, Wong, M, Zain, Z, Zakaria, Z, Mazlan, L, Mohd Azman ZA, Sagap, I, Psaila, J, Andrejevic, P, Cini, C, Ellul, S, Pace, K, Ahallat, M, Hamid, M, Hrora, A, Majbar, Ma, Raiss, M, Westerduin, E, Tanis, P, van der Sluis PC, Davids, Ph, Pronk, A, Schiphorst, Ahw, Smakman, N, Zimmerman, D, Koeter, T, Stijns, J, van Loon YT, Vermaas, M, de Graaf, E, Doornebosch, P, van Hagen, P, van Ruler, O, Toorenvliet, B, Nonner, J, van den Berg, I, van Steensel, L, Vles, W, Melenhorst, J, Orsini, R, Visschers, R, Hoff, C, Blom, R, Marsman, H, Mulder, I, Cense, H, de Castro, S, Demirkiran, A, Hunfeld, M, van Geloven, A, de Groof, J, Hendriks, E, Leeuwenburg, M, van Oorschot, N, Wit, F, Rupert, C, Veldman, P, Keijzers, M, Konsten, J, Den Boer, F, Corver, M, Boerma, Ej, Koolen, L, Martens, M, Van Wijck, K, Ignjatovic, D, Breuer, R, Gurpreet, B, Oresland, T, Tetens Moe, T, Nesbakken, A, Flateh Backe, I, Wik, Ta, Radiya, K, Dehli, T, Gjessing, P, Norderval, S, Woll, K, Anwer, M, Qureshi, Ms, Qureshi, Au, Billah, M, Jawad, My, Raza, A, Urooj, N, Wang, X, Li, L, Jajtner, D, Gasinski, B, Kabiesz, W, Walega, P, Romaniszyn, M, Zawadzki, M, Czarnecki, R, Obuszko, Z, Rzaca, M, Sitarska, M, Silva, P, Duarte, A, Gonçalves, D, Morais, 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Gallego, E, Elia Guedea, M, Escola, D, Martinez, S, Primo Romaguera, V, Parreno, R, Pastor, L, Rosell, E, Lozoya Trujillo, R, Alos Company, R, Ruiz Carmona, M, Solana Bueno, A, Salvans Ruiz, S, Alonso Goncalves, S, Jimenez-Toscano, M, Pascual Damieta, M, Pera Roman, M, Pellicer-Franco, E, Garcia-Marin, J, Mengual-Ballester, M, Soria-Aledo, V, Valero-Navarro, G, Vicente-Ruiz, M, Garcia-Zamora, C, Gonzalez-Gil, A, Montoya-Tabares, M, Paredes-Quiles, M, Die Trill, J, Abadia, P, Moreno, I, Pina, J, Ramos Rubio, D, Escartin, J, Blas, J, Fernando, J, Ferrer, R, Garcia Egea, J, Pros, I, Martinez, W, Rius, J, Socias, M, Sabia, D, Castellvi Valls, J, Gonzalez Santin, V, Mompart Garcia, S, Viso Pons, L, Julia, D, Codina-Cazador, A, Farres, R, Gomez, N, Planellas, P, Cuadrado, M, Camps, I, Rufas, M, Escoll, J, Ferminan, A, Muriel, P, Sierra, E, Alvarez-Laso, C, Lora, P, Padin, H, Garcia-Septiem, J, Bustamante, C, Jimenez, V, Jimenez-Miramon, J, Ramos, J, Gallardo, A, Benito, P, Colao, L, Galindo, P, Garcia, C, Forero-Torres, A, Alonso Poza, A, Dieguez Fernandez, B, Gilsanz Martin, C, Hernandez Garcia, M, Rojo Lopez, J, Gil Lopez, J, Gonzalez Zunzarren, M, Martinez Alegre, J, Zorrilla Matilla, J, Navarro-Sanchez, A, Alcala Serrano, F, Lopez-Fernandez, J, Montesdeoca Cabrera, D, Alvarez-Gallego, M, Guevara, J, Pascual Miguelanez, I, Rubio-Perez, I, Gomez Ruiz, M, Alonso Martin, J, Cagigas Fernandez, C, Castillo Diego, J, Pando, J, Maristany, C, Munoz-Duyos, A, Rada-Palomino, A, Vargas-Pierola, H, Pena Ros, E, Benavides Buleje, J, Munoz Camarena, J, Parra Banos, P, Ramirez Faraco, M, Arenal, J, Citores, M, Marcos, J, Sanchez, J, Tinoco, C, Garcia Florez, L, Arias Pacheco, R, Minguez Ruiz, G, Rodriguez Corral, N, Rodriguez Infante, A, Carrillo Lopez, M, Carrasco Prats, M, Lage Laredo, A, Martinez Manzano, A, Rodriguez Garcia, P, Segura-Sampedro, J, Alonso-Hernandez, N, Fernandez Isart, M, Gamundi Cuesta, M, Ochogavia Segui, A, Ibanez, N, Abrisqueta, J, Lujan, J, Gomez Perez, R, Corrales Valero, E, Monje Salazar, C, Sanchiz Cardenas, E, Soler Humanes, R, Jimenez-Rodriguez, R, De la Portilla, F, Diaz Pavon, J, Garcia Cabrera, A, Reyes Diaz, M, Espin, E, Marinello, F, Marti, M, Vallribera, F, Orts Mico, F, Ortin Navarro, M, Perez Climent, M, Serra Diaz, C, Millan, M, Caro, A, Escuder, J, Espina, B, Feliu, F, Climent Aira, A, Estevez Diz, A, Moreno Asencio, M, Varela Mato, A, Vazquez Bouzan, R, Minaya-Bravo, A, Diez-Alonso, M, Villeta-Plaza, R, Guadalajara, H, Alias, D, Garcia Olmo, D, Pastor, C, Valverde, I, Sanchez Romero, A, Gardea, A, Gil Santos, M, Nimmersgern, T, Serrano Paz, P, Romero-Simo, M, Blasco-Segura, T, Caravaca-Garcia, I, Costa-Navarro, D, Zarco-Pleguezuelos, A, Flor-Lorente, B, Garcia-Granero, A, Garcia-Granero, E, Arencibia, B, Alonso, J, Febles, G, Nogues, E, Roque, C, Segelman, J, Nygren, J, Nestler, G, Abraham-Nordling, M, Egenvall, M, Myrelid, P, Jung, B, Loftas, P, Lydrup, M, Azahr, N, Buchwald, P, Mangell, P, Syk, I, Nikberg, M, Carlander, J, Chabok, A, Smedh, K, Tiselius, C, Haapaniemi, S, Benckert, A, Adamina, M, Freil-Lanter, C, Gingert, C, Muller, P, Schafli, J, Regusci, L, Brenna, M, Fasolini, F, Misteli, H, Kirchhoff, P, Oertli, D, Hahnloser, D, Clerc, D, Hubner, M, Ris, F, Chevallay, M, Morel, P, Schiltz, B, Wang, J, Su, W, Huang, C, Ma, C, Tsai, H, Ozbalci, G, Ozkan, B, Karabacak, U, Bugra, D, Agalar, F, Baloglu, H, Basoglu, I, Okkabaz, N, Binboga, E, Biricik, A, Celik, A, Yavuz, E, Canda, A, Agalar, C, Fuzun, M, Sokmen, S, Terzi, C, Isik, A, Karip, B, Bilgili, A, Leventoglu, S, Aytac, B, Yildiz, A, Yuksel, O, Sinan, H, Hancerliogullari, O, Kaymak, S, Kozak, O, Ozer, M, Sarici, I, Akca, O, Kalayci, M, Kara, Y, Agcaoglu, O, Balik, E, Bayram, O, Sungurtekin, U, Ozgen, U, Demirbas, S, Ozturk, E, Isik, O, Yilmazlar, T, Colak, E, Karagul, S, Kinas, V, Fearnhead, N, Lord, I, Stewart, P, Zammit, M, Arnold, S, Battersby, N, Broadhurst, J, Mehta, A, Seretis, F, Shabbir, J, Jones, C, Kynaston, J, Vimalachandran, D, Blower, E, Mcfaul, C, Mcwhirter, D, Pilkington, J, Wilson, T, Chowdhary, M, Stubbs, B, Abdalkoddus, M, Lai, C, Thavanesan, N, Yao, C, Agarwal, T, Dindyal, S, Hill, R, Reade, S, Slesser, A, Paterson, H, Balfour, A, Boland, M, Geraghty, A, O'Kelly, J, Patel, P, Tezas, S, Yahia, S, Jadhav, V, Marimuthu, K, Narayanan, A, Piramanayagam, B, Bradley, N, Buchanan, F, Paul, K, Singh, J, Thomson, K, Korsgen, S, Bedford, M, Lee, K, Leong, K, Mcarthur, D, Malik, S, Mohamed, I, Cunha, P, Pilavas, A, Reddy, A, Ahmed, S, Ahmed, A, Voll, J, Velchuru, V, Lal, R, Mirshekar-Syahkal, B, Kassai, M, Aleem, M, Keogh-Bootland, S, Sarmah, P, Keegan, R, Kelkar, A, Sen, P, Oliveira-Cunha, M, Chaudhri, S, Fares, R, Thomas, W, Aslam, M, Boyle, K, Hemingway, D, Miller, A, Norwood, M, Gurjar, S, Al-Saeedi, M, Anandan, L, Sudlow, A, Zampitis, N, Malik, K, Bogdan, M, Smart, C, Iqbal, M, Bailey, S, Lawes, D, Omar, G, Tamhane, R, Evans, M, Ather, S, Lim, J, Nageswaran, H, Taylor, G, Hunt, L, Nicholls, J, Shaikh, I, Muscara, F, O'Brien, J, Photi, E, Stearns, A, Meylemans, D, Cunningham, C, Hompes, R, Tennakoon, A, Kumarasinghe, N, Rao, M, Upanishad, I, Smolarek, S, Platt, E, Rossi, B, Tham, J, Khan, J, Ahmad, N, Shweejawee, Z, Stefan, S, Smart, N, Daniels, I, Gregoir, T, Longstaff, L, Mcdermott, F, Varcada, M, Drami, I, Gala, T, Moggia, E, Ratnatunga, K, Harries, R, Hayes, J, Williams, G, Raymond, T, Bronder, C, Davies, E, Hawkin, P, Ryska, O, Ayral, K, Beveridge, A, Bhowmik, A, Gill, M, Simpson, R, Schofield, A, Mcardle, K, Parmar, M, Williamson, M, Burton, H, Courtney, E, Grant, C, Saracino, A, Newton, K, Epstein, J, Branagan, G, Bignell, M, Symankewicz, M, Zaman, S, Mankotia, R, Siddiqui, Z, Torrance, A, Artioukh, D, Eggleston, M, Gokul, K, Selwyn, D, Warusavitarne, J, Chandrasinghe, P, Grainger, J, Leo, C, Harris, G, Levy, B, Skull, A, Thaha, M, Garg, A, Patel, H, Ramsanahie, A, Mondragon-Pritchard, M, Cuinas Leon, K, Shukla, A, Brewer, H, Fitzgerald, J, Kho, H, Torkington, J, Tate, S, Wheat, J, Knight, J, Richardson, J, Tzivanakis, A, Gregori, M, Ashraf, M, Atif, M, Santos, J, Saffaf, N, Canning, L, Chandratreya, N, Bowen, M, Graham, B, Hamad, Y, Kaubrys, M, Chaudhry, Z, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Gouvas, N, Nicol, D, Pandey, S, Zilvetti, M, Sharma, A, Fatayer, T, Mothe, S, Rahman, M, Curtis, N, Allison, A, Dalton, R, Francis, N, Ockrim, J, Psaras, G, Dudarovaska, H, Marharint, T, Mostovoy, E, Voloshin, S, Kolesnik, O, Makhmudov, D, Altinel, Y, Iqbal, A, Cunningham, L, Go, K, Tan, S, Surgery, R. Tutino, G. Salamone, L. Licari, G. Cocorullo, G. Gulotta, European Society of Coloproctology (ESCP) Cohort Studie, and Tonini V, Cervellera M, Vaccari S
Subjects: Male, Medical audit, Treatment outcome, anastomotic leak, 030230 surgery, 0302 clinical medicine, Postoperative Complications, Prospective Studies, Multi centre, emergency surgery, Prospective cohort study, Colectomy, Medical Audit, Proctectomy, Proctectomy/adverse effects, Prospective audit, Primary anastomosis, Anastomosis, Surgical, Gastroenterology, Middle Aged, surgical complications, Europe, Treatment Outcome, colon cancer, gastrointestinal surgery, rectal cancer, Surgery, surgical outcomes, 030220 oncology & carcinogenesis, Postoperative Complications/etiology, Female, Colectomy/adverse effects, Emergency Treatment/adverse effects, Adult, medicine.medical_specialty, Adolescent, surgical outcome, Left sided, NO, 03 medical and health sciences, Young Adult, surgical complication, medicine, Humans, Emergency Treatment, Colorectal resection, Aged, ta3126, Anastomosis, Surgical/methods, business.industry, General surgery, Surgical Stomas, Surgical Stomas/statistics & numerical data, Settore MED/18 - Chirurgia Generale, Multivariate Analysis, business
Abstract: Introduction: Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided colorectal resection. Methods: A pre-planned analysis of the European Society of Coloproctology 2017 audit. Adult patients (>16years) who underwent emergency (unplanned, within 24h of hospital admission) left sided colonic or rectal resection were included. The primary endpoint was the 30-day major complication rate (Clavien-Dindo grade 3 to 5). Results: From 591 patients, 455 (77%) received an end stoma, 103 a primary anastomosis (17%) and 33 primary anastomosis with defunctioning stoma (6%). In multivariable models, anastomosis was associated with a similar major complication rate to end stoma (adjusted odds ratio for end stoma 1.52, 95%CI 0.83–2.79, P=0.173). Although a defunctioning stoma was not associated with reduced anastomotic leak (12% defunctioned [4/33] vs 13% not defunctioned [13/97], adjusted odds ratio 2.19, 95%CI 0.43–11.02, P=0.343), it was associated with less severe complications (75% [3/4] with defunctioning stoma, 86.7% anastomosis only [13/15]), a lower mortality rate (0% [0/4] vs 20% [3/15]), and fewer reoperations (50% [2/4] vs 73% [11/15]) when a leak did occur. Conclusions: Primary anastomosis in selected patients appears safe after left sided emergency colorectal resection. A defunctioning stoma might mitigate against risk of subsequent complications.
Published: 2018

20. Nationwide population‐based cohort study to assess risk of surgery for adhesive small bowel obstruction following open or laparoscopic rectal cancer resection

Author: Andersen, P., Jensen, K. K., Erichsen, R., Frøslev, T., Krarup, P.‐M., Madsen, M. R., Laurberg, S., and Iversen, L. H.
Subjects: Original Article, Original Articles
Abstract: Background Laparoscopic surgery has been reported to reduce the formation of adhesions following colorectal surgery. The aim of this nationwide cohort study was to investigate the risk of surgery for adhesive small bowel obstruction (SBO) following open and laparoscopic rectal cancer resection. Methods Patients undergoing rectal cancer resection between 2005 and 2013 were identified in the Danish Colorectal Cancer Group database. The primary outcome of surgery for adhesive SBO was identified in the Danish National Patient Registry. The risk of surgery for adhesive SBO was estimated as the cumulative incidence proportion, treating death as a competing risk. Cox proportional hazards regression analysis with multivariable adjustment was used to compute hazard ratios (HRs). The secondary outcome was 30‐day mortality after surgery for adhesive SBO. Results Of 7657 patients, 340 (4·4 per cent) underwent surgery for adhesive SBO. The 5‐year risk of surgery for adhesive SBO was 4·5 per cent among 4472 patients undergoing open resection and 3·0 per cent among 3185 patients having a laparoscopic resection. Laparoscopic rectal resection was associated with a lower risk of subsequent operation for adhesive SBO (adjusted HR 0·65, 95 per cent c.i. 0·50 to 0·86; P = 0·002). The adjusted HR of mortality after adhesive SBO was 0·84 (0·37 to 1·91; P = 0·671) comparing patients with previous laparoscopic and open resection. Conclusion Laparoscopic rectal cancer resection was associated with a decreased risk of surgery for adhesive SBO. There was a substantial difference in 30‐day mortality after surgery for adhesive SBO based on the surgical approach used at the time of rectal resection.
Published: 2017

21. Consensus and controversies regarding follow-up after treatment with curative intent of nonmetastatic colorectal cancer: a synopsis of guidelines used in countries represented in the European Society of Coloproctology

Author: Bastiaenen, V.P., Hovdenak Jakobsen, I., Labianca, R., Martling, A., Morton, D.G., Primrose, J.N., Tanis, P.J., and Laurberg, S.
Abstract: AIM: It is common clinical practice to follow patients for a period of years after treatment with curative intent of nonmetastatic colorectal cancer, but follow-up strategies vary widely. The aim of this systematic review was to provide an overview of recommendations on this topic in guidelines from member countries of the European Society of Coloproctology, with supporting evidence.METHOD: A systematic search of Medline, Embase and the guideline databases Trip database, BMJ Best Practice and Guidelines International Network was performed. Quality assessment included use of the AGREE-II tool. All topics with recommendations from included guidelines were identified and categorized. For each subtopic, a conclusion was made followed by the degree of consensus and the highest level of evidence.RESULTS: Twenty-one guidelines were included. The majority recommended that structured follow-up should be offered, except for patients in whom treatment of recurrence would be inappropriate. It was generally agreed that clinical visits, measurement of carcinoembryoinc antigen and liver imaging should be part of follow-up, based on a high level of evidence, although the frequency is controversial. There was also consensus on imaging of the chest and pelvis in rectal cancer, as well as endoscopy, based on lower levels of evidence and with a level of intensity that was contradictory.CONCLUSION: In available guidelines, multimodal follow-up after treatment with curative intent of colorectal cancer is widely recommended, but the exact content and intensity are highly controversial. International agreement on the optimal follow-up schedule is unlikely to be achieved on current evidence, and further research should refocus on individualized 'patient-driven' follow-up and new biomarkers.
Published: 2019

22. Relationship between method of anastomosis and anastomotic failure after right hemicolectomy and ileo-caecal resection : an international snapshot audit

Author: Pinkney, T., Battersby, N., Bhangu, A., Chaudhri, S., El-Hussuna, A., Frasson, M., Nepogodiev, D., Singh, B., Vennix, S., Zmora, O., Altomare, D., Bemelman, W., Christensen, P., D'Hoore, A., Laurberg, S., Morton, D., Rubbini, M., Vaizey, C., Magill, L., Perry, R., Sheward, N., Ives, N., Mehta, S., Cillo, M., Estefania, D., Patron Uriburu, J., Ruiz, H., Salomon, M., Makhmudov, A., Selnyahina, L., Varabei, A., Vizhynis, Y., Claeys, D., Defoort, B., Muysoms, F., Pletinckx, P., Vergucht, V., Debergh, I., Feryn, T., Reusens, H., Nachtergaele, M., Francart, D., Jehaes, C., Markiewicz, S., Monami, B., Weerts, J., Bouckaert, W., Houben, Bert, Knol, Joep, Sergeant, Gregory, Vangertruyden, G., Haeck, L., Lange, C., Sommeling, C., Vindevoghel, K., Castro, S., De Bruyn, H., Huyghe, M., De Wolf, E., Reynders, D., van Overstraeten, A. de Buck, Wolthuis, A., Delibegovic, S., Christiani, A., Marchiori, M., Jr., Rocha de Moraes, C., Tercioti, V., Jr., Arabadjieva, E., Bulanov, D., Dardanov, D., Stoyanov, V., Yonkov, A., Angelov, K., Maslyankov, S., Sokolov, M., Todorov, G., Toshev, S., Georgiev, Y., Karashmalakov, A., Zafirov, G., Wang, X., Condic, D., Kraljik, D., Mrkovic, H., Pavkovic, V., Raguz, K., Bencurik, V., Holaskova, E., Skrovina, M., Farkasova, M., Grolich, T., Kala, Z., Antos, F., Pruchova, V., Sotona, O., Chobola, M., Dusek, T., Ferko, A., Orhalmi, J., Hoch, J., Kocian, P., Martinek, L., Bernstein, I., Sunesen, K. Gotschalck, Leunbach, J., Thorlacius-Ussing, O., Oveson, A. Uth, Chirstensen, S. Dahl, Gamez, V., Oeting, M., Loeve, U. Schou, Ugianskis, A., Jessen, M., Krarup, P., Linde, K., Mirza, Q., Stovring, J. Overgaard, Erritzoe, L., Jakobsen, H. Loft, Lykke, J., Colov, E. Palmgren, Madsen, A. Husted, Friis, T. Linde, Funder, J. Amstrup, Dich, R., Kjaer, S., Rasmussen, S., Schlesinger, N., Kjaer, M. Dilling, Qvist, N., Khalid, A., Ali, G., Hadi, S., Walker, L. Rosell, Kivela, A., Lehtonen, T., Lepisto, A., Scheinin, T., Siironen, P., Kossi, J., Kuusanmaki, P., Tomminen, T., Turunen, A., Rautio, T., Vierimaa, M., Huhtinen, H., Karvonen, J., Lavonius, M., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Kepenekian, V., Passot, G., Maggiori, L., Manceau, G., Panis, Y., Gout, M., Rullier, E., van Geluwe, B., Chafai, N., Lefevre, J. H., Parc, Y., Tiret, E., Couette, C., Duchalais, E., Agha, A., Hornberger, M., Hungbauer, A., Iesalnieks, I., Weindl, I., Crescenti, F., Keller, M., Kolodziejski, N., Scherer, R., Sterzing, D., Bock, B., Boehm, G., El-Magd, M., Krones, C., Niewiera, M., Buhr, J., Cordesmeyer, S., Hoffmann, M., Krueckemeier, K., Vogel, T., Schoen, M., Baral, J., Lukoschek, T., Muench, S., Pullig, F., Horisberger, K., Kienle, P., Magdeburg, J., Post, S., Batzalexis, K., Germanos, S., Agalianos, C., Dervenis, C., Gouvas, N., Kanavidis, P., Kottikias, A., Katsoulis, I. E., Korkolis, D., Plataniotis, G., Sakorafas, G., Akrida, I., Argentou, M., Kollatos, C., Lampropoulos, C., Tsochatzis, S., Besznyak, I., Bursics, A., Egyed, T., Papp, G., Svastics, I., Atladottir, J., Moller, P., Sigurdsson, H., Stefansson, T., Valsdottir, E., Andrews, E., Foley, N., Hechtl, D., Majeed, M., McCourt, M., Hanly, A., Hyland, J., Martin, S., O'Connell, P. R., Winter, D., Connelly, T., Joyce, W., Wrafter, P., Berkovitz, R., Avital, S., Yahia, I. Haj, Hermann, N., Shpitz, B., White, I., Lishtzinsky, Y., Tsherniak, A., Wasserberg, N., Horesh, N., Keler, U., Pery, R., Shapiro, R., Tulchinsky, H., Badran, B., Dayan, K., Iskhakov, A., Lecaros, J., Nabih, N., Angrima, I., Bardini, R., Pizzolato, E., Tonello, M., Arces, F., Balestri, R., Ceccarelli, C., Prosperi, V., Rossi, E., Giannini, I., Vincenti, L., Altomare, D. F., Di Candido, F., Di Iena, M., Guglielmi, A., Caputi-Iam-Brenghi, O., Marsanic, P., Mellano, A., Muratore, A., Annecchiarico, M., Bencini, L., Bona-Pasta, S. Amore, Coratti, A., Guerra, F., Asteria, C. R., Boccia, L., Gerard, L., Pascariello, A., Manca, G., Marino, F., Casaril, A., Inama, M., Moretto, G., Bacchelli, C., Carvello, M., Mariani, N., Montorsi, M., Spinelli, A., Romairone, E., Scabini, S., Belli, A., Bianco, F., De Franciscis, S., Romano, G. Maria, Delrio, P., Pace, U., Rega, D., Sassaroli, C., Scala, D., De Luca, R., Ruggieri, E., Elbetti, C., Garzi, A., Romoli, L., Scatizzi, M., Vannucchi, A., Curletti, G., Durante, V., Galleano, R., Mariani, F., Reggiani, L., Bellomo, R., Infantino, A., Franceschilli, L., Sileri, P., Clementi, I., Coletta, D., La Torre, F., Mingoli, A., Velluti, F., Di Giacomo, A., Fiorot, A., Massani, M., Padoan, L., Ruffolo, C., Caruso, S., Franceschini, F., Laessig, R., Monaci, I., Rontini, M., De Nardi, P., Elmore, U., Lemma, M., Rosati, R., Tamburini, A., De Luca, M., Sartori, A., Benevento, A., Bottini, C., Ferrari, C. C., Pata, F., Tessera, G., Pellino, G., Selvaggi, F., Lanzani, A., Romano, F., Sgroi, G., Steccanella, F., Turati, L., Yamamoto, T., Ancans, G., Gerkis, S., Leja, M., Pcolkins, A., Sivins, A., Latkauskas, T., Lizdenis, P., Saladzin-Skas, Z., Svagzdys, S., Tamelis, A., Razbadauskas, A., Sokolovas, M., Dulskas, A., Samalavicius, N., Jotautas, V., Mikalauskas, S., Poskus, E., Poskus, T., Strupas, K., Camenzuli, C., Cini, C., Predrag, A., Psaila, J., Spiteri, N., Buskens, C., de Groof, E. J., Gooszen, J., Tanis, P., Belgers, E., Davids, P., Furnee, E., Postma, E., Pronk, A., Smakman, N., Clermonts, S., Zimmerman, D., Omloo, J., van der Zaag, E., van Duijvendijk, P., Wassenaar, E., Bruijninckx, M., de Graff, E., Doornebosch, P., Tetteroo, G., Vermaas, M., Iordens, G., Knops, S., Toorenvliet, B., van Westereenen, H. L., Boerma, E., Coene, P., van der Harst, E., Van der Pool, A., Raber, M., Melenhorst, J., de Castro, S., Gerhards, M., Arron, M., Bremers, A., de Wilt, H., Ferenschild, F., Yauw, S., Cense, H., Demirkiran, A., Hunfeld, M., Mulder, I., Nonner, J., Swank, H., van Wagensveld, B., Bolmers, M., Briel, J., van Geloven, A., van Rossem, C., Klemann, V., Konsten, J., Leenders, B., Schok, T., Bleeker, W., Brun, M., Helgeland, M., Ignjatovic, D., Oresland, T., Yousefi, P., Backe, I. Faten, Sjo, O. Helmer, Nesbakken, A., Tandberg-Eriksen, M., Cais, A., Traeland, J. Hallvard, Herikstad, R., Korner, H., Lauvland, N., Jajtner, D., Kabiesz, W., Rak, M., Gmerek, L., Horbacka, K., Horst, N., Krokowicz, P., Kwiatkowski, A., Pasnik, K., Karcz, P., Romaniszyn, M., Rusek, T., Walega, P., Czarencki, R., Obuszko, Z., Sitarska, M., Wojciech, W., Zawadzki, M., Amado, S., Clara, P., Couceiro, A., Malaquias, R., Rama, N., Almeida, A., Barbosa, E., Cernadas, E., Duarte, A., Silva, P., Costa, S., Martinez Insua, C., Pereira, J., Pereira, C., Sacchetti, M., Carvalho Pinto, B., Jorge Vieira Sousa, P., Marques, R., Oliveira, A., Cardoso, R., Carlos, S., Corte-Real, J., Moniz Pereira, P., Souto, R., Carneiro, C., Marinho, R., Nunes, V., Rocha, R., Sousa, M., Leite, J., Melo, F., Pimentel, J., Ventura, L., Vila Nova, C., Copacscu, C., Bintintan, V., Ciuce, C., Dindelegan, G., Scurtu, R., Seicean, R., Domansky, N., Karachun, A., Moiseenko, A., Pelipas, Y., Petrov, A., Pravosudov, I., Aiupov, R., Akmalov, Y., Parfenov, A., Suleymanov, N., Tarasov, N., Jumabaev, H., Mamedli, Z., Rasulov, A., Aliev, I., Chernikovskiy, I., Kochnev, V., Komyak, K., Smirnov, A., Achkasov, S., Bolikhov, K., Shelygin, Y., Sushkov, O., Zapolskiy, A., Gvozdenovic, M., Jovanovic, D., Lausevic, Z., Cvetkovic, D., Maravic, M., Milovanovic, B., Stojakovic, N., Tripkovic, I., Mihajlovic, D., Nestorovic, M., Pecic, V., Petrovic, D., Stanojevic, G., Barisic, G., Dimitrijevic, I., Krivokapic, Z., Markovic, V., Popovic, M., Aleksic, A., Dabic, D., Kostic, I., Milojkovic, A., Perunicic, V., Lukic, D., Petrovic, T., Radovanovic, D., Radovanovic, Z., Cuk, V. M., Cuk, V. V., Kenic, M., Kovacevic, B., Krdzic, I., Korcek, J., Rems, M., Toplak, J., Escarra, J., Gil Barrionuevo, M., Golda, T., Kreisler Moreno, E., Zerpa Martin, C., Alvarez Laso, C., Cumplido, P., Padin, H., Baixauli Fons, J., Hernandez-Lizoain, J., Martinez-Ortega, P., Molina-Fernandez, M., Sanchez-Justicia, C., Gracia Solanas, J. Antonio, Diaz de laspra, E. Cordoba, Echazarreta-Gallego, E., Elia-Guedea, M., Ramirez, J., Arredondo Chaves, J., Gonzalez, P. Diez, Elosua, T., Sahagun, J., Turienzo Frade, A., Alvarez Conde, J., Castrillo, E., Diaz Maag, R., Maderuelo, V., Saldarriaga, L., Aldrey Cao, I., Fernandez Varela, X., Nunez Fernandez, S., Parajo Calvo, A., Villar Alvarez, S., Blesa Sierra, I., Lozano, R., Marquez, M., Porcel, O., Menendez, P., Fernandez Hevia, M., Flores Siguenza, L., Jimenez Toscano, M., Lacy Fortuny, A., Ordonez Trujillo, J., Espi, A., Garcia-Botello, S., Martin-Arevalo, J., Moro-Valdezate, D., Pla-Marti, V., Blanco-Antona, F., Abrisqueta, J., Ibanez Canovas, N., Lujan Mompean, J., Escola Ripoll, D., Martinez Gonzalez, S., Parodi, J., Fernandez Lopez, A., Ramos Fernandez, M., Castellvi Valls, J., Ortiz de Zarate, L., Ribas, R., Sabia, D., Viso, L., Alonso Goncalves, S., Gil Egea, M. Jose, Pascual Damieta, M., Pera, M., Salvans Ruiz, S., Bernal, J., Landete, F., Ais, G., Etreros, J., Aguilo Lucia, J., Bosca, A., Deusa, S., Garcia del Cano, J., Viciano, V., Garcia-Armengol, J., Roig, J., Blas, J., Escartin, J., Fatas, J., Fernando, J., Ferrer, R., Arias Pacheco, R., Garcia Florez, L., Moreno Gijon, M., Otero Diez, J., Solar Garcia, L., Aguilar Teixido, F., Balaguer Ojo, C., Bargallo Berzosa, J., Lamas Moure, S., J., Enrique Sierra, Ferminan, A., Herrerias, F., Rufas, M., Vinas, J., Codina-Cazador, A., Farres, R., Gomez, N., Julia, D., Planellas, P., Lopez, J., Luna, A., Maristany, C., Munoz Duyos, A., Puertolas, N., Alcantara Moral, M., Serra-Aracil, X., Concheiro Coello, P., Gomez, D., Carton, C., Miguel, A., Reoyo Pascual, F., Valero Cerrato, X., Zambrano Munoz, R., Cervera-Aldama, J., Gonzalez, J. Garcia, Ramos-Prada, J., Santamaria-Olabarrieta, M., Uriguen-Echeverria, A., Coves Alcover, R., Espinosa Soria, J., Fernandez Rodriguez, E., Hernandis Villalba, J., Maturana Ibanenz, V., De la Torre Gonzalez, F., Huerga, D., Perez Viejo, E., Rivera, A., Ruiz Ucar, E., Garcia-Septiem, J., Jimenez, V., Jimenez Miramon, J., Ramons Rodriquez, J., Rodriguez Alvarez, V., Garcea, A., Ponchietti, L., Borda, N., Enriquez-Navascues, J., Saralegui, Y., Febles Molina, G., Nogues, E., Rodriguez Mendez, A., Roque Castellano, C., Sosa Quesada, Y., Alvarez-Gallego, M., Pascual, I., Rubio-Perez, I., Diaz-San Andres, B., Tone-Villanueva, F., Alonso, J., Cagigas, C., Castillo, J., Gomez, M., Martin-Parra, J., Mengual Ballester, M., Pellicer Franco, E., Soria Aledo, V., Valero Navarro, G., Caballero Rodriguez, E., Gonzalez De Chaves, P., Hernandez, G., Perez Alvarez, A., Soto Sanchez, A., Becerra Garcia, F. Cesar, Alonso Roque, J. Guillermo, Rodriguez Arias, F. Lopez, Del Valle Ruiz, S. R., Sanchez De la Villa, G., Compan, A., Garcia Marin, A., Nofuentes, C., Orts Mico, F., Perez Auladell, V., Carrasco, M., Duque Perez, C., Galvez-Pastor, S., Navarro Garcia, I., Sanchez Perez, A., Enjuto, D., Manuel Bujalance, F., Marcelin, N., Perez, M., Serrano Garcia, R., Cabrera, A., de la Portilla, F., Diaz-Pavon, J., Jimenez-Rodriguez, R., Vazquez-Monchul, J., Daza Gonzalez, J., Gomez Perez, R., Rivera Castellano, J., Roldan de la Rua, J., Errasti Alustiza, J., Fernandez, L., Romeo Ramirez, J., Sardon Ramos, J., Cermeno Toral, B., Alias, D., Garcia-Olmo, D., Guadalajara, H., Herreros, M., Pacheco, P., del Castillo Diez, F., Lima Pinto, F., Martinez Alegre, J., Ortega, I., Nieto Antonio, A. Picardo, Caro, A., Escuder, J., Feliu, F., Millan, M., Alos Company, R., Frangi Caregnato, A., Lozoya Trujillo, R., Rodriguez Carrillo, R., Ruiz Carmona, M., Alonso, N., Ambrona Zafra, D., Ayala Candia, B. Amilka, Bonnin Pascual, J., Pineno Flores, C., Alcazar Montero, J., Angoso Clavijo, M., Garcia, J., Sanchez Tocino, J., Gomez-Alcazar, C., Costa-Navarro, D., Ferri-Romero, J., Rey-Riveiro, M., Romero-Simo, M., Arencibia, B., Esclapez, P., Garcia-Granero, E., Granero, P., Medina Fernandez, F. J., Gallardo Herrera, A. B., Diaz Lopez, C., Navarro Rodriguez, E., Torres Tordera, E., Arenal, J., Citores, M., Marcos, J., Sanchez, J., Tinoco, C., Espin, E., Garcia Granero, A., Jimenez Gomez, L., Sanchez Garcia, J., Vallribera, F., Folkesson, J., Skoldberg, F., Bergman, K., Borgstrom, E., Frey, J., Silfverberg, A., Soderholm, M., Nygren, J., Segelman, J., Gustafsson, D., Lagerqvist, A., Papp, A., Pelczar, M., Abraham-Nordling, M., Ahlberg, M., Sjovall, A., Tengstrom, J., Hagman, K., Chabok, A., Ezra, E., Nikberg, M., Smedh, K., Tiselius, C., Al-Naimi, N., Duc, M. Dao, Meyer, J., Mormont, M., Ris, F., Prevost, G., Villiger, P., Hoffmann, H., Kettelhack, C., Kirchhoff, P., Oertli, D., Weixler, B., Aytac, B., Leventoglu, S., Mentes, B., Yuksel, O., Demirbas, S., Ozkan, B. Busra, Ozbalci, G. Selcuk, Sungurtekin, U., Gulcu, B., Ozturk, E., Yilmazlar, T., Challand, C., Fearnhead, N., Hubbard, R., Kumar, S., Arthur, J., Barben, C., Skaife, P., Slawik, S., Williams, M., Zammit, M., Barker, J., French, J., Sarantitis, I., Slawinski, C., Clifford, R., Eardley, N., Johnson, M., McFaul, C., Vimalachandran, D., Allan, S., Bell, A., Oates, E., Shanmugam, V., Brigic, A., Halls, M., Pucher, P., Stubbs, B., Agarwal, T., Chopada, A., Mallappa, S., Pathmarajah, M., Sugden, C., Brown, C., Macdonald, E., Mckay, A., Richards, J., Robertson, A., Kaushal, M., Patel, P., Tezas, S., Touqan, N., Ayaani, S., Marimuthu, K., Piramanayagam, B., Vourvachis, M., Iqbal, N., Korsgen, S., Seretis, C., Shariff, U., Arnold, S., Chan, H., Clark, E., Fernandes, R., Moran, B., Bajwa, A., McArthur, D., Cao, K., Cunha, P., Pardoe, H., Quddus, A., Theodoropoulou, K., Bolln, C., Denys, G., Gillespie, M., Manimaran, N., Reidy, J., Malik, A. I., Malik, A., Pitt, J., Aryal, K., El-Hadi, A., Lal, R., Pal, A., Velchuru, V., Cunha, M. Oliveira, Thomas, M., Bains, S., Boyle, K., Miller, A., Norwood, M., Yeung, J., Goian, L., Gurjar, S., Saghir, W., Sengupta, N., Stewart-Parker, E., Bailey, S., Khalil, T., Lawes, D., Nikolaou, S., Omar, G., Church, R., Muthiah, B., Garrett, W., Marsh, P., Obeid, N., Chandler, S., Coyne, P., Evans, M., Hunt, L., Lim, J., Oliphant, Z., Papworth, E., Weaver, H., Leon, K. Cuinas, Williams, G., Hernon, J., Kapur, S., Moosvi, R., Shaikh, I., Swafe, L., Aslam, M., Evans, J., Ihedioha, U., Kang, P., Merchant, J., Hompes, R., Middleton, R., Broomfield, A., Crutten-Wood, D., Foster, J., Nash, G., Akhtar, M., Boshnaq, M., Eldesouky, S., Mangam, S., Rabie, M., Ahmed, J., Khan, J., Goh, N. Ming, Shamali, A., Stefan, S., Thompson, C., Amin, A., Docherty, J., Lim, M., Walker, K., Watson, A., Hossack, M., Mackenzie, N., Paraoan, M., Alam, N., Daniels, I., Narang, S., Pathak, S., Smart, N., Al-Qaddo, A., Codd, R., Rutka, O., Bronder, C., Crighton, I., Davies, E., Raymond, T., Bookless, L., Griffiths, B., Plusa, S., Carlson, G., Harrison, R., Lees, N., Mason, C., Quayle, J., Branagan, G., Broadhurst, J., Chave, H., Sleight, S., Awad, F., Cruickshank, N., Joy, H., Boereboom, C., Daliya, P., Dhillon, A., Watson, N., Watson, R., Artioukh, D., Gokul, K., Javed, M., Kong, R., Sutton, J., Faiz, O., Jenkins, I., Leo, C. A., Samaranayake, S. F., Warusavitarne, J., Arya, S., Bhan, C., Mukhtar, H., Oshowo, A., Wilson, J., Duff, S., Fatayer, T., Mbuvi, J., Sharma, A., Cornish, J., Davies, L., Harries, R., Morris, C., Torkington, J., Knight, J., Lai, C., Shihab, O., Tzivanakis, A., Hussain, A., Luke, D., Padwick, R., Torrance, A., Tsiamis, A., Dawson, P., Balfour, A., Brady, R., Mander, J., Paterson, H., Chandratreya, N., Chu, H., Cutting, J., Vernon, S., Ho, C. Wai, Andreani, S., Patel, H., Warner, M., Tan, J. Yan Qi, Gidwani, A., Lawther, R., Loughlin, P., Skelly, B., Spence, R., Iqbal, A., Khan, A., Perrin, K., Raza, A., Tan, S., MUMC+: MA Heelkunde (9), Promovendi PHPC, MUMC+: MA AIOS Heelkunde (9), RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, (ukupan broj autora: 1112), OMÜ, Battersby, N., Bhangu, A., Chaudhri, S., El-Hussuna, A., Frasson, M., Nepogodiev, D., Singh, B., Vennix, S., Zmora, O., Altomare, D., Bemelman, W., Christensen, P., D'Hoore, A., Laurberg, S., Morton, D., Rubbini, M., Vaizey, C., Magill, L., Perry, R., Sheward, N., Ives, N., Mehta, S., Cillo, M., Estefania, D., Patron Uriburu, J., Ruiz, H., Salomon, M., Makhmudov, A., Selnyahina, L., Varabei, A., Vizhynis, Y., Claeys, D., Defoort, B., Muysoms, F., Pletinckx, P., Vergucht, V., Debergh, I., Feryn, T., Reusens, H., Nachtergaele, M., Francart, D., Jehaes, C., Markiewicz, S., Monami, B., Weerts, J., Bouckaert, W., Houben, B., Knol, J., Sergeant, G., Vangertruyden, G., Haeck, L., Lange, C., Sommeling, C., Vindevoghel, K., Castro, S., De Bruyn, H., Huyghe, M., De Wolf, E., Reynders, D., Wolthuis, A., Delibegovic, S., Christiani, A., Marchiori, M., de Moraes, C. Rocha, Tercioti, V., Arabadjieva, E., Bulanov, D., Dardanov, D., Stoyanov, V., Yonkov, A., Angelov, K., Maslyankov, S., Sokolov, M., Todorov, G., Toshev, S., Georgiev, Y., Karashmalakov, A., Zafirov, G., Wang, X., Condic, D., Kraljik, D., Mrkovic, H., Pavkovic, V., Raguå¾, K., Bencurik, V., Holã¡å¡kovã¡, E., Skrovina, M., Farkaå¡ovã¡, M., Grolich, T., Kala, Z., Antos, F., Pruchova, V., Sotona, O., Chobola, M., Dusek, T., Ferko, A., Ã–rhalmi, J., Hoch, J., Kocian, P., Martinek, L., Bernstein, I., Gotschalck Sunesen, K., Leunbach, J., Thorlacius-Ussing, O., Uth Oveson, A., Dahl Chirstensen, S., Gamez, V., Oeting, M., Schou Loeve, U., Ugianskis, A., Jessen, M., Krarup, P., Linde, K., Mirza, Q., Overgaard Stovring, J., Erritzã¸e, L., Loft Jakobsen, H., Lykke, J., Palmgren Colov, E., Husted Madsen, A., Linde Friis, T., Amstrup Funder, J., Dich, R., Kjã¦r, S., Rasmussen, S., Schlesinger, N., Dilling Kjaer, M., Qvist, N., Khalid, A., Ali, G., Hadi, S., Rosell Walker, L., Kivelã¤, A., Lehtonen, T., Lepistã¶, A., Scheinin, T., Siironen, P., Kã¶ssi, J., Kuusanmã¤ki, P., Tomminen, T., Turunen, A., Rautio, T., Vierimaa, M., Huhtinen, H., Karvonen, J., Lavonius, M., Rantala, A., Varpe, P., Cotte, E., Francois, Y., Glehen, O., Kepenekian, V., Passot, G., Maggiori, L., Manceau, G., Panis, Y., Gout, M., Rullier, E., Chafai, N., Lefevre, J. H., Parc, Y., Tiret, E., Couette, C., Duchalais, E., Agha, A., Hornberger, M., Hungbauer, A., Iesalnieks, I., Weindl, I., Crescenti, F., Keller, M., Kolodziejski, N., Scherer, R., Sterzing, D., Bock, B., Boehm, G., El-Magd, M., Krones, C., Niewiera, M., Buhr, J., Cordesmeyer, S., Hoffmann, M., Krã¼ckemeier, K., Vogel, T., Schã¶n, M., Baral, J., Lukoschek, T., Mã¼nch, S., Pullig, F., Horisberger, K., Kienle, P., Magdeburg, J., Post, S., Batzalexis, K., Germanos, S., Agalianos, C., Dervenis, C., Gouvas, N., Kanavidis, P., Kottikias, A., Katsoulis, I. E., Korkolis, D., Plataniotis, G., Sakorafas, G., Akrida, I., Argentou, M., Kollatos, C., Lampropoulos, C., Tsochatzis, S., Besznyã¡k, I., Bursics, A., Egyed, T., Papp, G., Svastics, I., Atladottir, J., Mã¶ller, P., Sigurdsson, H., Stefã¡nsson, T., Valsdottir, E., Andrews, E., Foley, N., Hechtl, D., Majeed, M., Mccourt, M., Hanly, A., Hyland, J., Martin, S., O'Connell, P. R., Winter, D., Connelly, T., Joyce, W., Wrafter, P., Berkovitz, R., Avital, S., Haj Yahia, I., Hermann, N., Shpitz, B., White, I., Lishtzinsky, Y., Tsherniak, A., Wasserberg, N., Horesh, N., Keler, U., Pery, R., Shapiro, R., Tulchinsky, H., Badran, B., Dayan, K., Iskhakov, A., Lecaros, J., Nabih, N., Angrima, I., Bardini, R., Pizzolato, E., Tonello, M., Arces, F., Balestri, R., Ceccarelli, C., Prosperi, V., Rossi, E., Giannini, I., Vincenti, L., Altomare, D. F., Di Candido, F., Di Iena, M., Guglielmi, A., Caputi-Iambrenghi, O., Marsanic, P., Mellano, A., Muratore, A., Annecchiarico, M., Bencini, L., Amore Bonapasta, S., Coratti, A., Guerra, F., Asteria, C. R., Boccia, L., Gerard, L., Pascariello, A., Manca, G., Marino, F., Casaril, A., Inama, M., Moretto, G., Bacchelli, C., Carvello, M., Mariani, N., Montorsi, M., Spinelli, A., Romairone, E., Scabini, S., Belli, A., Bianco, F., De Franciscis, S., Maria Romano, G., Delrio, P., Pace, U., Rega, D., Sassaroli, C., Scala, D., De Luca, R., Ruggieri, E., Elbetti, C., Garzi, A., Romoli, L., Scatizzi, M., Vannucchi, A., Curletti, G., Durante, V., Galleano, R., Mariani, F., Reggiani, L., Bellomo, R., Infantino, A., Franceschilli, L., Sileri, P., Clementi, I., Coletta, D., La Torre, F., Mingoli, A., Velluti, F., Di Giacomo, A., Fiorot, A., Massani, M., Padoan, L., Ruffolo, C., Caruso, S., Franceschini, F., Laessig, R., Monaci, I., Rontini, M., De Nardi, P., Elmore, U., Lemma, M., Rosati, R., Tamburini, A., De Luca, M., Sartori, A., Benevento, A., Bottini, C., Ferrari, C. C., Pata, F., Tessera, G., Pellino, G., Selvaggi, F., Lanzani, A., Romano, F., Sgroi, G., Steccanella, F., Turati, L., Yamamoto, T., Ancans, G., Gerkis, S., Leja, M., Pcolkins, A., Sivins, A., Latkauskas, T., Lizdenis, P., Saladå¾inskas, Å. ½., Å vagå¾dys, S., Tamelis, A., Razbadauskas, A., Sokolovas, M., Dulskas, A., Samalavicius, N., Jotautas, V., Mikalauskas, S., Poskus, E., Poskus, T., Strupas, K., Camenzuli, C., Cini, C., Predrag, A., Psaila, J., Spiteri, N., Buskens, C., Gooszen, J., Tanis, P., Belgers, E., Davids, P., Furnee, E., Postma, E., Pronk, A., Smakman, N., Clermonts, S., Zimmerman, D., Omloo, J., Wassenaar, E., Bruijninckx, M., Doornebosch, P., Tetteroo, G., Vermaas, M., Iordens, G., Knops, S., Toorenvliet, B., Boerma, E., Coene, P., Raber, M., Melenhorst, J., Gerhards, M., Arron, M., Bremers, A., Ferenschild, F., Yauw, S., Cense, H., Demirkiran, A., Hunfeld, M., Mulder, I., Nonner, J., Swank, H., Bolmers, M., Briel, J., Klemann, V., Konsten, J., Leenders, B., Schok, T., Bleeker, W., Gidwani, A., Lawther, R., Loughlin, P., Skelly, B., Spence, R., Brun, M., Helgeland, M., Ignjatovic, D., Ã˜resland, T., Yousefi, P., FlÃ¥ten Backe, I., Helmer Sjo, O., Nesbakken, A., Tandberg-Eriksen, M., Cais, A., Hallvard TrÃ¦land, J., Herikstad, R., Kã¸rner, H., Lauvland, N., Jajtner, D., Kabiesz, W., Rak, M., Gmerek, L., Horbacka, K., Horst, N., Krokowicz, P., Kwiatkowski, A., Pasnik, K., Karcz, P., Romaniszyn, M., Rusek, T., Walega, P., Czarencki, R., Obuszko, Z., Sitarska, M., Wojciech, W., Zawadzki, M., Amado, S., Clara, P., Couceiro, A., Malaquias, R., Rama, N., Almeida, A., Barbosa, E., Cernadas, E., Duarte, A., Silva, P., Costa, S., Martinez Insua, C., Pereira, J., Pereira, C., Sacchetti, M., Carvalho Pinto, B., Jorge Vieira Sousa, P., Marques, R., Oliveira, A., Cardoso, R., Carlos, S., Corte-Real, J., Moniz Pereira, P., Souto, R., Carneiro, C., Marinho, R., Nunes, V., Rocha, R., Sousa, M., Fonseca, Fernando, Leite, J., Melo, F., Pimentel, J., Ventura, L., Vila Nova, C., Copäƒescu, C., Bintintan, V., Ciuce, C., Dindelegan, G., Scurtu, R., Seicean, R., Domansky, N., Karachun, A., Moiseenko, A., Pelipas, Y., Petrov, A., Pravosudov, I., Aiupov, R., Akmalov, Y., Parfenov, A., Suleymanov, N., Tarasov, N., Jumabaev, H., Mamedli, Z., Rasulov, A., Aliev, I., Chernikovskiy, I., Kochnev, V., Komyak, K., Smirnov, A., Achkasov, S., Bolikhov, K., Shelygin, Y., Sushkov, O., Zapolskiy, A., Gvozdenovic, M., Jovanovic, D., Lausevic, Z., CvetkoviÄ‡, D., MaraviÄ‡, M., Milovanovic, B., Stojakovic, N., TripkoviÄ‡, I., Mihajlovic, D., Nestorovic, M., Pecic, V., Petrovic, D., Stanojevic, G., Barisic, G., Dimitrijevic, I., Krivokapic, Z., Markovic, V., Popovic, M., Aleksic, A., Dabic, D., Kostic, I., Milojkovic, A., Perunicic, V., Lukic, D., Petrovic, T., Radovanovic, D., Radovanovic, Z., Cuk, V. M., Cuk, V. V., Kenic, M., Kovacevic, B., Krdzic, I., Korcek, J., Rems, M., Toplak, J., Escarrã¢, J., Gil Barrionuevo, M., Golda, T., Kreisler Moreno, E., Zerpa Martin, C., Ã lvarez Laso, C., Cumplido, P., Padin, H., Baixauli Fons, J., HernÃ¡ndez-Lizoain, J., Martinez-Ortega, P., Molina-FernÃ¡ndez, M., SÃ¡nchez-Justicia, C., Antonio Gracia Solanas, J., de Laspra, E. CÃ³rdoba DÃaz, Echazarreta-Gallego, E., Elia-Guedea, M., Ramirez, J., Arredondo Chaves, J., Diez GonzÃ¡lez, P., Elosua, T., Sahagãºn, J., Turienzo Frade, A., Ã lvarez Conde, J., Castrillo, E., Diaz Maag, R., Maderuelo, V., Saldarriaga, L., Aldrey Cao, I., FernÃ¡ndez Varela, X., NÃºÃ±ez FernÃ¡ndez, S., ParajÃ³ Calvo, A., Villar Ã lvarez, S., Blesa Sierra, I., Lozano, R., Mã¡rquez, M., Porcel, O., Menendez, P., FernÃ¡ndez Hevia, M., Flores SigÃ¼enza, L., Jimenez Toscano, M., Lacy Fortuny, A., OrdoÃ±ez Trujillo, J., Espi, A., Garcia-Botello, S., MartÃn-ArÃ©valo, J., Moro-Valdezate, D., Pla-MartÃ, V., Blanco-Antona, F., Abrisqueta, J., IbaÃ±ez Canovas, N., Lujan Mompean, J., EscolÃ¡ Ripoll, D., Martinez Gonzalez, S., Parodi, J., FernÃ¡ndez LÃ³pez, A., Ramos FernÃ¡ndez, M., Castellvi Valls, J., de Zarate, L. Ortiz, Ribas, R., Sabia, D., Viso, L., Alonso GonÃ§alves, S., JosÃ© Gil Egea, M., Pascual Damieta, M., Pera, M., Salvans Ruiz, S., Bernal, J., Landete, F., Ais, G., Etreros, J., AguilÃ³ Lucia, J., Boscã¡, A., Deusa, S., GarcÃa del CaÃ±o, J., Viciano, V., GarcÃa-Armengol, J., Roig, J., Blas, J., Escartin, J., Fatã¡s, J., Fernando, J., Ferrer, R., Arias Pacheco, R., GarcÃa FlÃ³rez, L., Moreno GijÃ³n, M., Otero DÃez, J., Solar Garcia, L., Aguilar Teixido, F., Balaguer Ojo, C., Bargallo Berzosa, J., Lamas Moure, S., Enrique Sierra, J., Fermiã±ã¡n, A., Herrerias, F., Rufas, M., Viã±as, J., Codina-Cazador, A., Farrã©s, R., Gã³mez, N., Juliã , D., Planellas, P., Lã³pez, J., Luna, A., Maristany, C., MuÃ±oz Duyos, A., Puã©rtolas, N., Alcantara Moral, M., Serra-Aracil, X., Concheiro Coello, P., Gã³mez, D., Carton, C., Miguel, A., Reoyo Pascual, F., Valero Cerrato, X., Zambrano MuÃ±oz, R., Cervera-Aldama, J., GarcÃa GonzÃ¡lez, J., Ramos-Prada, J., SantamarÃa-Olabarrieta, M., UrigÃ¼en-EcheverrÃa, A., Coves Alcover, R., Espinosa Soria, J., Fernandez Rodriguez, E., Hernandis Villalba, J., Maturana IbaÃ±ez, V., De la Torre Gonzalez, F., Huerga, D., PÃ©rez Viejo, E., Rivera, A., Ruiz Ucar, E., Garcia-Septiem, J., Jimã©nez, V., JimÃ©nez MiramÃ³n, J., Ramons Rodriquez, J., Rodriguez Alvarez, V., Garcea, A., Ponchietti, L., Borda, N., Enriquez-Navascues, J., Saralegui, Y., Febles Molina, G., Nogues, E., RodrÃguez MÃ©ndez, Ã. ., Roque Castellano, C., Sosa Quesada, Y., Alvarez-Gallego, M., Pascual, I., Rubio-Perez, I., Diaz-San AndrÃ©s, B., Tone-Villanueva, F., Alonso, J., Cagigas, C., Castillo, J., Gã³mez, M., MartÃn-Parra, J., Mengual Ballester, M., Pellicer Franco, E., Soria Aledo, V., Valero Navarro, G., Caballero RodrÃguez, E., De Chaves, P. Gonzalez, Hernandez, G., Perez Alvarez, A., Soto Sanchez, A., Cesar Becerra Garcia, F., Guillermo Alonso Roque, J., LÃ³pez RodrÃguez Arias, F., Del Valle Ruiz, S. R., De La Villa, G. SÃ¡nchez, Compaã±, A., GarcÃa MarÃn, A., Nofuentes, C., Orts MicÃ³, F., PÃ©rez Auladell, V., Carrasco, M., Duque Perez, C., GÃ¡lvez-Pastor, S., Navarro Garcia, I., Sanchez Perez, A., Enjuto, D., Manuel Bujalance, F., Marcelin, N., Pã©rez, M., Serrano GarcÃa, R., Cabrera, A., de la Portilla, F., Diaz-Pavon, J., Jimenez-Rodriguez, R., Vazquez-Monchul, J., Daza GonzÃ¡lez, J., GÃ³mez PÃ©rez, R., Rivera Castellano, J., de la Rua, J. RoldÃ¡n, Errasti Alustiza, J., Fernandez, L., Romeo Ramirez, J., Sardon Ramos, J., CermeÃ±o Toral, B., Alias, D., Garcia-Olmo, D., Guadalajara, H., Herreros, M., Pacheco, P., Lima, P., MartÃnez Alegre, J., Ortega, I., Picardo Nieto Antonio, A., Caro, A., Escuder, J., Feliu, F., Millan, M., Frangi Caregnato, A., Lozoya Trujillo, R., RodrÃguez Carrillo, R., Ruiz Carmona, M., Alonso, N., Ambrona Zafra, D., Amilka Ayala Candia, B. J., PineÃ±o Flores, C., Alcazar Montero, J., Angoso Clavijo, M., Garcia, J., Sanchez Tocino, J., GÃ³mez-Alcazar, C., Costa-Navarro, D., Ferri-Romero, J., Rey-Riveiro, M., Romero-SimÃ³, M., Arencibia, B., Esclapez, P., GarcÃa-Granero, E., Granero, P., Medina FernÃ¡ndez, F. J., Gallardo Herrera, A. B., Diaz LÃ³pez, C., Navarro Rodriguez, E., Torres Tordera, E., Arenal, J., Citores, M., Marcos, J., Sã¡nchez, J., Tinoco, C., Espin, E., Garcia Granero, A., Jimenez Gomez, L., Sanchez Garcia, J., Vallribera, F., Folkesson, J., Skã¶ldberg, F., Bergman, K., Borgstrã¶m, E., Frey, J., Silfverberg, A., Sã¶derholm, M., Nygren, J., Segelman, J., Gustafsson, D., Lagerqvist, A., Papp, A., Pelczar, M., Abraham-Nordling, M., Ahlberg, M., Sjovall, A., Tengstrom, J., Hagman, K., Chabok, A., Ezra, E., Nikberg, M., Smedh, K., Tiselius, C., Al-Naimi, N., Dao Duc, M., Meyer, J., Mormont, M., Ris, F., Prevost, G., Villiger, P., Hoffmann, H., Kettelhack, C., Kirchhoff, P., Oertli, D., Weixler, B., Aytac, B., Leventoglu, S., Mentes, B., Yuksel, O., Demirbas, S., Busra Ozkan, B., SelÃ§uk Ã–zbalci, G., Sungurtekin, U., Gã¼lcã¼, B., Ozturk, E., Yilmazlar, T., Challand, C., Fearnhead, N., Hubbard, R., Kumar, S., Arthur, J., Barben, C., Skaife, P., Slawik, S., Williams, M., Zammit, M., Barker, J., Sarantitis, I., Slawinski, C., Clifford, R., Eardley, N., Johnson, M., Mcfaul, C., Vimalachandran, D., Allan, S., Bell, A., Oates, E., Shanmugam, V., Brigic, A., Halls, M., Pucher, P., Stubbs, B., Agarwal, T., Chopada, A., Mallappa, S., Pathmarajah, M., Sugden, C., Brown, C., Macdonald, E., Mckay, A., Richards, J., Robertson, A., Kaushal, M., Patel, P., Tezas, S., Touqan, N., Ayaani, S., Marimuthu, K., Piramanayagam, B., Vourvachis, M., Iqbal, N., Korsgen, S., Seretis, C., Shariff, U., Arnold, S., Chan, H., Clark, E., Fernandes, R., Moran, B., Bajwa, A., Mcarthur, D., Cao, K., Cunha, P., Pardoe, H., Quddus, A., Theodoropoulou, K., Bolln, C., Denys, G., Gillespie, M., Manimaran, N., Reidy, J., Malik, A. I., Malik, A., Pitt, J., Aryal, K., El-Hadi, A., Lal, R., Pal, A., Velchuru, V., Oliveira Cunha, M., Thomas, M., Bains, S., Boyle, K., Miller, A., Norwood, M., Yeung, J., Goian, L., Gurjar, S., Saghir, W., Sengupta, N., Stewart-Parker, E., Bailey, S., Khalil, T., Lawes, D., Nikolaou, S., Omar, G., Church, R., Muthiah, B., Garrett, W., Marsh, P., Obeid, N., Chandler, S., Coyne, P., Evans, M., Hunt, L., Lim, J., Oliphant, Z., Papworth, E., Weaver, H., CuiÃ±as Leon, K., Williams, G., Hernon, J., Kapur, S., Moosvi, R., Shaikh, I., Swafe, L., Aslam, M., Evans, J., Ihedioha, U., Kang, P., Merchant, J., Hompes, R., Middleton, R., Broomfield, A., Crutten-Wood, D., Foster, J., Nash, G., Akhtar, M., Boshnaq, M., Eldesouky, S., Mangam, S., Rabie, M., Ahmed, J., Khan, J., Ming Goh, N., Shamali, A., Stefan, S., Thompson, C., Amin, A., Docherty, J., Lim, M., Walker, K., Watson, A., Hossack, M., Mackenzie, N., Paraoan, M., Alam, N., Daniels, I., Narang, S., Pathak, S., Smart, N., Al-Qaddo, A., Codd, R., Rutka, O., Bronder, C., Crighton, I., Davies, E., Raymond, T., Bookless, L., Griffiths, B., Plusa, S., Carlson, G., Harrison, R., Lees, N., Mason, C., Quayle, J., Branagan, G., Broadhurst, J., Chave, H., Sleight, S., Awad, F., Cruickshank, N., Joy, H., Boereboom, C., Daliya, P., Dhillon, A., Watson, N., Watson, R., Artioukh, D., Gokul, K., Javed, M., Kong, R., Sutton, J., Faiz, O., Jenkins, I., Leo, C. A., Samaranayake, S. F., Warusavitarne, J., Arya, S., Bhan, C., Mukhtar, H., Oshowo, A., Wilson, J., Duff, S., Fatayer, T., Mbuvi, J., Sharma, A., Cornish, J., Davies, L., Harries, R., Morris, C., Torkington, J., Knight, J., Lai, C., Shihab, O., Tzivanakis, A., Hussain, A., Luke, D., Padwick, R., Torrance, A., Tsiamis, A., Dawson, P., Balfour, A., Brady, R., Mander, J., Paterson, H., Chandratreya, N., Chu, H., Cutting, J., Vernon, S., Wai Ho, C., Andreani, S., Patel, H., Yan Qi Tan, J., Iqbal, A., Khan, A., Perrin, K., Raza, A., Tan, S., Other departments, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, CCA - Cancer Treatment and Quality of Life, Surgery, Meyer, Jérémy, Al-Naimi, Noof, Mormont, Murielle, Ris, Frédéric, 2015 European Society of Coloproctology collaborating, Group, Rosati, R, Sileri, P, and Radiology and nuclear medicine
Subjects: medicine.medical_specialty, Leak, SURGERY, colorectal cancer, Audit, 030230 surgery, Anastomosis, Logistic regression, NO, Resection, 03 medical and health sciences, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Primary outcome, All institutes and research themes of the Radboud University Medical Center, Anastomotic leak, colorectal cancer, Crohn's disease, epidemiology, international, Journal Article, Medicine, Anastomotic leak, LEAK, COMPLICATIONS, ddc:617, business.industry, MORTALITY, Gastroenterology, Crohns disease, anastomotic leak, crohn's disease, epidemiology, international, ta3121, 3. Good health, Surgery, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Crohn's disease, DEFINITION, 030220 oncology & carcinogenesis, Mixed effects, RISK-FACTORS, business, Right hemicolectomy
Abstract: Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn)., Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable., Results This study included 3208 patients, of whom 78.4% (n = 2515) underwent surgery for malignancy and 11.7% (n = 375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8% (n = 3041) of patients, which was handsewn in 38.9% (n = 1183) and stapled in 61.1% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5% handsewn vs 12.9% stapled) and to undergo open surgery (54.7% handsewn vs 36.6% stapled). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95% CI: 1.04-1.95; P = 0.03)., Conclusion Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe.
Published: 2017

23. The 2017 European Society of Coloproctology (ESCP) international snapshot audit of left colon, sigmoid and rectal resections - study protocol

Author: El-Hussuna, A., Chaudri, S., Frasson, M., Gallo, G., Minaya-Bravo, A. M., Negoi, I., Pata, F., Sanchez-Guillen, L., Singh, B., Glasbey, J., Magill, L., Mekic, D., Nepogodiev, D., Perry, R., Bhangu, A., Morton, D., Altomare, D., Bemelman, W., Brown, S., Buskens, C., Denost, Q., Knowles, C., Laurberg, S., Lefevre, J., Moeslein, G., Pinkney, T., Vaizey, C., Zmora, O., and Poskus, T.
Subjects: Male, left colon, sigmoid resection, rectal resection, Clinical Audit, Proctectomy, Colon, Gastroenterology, Rectum, Middle Aged, Europe, Colon, Sigmoid, Research Design, Humans, Female, Prospective Studies, Practice Patterns, Physicians', Colorectal Surgery, Colectomy, Societies, Medical, Aged
Abstract: BACKGROUND: Left hemicolectomy, sigmoid, and rectal resections are commonly performed colorectal operations. There is significant variability in the techniques utilised to undertake these operationsat patient, surgeon and unit level.AIM: To explore differences in patients, techniques and outcomes across an international cohort to identify areas of practice variability resulting in apparent differences in outcome warranting further study.ENDPOINTS: A three-stage data collection strategy collecting patient demographics, operative details and outcome markers. Several outcomes measures will be used including mortality, surgical morbidity (including anastomotic leak) and length of hospital stay.METHODS: A two-month prospective audit to be performed across Europe in early 2017, co-ordinated by the European Society of Coloproctology. The main audit will be preceded by a one-week, five centre pilot. Sites will be asked to pre-register for the audit and obtain appropriate regional or national approvals. During the study period all eligible operations will be recorded contemporaneously and followed-up through to 30 days. The audit will be performed using a standardised pre-determined protocol and a secure online database. In the first ESCP conducted audit in 2015, 38 countries registered 3208 patients undergoing right hemi-colectomy, while in the second audit 2441 patients undergoing stoma closure were recruited from 48 countries. It is expected that equivalent numbers will be obtained in this audit. The report of this audit will be prepared in accordance with guidelines set by the STROBE (strengthening the reporting of observational studies in epidemiology) statement for observational studies.DISCUSSION: This multicentre, pan-European audit will be delivered by colorectal surgeons and trainees in an organised and homogenous manner. The data obtained about areas of variability in provision or practice, and how this may impact upon outcomes, will serve to improve overall patient care as well as being hypothesis generating and inform areas needing future prospective study.
Published: 2018

24. Brain MRI reveals white matter tract abnormalities in patients with idiopathic fecal incontinence

Author: Muthulingam, Janusiya, Haase, Anne-Mette, Hansen, Tine Maria, Laurberg, S, Lundby, L, Stødkilde, H, Jørgensen, H, Drewes, Asbjørn, Krogh, K, and Frøkjær, Jens Brøndum
Published: 2017

25. right hemicolectomy and ileo-caecal resection: an international snapshot

Author: Pinkney, T, Battersby, N, Bhangu, A, Chaudhri, S, El-Hussuna, A, Frasson, M, Nepogodiev, D, Singh, B, Vennix, S, Zmora, O, Altomare, D, Bemelman, W, Christensen, P, D'Hoore, A, Laurberg, S, Morton, D, Rubbini, M, Vaizey, C, Magill, L, Perry, R, Sheward, N, Ives, N, Mehta, S, Cillo, M, Estefania, D, Uriburu, JP, Ruiz, H, Salomon, M, Makhmudov, A, Selnyahina, L, Varabei, A, Vizhynis, Y, Claeys, D, Defoort, B, Muysoms, F, Pletinckx, P, Vergucht, V, Debergh, I, Feryn, T, Reusens, H, Nachtergaele, M, Francart, D, Jehaes, C, Markiewicz, S, Monami, B, Weerts, J, Bouckaert, W, Houben, B, Knol, J, Sergeant, G, Vangertruyden, G, Haeck, L, Lange, C, Sommeling, C, Vindevoghel, K, Castro, S, De Bruyn, H, Huyghe, M, De Wolf, E, Reynders, D, van Overstraeten, AD, Wolthuis, A, Delibegovic, S, Christiani, A, Marchiori, M, de Moraes, CR, Tercioti, V, Arabadjieva, E, Bulanov, D, Dardanov, D, Stoyanov, V, Yonkov, A, Angelov, K, Maslyankov, S, Sokolov, M, Todorov, G, Toshev, S, Georgiev, Y, Karashmalakov, A, Zafirov, G, Wang, X, Condic, D, Kraljik, D, Mrkovic, H, Pavkovic, V, Raguz, K, Bencurik, V, Holaskova, E, Skrovina, M, Farkasova, M, Grolich, T, Kala, Z, Antos, F, Pruchova, V, Sotona, O, Chobola, M, Dusek, T, Ferko, A, Orhalmi, J, Hoch, J, Kocian, P, Martinek, L, Bernstein, I, Sunesen, KG, Leunbach, J, Thorlacius-Ussing, O, Oveson, AU, Chirstensen, SD, Gamez, V, Oeting, M, Loeve, US, Ugianskis, A, Jessen, M, Krarup, P, Linde, K, Mirza, Q, Stovring, JO, Erritzoe, L, Jakobsen, HL, Lykke, J, Colov, EP, Madsen, AH, Friis, TL, Funder, JA, Dich, R, Kjaer, S, Rasmussen, S, Schlesinger, N, Kjaer, MD, Qvist, N, Khalid, A, Ali, G, Hadi, S, Walker, LR, Kivela, A, Lehtonen, T, Lepisto, A, Scheinin, T, Siironen, P, Kossi, J, Kuusanmaki, P, Tomminen, T, Turunen, A, Rautio, T, Vierimaa, M, Huhtinen, H, Karvonen, J, Lavonius, M, Rantala, A, Varpe, P, Cotte, E, Francois, Y, Glehen, O, Kepenekian, V, Passot, G, Maggiori, L, Manceau, G, Panis, Y, Gout, M, Rullier, E, van Geluwe, B, Chafai, N, Lefevre, JH, Parc, Y, Tiret, E, Couette, C, Duchalais, E, Agha, A, Hornberger, M, Hungbauer, A, Iesalnieks, I, Weindl, I, Crescenti, F, Keller, M, Kolodziejski, N, Scherer, R, Sterzing, D, Bock, B, Boehm, G, El-Magd, M, Krones, C, Niewiera, M, Buhr, J, Cordesmeyer, S, Hoffmann, M, Kruckemeier, K, Vogel, T, Schon, M, Baral, J, Lukoschek, T, Munch, S, Pullig, F, Horisberger, K, Kienle, P, Magdeburg, J, Post, S, Batzalexis, K, Germanos, S, Agalianos, C, Dervenis, C, Gouvas, N, Kanavidis, P, Kottikias, A, Katsoulis, IE, Korkolis, D, Plataniotis, G, Sakorafas, G, Akrida, I, Argentou, M, Kollatos, C, Lampropoulos, C, Tsochatzis, S, Besznyak, I, Bursics, A, Egyed, T, Papp, G, Svastics, I, Atladottir, J, Moller, P, Sigurdsson, H, Stefansson, T, Valsdottir, E, Andrews, E, Foley, N, Hechtl, D, Majeed, M, McCourt, M, Hanly, A, Hyland, J, Martin, S, O'Connell, PR, Winter, D, Connelly, T, Joyce, W, Wrafter, P, Berkovitz, R, Avital, S, Yahia, IH, Hermann, N, Shpitz, B, White, I, Lishtzinsky, Y, Tsherniak, A, Wasserberg, N, Horesh, N, Keler, U, Pery, R, Shapiro, R, Tulchinsky, H, Badran, B, Dayan, K, Iskhakov, A, Lecaros, J, Nabih, N, Angrima, I, Bardini, R, Pizzolato, E, Tonello, M, Arces, F, Balestri, R, Ceccarelli, C, Prosperi, V, Rossi, E, Giannini, I, Vincenti, L, Altomare, DF, Di Candido, F, Di Iena, M, Guglielmi, A, Caputi-Iam-Brenghi, O, Marsanic, P, Mellano, A, Muratore, A, Annecchiarico, M, Bencini, L, Bona-Pasta, SA, Coratti, A, Guerra, F, Asteria, CR, Boccia, L, Gerard, L, Pascariello, A, Manca, G, Marino, F, Casaril, A, Inama, M, Moretto, G, Bacchelli, C, Carvello, M, Mariani, N, Montorsi, M, Spinelli, A, Romairone, E, Scabini, S, Belli, A, Bianco, F, De Franciscis, S, Romano, GM, Delrio, P, Pace, U, Rega, D, Sassaroli, C, Scala, D, De Luca, R, Ruggieri, E, Elbetti, C, Garzi, A, Romoli, L, Scatizzi, M, Vannucchi, A, Curletti, G, Durante, V, Galleano, R, Mariani, F, Reggiani, L, Bellomo, R, Infantino, A, Franceschilli, L, Sileri, P, Clementi, I, Coletta, D, La Torre, F, Mingoli, A, Velluti, F, Di Giacomo, A, Fiorot, A, Massani, M, Padoan, L, Ruffolo, C, Caruso, S, Franceschini, F, Laessig, R, Monaci, I, Rontini, M, De Nardi, P, Elmore, U, Lemma, M, Rosati, R, Tamburini, A, De Luca, M, Sartori, A, Benevento, A, Bottini, C, Ferrari, CC, Pata, F, Tessera, G, Pellino, G, Selvaggi, F, Lanzani, A, Romano, F, Sgroi, G, Steccanella, F, Turati, L, Yamamoto, T, Ancans, G, Gerkis, S, Leja, M, Pcolkins, A, Sivins, A, Latkauskas, T, Lizdenis, P, Saladzin-Skas, Z, Svagzdys, S, Tamelis, A, Razbadauskas, A, Sokolovas, M, Dulskas, A, Samalavicius, N, Jotautas, V, Mikalauskas, S, Poskus, E, Poskus, T, Strupas, K, Camenzuli, C, Cini, C, Predrag, A, Psaila, J, Spiteri, N, Buskens, C, de Groof, EJ, Gooszen, J, Tanis, P, Belgers, E, Davids, P, Furnee, E, Postma, E, Pronk, A, Smakman, N, Clermonts, S, Zimmerman, D, Omloo, J, van der Zaag, E, van Duijvendijk, P, Wassenaar, E, Bruijninckx, M, de Graff, E, Doornebosch, P, Tetteroo, G, Vermaas, M, Iordens, G, Knops, S, Toorenvliet, B, van Westereenen, HL, Boerma, E, Coene, P, van der Harst, E, Van der Pool, A, Raber, M, Melenhorst, J, de Castro, S, Gerhards, M, Arron, M, Bremers, A, de Wilt, H, Ferenschild, F, Yauw, S, Cense, H, Demirkiran, A, Hunfeld, M, Mulder, I, Nonner, J, Swank, H, van Wagensveld, B, Bolmers, M, Briel, J, van Geloven, A, van Rossem, C, Klemann, V, Konsten, J, Leenders, B, Schok, T, Bleeker, W, Brun, M, Helgeland, M, Ignjatovic, D, Oresland, T, Yousefi, P, Backe, IF, Sjo, OH, Nesbakken, A, Tandberg-Eriksen, M, Cais, A, Traeland, JH, Herikstad, R, Korner, H, Lauvland, N, Jajtner, D, Kabiesz, W, Rak, M, Gmerek, L, Horbacka, K, Horst, N, Krokowicz, P, Kwiatkowski, A, Pasnik, K, Karcz, P, Romaniszyn, M, Rusek, T, Walega, P, Czarencki, R, Obuszko, Z, Sitarska, M, Wojciech, W, Zawadzki, M, Amado, S, Clara, P, Couceiro, A, Malaquias, R, Rama, N, Almeida, A, Barbosa, E, Cernadas, E, Duarte, A, Silva, P, Costa, S, Insua, CM, Pereira, J, Pereira, C, Sacchetti, M, Pinto, BC, Sousa, PJV, Marques, R, Oliveira, A, Cardoso, R, Carlos, S, Corte-Real, J, Pereira, PM, Souto, R, Carneiro, C, Marinho, R, Nunes, V, Rocha, R, Sousa, M, Leite, J, Melo, F, Pimentel, J, Ventura, L, Nova, CV, Copacscu, C, Bintintan, V, Ciuce, C, Dindelegan, G, Scurtu, R, Seicean, R, Domansky, N, Karachun, A, Moiseenko, A, Pelipas, Y, Petrov, A, Pravosudov, I, Aiupov, R, Akmalov, Y, Parfenov, A, Suleymanov, N, Tarasov, N, Jumabaev, H, Mamedli, Z, Rasulov, A, Aliev, I, Chernikovskiy, I, Kochnev, V, Komyak, K, Smirnov, A, Achkasov, S, Bolikhov, K, Shelygin, Y, Sushkov, O, Zapolskiy, A, Gvozdenovic, M, Jovanovic, D, Lausevic, Z, Cvetkovic, D, Maravic, M, Milovanovic, B, Stojakovic, N, Tripkovic, I, Mihajlovic, D, Nestorovic, M, Pecic, V, Petrovic, D, Stanojevic, G, Barisic, G, Dimitrijevic, I, Krivokapic, Z, Markovic, V, Popovic, M, Aleksic, A, Dabic, D, Kostic, I, Milojkovic, A, Perunicic, V, Lukic, D, Petrovic, T, Radovanovic, D, Radovanovic, Z, Cuk, VM, Cuk, VV, Kenic, M, Kovacevic, B, Krdzic, I, Korcek, J, Rems, M, Toplak, J, Escarra, J, Barrionuevo, MG, Golda, T, Moreno, EK, Martin, CZ, Laso, CA, Cumplido, P, Padin, H, Fons, JB, Hernandez-Lizoain, J, Martinez-Ortega, P, Molina-Fernandez, M, Sanchez-Justicia, C, Solanas, JAG, de Laspra, ECD, Echazarreta-Gallego, E, Elia-Guedea, M, Ramirez, J, Chaves, JA, Gonzalez, PD, Elosua, T, Sahagun, J, Frade, AT, Conde, JA, Castrillo, E, Maag, RD, Maderuelo, V, Saldarriaga, L, Cao, IA, Varela, XF, Fernandez, SN, Calvo, AP, Alvarez, SV, Sierra, IB, Lozano, R, Marquez, M, Porcel, O, Menendez, P, Hevia, MF, Siguenza, LF, Toscano, MJ, Fortuny, AL, Trujillo, JO, Espi, A, Garcia-Botello, S, Martin-Arevalo, J, Moro-Valdezate, D, Pla-Marti, V, Blanco-Antona, F, Abrisqueta, J, Canovas, NI, Mompean, JL, Ripoll, DE, Gonzalez, SM, Parodi, J, Lopez, AF, Fernandez, MR, Valls, JC, de Zarate, LO, Ribas, R, Sabia, D, Viso, L, Goncalves, SA, Egea, MJG, Damieta, MP, Pera, M, Ruiz, SS, Bernal, J, Landete, F, Ais, G, Etreros, J, Lucia, JA, Bosca, A, Deusa, S, del Cano, JG, Viciano, V, Garcia-Armengol, J, Roig, J, Blas, J, Escartin, J, Fatas, J, Fernando, J, Ferrer, R, Pacheco, RA, Florez, LG, Gijon, MM, Diez, JO, Garcia, LS, Teixido, FA, Ojo, CB, Berzosa, JB, Moure, SL, Sierra, JE, Ferminan, A, Herrerias, F, Rufas, M, Vinas, J, Codina-Cazador, A, Farres, R, Gomez, N, Julia, D, Planellas, P, Lopez, J, Luna, A, Maristany, C, Duyos, AM, Puertolas, N, Moral, MA, Serra-Aracil, X, Coello, PC, Gomez, D, Carton, C, Miguel, A, Pascual, FR, Cerrato, XV, Munoz, RZ, Cervera-Aldama, J, Gonzalez, JG, Ramos-Prada, J, Santamaria-Olabarrieta, M, Uriguen-Echeverria, A, Alcover, RC, Soria, JE, Rodriguez, EF, Villalba, JH, Ibanenz, VM, Gonzalez, FD, Huerga, D, Viejo, EP, Rivera, A, Ucar, ER, Garcia-Septiem, J, Jimenez, V, Miramon, J, Rodriquez, JR, Alvarez, VR, Garcea, A, Ponchietti, L, Borda, N, Enriquez-Navascues, J, Saralegui, Y, Molina, GF, Nogues, E, Mendez, AR, Castellano, CR, Quesada, YS, Alvarez-Gallego, M, Pascual, I, Rubio-Perez, I, Andres, BDS, Tone-Villanueva, F, Alonso, J, Cagigas, C, Castillo, J, Gomez, M, Martin-Parra, J, Ballester, MM, Franco, EP, Aledo, VS, Navarro, GV, Rodriguez, EC, De Chaves, PG, Hernandez, G, Alvarez, AP, Sanchez, AS, Garcia, FCB, Roque, JGA, Arias, FLR, Ruiz, SRD, De la Villa, GS, Compan, A, Marin, AG, Nofuentes, C, Mico, FO, Auladell, VP, Carrasco, M, Perez, CD, Galvez-Pastor, S, Garcia, IN, Perez, AS, Enjuto, D, Bujalance, FM, Marcelin, N, Perez, M, Garcia, RS, Cabrera, A, de la Portilla, F, Diaz-Pavon, J, Jimenez-Rodriguez, R, Vazquez-Monchul, J, Gonzalez, JD, Perez, RG, Castellano, JR, de la Rua, JR, Alustiza, JE, Fernandez, L, Ramos, JS, Toral, BC, Alias, D, Garcia-Olmo, D, Guadalajara, H, Herreros, M, Pacheco, P, Diez, FDC, Pinto, FL, Alegre, JM, Ortega, I, Antonio, APN, Caro, A, Escuder, J, Feliu, F, Millan, M, Company, RA, Caregnato, AF, Trujillo, RL, Carrillo, RR, Carmona, MR, Alonso, N, Zafra, DA, Candia, BAA, Pascual, JB, Flores, CP, Montero, JA, Clavijo, MA, Garcia, J, Tocino, JS, Gomez-Alcazar, C, Costa-Navarro, D, Ferri-Romero, J, Rey-Riveiro, M, Romero-Simo, M, Arencibia, B, Esclapez, P, Garcia-Granero, E, Granero, P, Fernandez, FJM, Herrera, ABG, Lopez, CD, Rodriguez, EN, Tordera, ET, Arenal, J, Citores, M, Marcos, J, Sanchez, J, Tinoco, C, Espin, E, Granero, AG, Gomez, LJ, Garcia, JS, Vallribera, F, Folkesson, J, Skoldberg, F, Bergman, K, Borgstrom, E, Frey, J, Silfverberg, A, Soderholm, M, Nygren, J, Segelman, J, Gustafsson, D, Lagerqvist, A, Papp, A, Pelczar, M, Abraham-Nordling, M, Ahlberg, M, Sjovall, A, Tengstrom, J, Hagman, K, Chabok, A, Ezra, E, Nikberg, M, Smedh, K, Tiselius, C, Al-Naimi, N, Duc, MD, Meyer, J, Mormont, M, Ris, F, Prevost, G, Villiger, P, Hoffmann, H, Kettelhack, C, Kirchhoff, P, Oertli, D, Weixler, B, Aytac, B, Leventoglu, S, Mentes, B, Yuksel, O, Demirbas, S, Ozkan, BB, Ozbalci, GS, Sungurtekin, U, Gulcu, B, Ozturk, E, Yilmazlar, T, Challand, C, Fearnhead, N, Hubbard, R, Kumar, S, Arthur, J, Barben, C, Skaife, P, Slawik, S, Williams, M, Zammit, M, Barker, J, French, J, Sarantitis, I, Slawinski, C, Clifford, R, Eardley, N, Johnson, M, McFaul, C, Vimalachandran, D, Allan, S, Bell, A, Oates, E, Shanmugam, V, Brigic, A, Halls, M, Pucher, P, Stubbs, B, Agarwal, T, Chopada, A, Mallappa, S, Pathmarajah, M, Sugden, C, Brown, C, Macdonald, E, Mckay, A, Richards, J, Robertson, A, Kaushal, M, Patel, P, Tezas, S, Touqan, N, Ayaani, S, Marimuthu, K, Piramanayagam, B, Vourvachis, M, Iqbal, N, Korsgen, S, Seretis, C, Shariff, U, Arnold, S, Chan, H, Clark, E, Fernandes, R, Moran, B, Bajwa, A, McArthur, D, Cao, K, Cunha, P, Pardoe, H, Quddus, A, Theodoropoulou, K, Bolln, C, Denys, G, Gillespie, M, Manimaran, N, Reidy, J, Malik, AI, Malik, A, Pitt, J, Aryal, K, El-Hadi, A, Lal, R, Pal, A, Velchuru, V, Cunha, MO, Thomas, M, Bains, S, Boyle, K, Miller, A, Norwood, M, Yeung, J, Goian, L, Gurjar, S, Saghir, W, Sengupta, N, Stewart-Parker, E, Bailey, S, Khalil, T, Lawes, D, Nikolaou, S, Omar, G, Church, R, Muthiah, B, Garrett, W, Marsh, P, Obeid, N, Chandler, S, Coyne, P, Evans, M, Hunt, L, Lim, J, Oliphant, Z, Papworth, E, Weaver, H, Leon, KC, Williams, G, Hernon, J, Kapur, S, Moosvi, R, Shaikh, I, Swafe, L, Aslam, M, Evans, J, Ihedioha, U, Kang, P, Merchant, J, Hompes, R, Middleton, R, Broomfield, A, Crutten-Wood, D, Foster, J, Nash, G, Akhtar, M, Boshnaq, M, Eldesouky, S, Mangam, S, Rabie, M, Ahmed, J, Khan, J, Goh, NM, Shamali, A, Stefan, S, Thompson, C, Amin, A, Docherty, J, Lim, M, Walker, K, Watson, A, Hossack, M, Mackenzie, N, Paraoan, M, Alam, N, Daniels, I, Narang, S, Pathak, S, Smart, N, Al-Qaddo, A, Codd, R, Rutka, O, Bronder, C, Crighton, I, Davies, E, Raymond, T, Bookless, L, Griffiths, B, Plusa, S, Carlson, G, Harrison, R, Lees, N, Mason, C, Quayle, J, Branagan, G, Broadhurst, J, Chave, H, Sleight, S, Awad, F, Cruickshank, N, Joy, H, Boereboom, C, Daliya, P, Dhillon, A, Watson, N, Watson, R, Artioukh, D, Gokul, K, Javed, M, Kong, R, Sutton, J, Faiz, O, Jenkins, I, Leo, CA, Samaranayake, SF, Warusavitarne, J, Arya, S, Bhan, C, Mukhtar, H, Oshowo, A, Wilson, J, Duff, S, Fatayer, T, Mbuvi, J, Sharma, A, Cornish, J, Davies, L, Harries, R, Morris, C, Torkington, J, Knight, J, Lai, C, Shihab, O, Tzivanakis, A, Hussain, A, Luke, D, Padwick, R, Torrance, A, Tsiamis, A, Dawson, P, Balfour, A, Brady, R, Mander, J, Paterson, H, Chandratreya, N, Chu, H, Cutting, J, Vernon, S, Ho, CW, Andreani, S, Patel, H, Warner, M, Tan, JYQ, Gidwani, A, Lawther, R, Loughlin, P, Skelly, B, Spence, R, Iqbal, A, Khan, A, Perrin, K, Raza, A, and Tan, S
Subjects: international, Anastomotic leak, colorectal cancer, Crohn's disease, epidemiology
Abstract: Aim The anastomosis technique used following right-sided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a 2-month period in early 2015. The primary outcome measure was the presence of anastomotic leak within 30 days of surgery, determined using a prespecified definition. Mixed effects logistic regression models were used to assess the association between leak and anastomosis method, adjusting for patient, disease and operative cofactors, with centre included as a random-effect variable. Results This study included 3208 patients, of whom 78.4% (n = 2515) underwent surgery for malignancy and 11.7% (n = 375) underwent surgery for Crohn's disease. An anastomosis was performed in 94.8% (n = 3041) of patients, which was handsewn in 38.9% (n = 1183) and stapled in 61.1% (n = 1858). Patients undergoing hand-sewn anastomosis were more likely to be emergency admissions (20.5% handsewn vs 12.9% stapled) and to undergo open surgery (54.7% handsewn vs 36.6% stapled). The overall anastomotic leak rate was 8.1% (245/3041), which was similar following handsewn (7.4%) and stapled (8.5%) techniques (P = 0.3). After adjustment for cofactors, the odds of a leak were higher for stapled anastomosis (adjusted OR = 1.43; 95% CI: 1.04-1.95; P = 0.03). Conclusion Despite being used in lower-risk patients, stapled anastomosis was associated with an increased anastomotic leak rate in this observational study. Further research is needed to define patient groups in whom a stapled anastomosis is safe.
Published: 2017

26. Sacral nerve stimulation for faecal incontinence and constipation: A European consensus statement

Author: Maeda, Y., O'Connell, P. R., Lehur, P. -A., Matzel, K. E., Laurberg, S., Altomare, D. F., Baeten, C. G. I., Buntzen, S., Damon, H., Espin-Basany, E., Ganio, E., Etienney, I., Faucheron, J. -L., Hanly, A., Hetzer, F., Johansson, C., Knowles, C., Leroi, A. -M., Lundby, L., Ratto, Carlo, Robert-Yap, J., Schwandner, T., and Vaizey, C. J.
Subjects: medicine.medical_specialty, Constipation, Consensus, Delphi Technique, Settore MED/18 - CHIRURGIA GENERALE, Lumbosacral Plexus, Modified delphi, Sacral nerve stimulation, Electric Stimulation Therapy, Medicine, Humans, business.industry, Gastroenterology, Sacral neuromodulation, Faecal incontinence, Electrodes, Implanted, Europe, Current practice, Expert opinion, Physical therapy, Delphi process, medicine.symptom, business, Fecal Incontinence, Systematic search
Abstract: AIM: In Europe during the last decade sacral nerve stimulation (SNS) or sacral neuromodulation (SNM) has been used to treat faecal incontinence (FI) and constipation. Despite this, there is little consensus on baseline investigations, patient selection and operative technique. A modified Delphi process was conducted to seek consensus on the current practice of SNS/SNM for FI and constipation.METHOD: A systematic literature search of SNS for FI and constipation was conducted using PubMed. A set of questions derived from the search and expert opinion were answered on-line on two occasions by an international panel of specialists from Europe. A 1-day face-to-face meeting of the experts finalized the discussion.RESULTS: Three hundred and ninety-three articles were identified from the literature search, of which 147 fulfilled the inclusion criteria. Twenty-two specialists in FI and constipation from Europe participated. Agreement was achieved on 43 (86%) of 50 domains including the set-up of service, patient selection, baseline investigations, operative technique and programming of the device. The median of agreement was 95% (35-100%).CONCLUSION: Consensus was achieved on the majority of domains of SNS/SNM for FI and constipation. This should serve as a benchmark for safe and quality practice of SNS/SNM in Europe.
Published: 2015

27. Female urinary and sexual dysfunction after resection with and without preoperative radiotherapy for rectal cancer:a population-based cross-sectional study

Author: Bregendahl, S, Emmertsen, Katrine J, Lindegaard, Jacob Christian, and Laurberg, S
Abstract: AIM: Knowledge of female urinary and sexual dysfunction after rectal cancer treatment is limited. This study addresses this in relation to the use of preoperative radiotherapy, type of surgery and presence of bowel dysfunction.METHOD: All living female patients who underwent abdominoperineal resection (APR) or low anterior resection (LAR) for rectal cancer in Denmark in 2001-2007 were identified. Validated questionnaires (the ICIQ-FLUTS and the SVQ) on urinary and sexual function were completed by 516 (75%) and 482 (72%) recurrence-free patients in 2009.RESULTS: Urgency and incontinence were reported by 77% and 63%. Vaginal dryness, dyspareunia and reduced vaginal dimensions occurred in 72%, 53% and 29%, and 69% reported that they had little/no sexual desire. Preoperative radiotherapy was associated with voiding difficulties (OR=1.63, 95% CI 1.09-2.44), reduced vaginal dimensions (OR=4.77, 95% CI 1.97-11.55), dyspareunia (OR=2.76, 95% CI 1.12-6.79), lack of desire (OR=2.22, 95% CI 1.09-4.53) and reduced sexual activity (OR=0.55, 95% CI 0.30-0.98). Patients undergoing APR had a higher risk of dyspareunia (OR=2.61, 95% CI 1.00-6.85). Bowel dysfunction after LAR was associated with bladder storage difficulties (OR=1.64, 95% CI 1.01-2.65), incontinence symptoms (OR=2.17, 95% CI 1.35-3.50), lack of sexual desire (OR=2.69, 95% CI 1.21-5.98), sexual inactivity (OR=0.48, 95% CI 0.24-0.96) and sexual dissatisfaction (OR=0.40, 95% CI 0.20-0.82).CONCLUSION: Female urinary and sexual problems are common after rectal cancer treatment. Preoperative radiotherapy interferes with several aspects of urinary and sexual functioning. Bowel dysfunction after LAR is associated with urinary dysfunction and a reduction in sexual desire, activity and satisfaction. This article is protected by copyright. All rights reserved.
Published: 2015

28. Treatment of fecal incontinence and constipation in patients with spinal cord injury: a prospective, randomized, controlled, multicenter trial of transanal irrigation vs conservative bowel management

Author: Christensen P., Coggrave M., Abel R., Hultling C., Krogh K., Media S., Laurberg S., BAZZOCCHI, GABRIELE, Christensen P, Bazzocchi G, Coggrave M, Abel R, Hultling C, Krogh K, Media S, Laurberg S., Christensen P., Bazzocchi G., Coggrave M., Abel R., Hultling C., Krogh K., and Media S.
Published: 2006

29. Health-related quality of life of patients 14 years after short-term preoperative radiotherapy and total mesorectal excision for rectal cancer: Report of a multicenter randomized trial

Author: Wiltink, L.M., Chen, T.Y.T., Nout, R.A., Kranenbarg, E.M.K., Laurberg, S., Velde, C.J.H. van de, and Marijnen, C.A.M.
Published: 2013

30. Bowel function 14 years after sphincter-preserving total mesorectal excision for rectal cancer: Report of a multicentre randomised trial

Author: Chen, T.Y.T., Wiltink, L.M., Nout, R.A., Kranenbarg, E.M.K., Laurberg, S., Marijnen, C.A.M., and Velde, C.J.H. van de
Published: 2013

31. Non-CpG island promoter hypomethylation and miR-149 regulate the expression of SRPX2 in colorectal cancer

Author: Øster B, Linnet L, Christensen LL, Thorsen K, Ongen H, Dermitzakis ET, Sandoval J, Moran S, Esteller M, Hansen TF, Lamy P, COLOFOL steering group, Laurberg S, Ørntoft TF, and Andersen CL
Abstract: Gene silencing by DNA hypermethylation of CpG islands is a well-characterized phenomenon in cancer. The effect of hypomethylation in particular of non-CpG island genes is much less well described. By genome-wide screening, we identified 105 genes in microsatellite stable (MSS) colorectal adenocarcinomas with an inverse correlation (Spearman's ? = -0.40) between methylation and expression. Of these, 35 (33%) were hypomethylated non-CpG island genes and two of them, APOLD1 (Spearman's ? = -0.82) and SRPX2 (Spearman's ? = -0.80) were selected for further analyses. Hypomethylation of both genes were localized events not shared by adjacent genes. A set of 662 FFPE DNA samples not only confirmed that APOLD1 and SRPX2 are hypomethylated in CRC but also revealed hypomethylation to be significantly (p < 0.01) associated with tumors being localized in the left side, CpG island methylator phenotype negative, MSS, BRAF wt, undifferentiated and of adenocarcinoma histosubtype. Demethylation experiments supported SRPX2 being epigenetically regulated via DNA methylation, whereas other mechanisms in addition to DNA methylation seem to be involved in the regulation of APOLD1. We further identified miR-149 as a potential novel post-transcriptional regulator of SRPX2. In carcinoma tissue, miR-149 was downregulated and inversely correlated to SRPX2 (? = -0.77). Furthermore, ectopic expression of miR-149 significantly reduced SRPX2 transcript levels. Our study highlights that in colorectal tumors, hypomethylation of non-CpG island-associated promoters deregulate gene expression nearly as frequent as do CpG-island hypermethylation. The hypomethylation of SRPX2 is focal and not part of a large block. Furthermore, it often translates to an increased expression level, which may be modulated by miR-149.
Published: 2013

32. Fecal incontinence and sacral nerve stimulation:Is cerebral neuro modulation a cause of effect

Author: Haas, S., Brock, Christina, Drewes, Asbjørn, Krogh, K., and Laurberg, S.
Published: 2013

33. Functional results and patient satisfaction with sacral nerve stimulation for idiopathic faecal incontinence

Author: Duelund-Jakobsen, J., van Wunnik, B., Buntzen, S., Lundby, L., Baeten, C.G.M.I., Laurberg, S., Surgery, and RS: NUTRIM - R2 - Gut-liver homeostasis
Subjects: NEUROMODULATION, patient satisfaction, faecal incontinence, Sacral nerve stimulation, EXPERIENCE, functional outcome, SINGLE-CENTER
Abstract: Aim Sacral nerve stimulation (SNS) is an established treatment for faecal incontinence (FI) when conservative modalities have failed to restore continence. This two-centre study aimed to document functional outcome and its relationship to patient satisfaction. Method Patients treated with SNS for idiopathic FI in Aarhus (Denmark) and Maastricht (The Netherlands) were included. At the most recent follow-up appointment, 127 patients (80%) were identified as receiving active SNS therapy. A questionnaire considering bowel habits, quality of life, and self-reported satisfaction and a 3-week bowel-habit diary were mailed to these patients, and 85% responded. Results Patient satisfaction was clearly related to the number of FI episodes. Patients experiencing full continence were all satisfied, and although the satisfaction rate decreased as the number of FI episodes increased, 46% of the patients with more FI episodes at follow-up than at baseline were still satisfied. Per-protocol analysis resulted in a satisfaction rate of 57.3%. In total, 74.7% of the patients receiving active SNS therapy reported a reduction of = 50% in FI episodes, 10.3% of whom were dissatisfied after a median of 46 months of follow-up. Conclusion There is a clear relationship between patient satisfaction and improved continence. A total of 57.3% of the patients offered SNS therapy were satisfied at follow-up. However, 46% of the patients with more FI episodes at follow-up than at baseline were also satisfied. Therefore, functional outcome of SNS therapy cannot be based only on bowel-habit diaries and bowel scores.
Published: 2012

34. Turning off sacral nerve stimulation does not affect gastric and small intestinal motility in patients treated for faecal incontinence

Author: Worsøe, Jonas, Fassov, J., Schlageter, V., Rijkhoff, Nico, Laurberg, S., and Krogh, K.
Subjects: Adult, animal structures, Cross-Over Studies, Lumbosacral Plexus, Electric Stimulation Therapy, Pilot Projects, Middle Aged, body regions, Implantable Neurostimulators, Magnetic Fields, Double-Blind Method, Intestine, Small, Magnets, Humans, Female, Gastrointestinal Motility, Fecal Incontinence, Aged
Abstract: Sacral nerve stimulation (SNS) reduces symptoms in up to 80% of patients with faecal incontinence (FI). Its effects are not limited to the distal colon and the pelvic floor. Accordingly, spinal or supraspinal neuromodulation have been suggested as part of the mode of action. The effect of SNS on gastric and small-intestinal motility was studied.
Published: 2012

35. Gastric and small intestinal dysfunction in spinal cord injury patients

Author: Fynne, L, Worsøe, J, Gregersen, Tine, Schlageter, V, Laurberg, S, and Krogh, K
Subjects: digestive, oral, and skin physiology
Abstract: Fynne L, Worsøe J, Gregersen T, Schlageter V, Laurberg S, Krogh K. Gastric and small intestinal dysfunction in spinal cord injury patients. Acta Neurol Scand: DOI: 10.1111/j.1600-0404.2011.01508.x. © 2011 John Wiley & Sons A/S. Background - Many patients with spinal cord injury (SCI) suffer from constipation, abdominal pain, nausea, or bloating, and colonic transit times are prolonged in most. Gastric and small intestinal dysfunction could contribute to symptoms but remain to be described in detail. Also, it is obscure whether the level of SCI affects gastric and small intestinal function. Aim - To study orocecal transit time and gastric emptying (GE) in patients with SCI. Methods - Nineteen patients with SCI (7 ♀, median age 54 years) and 15 healthy volunteers (9 ♀, median age 32 years) were included. All were referred because of neurogenic bowel problems. Eleven patients had low SCI (located at conus medullaris or cauda equina) affecting only the parasympathetic nerves to the left colon and eight had high SCI (above Th6) affecting parasympathetic and sympathetic innervation. Subjects ingested a small magnetic pill that subsequently was tracked by the Motility Tracking System - MTS-1 (Motilis, Lausanne, Switzerland). Results - Orocecal transit time was longer than normal both in individuals with high lesions (P
Published: 2011

36. Case Management to improve patient and GP evaluation of cancer care pathways

Author: Wullf, C.N., Søndergaard, Jens, Vedsted, Peter, Laurberg, S., and Rasmussen, P.C.
Published: 2011

37. Effect of electrical stimulation of the dorsal clitoral nerve on faecal incontinence

Author: Rijkhoff, Nico, Worsøe, Jonas, Krogh, K., and Laurberg, S.
Published: 2011

38. Effect of injury on S1 dorsal root ganglia in an experimental model of neuropathic faecal incontinence (Br J Surg 2011; 98:1155-1159) and Sacral nerve stimulation increases activation of the primary somatosensory cortex by anal canal stimulation in an experimental model (Br J Surg 2011; 98: 1160-1169)

Author: Laurberg, S
Subjects: Activating Transcription Factor 3, Ganglia, Spinal, Animals, Female, Fecal Incontinence
Published: 2011

39. Effect of case management in complex cancer pathways. A randomised controlled trial

Author: Wulff , CN, Søndergaard, Jens, Vedsted, P., Laurberg, S., and Rasmussen, PC.
Published: 2010

40. Rectal motility after sacral nerve stimulation for faecal incontinence

Author: Michelsen, H B, Worsøe, J, Krogh, K, Lundby, L, Christensen, Peter, Buntzen, S, and Laurberg, S
Subjects: Adult, medicine.medical_specialty, animal structures, Manometry, Physiology, Lumbosacral Plexus, Urology, Motility, Electric Stimulation Therapy, Internal medicine, medicine, Humans, Fasting state, Aged, Endocrine and Autonomic Systems, business.industry, Rectum, Gastroenterology, Middle Aged, Postprandial Period, Spinal Nerves, Endocrinology, Postprandial, Rectal wall, Sacral nerve stimulation, Reflex, Female, business, Gastrocolic reflex, Fecal Incontinence, Muscle Contraction
Abstract: Udgivelsesdato: 2010-Jan Sacral nerve stimulation (SNS) is effective against faecal incontinence, but the mode of action is obscure. The aim of this study was to describe the effects of SNS on fasting and postprandial rectal motility. Sixteen patients, 14 women age 33-73 (mean 58), with faecal incontinence of various aetiologies were examined. Before and during SNS, rectal cross-sectional area (CSA) and ano-rectal pressures were determined with impedance planimetry and manometry for 1 h during fast and 1 h postprandially. Neither in the fasting state nor postprandially did SNS affect the number of single rectal contractions, total time with cyclic rectal contractions, the number of aborally and orally propagating contractions, the number of anal sampling reflexes or rectal wall tension during contractions. Postprandial changes in rectal tone were significantly reduced during SNS (P < 0.02). Before SNS, median rectal CSA was 2999 mm(2) (range: 1481-3822) during fast and 2697 mm(2) (range: 1227-3310) postprandially (P < 0.01). During SNS, median rectal CSA was 2990 mm(2) (1823-3678) during fast and 2547 mm(2) (1831-3468) postprandially (P = 0.22). SNS for faecal incontinence does not affect phasic rectal motility but it impairs postprandial changes in rectal tone.
Published: 2010

41. Evidence-based medicine: the time has come to set standards for staging

Author: Quirke, P., Cuvelier, C., Ensari, A., Glimelius, B., Laurberg, S., Ortiz, H., Piard, F., Punt, C.J.A., Glenthoj, A., Pennickx, F., Seymour, M., Valentini, V., Williams, G., Nagtegaal, I.D., and Other departments
Subjects: Evidence-Based Medicine, Translational research [ONCOL 3], Lymphatic Metastasis, Neoplasms, Humans, Aetiology, screening and detection [ONCOL 5], Colorectal Neoplasms, evidence-based medicine, neoplasms, digestive system diseases, Neoplasm Staging, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
Abstract: Contains fulltext : 88652.pdf (Publisher’s version ) (Closed access) For international communication in cancer, staging systems such as TNM are essential; however, the principles and processes used to decide about changes in every new edition of TNM need to be subject to debate. Changes with major impact for patient treatment are introduced without evidence. We think that TNM should be a continual reactive process, rather than a proactive process. Changes should only occur after extensive discussion within the community, and before the introduction of any changes these should be tested for reproducibility and compared to the currently used gold standard. TNM should not be used to test hypotheses. It should introduce established facts that are beneficial to predicting patient prognosis. TNM should thus be restructured on a basis equivalent to evidence-based guidelines. The strength of the evidence should be explicitly stated and the evidence base given. It is time for the principles of staging to be widely debated and new principles and processes to be introduced to ensure that we are not in the same situation in the future. The disparity between therapeutic decision making and TNM staging is marked and we would appeal for the radical overhaul of TNM staging to make it fit for the twenty-first century. TNM is central to the management of cancer patients and we must protect and enhance its reputation. 01 augustus 2010
Published: 2010

42. Multidisciplinary Rectal Cancer Management: 2nd European Rectal Cancer Consensus Conference (EURECA-CC2)

Author: Valentini, Vincenzo, Aristei, C, Glimelius, B, Minsky, Bd, Beets Tan, R, Borras, Jm, Haustermans, K, Maingon, P, Overgaard, J, Pahlman, L, Quirke, P, Schmoll, H, Sebag Montefiore, D, Taylor, I, Van Cutsem, E, Van De Velde, C, Cellini, Numa, Aranda, E, Latini, P, Blomqvist, L, Bosset, Jf, Brown, G, Bujko, K, Ectors, N, Gerard, Jp, Glynne Jones, R, Heald, R, Hohenberger, W, Holm, T, Laurberg, S, Leer, Jw, Marijnen, C, Nagtegaal, I, Rodel, C, Rutten, H, Scheithauer, W, Willet, Cg, Coco, Claudio, Gambacorta, Maria Antonietta, Genovesi, D, Lupattelli, M, Mantello, G, Valvo, E., Laboratory of Molecular Cytogenetics and Mutagenesis, University of Tuscia, Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: MESH: Combined Modality Therapy, Colorectal cancer, Cost-Benefit Analysis, Delphi method, 030218 nuclear medicine & medical imaging, Scientific evidence, [ SDV.CAN ] Life Sciences [q-bio]/Cancer, 0302 clinical medicine, Multidisciplinary approach, Risk Factors, MESH: Risk Factors, Voting, MESH : Neoplasm Staging, MESH : Rectal Neoplasms, Settore MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA, media_common, european consensus, Hematology, MESH: Neoplasm Staging, Combined Modality Therapy, MESH : Risk Factors, 3. Good health, Oncology, 030220 oncology & carcinogenesis, MESH : Cost-Benefit Analysis, Sentence, medicine.medical_specialty, media_common.quotation_subject, education, MEDLINE, [SDV.CAN]Life Sciences [q-bio]/Cancer, cc2, MESH : Diet, 03 medical and health sciences, Quality of life (healthcare), eureca, MESH: Diet, medicine, Humans, Radiology, Nuclear Medicine and imaging, rectal cancer, Neoplasm Staging, Settore MED/06 - ONCOLOGIA MEDICA, MESH: Humans, business.industry, Rectal Neoplasms, MESH : Humans, MESH: Quality of Life, MESH: Rectal Neoplasms, MESH : Quality of Life, medicine.disease, Surgery, Diet, Family medicine, Quality of Life, business, MESH : Combined Modality Therapy, MESH: Cost-Benefit Analysis
Abstract: International audience; BACKGROUND AND PURPOSE: During the first decade of the 21st century a number of important European randomized studies were published. In order to help shape clinical practice based on best scientific evidence from the literature, the International Conference on 'Multidisciplinary Rectal Cancer Treatment: Looking for an European Consensus' (EURECA-CC2) was organized in Italy under the endorsement of European Society of Medical Oncology (ESMO), European Society of Surgical Oncology (ESSO), and European Society of Therapeutic Radiation Oncology (ESTRO). METHODS: Consensus was achieved using the Delphi method. The document was available to all Committee members as a web-based document customized for the consensus process. Eight chapters were identified: epidemiology, diagnostics, pathology, surgery, radiotherapy and chemotherapy, treatment toxicity and quality of life, follow-up, and research questions. Each chapter was subdivided by a topic, and a series of statements were developed. Each member commented and voted, sentence by sentence thrice. Sentences upon which an agreement was not reached after voting round # 2 were openly debated during a Consensus Conference in Perugia (Italy) from 11 December to 13 December 2008. A hand-held televoting system collected the opinions of both the Committee members and the audience after each debate. The Executive Committee scored percentage consensus based on three categories: "large consensus", "moderate consensus", and "minimum consensus". RESULTS: The total number of the voted sentences was 207. Of the 207, 86% achieved large consensus, 13% achieved moderate consensus, and only 3 (1%) resulted in minimum consensus. No statement was disagreed by more than 50% of the members. All chapters were voted on by at least 75% of the members, and the majority was voted on by >85%. CONCLUSIONS: This Consensus Conference represents an expertise opinion process that may help shape future programs, investigational protocols, and guidelines for staging and treatment of rectal cancer throughout Europe.
Published: 2009

43. Bowel symptoms in patients with primary Sjögren's syndrome [5]

Author: Krogh, K., Asmussen, K., Stengaard-Pedersen, K., Laurberg, S., and Deleuran, B. W.
Published: 2007

44. Suppression of anal sphincter activation during sacral root stimulation in Göttingen minipigs

Author: Møller, Flemming Vejby, Rijkhoff, Nico, Buntzen, S., and Laurberg, S.
Published: 2007

45. Suppression of external anal sphincter activation during sacral nerve root stimulation in pigs

Author: Møller, Flemming Vejby, Rijkhoff, Nico, Buntzen, S., and Laurberg, S.
Published: 2006

46. Ano-rectal motility responses to selective stimulation of the ventral sacral nerve roots:an experimental study in the Göttingen Minipig

Author: Andersen, I. S., Rijkhoff, Nico, Vuckovic, Aleksandra, Buntzen, S., Djurhuus, J. C., and Laurberg, S.
Published: 2004

47. Educational crisis within gastrointestinal surgery.The solution is not no longer working hours, but also reduced number of younger surgeons . The condition is centralized emergency surgery

Author: Laurberg, S and Rosenberg, J
Published: 2004

48. Ano-rectal motility responses to pelvic-, hypogastric- and pudendal nerve stimulation in the Göttingen Minipig

Author: Andersen, I. S., Buntzen, S., Rijkhoff, Nico, Djurhuus, J. C., and Laurberg, S.
Published: 2004

49. Pseudomyxoma peritonei

Author: Iversen, L.H, Rasmussen, P.C, Wara, P, Ambrose, N.S, and Laurberg, S
Published: 2004

50. Sacral nerve stimulation for treatment of fecal incontinence in a patient with muscular dystrophy.Report of a case

Author: Buntzen, S, Ryhammer, A.M, Laurberg, S, Rasmussen, O.Ø, Sørensen, M, and Christiansen, J
Published: 2004

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