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Background The high incidence of diverticulitis and hemorrhoidal proctitis episodes in the population imposes an important healthcare and economic burden. Aim To determine the association between intake of certain plant foods and diverticulitis and hemorrhoidal proctitis episodes. Methods Case-control study with quantitative food frequency questionnaire focusing on selected plant foods and derived products. These were grouped by main chemical components into: ethanol, caffeine/theine/theobromine, capsaicin, alliin, acids, eugenol, and miscellaneous foods like curcumin. We quantified intake according to 24-h recall, either on a 1-4 scale (no intake, low, moderate, high intake) or as the number of units consumed (e.g. cups of tea/coffee, n of oranges or lemons); this value was multiplied by the number of reported intake days per week (1-7). Overall intake was expressed as a continuous variable obtained by successively multiplying the score for each food category, and the result was transformed into a common logarithm (range 0.3 to 27.7). Cases and controls were compared using the chi-squared test, student’s t test, odds ratio (OR) and 95% confidence interval (CI), and predictive analysis (multiple logistic regression). Results The sample included 410 cases and 401 controls, who were similar in mean age and gender distribution. The mean score for overall intake of included plant foods was 6.3 points (standard deviation [SD] 4.5), and this was significantly higher in cases (8.5 points, SD 5.3) than in controls (4.1 points, SD 1.2; p < 0.001). Overall intake was similar in cases presenting diverticulitis or hemorrhoidal proctitis. Cases had 13 times the odds of being in the upper quartile for overall intake (> 7 points) compared to controls (OR 13.2, 95% CI 8.3 to 20.8, p < 0.001). Predictive logistic regression models showed that the chemical food group most closely associated with diverticulitis and hemorrhoidal proctitis was capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids. The OR for age was near the null value. Neither alliin nor miscellaneous food groups showed any association. Conclusions High, frequent consumption of some plant foods and derived products increases the risk of presenting symptoms of diverticulitis and hemorrhoidal proctitis.

Diverticulitis and hemorrhoidal proctitis in the population are significant public health problems. We studied the potential association between the intake of certain plant foods and diverticulitis or hemorrhoidal episodes through a case-control study including 410 cases and 401 controls. We used a semiquantitative food frequency questionnaire. The intake was additionally quantified according to a 24 h recall. The plant foods or derived food products were categorized by their main chemical components into ethanol, caffeine/theine/theobromine, capsaicin, alliin, acids, eugenol, and miscellaneous foods such as curcumin. The mean score for overall intake of plant foods under consideration was 6.3 points, and this was significantly higher in cases (8.5) than in controls (4.1). Overall intake was similar in cases presenting with diverticulitis or hemorrhoidal proctitis. Cases had 13 times the odds of being in the upper quartile for overall intake (>7 points), compared to controls. Explanatory logistic regression models showed that the strongest association with diverticulitis and hemorrhoidal proctitis was shown by the chemical food group of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids. Neither alliin nor miscellaneous food groups showed any association. High, frequent consumption of capsaicin, followed by ethanol, eugenol, caffeine/theine/theobromine, and acids increase the risk of diverticulitis and hemorrhoidal proctitis.

Esta comunicación se encuentra disponible en la siguiente URL: https://www.fortunejournals.com/articles/can-we-set-quality-standards-for-the-centers-minimally-invasive-surgery-vs-open-surgery-in-colorectal-cancer-resection.pdf Background: Minimally invasive surgery (MIS) is the standard method for resection of colorectal cancer, but its indications have limitations that are constantly debated. In our study, the center had to meet the following four factors: surgeons should have considerable experience, there should be a high percentage of MIS, a low conversion rate, and good results in the intervention. Methods: Retrospective observational study of a cohort of 948 patients with colorectal cancer who underwent scheduled open surgery (OS) and MIS between 2011-2016. Results: There were no differences based on sex, body mass index, or location of the tumor, but OS was related to older age, higher ASA, a higher stage, previous surgery, and operative adverse events. The location of the primary tumor and the existence of synchronous tumors were related to variability in the technique. The implementation of MIS increased from 36.2% in 2011 to 89.6% in 2016. The surgeon's experience decreased the conversion rate from 6.5% in 2011 to 3.1% in 2016, with 2% in T0-2 tumors. In logistic regression, the factor that most increased the possibility of choosing MIS was the pT grade of the tumor, and the factors that most contraindicated MIS were stages 2-4, ASA 4, stage 1, previous surgery, and advanced age. Conclusions: In hospitals where surgeons have long experience, minimally invasive surgery could be implemented in up to 90% of cases, with low conversion rates (3-4%) and good results for patients.