602 results on '"Bislenghi, G."'
Search Results
2. No increased risk of venous thromboembolism or infectious complications after JAK inhibitor exposure in patients with ulcerative colitis undergoing surgery.
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De Greef I, Bislenghi G, Terrasson I, Sabino J, Ferrante M, D'Hoore A, Verstockt B, and Vermeire S
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Introduction Total colectomy for ulcerative colitis (UC) is associated with postoperative morbidity, including venous thromboembolic events (VTE). In light of recent concerns on increased major adverse events associated with JAK inhibitor exposure, we aimed to evaluate the postoperative VTE risk as well as other complications in UC patients undergoing colectomy. Methods This single-center retrospective cohort study included all UC patients who underwent (procto)colectomy between 2013 and March 2022, and documented the 180-day postoperative non-infectious and infectious complications. Results One hundred seventy-five UC patients (43.4% women, median age 41.0 years) underwent colectomy. Forty-nine patients (28.0%) were operated in an urgent setting. In the twelve weeks prior to surgery, 53 (30.3%) patients had received anti-TNF agents, 40 (22.9%) anti-adhesion therapy, 16 (9.1%) anti-IL12/23 and 34 (19.4%) JAK inhibitors. Preoperatively, 26 patients (14.9%) received moderate to high doses of systemic corticosteroids. All except two patients received prophylactic LMWH postoperatively. During the 180-day postoperative period, 2 patients developed a thrombosis, all incidental findings on abdominal CT scan. No VTE was seen in the patients who underwent colectomy while on JAK inhibitor. Three out of 34 JAK-inhibitor treated patients (8.8%) developed a postoperative infectious complication, while the overall incidence of infectious complications was 17.1%. Conclusion Our findings suggest that the overall VTE risk in UC patients undergoing colectomy is low with adequate antithrombotic prophylaxis. JAK inhibitor use prior to surgery was not linked to increased short-term thromboembolic or infectious complications. However, the limited sample size warrants further study in larger cohorts., (S. Karger AG, Basel.)
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- 2025
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3. The impact of advanced medical therapies on time to resection and colorectal cancer outcomes in ulcerative colitis patients undergoing colectomy.
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Visser E, Luberto A, Heuthorst L, Hompes R, Vermeire S, D'Haens GR, Bemelman WA, D'Hoore A, Bislenghi G, and Buskens CJ
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- Humans, Male, Female, Middle Aged, Adult, Netherlands epidemiology, Belgium epidemiology, Time-to-Treatment statistics & numerical data, Cohort Studies, Colitis, Ulcerative surgery, Colitis, Ulcerative drug therapy, Colectomy statistics & numerical data, Colectomy methods, Colorectal Neoplasms surgery
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Background: We aimed to evaluate the impact of advanced medical therapies (biologicals and small molecules) on time to colectomy and oncological outcomes in ulcerative colitis (UC)., Methods: This cohort study included UC patients who underwent colectomy between 2003 and 2022 at 2 referral centers in Belgium and the Netherlands. Exposure was the use of advanced medical therapies. Primary outcomes were time to colectomy and colorectal cancer (CRC) rate, compared between 4 periods: P1 (2003-2007), P2 (2008-2012), P3 (2013-2017), and P4 (2018-2022). Secondary outcomes were oncological outcomes, including incidental cancers found unexpectedly in resection specimens or during endoscopic follow-up for medication switch., Results: Among 716 patients, the usage of advanced therapies increased from 36.8% in P1 to 89.7% in P4 (P < .0001). Median time to colectomy remained comparable (P1: 7.1 years [interquartile ranges (IQR), 2.8-12.9] vs P4: 7.2 years [IQR, 2.7-14.6]; P = not significant). Colectomy and colorectal cancer was diagnosed in 72 (10.1%) patients, with no significant change over time (P = .44). Proportion of CRC was lower in patients treated with advanced therapies (4.7% vs 23.6%, P < .0001) and related to a shorter follow-up (median 6.1 vs 10.3 years, P < .0001). Advanced therapy patients had higher incidental cancer rates (37.5% vs 8.3%, P = .002), which was associated with reduced CRC-related survival (HR for CRC-related death: 3.3, 95% CI 1.17-9.4; P = .02)., Conclusion: Despite increased usage of advanced medical therapies, time to resection and CRC rates have remained unchanged in UC patients undergoing colectomy over the past 2 decades. Advanced therapy patients had higher incidental cancers rates, associated with decreased CRC survival. Awareness of timely colectomy is crucial for this group., (© The Author(s) 2025. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation.)
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- 2025
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4. European expert consensus on a structured approach to circular stapling anastomosis in minimally invasive left-sided colorectal resection.
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Tou S, Gallagher AG, Bislenghi G, Farinha R, and Wolthuis A
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- Humans, Europe, Colon surgery, Colorectal Surgery methods, Colorectal Surgery standards, Surgeons standards, Rectum surgery, Anastomosis, Surgical methods, Consensus, Delphi Technique, Minimally Invasive Surgical Procedures methods, Surgical Stapling methods, Colectomy methods, Colectomy standards
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Aim: The aim of this work is to develop and operationally define performance metrics that characterize a reference approach to circular stapling anastomosis during minimally invasive left-sided colorectal resection and to obtain face and content validity through a consensus meeting., Method: Three expert colorectal surgeons with advanced experience with minimally invasive surgery, a senior behavioural scientist and a research fellow with experience in performance metrics development formed the Metrics Group. Technical support was provided by device engineers. Published guidelines, training materials, manufacturers' instructions for use and unedited videos of circular stapling anastomosis in minimally invasive left-sided colorectal resection were used to deconstruct the task into defined, observable performance units or metrics (i.e. procedural phases, steps, errors and critical errors). The performance metrics were then subjected to detailed review by 16 expert colorectal surgeons in a modified Delphi process., Results: Performance metrics for circular stapling anastomosis during minimally invasive left-sided colorectal resection had three procedural phases with 32 steps, 40 errors and 38 critical errors. After the modified Delphi process the agreed performance metrics consisted of three procedural phases, 36 steps, 42 errors and 39 critical errors. A group of expert colorectal surgeons from Europe verified the face and content of these metrics. After discussion, all procedural phases received unanimous consensus by the Delphi panel., Conclusion: Circular stapling anastomosis during the minimally invasive approach to left-sided colorectal resection can be broken down into procedural phases and steps, with errors and critical errors known as performance metrics. We consider the metrics essential for the development of structured training in using circular stapling anastomosis in the minimally invasive approach to left-sided colorectal resection., (© 2025 The Author(s). Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)
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- 2025
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5. The Impact of Peptidyl Arginine Deiminase 4-Dependent Neutrophil Extracellular Trap Formation on the Early Development of Intestinal Fibrosis in Crohn's Disease.
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Dragoni G, Ke BJ, Picariello L, Abdurahiman S, Ceni E, Biscu F, Mello T, Polvani S, Innocenti T, Spalart V, Milani S, D'Hoore A, Bislenghi G, Scaringi S, Verstockt B, De Hertogh G, Martinod K, Galli A, Matteoli G, and Vermeire S
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- Mice, Animals, Humans, Signal Transduction, Neutrophils metabolism, Toll-Like Receptor 2 metabolism, Toll-Like Receptor 2 genetics, Ileum pathology, Ileum metabolism, Disease Models, Animal, Crohn Disease pathology, Crohn Disease metabolism, Extracellular Traps metabolism, Protein-Arginine Deiminase Type 4 metabolism, Fibrosis, Fibroblasts metabolism, NF-kappa B metabolism
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Background and Aims: During early phases of inflammation, activated neutrophils extrude neutrophil extracellular traps (NETs) in a peptidyl arginine deiminase 4 (PAD4)-dependent manner, aggravating tissue injury and remodeling. In this study, we investigated the potential pro-fibrotic properties and signaling of NETs in Crohn's disease (CD)., Methods: NETs and activated fibroblasts were labeled on resected ileum from CD patients by multiplex immunofluorescence staining. NETs-treated human primary intestinal fibroblasts were analyzed by bulk RNA sequencing to uncover cell signaling pathways, and by high-throughput imaging to assess collagen production and migratory activity. Consequentially, TLR2/NF-κB pathway was evaluated by transfection of CCD-18Co fibroblasts with an NF-κB-luciferase reporter plasmid, incorporating C29 to block TLR2 signaling. A chronic dextran sulfate sodium (DSS) mouse model was used to define the specific role of PAD4 deletion in neutrophils (MRP8-Cre, Pad4fl/fl)., Results: Immunofluorescence showed spatial colocalization of NETs and activated fibroblasts in ileal ulcerations of CD patients. Transcriptomic analysis revealed upregulation of pro-fibrotic genes and activation of Toll-like receptor signaling pathways in NETs-treated fibroblasts. NETs treatment induced fibroblast proliferation, diminished migratory capability, and increased collagen release. Transfection experiments indicated a substantial increase in an NF-κB expression with NETs, whereas C29 led to decreased expression and release of collagen. In line, a significant reduction in collagen content was observed in the colon of MRP8-Cre, Pad4fl/fl mice subjected to chronic DSS colitis., Conclusions: NETs potentially serve as an initial stimulus for pathological activation of fibroblasts within the intestine via the TLR2/NF-κB pathway. Given their early involvement in inflammation, inhibition of PAD4 might offer a strategy to modulate both inflammation and fibrogenesis in CD., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2025
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6. Perianal Fistulizing Crohn's Disease-Associated Anorectal and Fistula Cancers: Systematic Review and Expert Consensus.
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Wong, S-Y, Rowan, C, Brockmans, ED, Law, CCY, Giselbrecht, E, Ang, C, Khaitov, S, Sachar, D, Polydorides, AD, Winata, LS-H, Verstockt, B, Spinelli, A, Rubin, DT, Deepak, P, McGovern, DPB, McDonald, BD, Lung, P, Lundby, L, Lightner, AL, Holubar, SD, Hanna, L, Hamarth, C, Geldof, J, Dige, A, Cohen, BL, Carvello, M, Bonifacio, C, Bislenghi, G, Behrenbruch, C, Ballard, DH, Altinmakas, E, Sebastian, S, Tozer, P, Hart, A, Colombel, J-F, Wong, S-Y, Rowan, C, Brockmans, ED, Law, CCY, Giselbrecht, E, Ang, C, Khaitov, S, Sachar, D, Polydorides, AD, Winata, LS-H, Verstockt, B, Spinelli, A, Rubin, DT, Deepak, P, McGovern, DPB, McDonald, BD, Lung, P, Lundby, L, Lightner, AL, Holubar, SD, Hanna, L, Hamarth, C, Geldof, J, Dige, A, Cohen, BL, Carvello, M, Bonifacio, C, Bislenghi, G, Behrenbruch, C, Ballard, DH, Altinmakas, E, Sebastian, S, Tozer, P, Hart, A, and Colombel, J-F
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BACKGROUND & AIMS: Perianal fistulizing Crohn's disease (PFCD)-associated anorectal and fistula cancers are rare but often devastating diagnoses. However, given the low incidence and consequent lack of data and clinical trials in the field, there is little to no guidance on screening and management of these cancers. To inform clinical practice, we developed consensus guidelines on PFCD-associated anorectal and fistula cancers by multidisciplinary experts from the international TOpClass consortium. METHODS: We conducted a systematic review by standard methodology, using the Newcastle-Ottawa Scale quality assessment tool. We subsequently developed consensus statements using a Delphi consensus approach. RESULTS: Of 561 articles identified, 110 were eligible, and 76 articles were included. The overall quality of evidence was low. The TOpClass consortium reached consensus on 6 structured statements addressing screening, risk assessment, and management of PFCD-associated anorectal and fistula cancers. Patients with long-standing (>10 years) PFCD should be considered at small but increased risk of developing perianal cancer, including squamous cell carcinoma of the anus and anorectal carcinoma. Risk factors for squamous cell carcinoma of the anus, notably human papilloma virus, should be considered. New, refractory, or progressive perianal symptoms should prompt evaluation for fistula cancer. There was no consensus on timing or frequency of screening in patients with asymptomatic perianal fistula. Multiple modalities may be required for diagnosis, including an examination under anesthesia with biopsy. Multidisciplinary team efforts were deemed central to the management of fistula cancers. CONCLUSIONS: Inflammatory bowel disease clinicians should be aware of the risk of PFCD-associated anorectal and fistula cancers in all patients with PFCD. The TOpClass consortium consensus statements outlined herein offer guidance in managing this challenging scenario.
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- 2024
7. Surgical management of acquired rectourethral fistula: a retrospective analysis of 52 consecutive patients
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Bislenghi, G., Verstraeten, L., Verlinden, I., Castiglione, F., Debaets, K., Van der Aa, F., Fieuws, S., Wolthuis, A., D’Hoore, A., and Joniau, S.
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- 2020
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8. Ileal pouch-anal anastomosis for ulcerative colitis: 30-year analysis on surgical evolution and patient outcome.
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Bislenghi G, Luberto A, De Coster W, van Langenhoven L, Wolthuis A, Ferrante M, Vermeire S, and D'Hoore A
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- Humans, Male, Female, Adult, Retrospective Studies, Middle Aged, Treatment Outcome, Laparoscopy adverse effects, Anastomosis, Surgical adverse effects, Postoperative Complications epidemiology, Postoperative Complications etiology, Colitis, Ulcerative surgery, Proctocolectomy, Restorative adverse effects, Proctocolectomy, Restorative methods, Anastomotic Leak epidemiology, Anastomotic Leak etiology, Colonic Pouches adverse effects
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Background: Proctocolectomy with ileal pouch-anal anastomosis is the treatment of choice for patients with ulcerative colitis with medical refractory disease or dysplasia. The aim of this research was to describe the evolution of ileal pouch-anal anastomosis surgery and surgical outcomes over a three-decade interval in a high-volume referral centre., Methods: All consecutive patients undergoing ileal pouch-anal anastomosis for ulcerative colitis between 1990 and 2022 at the University Hospitals of Leuven were retrospectively included. Patients were divided into three interval arms (interval A 1990-2000, interval B 2001-2010 and interval C 2011-2022). The primary outcomes of interest were anastomotic leakage at 30 days and pouch failure., Results: Overall, 492 patients were included. The use of preoperative advanced therapies increased over time (P < 0.001). An increase in laparoscopic procedures (23.2% in interval A, 66.4% in interval B, 86.0% in interval C; P < 0.001) and a shift towards delayed ileal pouch-anal anastomosis (colectomy-first approach with delayed ileal pouch-anal anastomosis construction: 23.0% in interval A, 40.9% in interval B, 85.8% in interval C; P < 0.001) were observed. Anastomotic leakage rate decreased from 16.7% (interval A) to 8.4% (interval C) (P = 0.04). Delayed ileal pouch-anal anastomosis was the most relevant factor in limiting leakage (OR 0.49 (95% c.i. 0.27 to 0.87); P = 0.016). Median follow-up was 7.5 years (interquartile range 2.5-16). Cumulative pouch failure incidence was 8.2%, not significantly different between the three intervals (P = 0.580). Anastomotic leakage was the only significant risk factor for pouch failure (HR 2.82 (95% c.i. 1.29 to 6.20); P = 0.010)., Conclusion: Significant changes in the management of ulcerative colitis patients occurred. Despite the widespread use of advanced therapies and the expanded surgical indications, anastomotic leakage rate decreased over time. In the context of a delayed ileal pouch-anal anastomosis, diverting ileostomy could be avoided in selected cases. Anastomotic leakage remains the most relevant risk factor for pouch failure. Pouch failure incidence remained stable over the years., (© The Author(s) 2025. Published by Oxford University Press on behalf of BJS Foundation Ltd.)
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- 2024
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9. Organ Preservation After Immune Checkpoint Inhibition for Locally Advanced Rectal Cancer.
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Claeys C, Billiet A, Haustermans K, Wolthuis A, Bislenghi G, D'Hoore A, Dresen R, Rasschaert G, Van Cutsem E, Van Herpe F, and Dekervel J
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Competing Interests: Disclosure The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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- 2024
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10. ECCO Guidelines on Therapeutics in Crohn's Disease: Surgical Treatment.
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Adamina M, Minozzi S, Warusavitarne J, Buskens CJ, Chaparro M, Verstockt B, Kopylov U, Yanai H, Vavricka SR, Sigall-Boneh R, Sica GS, Reenaers C, Peros G, Papamichael K, Noor N, Moran GW, Maaser C, Luglio G, Kotze PG, Kobayashi T, Karmiris K, Kapizioni C, Iqbal N, Iacucci M, Holubar S, Hanzel J, Sabino JG, Gisbert JP, Fiorino G, Fidalgo C, Ellu P, El-Hussuna A, de Groof J, Czuber-Dochan W, Casanova MJ, Burisch J, Brown SR, Bislenghi G, Bettenworth D, Battat R, Atreya R, Allocca M, Agrawal M, Raine T, Gordon H, and Myrelid P
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- Humans, Preoperative Care methods, Preoperative Care standards, Immunosuppressive Agents therapeutic use, Crohn Disease surgery, Crohn Disease drug therapy
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This article is the second in a series of two publications on the European Crohn's and Colitis Organisation [ECCO] evidence-based consensus on the management of Crohn's disease. The first article covers medical management; the present article addresses surgical management, including preoperative aspects and drug management before surgery. It also provides technical advice for a variety of common clinical situations. Both articles together represent the evidence-based recommendations of the ECCO for Crohn's disease and an update of prior ECCO Guidelines., (© The Author(s) 2024. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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11. ECCO Guidelines on Therapeutics in Crohn's Disease: Medical Treatment.
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Gordon H, Minozzi S, Kopylov U, Verstockt B, Chaparro M, Buskens C, Warusavitarne J, Agrawal M, Allocca M, Atreya R, Battat R, Bettenworth D, Bislenghi G, Brown SR, Burisch J, Casanova MJ, Czuber-Dochan W, de Groof J, El-Hussuna A, Ellul P, Fidalgo C, Fiorino G, Gisbert JP, Sabino JG, Hanzel J, Holubar S, Iacucci M, Iqbal N, Kapizioni C, Karmiris K, Kobayashi T, Kotze PG, Luglio G, Maaser C, Moran G, Noor N, Papamichael K, Peros G, Reenaers C, Sica G, Sigall-Boneh R, Vavricka SR, Yanai H, Myrelid P, Adamina M, and Raine T
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- Humans, Immunosuppressive Agents therapeutic use, Gastrointestinal Agents therapeutic use, Anti-Inflammatory Agents therapeutic use, Crohn Disease drug therapy, Crohn Disease therapy
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- 2024
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12. Appearance of the Bowel and Mesentery During Surgery Is Not Predictive of Postoperative Recurrence After Ileocecal Resection for Crohn's Disease: A Prospective Monocentric Study.
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Bislenghi G, Van Den Bossch J, Fieuws S, Wolthuis A, Ferrante M, de Hertogh G, Vermeire S, and D'Hoore A
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- Humans, Female, Male, Prospective Studies, Adult, Risk Factors, Middle Aged, Young Adult, Postoperative Complications, Cecum surgery, Cecum pathology, Crohn Disease surgery, Crohn Disease pathology, Mesentery surgery, Mesentery pathology, Ileum surgery, Ileum pathology, Recurrence
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Background: Very few risk factors for postoperative recurrence (POR) of Crohn's Disease (CD) after ileocecal resection have been identified. The aim of the present study was to verify the association between an a priori defined list of intraoperative macroscopic findings and POR., Methods: This was a prospective observational study including patients undergoing primary ileocecal resection for CD. Four intraoperative factors were independently evaluated by 2 surgeons: length of resected ileum, mesentery thickness, presence of areas of serosal fat infiltration, or abnormal serosal vasodilation on normal bowel proximal to the resected bowel. The primary end point was early endoscopic POR at month 6 and defined as modified Rutgeerts score ≥i2b. Secondary end points were clinical and surgical recurrence., Results: Between September 2020 and November 2022, 83 consecutive patients were included. Early endoscopic recurrence occurred in 45 of 76 patients (59.2%). Clinical and biochemical recurrence occurred in 17.3% (95% confidence interval, [CI], 10.4%-28.0%) and 14.6% of the patients after 12 months. The risk of developing endoscopic and clinical recurrence was 1.127 (95% CI, 0.448;2.834, P = .799) and 0.896 (95% CI, 0.324-2.478, P = .832) when serosal fat infiltration was observed, and 1.388 (95% CI, 0.554-3.476, P = .484), and 1.153 (95% CI, 0.417;3.187, P = .783) when abnormal serosal vasodilation was observed. Similarly, length of the resected bowel and mesentery thickness showed no association with POR. A subgroup analysis on patients who received no postoperative medical prophylaxis did not identify any risk factor for endoscopic POR., Conclusions: The macroscopic appearance of the bowel and associated mesentery during surgery does not seem to be predictive of POR after ileocecal resection for CD., (© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)
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- 2024
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13. Salvage Surgery for Unifocal Progressive Metastatic Mismatch Repair-Deficient GI Cancer Responding to Immune Checkpoint Inhibition.
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Perremans P, Van Herpe F, Rasschaert G, Van Ongeval J, Decaestecker J, Topal B, Bislenghi G, Wolthuis A, Topal H, Deroose C, Van Cutsem E, and Dekervel J
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- Aged, Female, Humans, Male, Middle Aged, Gastrointestinal Neoplasms surgery, Gastrointestinal Neoplasms pathology, Gastrointestinal Neoplasms drug therapy, Retrospective Studies, DNA Mismatch Repair, Immune Checkpoint Inhibitors therapeutic use, Salvage Therapy
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Case series describing excellent outcomes for patients with dMMR GI cancer after resection of a single progressive lesion under immunotherapy.
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- 2024
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14. Stoma-free survival after anastomotic leak following rectal cancer resection: worldwide cohort of 2470 patients
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Greijdanus, N, Wienholts, K, Ubels, S, Talboom, K, Hannink, G, Wolthuis, A, de Lacy, F, Lefevre, J, Solomon, M, Frasson, M, Rotholtz, N, Denost, Q, Perez, R, Konishi, T, Panis, Y, Rutegard, M, Hompes, R, Rosman, C, van Workum, F, Tanis, P, de Wilt, J, Bremers, A, Ferenschild, F, de Vriendt, S, D'Hoore, A, Bislenghi, G, Farguell, J, Lacy, A, Atienza, P, van Kessel, C, Parc, Y, Voron, T, Collard, M, Muriel, J, Cholewa, H, Mattioni, L, Frontali, A, Polle, S, Polat, F, Obihara, N, Vailati, B, Kusters, M, Tuynmann, J, Hazen, S, Gruter, A, Amano, T, Fujiwara, H, Salomon, M, Ruiz, H, Gonzalez, R, Estefania, D, Avellaneda, N, Carrie, A, Santillan, M, Pachajoa, D, Parodi, M, Gielis, M, Binder, A, Gurtler, T, Riedl, P, Badiani, S, Berney, C, Morgan, M, Hollington, P, da Silva, N, Nair, G, Ho, Y, Lamparelli, M, Kapadia, R, Kroon, H, Dudi-Venkata, N, Liu, J, Sammour, T, Flamey, N, Pattyn, P, Chaoui, A, Vansteenbrugge, L, van den Broek, N, Vanclooster, P, de Gheldere, C, Pletinckx, P, Defoort, B, Dewulf, M, Slavchev, M, Belev, N, Atanasov, B, Krastev, P, Sokolov, M, Maslyankov, S, Gribnev, P, Pavlov, V, Ivanov, T, Karamanliev, M, Filipov, E, Tonchev, P, Aigner, F, Mitteregger, M, Allmer, C, Seitinger, G, Colucci, N, Buchs, N, Ris, F, Toso, C, Gialamas, E, Vuagniaux, A, Chautems, R, Sauvain, M, Daester, S, von Flue, M, Guenin, M, Taha-Mehlitz, S, Hess, G, Martinek, L, Skrovina, M, Machackova, M, Bencurik, V, Uluk, D, Pratschke, J, Dittrich, L, Guel-Klein, S, Perez, D, Grass, J, Melling, N, Mueller, S, Iversen, L, Eriksen, J, Baatrup, G, Al-Najami, I, Bjorsum-Meyer, T, Teras, J, Teras, R, Monib, F, Ahmed, N, Alkady, E, Ali, A, Khedr, G, Abdelaal, A, Ashoush, F, Ewedah, M, Elshennawy, E, Hussein, M, Fernandez-Martinez, D, Garcia-Florez, L, Fernandez-Hevia, M, Suarez-Sanchez, A, Aretxabala, I, Docampo, I, Zabala, J, Tejedor, P, Morales Bernaldo de Quiros, J, Quiroga, I, Navarro-Sanchez, A, Darias, I, Fernandez, C, de La Cruz Cuadrado, C, Sanchez-Guillen, L, Lopez-Rodriguez-Arias, F, Soler-Silva, A, Arroyo, A, Bernal-Sprekelsen, J, Gomez-Abril, S, Gonzalvez, P, Torres, M, Sanchez, T, Antona, F, Lara, J, Montero, J, Mendoza-Moreno, F, Diez-Alonso, M, Matias-Garcia, B, Quiroga-Valcarcel, A, Colas-Ruiz, E, Tasende-Presedo, M, Fernandez-Hurtado, I, Cifuentes-Rodenas, J, Suarez, M, Losada, M, Hernandez, M, Alonso, A, Dieguez, B, Serralta, D, Quintana, R, Lopez, J, Pinto, F, Nieto-Moreno, E, Bonito, A, Santacruz, C, Marcos, E, Septiem, J, Calero-Lillo, A, Alanez-Saavedra, J, Munoz-Collado, S, Lopez-Lara, M, Martinez, M, Herrero, E, Borda, F, Villar, O, Escartin, J, Blas, J, Ferrer, R, Egea, J, Rodriguez-Infante, A, Minguez-Ruiz, G, Carreno-Villarreal, G, Pire-Abaitua, G, Dziakova, J, Rodriguez, C, Aranda, M, Huguet, J, Borda-Arrizabalaga, N, Enriquez-Navascues, J, Echaniz, G, Ansorena, Y, Estaire-Gomez, M, Martinez-Pinedo, C, Barbero-Valenzuela, A, Ruiz-Garcia, P, Kraft, M, Gomez-Jurado, M, Pellino, G, Espin-Basany, E, Cotte, E, Panel, N, Goutard, C, de Angelis, N, Lauka, L, Shaikh, S, Osborne, L, Ramsay, G, Nichita, V, Bhandari, S, Sarmah, P, Bethune, R, Pringle, H, Massey, L, Fowler, G, Hamid, H, de Simone, B, Kynaston, J, Bradley, N, Stienstra, R, Gurjar, S, Mukherjee, T, Chandio, A, Ahmed, S, Singh, B, Runau, F, Chaudhri, S, Siaw, O, Sarveswaran, J, Miu, V, Ashmore, D, Darwich, H, Singh-Ranger, D, Singh, N, Shaban, M, Gareb, F, Petropolou, T, Polydorou, A, Dattani, M, Afzal, A, Bavikatte, A, Sebastian, B, Ward, N, Mishra, A, Manatakis, D, Agalianos, C, Tasis, N, Antonopoulou, M, Karavokyros, I, Charalabopoulos, A, Schizas, D, Baili, E, Syllaios, A, Karydakis, L, Vailas, M, Balalis, D, Korkolis, D, Plastiras, A, Rompou, A, Xenaki, S, Xynos, E, Chrysos, E, Venianaki, M, Christodoulidis, G, Perivoliotis, K, Tzovaras, G, Baloyiannis, I, Ho, M, Ng, S, Mak, T, Futaba, K, Santak, G, Simlesa, D, Cosic, J, Zukanovic, G, Kelly, M, Larkin, J, Mccormick, P, Mehigan, B, Connelly, T, Neary, P, Ryan, J, Mccullough, P, Al-Juaifari, M, Hammoodi, H, Abbood, A, 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Dudi-Venkata, N, Liu, J, Sammour, T, Flamey, N, Pattyn, P, Chaoui, A, Vansteenbrugge, L, van den Broek, N, Vanclooster, P, de Gheldere, C, Pletinckx, P, Defoort, B, Dewulf, M, Slavchev, M, Belev, N, Atanasov, B, Krastev, P, Sokolov, M, Maslyankov, S, Gribnev, P, Pavlov, V, Ivanov, T, Karamanliev, M, Filipov, E, Tonchev, P, Aigner, F, Mitteregger, M, Allmer, C, Seitinger, G, Colucci, N, Buchs, N, Ris, F, Toso, C, Gialamas, E, Vuagniaux, A, Chautems, R, Sauvain, M, Daester, S, von Flue, M, Guenin, M, Taha-Mehlitz, S, Hess, G, Martinek, L, Skrovina, M, Machackova, M, Bencurik, V, Uluk, D, Pratschke, J, Dittrich, L, Guel-Klein, S, Perez, D, Grass, J, Melling, N, Mueller, S, Iversen, L, Eriksen, J, Baatrup, G, Al-Najami, I, Bjorsum-Meyer, T, Teras, J, Teras, R, Monib, F, Ahmed, N, Alkady, E, Ali, A, Khedr, G, Abdelaal, A, Ashoush, F, Ewedah, M, Elshennawy, E, Hussein, M, Fernandez-Martinez, D, Garcia-Florez, L, Fernandez-Hevia, M, Suarez-Sanchez, A, Aretxabala, I, Docampo, I, Zabala, J, 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M, Martinez-Pinedo, C, Barbero-Valenzuela, A, Ruiz-Garcia, P, Kraft, M, Gomez-Jurado, M, Pellino, G, Espin-Basany, E, Cotte, E, Panel, N, Goutard, C, de Angelis, N, Lauka, L, Shaikh, S, Osborne, L, Ramsay, G, Nichita, V, Bhandari, S, Sarmah, P, Bethune, R, Pringle, H, Massey, L, Fowler, G, Hamid, H, de Simone, B, Kynaston, J, Bradley, N, Stienstra, R, Gurjar, S, Mukherjee, T, Chandio, A, Ahmed, S, Singh, B, Runau, F, Chaudhri, S, Siaw, O, Sarveswaran, J, Miu, V, Ashmore, D, Darwich, H, Singh-Ranger, D, Singh, N, Shaban, M, Gareb, F, Petropolou, T, Polydorou, A, Dattani, M, Afzal, A, Bavikatte, A, Sebastian, B, Ward, N, Mishra, A, Manatakis, D, Agalianos, C, Tasis, N, Antonopoulou, M, Karavokyros, I, Charalabopoulos, A, Schizas, D, Baili, E, Syllaios, A, Karydakis, L, Vailas, M, Balalis, D, Korkolis, D, Plastiras, A, Rompou, A, Xenaki, S, Xynos, E, Chrysos, E, Venianaki, M, Christodoulidis, G, Perivoliotis, K, Tzovaras, G, Baloyiannis, I, Ho, M, Ng, S, Mak, T, Futaba, K, Santak, G, 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Perrone, G, Grossi, U, Santoro, G, Zanus, G, Iacomino, A, Novello, S, Passuello, N, Zucchella, M, Puca, L, Degiuli, M, Reddavid, R, Scabini, S, Aprile, A, Soriero, D, Fioravanti, E, Rottoli, M, Romano, A, Tanzanu, M, Belvedere, A, Mariani, N, Ceretti, A, Opocher, E, Gallo, G, Sammarco, G, de Paola, G, Pucciarelli, S, Marchegiani, F, Spolverato, G, Buzzi, G, Di Saverio, S, Meroni, P, Parise, C, Bottazzoli, E, Lapolla, P, Brachini, G, Cirillo, B, Mingoli, A, Sica, G, Siragusa, L, Bellato, V, Cerbo, D, de Pasqual, C, de Manzoni, G, di Cosmo, M, Alrayes, B, Qandeel, M, Hani, M, Rabadi, A, el Muhtaseb, M, Abdeen, B, Karmi, F, Zilinskas, J, Latkauskas, T, Tamelis, A, Pikuniene, I, Slenfuktas, V, Poskus, T, Kryzauskas, M, Jakubauskas, M, Mikalauskas, S, Jakubauskiene, L, Hassan, S, Altrabulsi, A, Abdulwahed, E, Ghmagh, R, Deeknah, A, Alshareea, E, Elhadi, M, Abujamra, S, Msherghi, A, Tababa, O, Majbar, M, Souadka, A, Benkabbou, A, Mohsine, R, Echiguer, S, Moctezuma-Velazquez, P, Salgado-Nesme, N, Vergara-Fernandez, O, Sainz-Hernandez, J, Alvarez-Bautista, F, Zakaria, A, Zakaria, Z, Wong, M, Ismail, R, Ibrahim, A, Abdullah, N, Julaihi, R, Bhat, S, O'Grady, G, Bissett, I, Lamme, B, Musters, G, Dinaux, A, Grotenhuis, B, Steller, E, Aalbers, A, Leeuwenburgh, M, Rutten, H, Burger, J, Bloemen, J, Ketelaers, S, Waqar, U, Chawla, T, Rauf, H, Rani, P, Talsma, A, Scheurink, L, van Praagh, J, Segelman, J, Nygren, J, Anderin, K, Tiefenthal, M, de Andres, B, Beltran de Heredia, J, Vazquez, A, Gomez, T, Golshani, P, Kader, R, Mohamed, A, Westerterp, M, Marinelli, A, Niemer, Q, Doornebosch, P, Shapiro, J, Vermaas, M, de Graaf, E, van Westreenen, H, Zwakman, M, van Dalsen, A, Vles, W, Nonner, J, Toorenvliet, B, Janssen, P, Verdaasdonk, E, Amelung, F, Peeters, K, Bahadoer, R, Holman, F, Heemskerk, J, Vosbeek, N, Leijtens, J, Taverne, S, Heijnen, B, El-Massoudi, Y, de Groot-Van Veen, I, Hoff, C, Jou-Valencia, D, Consten, E, Burghgraef, T, Geitenbeek, R, Hulshof, L, Slooter, G, Reudink, M, Bouvy, N, Wildeboer, A, Verstappen, S, Pennings, A, van den Hengel, B, Wijma, A, de Haan, J, de Nes, L, Heesink, V, Karsten, T, Heidsma, C, Koemans, W, Dekker, J, van der Zijden, C, Roos, D, Demirkiran, A, van der Burg, S, Oosterling, S, Hoogteijling, T, Wiering, B, Smeeing, D, Havenga, K, Lutfi, H, Tsimogiannis, K, Skoldberg, F, Folkesson, J, den Boer, F, van Schaik, T, van Gerven, P, Sietses, C, Hol, J, Boerma, E, Creemers, D, Schultz, J, Frivold, T, Riis, R, Gregussen, H, Busund, S, Sjo, O, Gaard, M, Krohn, N, Ersryd, A, Leung, E, Sultan, H, Hajjaj, B, Alhisi, A, Khader, A, Mendes, A, Semiao, M, Faria, L, Azevedo, C, da Costa Devesa, H, Martins, S, Jarimba, A, Marques, S, Ferreira, R, Oliveira, A, Ferreira, C, Pereira, R, Surlin, V, Graure, G, Ramboiu, S, Negoi, I, Ciubotaru, C, Stoica, B, Tanase, I, Negoita, V, Florea, S, Macau, F, Vasile, M, Stefanescu, V, Dimofte, G, Lunca, S, Roata, C, Musina, A, Garmanova, T, Agapov, M, Markaryan, D, Eduard, G, Yanishev, A, Abelevich, A, Bazaev, A, Rodimov, S, Filimonov, V, Melnikov, A, Suchkov, I, Drozdov, E, Kostromitskiy, D, Sjostrom, O, Matthiessen, P, Baban, B, Gadan, S, Jadid, K, Staffan, M, Park, J, Rydbeck, D, Lydrup, M, Buchwald, P, Jutesten, H, Darlin, L, Lindqvist, E, Nilsson, K, Larsson, P, Jangmalm, S, Kosir, J, Tomazic, A, Grosek, J, Bozic, T, Zazo, A, Zazo, R, Fares, H, Ayoub, K, Niazi, A, Mansour, A, Abbas, A, Tantoura, M, Hamdan, A, Hassan, N, Hasan, B, Saad, A, Sebai, A, Haddad, A, Maghrebi, H, Kacem, M, Yalkin, O, Samsa, M, Atak, I, Balci, B, Haberal, E, Dogan, L, Gecim, I, Akyol, C, Koc, M, Sivrikoz, E, Piyadeoglu, D, Avanagh, D, Sokmen, S, Bisgin, T, Gunenc, E, Guzel, M, Leventoglu, S, Yuksel, O, Kozan, R, Gobut, H, Cengiz, F, Erdinc, K, Acar, N, Kamer, E, Ozgur, I, Aydin, O, Keskin, M, Bulut, M, Kulle, C, Kara, Y, Sibic, O, Ozata, I, Bugra, D, Balik, E, Cakir, M, Alhardan, A, Colak, E, Aybar, A, Sari, A, Atici, S, Kaya, T, Dursun, A, Calik, B, Ozkan, O, Ulgur, H, Duzgun, O, Monson, 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G., Wienholts K., Ubels S., Talboom K., Hannink G., Wolthuis A., de Lacy F. B., Lefevre J. H., Solomon M., Frasson M., Rotholtz N., Denost Q., Perez R. O., Konishi T., Panis Y., Rutegard M., Hompes R., Rosman C., van Workum F., Tanis P. J., de Wilt J. H. W., Bremers A. J. A., Ferenschild F. T., de Vriendt S., D'Hoore A., Bislenghi G., Farguell J., Lacy A. M., Atienza P. G., van Kessel C. S., Parc Y., Voron T., Collard M. K., Muriel J. S., Cholewa H., Mattioni L. A., Frontali A., Polle S. W., Polat F., Obihara N. J., Vailati B. B., Kusters M., Tuynmann J. B., Hazen S. J. A., Gruter A. A. J., Amano T., Fujiwara H., Salomon M., Ruiz H., Gonzalez R., Estefania D., Avellaneda N., Carrie A., Santillan M., Pachajoa D. A. P., Parodi M., Gielis M., Binder A. -D., Gurtler T., Riedl P., Badiani S., Berney C., Morgan M., Hollington P., da Silva N., Nair G., Ho Y. M., Lamparelli M., Kapadia R., Kroon H. M., Dudi-Venkata N. N., Liu J., Sammour T., Flamey N., Pattyn P., Chaoui A., Vansteenbrugge L., van den Broek N. E. J., Vanclooster P., de Gheldere C., Pletinckx P., Defoort B., Dewulf M., Slavchev M., Belev N., Atanasov B., Krastev P., Sokolov M., Maslyankov S., Gribnev P., Pavlov V., Ivanov T., Karamanliev M., Filipov E., Tonchev P., Aigner F., Mitteregger M., Allmer C., Seitinger G., Colucci N., Buchs N., Ris F., Toso C., Gialamas E., Vuagniaux A., Chautems R., Sauvain M. -O., Daester S., von Flue M., Guenin M. -O., Taha-Mehlitz S., Hess G. F., Martinek L., Skrovina M., Machackova M., Bencurik V., Uluk D., Pratschke J., Dittrich L. S., Guel-Klein S., Perez D., Grass J. -K., Melling N., Mueller S., Iversen L. H., Eriksen J. D., Baatrup G., Al-Najami I., Bjorsum-Meyer T., Teras J., Teras R. M., Monib F. A., Ahmed N. E. A. E., Alkady E., Ali A. K., Khedr G. A. E., Abdelaal A. S., Ashoush F. M. B., Ewedah M., Elshennawy E. M., Hussein M., Fernandez-Martinez D., Garcia-Florez L. J., Fernandez-Hevia M., Suarez-Sanchez A., Aretxabala I. D. H., Docampo I. L., Zabala J. G., Tejedor P., Morales Bernaldo de Quiros J. T., Quiroga I. B., Navarro-Sanchez A., Darias I. S., Fernandez C. L., de La Cruz Cuadrado C., Sanchez-Guillen L., Lopez-Rodriguez-Arias F., Soler-Silva A., Arroyo A., Bernal-Sprekelsen J. C., Gomez-Abril S. A., Gonzalvez P., Torres M. T., Sanchez T. R., Antona F. B., Lara J. E. S., Montero J. A. A., Mendoza-Moreno F., Diez-Alonso M., Matias-Garcia B., Quiroga-Valcarcel A., Colas-Ruiz E., Tasende-Presedo M. M., Fernandez-Hurtado I., Cifuentes-Rodenas J. A., Suarez M. C., Losada M., Hernandez M., Alonso A., Dieguez B., Serralta D., Quintana R. E. M., Lopez J. M. G., Pinto F. L., Nieto-Moreno E., Bonito A. C., Santacruz C. C., Marcos E. B., Septiem J. G., Calero-Lillo A., Alanez-Saavedra J., Munoz-Collado S., Lopez-Lara M., Martinez M. L., Herrero E. F., Borda F. J. G., Villar O. G., Escartin J., Blas J. L., Ferrer R., Egea J. G., Rodriguez-Infante A., Minguez-Ruiz G., Carreno-Villarreal G., Pire-Abaitua G., Dziakova J., Rodriguez C. S. -C., Aranda M. J. P., Huguet J. M. M., Borda-Arrizabalaga N., Enriquez-Navascues J. M., Echaniz G. E., Ansorena Y. S., Estaire-Gomez M., Martinez-Pinedo C., Barbero-Valenzuela A., Ruiz-Garcia P., Kraft M., Gomez-Jurado M. J., Pellino G., Espin-Basany E., Cotte E., Panel N., Goutard C. -A., de Angelis N., Lauka L., Shaikh S., Osborne L., Ramsay G., Nichita V. -I., Bhandari S., Sarmah P., Bethune R. M., Pringle H. C. M., Massey L., Fowler G. E., Hamid H. K. S., de Simone B. D., Kynaston J., Bradley N., Stienstra R. M., Gurjar S., Mukherjee T., Chandio A., Ahmed S., Singh B., Runau F., Chaudhri S., Siaw O., Sarveswaran J., Miu V., Ashmore D., Darwich H., Singh-Ranger D., Singh N., Shaban M., Gareb F., Petropolou T., Polydorou A., Dattani M., Afzal A., Bavikatte A., Sebastian B., Ward N., Mishra A., Manatakis D., Agalianos C., Tasis N., Antonopoulou M. -I., Karavokyros I., Charalabopoulos A., Schizas D., Baili E., Syllaios A., Karydakis L., Vailas M., Balalis D., Korkolis D., Plastiras A., Rompou A., Xenaki S., Xynos E., Chrysos E., Venianaki M., Christodoulidis G., Perivoliotis K., Tzovaras G., Baloyiannis I., Ho M. -F., Ng S. S., Mak T. W. -C., Futaba K., Santak G., Simlesa D., Cosic J., Zukanovic G., Kelly M. E., Larkin J. O., McCormick P. H., Mehigan B. J., Connelly T. M., Neary P., Ryan J., McCullough P., Al-Juaifari M. A., Hammoodi H., Abbood A. H., Calabro M., Muratore A., La Terra A., Farnesi F., Feo C. V., Fabbri N., Pesce A., Fazzin M., Roscio F., Clerici F., Lucchi A., Vittori L., Agostinelli L., Ripoli M. C., Sambucci D., Porta A., Sinibaldi G., Crescentini G., Larcinese A., Picone E., Persiani R., Biondi A., Pezzuto R., Lorenzon L., Rizzo G., Coco C., D'Agostino L., Spinelli A., Sacchi M. M., Carvello M., Foppa C., Maroli A., Palini G. M., Garulli G., Zanini N., Delrio P., Rega D., Carbone F., Aversano A., Pirozzolo G., Recordare A., D'Alimonte L., Vignotto C., Corbellini C., Sampietro G. M., Lorusso L., Manzo C. A., Ghignone F., Ugolini G., Montroni I., Pasini F., Ballabio M., Bisagni P., Armao F. T., Longhi M., Ghazouani O., Galleano R., Tamini N., Oldani M., Nespoli L., Picciariello A., Altomare D. F., Tomasicchio G., Lantone G., Catena F., Giuffrida M., Annicchiarico A., Perrone G., Grossi U., Santoro G. A., Zanus G., Iacomino A., Novello S., Passuello N., Zucchella M., Puca L., deGiuli M., Reddavid R., Scabini S., Aprile A., Soriero D., Fioravanti E., Rottoli M., Romano A., Tanzanu M., Belvedere A., Mariani N. M., Ceretti A. P., Opocher E., Gallo G., Sammarco G., de Paola G., Pucciarelli S., Marchegiani F., Spolverato G., Buzzi G., Di Saverio S., Meroni P., Parise C., Bottazzoli E. I., Lapolla P., Brachini G., Cirillo B., Mingoli A., Sica G., Siragusa L., Bellato V., Cerbo D., de Pasqual C. A., de Manzoni G., di Cosmo M. A., Alrayes B. M. H., Qandeel M. W. M., Hani M. B., Rabadi A., el Muhtaseb M. S., Abdeen B., Karmi F., Zilinskas J., Latkauskas T., Tamelis A., Pikuniene I., Slenfuktas V., Poskus T., Kryzauskas M., Jakubauskas M., Mikalauskas S., Jakubauskiene L., Hassan S. Y., Altrabulsi A., Abdulwahed E., Ghmagh R., Deeknah A., Alshareea E., Elhadi M., Abujamra S., Msherghi A. A., Tababa O. W. E., Majbar M. A., Souadka A., Benkabbou A., Mohsine R., Echiguer S., Moctezuma-Velazquez P., Salgado-Nesme N., Vergara-Fernandez O., Sainz-Hernandez J. C., Alvarez-Bautista F. E., Zakaria A. D., Zakaria Z., Wong M. P. K., Ismail R., Ibrahim A. F., Abdullah N. A. N., Julaihi R., Bhat S., O'Grady G., Bissett I., Lamme B., Musters G. D., Dinaux A. M., Grotenhuis B. A., Steller E. J., Aalbers A. G. J., Leeuwenburgh M. M., Rutten H. J. T., Burger J. W. A., Bloemen J. G., Ketelaers S. H. J., Waqar U., Chawla T., Rauf H., Rani P., Talsma A. K., Scheurink L., van Praagh J. B., Segelman J., Nygren J., Anderin K., Tiefenthal M., de Andres B., Beltran de Heredia J. P., Vazquez A., Gomez T., Golshani P., Kader R., Mohamed A., Westerterp M., Marinelli A., Niemer Q., Doornebosch P. G., Shapiro J., Vermaas M., de Graaf E. J. R., van Westreenen H. L., Zwakman M., van Dalsen A. D., Vles W. J., Nonner J., Toorenvliet B. R., Janssen P. T. J., Verdaasdonk E. G. G., Amelung F. J., Peeters K. C. M. J., Bahadoer R. R., Holman F. A., Heemskerk J., Vosbeek N., Leijtens J. W. A., Taverne S. B. M., Heijnen B. H. M., El-Massoudi Y., de Groot-Van Veen I., Hoff C., Jou-Valencia D., Consten E. C. J., Burghgraef T. A., Geitenbeek R., Hulshof L. G. W. L., Slooter G. D., Reudink M., Bouvy N. D., Wildeboer A. C. L., Verstappen S., Pennings A. J., van den Hengel B., Wijma A. G., de Haan J., de Nes L. C. F., Heesink V., Karsten T., Heidsma C. M., Koemans W. J., Dekker J. -W. T., van der Zijden C. J., Roos D., Demirkiran A., van der Burg S., Oosterling S. J., Hoogteijling T. J., Wiering B., Smeeing D. P. J., Havenga K., Lutfi H., Tsimogiannis K., Skoldberg F., Folkesson J., den Boer F., van Schaik T. G., van Gerven P., Sietses C., Hol J. C., Boerma E. -J. G., Creemers D. M. J., Schultz J. K., Frivold T., Riis R., Gregussen H., Busund S., Sjo O. H., Gaard M., Krohn N., Ersryd A. L., Leung E., Sultan H., Hajjaj B. N., Alhisi A. J., Khader A. A. E., Mendes A. F. D., Semiao M., Faria L. Q., Azevedo C., da Costa Devesa H. M., Martins S. F., Jarimba A. M. R., Marques S. M. R., Ferreira R. M., Oliveira A., Ferreira C., Pereira R., Surlin V. M., Graure G. M., Ramboiu S. P. S. D., Negoi I., Ciubotaru C., Stoica B., Tanase I., Negoita V. M., Florea S., Macau F., Vasile M., Stefanescu V., Dimofte G. -M., Lunca S., Roata C. -E., Musina A. -M., Garmanova T., Agapov M. N., Markaryan D. G., Eduard G., Yanishev A., Abelevich A., Bazaev A., Rodimov S. V., Filimonov V. B., Melnikov A. A., Suchkov I. A., Drozdov E. S., Kostromitskiy D. N., Sjostrom O., Matthiessen P., Baban B., Gadan S., Jadid K. D., Staffan M., Park J. M., Rydbeck D., Lydrup M. -L., Buchwald P., Jutesten H., Darlin L., Lindqvist E., Nilsson K., Larsson P. -A., Jangmalm S., Kosir J. A., Tomazic A., Grosek J., Bozic T. K., Zazo A., Zazo R., Fares H., Ayoub K., Niazi A., Mansour A., Abbas A., Tantoura M., Hamdan A., Hassan N., Hasan B., Saad A., Sebai A., Haddad A., Maghrebi H., Kacem M., Yalkin O., Samsa M. V., Atak I., Balci B., Haberal E., Dogan L., Gecim I. E., Akyol C., Koc M. A., Sivrikoz E., Piyadeoglu D., Avanagh D. O., Sokmen S., Bisgin T., Gunenc E., Guzel M., Leventoglu S., Yuksel O., Kozan R., Gobut H., Cengiz F., Erdinc K., Acar N. C., Kamer E., Ozgur I., Aydin O., Keskin M., Bulut M. T., Kulle C. B., Kara Y., Sibic O., Ozata I. H., Bugra D., Balik E., Cakir M., Alhardan A., Colak E., Aybar A. B. C., Sari A. C., Atici S. D., Kaya T., Dursun A., Calik B., Ozkan O. F., Ulgur H. S., Duzgun O., Monson J., George S., Woods K., Al-Eryani F., Albakry R., Coetzee E., Boutall A., Herman A., Warden C., Mugla N., Forgan T., Mia I., and Lambrechts A.
- Abstract
Background: The optimal treatment of anastomotic leak after rectal cancer resection is unclear. This worldwide cohort study aimed to provide an overview of four treatment strategies applied. Methods: Patients from 216 centres and 45 countries with anastomotic leak after rectal cancer resection between 2014 and 2018 were included. Treatment was categorized as salvage surgery, faecal diversion with passive or active (vacuum) drainage, and no primary/secondary faecal diversion. The primary outcome was 1-year stoma-free survival. In addition, passive and active drainage were compared using propensity score matching (2: 1). Results: Of 2470 evaluable patients, 388 (16.0 per cent) underwent salvage surgery, 1524 (62.0 per cent) passive drainage, 278 (11.0 per cent) active drainage, and 280 (11.0 per cent) had no faecal diversion. One-year stoma-free survival rates were 13.7, 48.3, 48.2, and 65.4 per cent respectively. Propensity score matching resulted in 556 patients with passive and 278 with active drainage. There was no statistically significant difference between these groups in 1-year stoma-free survival (OR 0.95, 95 per cent c.i. 0.66 to 1.33), with a risk difference of -1.1 (95 per cent c.i. -9.0 to 7.0) per cent. After active drainage, more patients required secondary salvage surgery (OR 2.32, 1.49 to 3.59), prolonged hospital admission (an additional 6 (95 per cent c.i. 2 to 10) days), and ICU admission (OR 1.41, 1.02 to 1.94). Mean duration of leak healing did not differ significantly (an additional 12 (-28 to 52) days). Conclusion: Primary salvage surgery or omission of faecal diversion likely correspond to the most severe and least severe leaks respectively. In patients with diverted leaks, stoma-free survival did not differ statistically between passive and active drainage, although the increased risk of secondary salvage surgery and ICU admission suggests residual confounding.
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- 2023
15. P564 Surgical treatment of jejuno-ileal Crohn’s disease. Results from the The JejUno Ileal Crohn's disEase (JUICE) international, multicentric, observational study
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Baldi, C, primary, Mineccia, M, additional, Ferrero, A, additional, Di Benedetto, M, additional, Spinelli, A, additional, Scarpa, M, additional, Angriman, I, additional, Cricrì, M, additional, Luglio, G, additional, Colombo, F, additional, Danelli, P, additional, Bislenghi, G, additional, D'Hoore, A, additional, Nasasra, A, additional, Warusavitarne, J, additional, Manzo, C A, additional, Celentano, V, additional, Marti-Gallostra, M, additional, Espin Basany, E, additional, Schena, C A, additional, Pellino, G, additional, De Angelis, N, additional, Rottoli, M, additional, Poggioli, G, additional, and Sampietro, G M, additional
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- 2024
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16. P934 A delphi consensus on the optimisation of medical and surgical therapy in perianal fistulising Crohn’s disease, targeted at individual TOpCLASS classification groups
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Hanna, L, primary, Anandabaskaran, S, additional, Iqbal, N, additional, Geldof, J, additional, LeBlanc, J F, additional, Dige, A, additional, Lundby, L, additional, Bislenghi, G, additional, Verstockt, B, additional, D'Hoore, A, additional, Vermeire, S, additional, De Looze, D, additional, Lobaton, T, additional, Van de Putte, D, additional, De Kock, I, additional, Carvello, M, additional, Spinelli, A, additional, Danese, S, additional, Buskens, C J, additional, Gecse, K, additional, Hompes, R, additional, van der Bilt, J D W, additional, Bemelman, W A, additional, Sebastian, S, additional, Moran, G W, additional, Lightner, A, additional, Wong, S Y, additional, Cohen, B L, additional, Holubar, S, additional, Ding, N S, additional, Behrenbruch, C, additional, Sahnan, K, additional, Misra, R, additional, Lung, P, additional, Hart, A, additional, and Tozer, P, additional
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- 2024
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17. P1171 The impact of biological and small molecule therapy on time to colonic resection and cancer rates in patients with Ulcerative Colitis
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Visser, E, primary, Luberto, A, additional, Heuthorst, L, additional, Bislenghi, G, additional, Hompes, R, additional, Vermeire, S, additional, D'Haens, G R, additional, Bemelman, W A, additional, Buskens, C J, additional, and D'Hoore, A, additional
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- 2024
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18. P573 Simplified MARIA score does not predict long-term outcomes in Crohn’s disease patients undergoing modified side-to-side strictureplasty for extensive ileitis
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De Greef, I, primary, Bislenghi, G, additional, Lenfant, M, additional, Verstockt, S, additional, Terrasson, I, additional, Verstockt, B, additional, Sabino, J, additional, Ferrante, M, additional, Vanbeckevoort, D, additional, D'Hoore, A, additional, and Vermeire, S, additional
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- 2024
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19. DOP04 Screening and management of fistula cancers in patients with perianal fistulising Crohn’s Disease: an expert consensus
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Wong, S Y, primary, Rowan, C, additional, Law, C C, additional, Brockmans, E D, additional, Khaitov, S, additional, Sachar, D, additional, Altinmakas, E, additional, Ballard, D, additional, Behrenbruch, C, additional, Bislenghi, G, additional, Bonifacio, C, additional, Carvello, M, additional, Cohen, B, additional, Deepak, P, additional, Dige, A, additional, Geldof, J, additional, Hanna, L, additional, Harmath, C, additional, Holubar, S, additional, Lundby, L, additional, Lightner, A, additional, Lung, P, additional, McDonald, B, additional, McGovern, D, additional, Rubin, D, additional, Sebastian, S, additional, Spinelli, A, additional, Verstockt, B, additional, Winata, L S H, additional, Tozer, P, additional, Hart, A, additional, and Colombel, J F, additional
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- 2024
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20. P049 The lipidome of creeping fat in Crohn’s disease points towards a harmful microenvironment
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Verstockt, S, primary, Dehairs, J, additional, Vanderhoydonc, F, additional, Ke, B J, additional, De Greef, I, additional, Sabino, J, additional, Ferrante, M, additional, Bislenghi, G, additional, D’Hoore, A, additional, Swinnen, J, additional, Verstockt, B, additional, and Vermeire, S, additional
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- 2024
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21. P832 Postoperative fever and CRP levels as predictive markers of postoperative recurrence of Crohn’s disease after ileocolic resection
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Van Tieghem, C, primary, Bislenghi, G, additional, Fieuws, S, additional, Wolthuis, A, additional, and D'Hoore, A, additional
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- 2024
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22. P433 Short-term outcomes of surgical treatment in primary ileocecal Crohn’s disease patients. Results of Crohn’s(urg) study, multicenter, retrospective, comparative analysis between indications for luminal and complicated phenotype
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Avellaneda, N L, primary, Pellino, G, additional, Maroli, A, additional, Tottrup, A, additional, Bislenghi, G, additional, Colpaert, J, additional, D'Hoore, A, additional, Giorgi, L, additional, Juachon, P, additional, Harsløf, S, additional, de Buck Van Overstraeten, A, additional, Olivera, P, additional, Gomez, J, additional, Holubar, S, additional, Lincango Naranjo, E, additional, Steele, S, additional, Merchea, A, additional, Shacker, A, additional, Marti Gallostra, M, additional, Kraft, M, additional, Kotze, P G, additional, Yuki Maruyana, B, additional, Wexner, S, additional, Garoufalia, Z, additional, Zhihui, C, additional, Hahnloser, D, additional, Rrupa, D, additional, Buskens, C, additional, Haanappel, A, additional, Warusavitarne, J, additional, Williams, K, additional, Christensen, P, additional, and Spinelli, A, additional
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- 2024
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23. Quality indicators for ambulatory colectomy: literature search and expert consensus.
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Coeckelberghs E, Bislenghi G, Wolthuis A, Teunkens A, Dewinter G, Coppens S, Vanhaecht K, and D'Hoore A
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- Humans, Consensus, Ambulatory Care, Length of Stay, Delphi Technique, Quality Indicators, Health Care, Hospitals
- Abstract
Background: Care for patients undergoing elective colectomy has become increasingly standardized using Enhanced Recovery Programs (ERP). ERP, encorporating minimally invasive surgery (MIS), decreased postoperative morbidity and length of stay (LOS). However, disruptive changes are needed to safely introduce colectomy in an ambulatory or same-day discharge (SDD) setting. Few research groups showed the feasibility of ambulatory colectomy. So far, no minimum standards for the quality of care of this procedure have been defined. This study aims to identify quality indicators (QIs) that assess the quality of care for ambulatory colectomy., Methods: A literature search was performed to identify recommendations for ambulatory colectomy. Based on that search, a set of QIs was identified and categorized into seven domains: preparation of the patient (pre-admission), anesthesia, surgery, in-hospital monitoring, home monitoring, feasibility, and clinical outcomes. This list was presented to a panel of international experts (surgeons and anesthesiologists) in a 1 round Delphi to assess the relevance of the proposed indicators., Results: Based on the literature search (2010-2021), 3841 results were screened on title and abstract for relevant information. Nine papers were withheld to identify the first set of QIs (n = 155). After excluding duplicates and outdated QIs, this longlist was narrowed down to 88 indicators. Afterward, consensus was reached in a 1 round Delphi on a final list of 32 QIs, aiming to be a comprehensive set to evaluate the quality of ambulatory colectomy care., Conclusion: We propose a list of 32 QI to guide and evaluate the implementation of ambulatory colectomy., (© 2024. The Author(s).)
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- 2024
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24. Perianal Fistulizing Crohn's Disease: Utilizing the TOpClass Classification in Clinical Practice to Provide Targeted Individualized Care.
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Hanna LN, Anandabaskaran S, Iqbal N, Geldof J, LeBlanc JF, Dige A, Lundby L, Vermeire S, D'Hoore A, Verstockt B, Bislenghi G, De Looze D, Lobaton T, Van de Putte D, Spinelli A, Carvello M, Danese S, Buskens CJ, Gecse K, Hompes R, Becker M, van der Bilt J, Bemelman W, Sebastian S, Moran G, Lightner AL, Wong SY, Colombel JF, Cohen BL, Holubar SD, Ding NS, Behrenbruch C, Sahnan K, Misra R, Lung P, Hart A, and Tozer P
- Abstract
Background & Aims: Perianal fistulation is a challenging phenotype of Crohn's disease, with significant impact on quality of life. Historically, fistulae have been classified anatomically in relation to the sphincter complex, and management guidelines have been generalized, with lack of attention to the clinical heterogenicity seen. The recent 'TOpClass classification system' for perianal fistulizing Crohn's disease (PFCD) addresses this issue, and classifies patients into defined groups, which provide a focus for fistula management that aligns with disease characteristics and patient goals. In this article, we discuss the clinical applicability of the TOpClass model and provide direction on its use in clinical practice., Methods: An international group of perianal clinicians participated in an expert consensus to define how the TOpClass system can be incorporated into real-life practice. This included gastroenterologists, inflammatory bowel disease surgeons, and radiologists specialized in PFCD. The process was informed by the multi-disciplinary team management of 8 high-volume fistula centres in North America, Europe, and Australia., Results: The process produced position statements to accompany the classification system and guide PFCD management. The statements range from the management of patients with quiescent perianal disease to those with severe PFCD requiring diverting-ostomy and/or proctectomy. The optimization of medical therapies, as well as the use of surgery, in fistula closure and symptom management is explored across each classification group., Conclusion: This article provides an overview of the system's use in clinical practice. It aims to enable clinicians to have a pragmatic and patient goal-centered approach to medical and surgical management options for individual patients with PFCD., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2024
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25. Preoperative optimization: Review on nutritional assessment and strategies in IBD.
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Vanderstappen J, Hoekx S, Bislenghi G, D'Hoore A, Verstockt B, and Sabino J
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- Humans, Nutritional Support methods, Malnutrition diagnosis, Malnutrition therapy, Nutritional Status, Nutrition Assessment, Preoperative Care methods, Inflammatory Bowel Diseases diet therapy
- Abstract
Inflammatory bowel diseases (IBD), encompassing conditions like Crohn's disease and ulcerative colitis, present multifaceted challenges requiring a comprehensive management approach. Patients often necessitate a combination of medical therapy, surgical interventions, and nutritional support. Despite advancements in medical and dietary therapies, the prevalence of surgery remains high among the IBD population, alongside the persistent risk of malnutrition. Preoperative nutritional optimization has thus become a critical element in the perioperative pathway, given its association with improved surgical outcomes. However, standardized protocols for preoperative optimization of IBD patients are lacking, and available data are mainly retrospective. This review provides an overview of the current knowledge on preoperative nutritional screening and optimization in IBD patients and identifies avenues for future research and clinical practice. Interdisciplinary collaboration among healthcare professionals, including gastroenterologists, surgeons, dietitians, physiotherapists, and psychologists, is crucial for comprehensive preoperative nutritional management in IBD patients. By addressing the interplay between inflammation, malnutrition, and surgical risk, clinicians can strive to enhance surgical care and postoperative outcomes. In conclusion, while recognizing the importance of preoperative nutritional optimization in improving surgical outcomes for IBD patients, challenges persist in standardizing management protocols. Prospective studies are needed to establish such protocols and evaluate the effectiveness of different nutritional strategies., Competing Interests: Declaration of competing interest JV received speaker's fees from Janssen; consultancy fees from Ferring. SH received speaker's fees from Janssen; consultancy fees from Ferring, Takeda. AD declaration of interest: none. GB declaration of interest: none. BV received research support from AbbVie, Biora Therapeutics, Landos, Pfizer, Sossei Heptares and Takeda. Speaker's fees from Abbvie, Biogen, Bristol Myers Squibb, Celltrion, Chiesi, Falk, Ferring, Galapagos, Janssen, Lily, MSD, Pfizer, R-Biopharm, Sandoz, Takeda, Tillots Pharma, Truvion and Viatris. Consultancy fees from Abbvie, Alfasigma, Alimentiv, Applied Strategic, Atheneum, BenevolentAI, Biora Therapeutics, Boxer Capital, Bristol Myers Squibb, Galapagos, Guidepont, Landos, Lily, Mylan, Inotrem, Ipsos, Janssen, Pfizer, Progenity, Sandoz, Sanofi, Santa Ana Bio, Sapphire Therapeutics, Sosei Heptares, Takeda, Tillots Pharma and Viatris. Stock options Vagustim. JS received speaker's fees from Pfizer, Abbvie, Ferring, Falk, Takeda, Janssen, Fresenius, and Galapagos; consultancy fees from Janssen, Ferring, Fresenius, Abbvie, Galapagos, Celltrion, Pharmacosmos, and Pharmanovia; and research support from Galapagos and Viatris. JS is supported by a Senior Clinical researcher grant from the Research foundation – Flanders., (Copyright © 2024. Published by Elsevier Ltd.)
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- 2024
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26. Intercellular interaction between FAP+ fibroblasts and CD150+ inflammatory monocytes mediates fibrostenosis in Crohn's disease.
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Ke BJ, Abdurahiman S, Biscu F, Zanella G, Dragoni G, Santhosh S, De Simone V, Zouzaf A, van Baarle L, Stakenborg M, Bosáková V, Van Rymenant Y, Verhulst E, Verstockt S, Klein E, Bislenghi G, Wolthuis A, Frič J, Breynaert C, D'Hoore A, Van der Veken P, De Meester I, Lovisa S, Hawinkels LJ, Verstockt B, De Hertogh G, Vermeire S, and Matteoli G
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- Humans, Male, Nuclear Proteins metabolism, Nuclear Proteins genetics, Female, Extracellular Matrix metabolism, Extracellular Matrix pathology, Receptors, Cell Surface metabolism, Receptors, Cell Surface genetics, Ileum pathology, Ileum metabolism, Ileum immunology, Cell Communication, Adult, Endopeptidases metabolism, Endopeptidases genetics, Animals, Mice, Crohn Disease metabolism, Crohn Disease pathology, Crohn Disease immunology, Fibroblasts metabolism, Fibroblasts pathology, Twist-Related Protein 1 metabolism, Twist-Related Protein 1 genetics, Monocytes metabolism, Monocytes pathology, Monocytes immunology, Fibrosis
- Abstract
Crohn's disease (CD) is marked by recurring intestinal inflammation and tissue injury, often resulting in fibrostenosis and bowel obstruction, necessitating surgical intervention with high recurrence rates. To elucidate the mechanisms underlying fibrostenosis in CD, we analyzed the transcriptome of cells isolated from the transmural ileum of patients with CD, including a trio of lesions from each patient: non-affected, inflamed, and stenotic ileum samples, and compared them with samples from patients without CD. Our computational analysis revealed that profibrotic signals from a subset of monocyte-derived cells expressing CD150 induced a disease-specific fibroblast population, resulting in chronic inflammation and tissue fibrosis. The transcription factor TWIST1 was identified as a key modulator of fibroblast activation and extracellular matrix (ECM) deposition. Genetic and pharmacological inhibition of TWIST1 prevents fibroblast activation, reducing ECM production and collagen deposition. Our findings suggest that the myeloid-stromal axis may offer a promising therapeutic target to prevent fibrostenosis in CD.
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- 2024
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27. Fibrostricturing Crohn's Disease Is Marked by an Increase in Active Eosinophils in the Deeper Layers.
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Jacobs I, Ke BJ, Ceulemans M, Cremer J, D'Hoore A, Bislenghi G, Matteoli G, De Hertogh G, Sabino J, Ferrante M, Vermeire S, Breynaert C, Vanuytsel T, and Verstockt B
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- Humans, Male, Female, Adult, Middle Aged, Fibroblasts pathology, Fibroblasts metabolism, Case-Control Studies, Young Adult, Constriction, Pathologic pathology, Flow Cytometry, Dendritic Cells immunology, Dendritic Cells pathology, Dendritic Cells metabolism, Immunohistochemistry, Crohn Disease pathology, Crohn Disease immunology, Crohn Disease metabolism, Eosinophils pathology, Eosinophils immunology, Ileum pathology, Ileum immunology, Fibrosis, Collagen metabolism, Collagen analysis
- Abstract
Introduction: Approximately 50% of patients with Crohn's disease (CD) develop intestinal strictures necessitating surgery. The immune cell distribution in these strictures remains uncharacterized. We aimed to identify the immune cells in intestinal strictures of patients with CD., Methods: During ileocolonic resections, transmural sections of terminal ileum were sampled from 25 patients with CD and 10 non-inflammatory bowel disease controls. Macroscopically unaffected, fibrostenotic, and inflamed ileum was collected and analyzed for immune cell distribution (flow cytometry) and protein expression. Collagen deposition was assessed through a Masson Trichrome staining. Eosinophil and fibroblast colocalization was assessed through immunohistochemistry., Results: The Masson Trichrome staining confirmed augmented collagen deposition in both the fibrotic and the inflamed regions, though with a significant increased collagen deposition in the fibrotic compared with inflamed tissue. Distinct Th1, Th2, regulatory T cells, dendritic cells, and monocytes were identified in fibrotic and inflamed CD ileum compared with unaffected ileum of patients with CD as non-inflammatory bowel disease controls. Only minor differences were observed between fibrotic and inflamed tissue, with more active eosinophils in fibrotic deeper layers and increased eosinophil cationic protein expression in inflamed deeper layers. Last, no differences in eosinophil and fibroblast colocalization were observed between the different regions., Discussion: This study characterized immune cell distribution and protein expression in fibrotic and inflamed ileal tissue of patients with CD. Immunologic, proteomic, and histological data suggest inflammation and fibrosis are intertwined, with a large overlap between both tissue types. However strikingly, we did identify an increased presence of active eosinophils only in the fibrotic deeper layers, suggesting their potential role in fibrosis development., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology.)
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- 2024
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28. Short-term outcomes of surgical treatment for primary ileocaecal Crohn's disease: Results of the Crohn's(urg) study, a multicentre, retrospective, comparative analysis between inflammatory and complicated phenotypes.
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Avellaneda N, Pellino G, Maroli A, Tottrup A, Bislenghi G, Colpaert J, D'Hoore A, Carvello M, Giorgi L, Juachon P, Harsløf S, de Buck Van Overstraeten A, Olivera PA, Gomez J, Holubar SD, Naranjo EL, Steele SR, Merchea A, Shaker A, Gallostra MM, Kraft M, Kotze PG, Maruyama BY, Wexner SD, Garoufalia Z, Chen Z, Hahnloser D, Rrupa D, Buskens C, Haanappel A, Warusavitarne J, Williams KJ, Christensen P, Wolthuis A, Potolicchio A, and Spinelli A
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- Humans, Female, Retrospective Studies, Male, Adult, Treatment Outcome, Middle Aged, Young Adult, Cecum surgery, Laparoscopy methods, Laparoscopy statistics & numerical data, Laparoscopy adverse effects, Operative Time, Length of Stay statistics & numerical data, Time Factors, Crohn Disease surgery, Crohn Disease complications, Phenotype, Postoperative Complications etiology, Postoperative Complications epidemiology, Ileum surgery
- Abstract
Aim: Recent evidence challenges the current standard of offering surgery to patients with ileocaecal Crohn's disease (CD) only when they present complications of the disease. The aim of this study was to compare short-term results of patients who underwent primary ileocaecal resection for either inflammatory (luminal disease, earlier in the disease course) or complicated phenotypes, hypothesizing that the latter would be associated with worse postoperative outcomes., Method: A retrospective, multicentre comparative analysis was performed including patients operated on for primary ileocaecal CD at 12 referral centres. Patients were divided into two groups according to indication of surgery for inflammatory (ICD) or complicated (CCD) phenotype. Short-term results were compared., Results: A total of 2013 patients were included, with 291 (14.5%) in the ICD group. No differences were found between the groups in time from diagnosis to surgery. CCD patients had higher rates of low body mass index, anaemia (40.9% vs. 27%, p < 0.001) and low albumin (11.3% vs. 2.6%, p < 0.001). CCD patients had longer operations, lower rates of laparoscopic approach (84.3% vs. 93.1%, p = 0.001) and higher conversion rates (9.3% vs. 1.9%, p < 0.001). CCD patients had a longer hospital stay and higher postoperative complication rates (26.1% vs. 21.3%, p = 0.083). Anastomotic leakage and reoperations were also more frequent in this group. More patients in the CCD group required an extended bowel resection (14.1% vs. 8.3%, p: 0.017). In multivariate analysis, CCD was associated with prolonged surgery (OR 3.44, p = 0.001) and the requirement for multiple intraoperative procedures (OR 8.39, p = 0.030)., Conclusion: Indication for surgery in patients who present with an inflammatory phenotype of CD was associated with better outcomes compared with patients operated on for complications of the disease. There was no difference between groups in time from diagnosis to surgery., (© 2024 The Author(s). Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)
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- 2024
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29. Belgian consensus guideline on the management of anal fissures.
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Roelandt, P., Bislenghi, G., Coremans, G., De Looze, D., Denis, M. A., De Schepper, H., Dewint, P., Geldof, J., Gijsen, I., Komen, N., Ruymbeke, H., Stijns, J., Surmont, M., Van de Putte, D., Van den Broeck, S., Van Geluwe, B., and Wyndaele, J.
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- 2024
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30. The effect of anterior quadratus lumborum block on morphine consumption in minimally invasive colorectal surgery: a multicentre, double‐blind, prospective randomised placebo‐controlled trial.
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Coppens, S., Somville, A., Hoogma, D. F., Dewinter, G., Neyrinck, A., Desmet, M., Vandebroek, A., D'Hoore, A., Wolthuis, A., Bislenghi, G., Fieuws, S., and Rex, S.
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MINIMALLY invasive procedures ,RIGHT hemicolectomy ,ANALGESIA ,POSTOPERATIVE nausea & vomiting ,PATIENT satisfaction ,MORPHINE ,LAPAROSCOPIC surgery - Abstract
Summary: We investigated the efficacy and safety of a bilateral anterior quadratus lumborum block in patients undergoing minimally invasive colorectal surgery. This was a two‐centre, double‐blind, prospective, randomised, placebo‐controlled trial including 150 patients undergoing laparoscopic colorectal surgery (left‐ or right hemicolectomy, sigmoidectomy) who were enrolled in the institutional abdominal enhanced recovery programme. Before induction of anaesthesia, patients received a bilateral anterior quadratus lumborum block in the left and right lateral decubitus position under ultrasound guidance and were allocated randomly to receive 30 ml of ropivacaine 0.375% (n = 75) or placebo (saline 0.9%) (n = 75) bilaterally. Postoperatively, all patients received multimodal intravenous analgesia including paracetamol, ketorolac and patient‐controlled analgesia with morphine. The primary outcome was morphine consumption during the first 24 h after tracheal extubation. Secondary outcomes included severity of pain; presence and extent of sensory block; incidence of postoperative nausea and vomiting; and hospital duration of stay. We also investigated the need for, and dose of, rescue analgesia. Safety outcomes included the incidence of adverse events. Mean (SD) 24‐hour morphine consumption was no different between patients allocated to ropivacaine and placebo (28.6 (22.3) mg vs. 28.4 (22.5) mg, p = 0.966, respectively). While a sensory block could be detected in significantly more patients allocated to the ropivacaine group, no differences were detected in pain scores or other secondary or safety endpoints. Patient satisfaction scores were high in both groups. In laparoscopic colorectal surgery, adding a bilateral anterior quadratus lumborum block to a standard multimodal analgesia regimen did not reduce opioid consumption or improve pain scores. [ABSTRACT FROM AUTHOR]
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- 2024
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31. Robotic Frykman−Goldberg procedure with natural orifice specimen extraction: A video vignette
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Bislenghi, G., primary, Luberto, A., additional, Wolthuis, A., additional, and D'Hoore, A., additional
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- 2023
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32. Perianal Fistulizing Crohn's Disease-Associated Anorectal and Fistula Cancers: Systematic Review and Expert Consensus.
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Wong SY, Rowan C, Brockmans ED, Law CCY, Giselbrecht E, Ang C, Khaitov S, Sachar D, Polydorides AD, Winata LS, Verstockt B, Spinelli A, Rubin DT, Deepak P, McGovern DPB, McDonald BD, Lung P, Lundby L, Lightner AL, Holubar SD, Hanna L, Hamarth C, Geldof J, Dige A, Cohen BL, Carvello M, Bonifacio C, Bislenghi G, Behrenbruch C, Ballard DH, Altinmakas E, Sebastian S, Tozer P, Hart A, and Colombel JF
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Background & Aims: Perianal fistulizing Crohn's disease (PFCD)-associated anorectal and fistula cancers are rare but often devastating diagnoses. However, given the low incidence and consequent lack of data and clinical trials in the field, there is little to no guidance on screening and management of these cancers. To inform clinical practice, we developed consensus guidelines on PFCD-associated anorectal and fistula cancers by multidisciplinary experts from the international TOpClass consortium., Methods: We conducted a systematic review by standard methodology, using the Newcastle-Ottawa Scale quality assessment tool. We subsequently developed consensus statements using a Delphi consensus approach., Results: Of 561 articles identified, 110 were eligible, and 76 articles were included. The overall quality of evidence was low. The TOpClass consortium reached consensus on 6 structured statements addressing screening, risk assessment, and management of PFCD-associated anorectal and fistula cancers. Patients with long-standing (>10 years) PFCD should be considered at small but increased risk of developing perianal cancer, including squamous cell carcinoma of the anus and anorectal carcinoma. Risk factors for squamous cell carcinoma of the anus, notably human papilloma virus, should be considered. New, refractory, or progressive perianal symptoms should prompt evaluation for fistula cancer. There was no consensus on timing or frequency of screening in patients with asymptomatic perianal fistula. Multiple modalities may be required for diagnosis, including an examination under anesthesia with biopsy. Multidisciplinary team efforts were deemed central to the management of fistula cancers., Conclusions: Inflammatory bowel disease clinicians should be aware of the risk of PFCD-associated anorectal and fistula cancers in all patients with PFCD. The TOpClass consortium consensus statements outlined herein offer guidance in managing this challenging scenario., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)
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- 2024
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33. Protocol of the LATFIA trial (Laser Assisted Treatment of Fistula in Ano): a multicentre, prospective, randomized controlled trial comparing fistula-tract laser closure (FiLaC™) with rectal advancement flap for high trans-sphincteric fistulas.
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Gaillard M, Van den Broeck S, Op de Beeck B, Wouters K, Stijns J, Van de Putte D, Gys B, Houben B, Van Dessel E, Bislenghi G, and Komen N
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- Adult, Female, Humans, Male, Middle Aged, Equivalence Trials as Topic, Fecal Incontinence etiology, Fecal Incontinence surgery, Prospective Studies, Rectum surgery, Recurrence, Treatment Outcome, Wound Healing, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Anal Canal surgery, Laser Therapy methods, Quality of Life, Rectal Fistula surgery, Surgical Flaps
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Aim: Anal fistula is one of the most common anal diseases, affecting between 1 and 3 per 10 000 people per year. Symptoms have a potentially severe effect on a patient's quality of life. Surgery is the mainstay of treatment, aiming to cure the fistula and preserve anal sphincter function. Rectal advancement flap (RAF) is currently the gold standard treatment but has recurrence rates varying between 20% and 50% and might lead to disturbance of continence. The aim of the trial described in this work is to discover if the minimally invasive fistula tract laser closure (FiLaC™) technique could achieve higher healing rates and a better functional outcome than RAF., Method: We will perform a randomized prospective multicentre noninferiority study of the treatment of high trans-sphincteric perianal fistulas, comparing FiLaC™ with RAF in terms of fistula healing, recurrence rate, functional outcome and quality of life. Primary and secondary fistula healing will be evaluated at 26 and 52 weeks' follow-up. Quality of life will be evaluated using the SF-36 questionnaire, the Faecal Incontinence Quality of Life Scale questionnaire and the Vaizey score at 3, 6, 12 and 26 weeks postoperatively., Conclusion: High trans-sphincteric fistulas have a potentially severe effect on a patient's quality of life. Classical treatment with RAF is a time-consuming invasive procedure. The LATFIA trial aims to compare FiLaC™ with the gold standard treatment with RAF. In case of noninferiority, FiLaC™ treatment could be standardized as a first line treatment for high trans-sphincteric fistulas. Better conservation of the patient's anal sphincter function could possibly be obtained. Likewise, we will report on the postoperative quality of life when applying these two techniques., (© 2024 Association of Coloproctology of Great Britain and Ireland.)
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- 2024
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34. Effect of anastomotic configuration on Crohn's disease recurrence after primary ileocolic resection: a comparative monocentric study of end-to-end versus side-to-side anastomosis.
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Bislenghi G, Vancoillie PJ, Fieuws S, Verstockt B, Sabino J, Wolthuis A, and D'Hoore A
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- Humans, Colon surgery, Retrospective Studies, Ileum surgery, Anastomosis, Surgical adverse effects, Anastomosis, Surgical methods, Postoperative Complications epidemiology, Colonoscopy, Recurrence, Crohn Disease surgery
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There is ongoing debate whether the type of anastomosis following intestinal resection for Crohn's disease (CD) can impact on complications and postoperative recurrence. The aim of the present study is to describe the outcomes of side-to-side (S-S) vs end-to-end (E-E) anastomosis after ileocecal resection for CD. A retrospective comparative study was conducted in consecutive CD patients who underwent primary ileocecal resection between 2005 and 2013. All patients underwent colonoscopy 6 months postoperatively to assess endoscopic recurrence, defined as Rutgeerts' score (RS) ≥ i2. Surgical recurrence implied reoperation due to CD activity at the anastomotic site. Modified surgical recurrence was defined as the need for reoperation or balloon-dilation. Perioperative factors related to recurrence were evaluated. Of the 127 patients included, 51 (40.2%) received an E-E anastomosis. Median follow-up was longer in the E-E group (8.62 vs 13.68 years). Apart from the microscopic resection margins, patient, disease and surgical characteristics were similar between both groups. Anastomotic complications were comparable (S-S 5.3% vs E-E 5.8%, p = 1.00)0. Postoperatively, biologicals were used in 55.3% and 62.7% (p = 0.47) in S-S and E-E patients, respectively. Endoscopic recurrence did not differ between S-S and E-E patients (78.9 vs 72.9%, p = 0.37), with no significant difference in RS values between both groups (p = 0.87). Throughout follow-up, a higher surgical (p = 0.04) and modified surgical recurrence (p = 0.002) rate was observed in the E-E anastomosis group. Type of anastomosis was an independent risk factor for modified surgical recurrence. The type of anastomosis did not influence endoscopic recurrence and immediate postoperative disease complications. However, the wide diameter and the morphologic characteristic of the stapled S-S anastomosis resulted in a significant reduced risk for surgical and endoscopic reintervention on the long term., (© 2023. Italian Society of Surgery (SIC).)
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- 2023
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35. P160 Influence of sarcopenia on perioperative management and postoperative outcome in patients with Crohn’s Disease undergoing intestinal surgery: a retrospective study
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O'Neill, C, primary, Haenen, S, additional, Coudyzer, W, additional, Bislenghi, G, additional, D'Hoore, A, additional, Verstockt, B, additional, Ferrante, M, additional, Vermeire, S, additional, and Sabino, J, additional
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- 2023
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36. P561 Risk of stoma formation in patients with Crohn’s perianal fistulas over a two decades period. A cohort study from a tertiary referral center
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Bislenghi, G, primary, Baldi, C, additional, Ferrante, M, additional, Sabino, J, additional, Verstockt, B, additional, Wolthuis, A, additional, Vermeire, S, additional, and D'Hoore, A, additional
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- 2023
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37. P454 No increased postoperative risk of venous thromboembolism nor infectious complications after JAK inhibitor exposure in patients with ulcerative colitis undergoing colectomy
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De Greef, I, primary, Bislenghi, G, additional, Terrasson, I, additional, Sabino, J, additional, Ferrante, M, additional, D'Hoore, A, additional, Vermeire, S, additional, and Verstockt, B, additional
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- 2023
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38. P666 Effect of anastomotic configuration on Crohn’s Disease recurrence after primary ileocolic resection. A comparative monocentric study of end-to-end versus side-to-side anastomosis
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Bislenghi, G, primary, Vancoillie, P J, additional, Fieuws, S, additional, Verstockt, B, additional, Sabino, J, additional, Wolthuis, A, additional, and D'Hoore, A, additional
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- 2023
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39. P008 Fibrostricturing Crohn’s disease is characterised by an imbalance in active eosinophils, Th1, Th2 and regulatory T cells
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Jacobs, I, primary, Ke, B J, additional, Cremer, J, additional, D'Hoore, A, additional, Bislenghi, G, additional, Matteoli, G, additional, De Hertogh, G, additional, Sabino, J, additional, Ferrante, M, additional, Vermeire, S, additional, Breynaert, C, additional, Vanuytsel, T, additional, and Verstockt, B, additional
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- 2023
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40. Non-conventional Versus Conventional Strictureplasties for Crohn’s Disease. A Systematic Review and Meta-analysis of Treatment Outcomes
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Bislenghi, G., Sucameli, F., FIEUWS, Steffen, Ferrante, M., Sabino, J., Wolthuis, A., Vermeire, S., D'Hoore, A., Vermeire, Severine/0000-0001-9942-3019, Bislenghi, G., Sucameli, F., FIEUWS, Steffen, Ferrante, M., Sabino, J., Wolthuis, A., Vermeire, S., and D'Hoore, A.
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meta-analysis ,surgery ,Crohn's disease ,recurrence ,side-to-side isoperistaltic strictureplasties ,morbidity ,strictureplasties - Abstract
Background Strictureplasties [SXP] represent an alternative to bowel resection in Crohn's disease [CD]. Over the years, there has been growing interest in the role of non-conventional SXP for the treatment of extensive CD. A systematic review was performed on complications and recurrence following conventional and non-conventional SXP. Methods The available literature was screened according to the PRISMA statement, until June 2020. Results were categorised into three groups: studies reporting on conventional SXPs; studies with a mixed cohort of conventional and non-conventional SXPs [% non-conventional SXPs
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- 2022
41. BJS commission on surgery and perioperative care post-COVID-19
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Abahuje, E, Abbas, A, Abd El Aziz Abd El Maksoud, M, Abdelhady, A, Abdelhamid, S, Abdelkarem Ahmed Faraj, H, Abdelqader, B, Abdelrahman, T, Abdou, H, Abdullah, A, Abedua Harrison, M, Abem Owusu, E, Aboalazayem, A, Aboulhosn, R, Abu Oda, S, Abubakar, A, Abutaka, A, Acevedo Fontalvo, D, Acuna, S, Adefemi, A, Adegbola, S, Adenuga, T, Adeyeye, A, Adil Hilmi, A, Adisa, A, Aditya, K, Adjeso, T, Aftab, R, Afzal, A, Aggarwal, V, Aggarwal, A, Aguilera, R, Aguilera-Arevalo, M, Aguirre Salamanca, E, Aguirre-Allende, I, Ahari, D, Ahmad, H, Ahmad Rauf, F, Ahmad Zartasht Khan, A, Ahmed, S, Ahmed Fieturi, N, Ahmed Mohamed, S, Ahmed-Bakhsh, Z, Ahsan Javed, M, Akano, L, Akbar, A, Akhbari, M, Akhmedov, P, Aksit, G, Akula, Y, Alagaratnam, A, Al Majid, S, Al Mukhtar, O, Al Omran, H, Alasali, N, Al-Azzawi, M, Al-Habsi, R, Al-Iraqi, H, Al-Naggar, H, Alameer, E, Albirnawi, H, Alderson, D, Aldulaijan, F, Alejandro Miranda Ojeda, R, Alhasan, A, Ali, S, Ali, A, Ali Khan, M, Alimova, Y, Aljanadi, F, Aljubure, R, Allopi, N, Almedbal, H, Almubarak, M, Alqaidoom, Z, Alselaim, N, Alshaar, M, Alshammari, R, Altaf, K, Altiner, S, Altunpak, B, Alvarez Lozada, L, Amal Nahal, E, Amer, A, Amin, K, Aminu, U, Amisi Numbi, N, Amjad, T, Amoah, R, An, Y, Anastasopoulos, N, Andres Urrutia, J, Angarita, F, Angarita, K, Angel Freiria Eiras, M, Antypas, A, Anwar, M, Anwar, H, Apampa, T, Apostolou, K, Aquina, C, Arachchige Adithi Himika Randeni, R, Archila Godinez, M, Arez, O, Arezzo, A, Armonis, P, Arshad, S, Arshad Salman, M, Arshid, A, Arteaga Asensio, P, Arthur, T, Arumuga Jothi, A, Aryo Damara, F, Asensio Gomez, L, Ashcroft, J, Ashraf, S, Asif, A, Atif, M, Attaullah Khan, M, Avellaneda, N, Awad, S, Awadh, M, Axiaq, A, Ayad Mohammed Shuwayyah, A, Ayalew, D, Aytac, E, Azam, F, Azevedo, J, Azhar, B, Aziz, J, Aziz, A, Azzam, A, Baba Ndajiwo, A, Baig, M, Baker, D, Bakko, F, Balachandran, R, Balachandran, G, Balagizi Mudekereza, J, Balai, E, Balci, B, Balduzzi, A, Balhareth, A, Bandyopadhyay, S, Banerjee, D, Bangalore Mahalinga, D, Bankhead-Kendall, B, Bankole, N, Banwell, V, Baris Bengur, F, Baris Ozmen, B, Barnard, M, Barnett, R, Barreras Espinoza, J, Barrios, A, Bass, G, Bass, M, Bausys, A, Bavikatte, A, Bayram, J, Belousov, M, Berardi, A, Beamish, A, Beattie, C, Belia, F, Bellato, V, Bellikatti, S, Benjamens, S, Benlice, C, Bennedsgaard, S, Bennett, S, Bentounsi, Z, Bergenfeldt, H, Bergenfelz, A, Besselink, M, Bhandoria, G, Bhangu, E, Bhatia, M, Bhatti, M, Bilgili, Z, Bislenghi, G, Bisset, C, Biswas, S, Blake, J, Blanco, R, Boccalatte, L, Boden, R, Bojanic, C, Boland, M, Boland, P, Bollen, E, Bonci, E, Boni, L, Booth, A, Booth, R, Borakati, A, Borunda Escudero, G, Bosco, S, Bostrom, P, Botelho De Alencar Ferreira Cruz, P, Bouchagier, K, Bouhuwaish, A, Boutros, M, Boyce, K, Boyle, C, Bradshaw, L, Brandl, A, Brar, A, Brat, G, Brenkman, H, Brennan, C, Brines, C, Brookmyre, A, Brosnan, C, Brouwers, L, Brown, A, Brown, L, Brown, C, Brown, J, Bs, V, Buksh, M, Bunani Emmanuel, M, Burbano, D, Burelli, A, Burke, A, Burke, J, Burlov, N, Burns, A, Burton, O, Butt, A, Buzra Ozkan, B, Cabrera Silva, L, Caicedo, E, Calderbank, T, Cambridge, W, Campelo, G, Can Tatar, O, Carbone, F, Carrano, F, Casallas, D, Casanova Portoles, D, Casciani, F, Cassimjee, I, Castaneda Ramirez, O, Catalan, V, Caviedes, J, Cayetano, L, Ceresoli, M, Chan, M, Chan, V, Chandrasinghe, P, Chapman, S, Chaturvedi, A, Chaudhry, D, Chaudry, H, Chen, H, Cheng, A, Chernykh, M, Cherrie, A, Cheruiyot, I, Cheung, J, Chia, C, Chica, J, Chinai, N, Chirwa, A, Chiwaligo, J, Choi, A, Choi, J, Chowdhury, M, Christopher, E, Christou, N, Chu, T, Chua, D, Chua, H, Chung, C, Cihat Yildirim, A, Cillo, M, Cioffi, S, Claireaux, H, Clermonts, S, Clifford, R, Climent, M, Clynch, A, Coelen, R, Colas-Ruiz, E, Collar, A, Collard, M, Conlon, K, Connelly, T, Connor, K, Cook, J, Correia De Sa, T, Cosgun Acar, N, Costa, T, Couch, D, Cowper, S, Creavin, B, Crook, B, Curell, A, D'Alessio, R, Dale, J, Damgaard Eriksen, J, Dario Martin Gonzalez, I, Darwish, A, Das, M, Das, R, Das, K, Dave, R, David, S, Davies, T, Davis, C, Davison, S, Davletshina, V, Dawidziuk, A, Dawson, A, De Andres Crespo, M, De Berker, H, De Dieu Ngo, P, Dekker, E, De La Caridad Espinosa Luis, R, De Lacy, B, Demartines, N, De Montserrat Medina Sifuentes, A, De Silva, S, Del Rio, C, Delaune, V, Dell, A, Demirbas, I, Demirli Atici, S, Deniz Tepe, M, Derebey, M, Desai, G, Desai, M, Devarakonda, S, Deveras, N, Di Franco, G, Di Martino, M, Di Marzo, F, Diaz, A, Diaz Del Gobbo, G, Diazcastrillon, C, Dick, L, Dickinson, K, Diego, E, Dimasi, I, Ding, A, Dingemans, S, Dixon, L, Dixon, B, Doherty, W, Dooreemeah, D, Donohue, C, Dornseifer, M, Dossa, F, Dossou, W, Drake, T, Drami, I, Drevin, G, Du Plessis, M, Dudi-Venkata, N, Dudley, R, Duffy, S, Duklas, D, Dumbrava, B, Duygu Avlar, F, Dworzynska, A, Ebrahim, W, Ebrahim, A, Efren Lozada Hernandez, E, Ehigie, N, El Boghdady, M, El Hasnaoui, C, El Sheikh, M, El-Hussuna, A, Eldurssi, O, Elfeki, H, Elhadi, M, Elhassan, M, Elhissi, A, Elliot, B, Elsenbroek, C, Elsolh, B, Elson, N, Eltyeb, H, Emerson, H, Emile, S, Endalle, G, English, W, Ercisli, C, Espinosa, G, Essam Abdelraheem, M, Essangri, H, Etienne, P, Evans, M, Evans, T, Ezeme, C, Ezzahraa, F, Fadalla, T, Fagan, J, Fahmy, M, Fairfield, C, Falade, O, Famularo, S, Faqar-Uz-Zaman, F, Farid, Y, Farooq, A, Farooq, H, Farooqui, F, Farquharson, B, Faruqi, A, Faulder, R, Faut, M, Fechner, K, Feenstra, T, Fehervari, M, Fernandez, L, Fernandez Alberti, J, Ferrario, L, Field, D, Fiore, L, Fingerhut, S, Finlayson, S, Fleming, N, Fleming, C, Florial, E, Fok, M, Fokin, D, Foley, M, Forero, M, Forgan, T, Fornasiero, M, Fowler, H, Fowler, G, Franchi, E, Franklin, L, Fredriksson, A, Fruhling, P, Fuentes Navarrette, G, Fulop, A, Furtado, M, Gaarder, T, Galbraith, N, Gallagher, I, Gallo, G, Gana, T, Gaskin, E, Gasparini, M, Gatan, R, Geary, E, Gelaye Wudineh, K, Gemenetzis, G, Georgi, M, Ghalige, H, Ghareeb, W, Ghatwary Tantawy, T, Ghomsi, C, Ghuman, A, Giannakis, P, Giron, F, Gjengedal, K, Gkotsis, E, Glasbey, J, Godahewa, S, Godula, D, Goffredo, P, Goh, S, Golriz, M, Gomez, L, Gomez Gomez, D, Gonzalez, R, Gonzalez, D, Gonzalez Gutierrez, E, Gopar, D, Gordini, L, Gori, A, Gortazar, S, Gousy, N, Gowda, R, Gowda, M, Gqada, J, Grechenig, M, Greer, J, Gregorio, L, Grigorova, A, Grimes, H, Groot, V, Grossman, R, Gruber, R, Gruter, A, Guest, R, Gujjuri, R, Gulcek, E, Gulcu, B, Gull, K, Gulmez, M, Gupta, V, Gutlic, A, Guven, T, Gwatirisa, T, Gwini, G, Gwodog, P, Gysling, S, Habib, M, Hafeez Bhatti, A, Hallesmith, J, Halloran, S, Hamza Sadiq, M, Haney, C, Hanna, N, Hanna, L, Hannington, M, Harbjerg, J, Haribaskaran, D, Harran, N, Harrington, B, Harrison, E, Hasan, R, Hashmi, S, Hassan, M, Hassan, A, Haverkamp, L, Hazen, S, Heer, B, Heil, J, Helliwell, J, Henriksen, N, Henshall, D, Hermanson, M, Hermena, S, Hettiarachchi, D, Hextall, C, Hidalgo, M, Hidayat, H, Hider, A, Higgins, P, Hinchliffe, R, Hirani, D, Hirpara, D, Hisham, I, Hite, M, Hoh, S, Holmberg, C, Holmich, E, Holst, F, Hossam, A, Hossam Elfallal, A, Howard, P, Huaman, E, Huang, Y, Huang, L, Huang, D, Huber, T, Hugh, J, Hughes, J, Huttner, F, Huynh, R, Hylands, A, Iannuzzi, J, Ielpo, B, Iftikhar Talib, A, Ignacio, J, Ignatavicius, P, Ike, S, Ikwu, C, Inama, M, Ing, A, Ingels, A, Isik, A, Islam, N, Ives, I, Al-Hasan, A, Perez Rivera, C, Jacome, F, Jaffer, T, Jagiella-Lodise, O, Jain, M, Jain, K, Jakubauskas, M, Jalal, M, James, H, Jang, Y, Janssen, B, Jansson, H, Jariod-Ferrer, U, Javanmard, H, Javed, S, Jayarajah, U, Jayasuriya, I, Je, J, Jessop, Z, Jia Lin Tang, E, Jiang, H, Jiayan, Y, Jih Huei, T, Jimenez-Rodriguez, R, Joh, D, Johnson, A, Jones, N, Jones, C, Jordan, C, Jose Nunez Ju, J, Jose Pizarro, M, Jose Salazar, C, Joseph, J, Justiniano, C, Kabir, T, Kadhum, M, Kalfountzos, C, Kalogiannaki, E, Kalyanasundaram, K, Kamarajah, S, Kamil Quraishi, M, Kanemitsu, Y, Kapila, A, Kapila, V, Karagiannidis, G, Kashif, M, Kathiravelupillai, S, Kathiravelupillai, A, Katsogridakis, E, Kaur, K, Kaur Sekhon Inderjit Singh, H, Kausur, N, Kawka, M, Keehan, G, Kehlet Watt, S, Kelly, M, Kelvin Egbuchulem, I, Kembuan, G, Khajeh, E, Khaled Elfaitur, A, Khan, M, Khan, S, Khan, D, Khan, H, Khatkar, H, Khatkov, E, Khaw, R, Kim, B, Kishore Siddiraju, K, Kitua, D, Kirimtay, B, Kmezic, S, Knight, S, Koeter, T, Koh, A, Koh Hong Xiang, F, Kojo Anyomih, T, Kok, A, Kokelaar, R, Koliarakis, I, Kolli, S, Kong, J, Konig, D, Koshy, M, Kotze, P, Kourdouli, A, Kowal, M, Kraima, A, Kramer, F, Kryzauskas, M, Kuchynskyi, I, Kuemmerli, C, Kuiper, S, Kumar, S, Kumar, A, Kumar, L, Kumar, H, Kumar, N, Kumar Bandyopadhyay, S, Kumar Garg, P, Kumar Venkatappa, S, Kung, J, Kural, S, Kushairi, A, Kuuzie, E, Kvietkauskas, M, Kwek, I, La, J, Lai, L, Lakpriya, S, Lam, K, Lami, M, Lansdorp-Vogelaar, I, Lapolla, P, Larsen, H, Latif, J, Laudari, U, Laurnezi, A, Lawal, A, Lawday, S, Lederhuber, H, Lednev, A, Lee, R, Van Leerdam, M, Lefevbre, G, Lesmus, M, Leyva Moraga, F, Leyva Moraga, E, Li, H, Li, A, Li, Z, Licardie, E, Light, A, Lightner, A, Lin, A, Lincango, E, Litta, F, Liu, H, Lofthouse, B, Londono, M, Lopes, R, Lopes De Freitas, R, Lopez, L, Lopez, A, Lopez-Gomez, J, Lopez-Pena, G, Lowe, R, Lowe, D, Lowey, M, Loy, G, Lozanovski, V, Luzon, J, Lynn, P, Maccabe, T, Machielsen, A, Mafla Herreria, C, Maggino, L, Mahawar, K, Mahmood, D, Mahmoud, M, Mahtani, K, Maitra, I, Maji, S, Majiet, I, Mal, L, Malherbe, J, Malhotra, K, Malkomes, P, Man, E, Manan Sheikh, A, Manjunath, S, Manzano Nunez, R, Manzoor, S, Maqsood, R, Marchegiani, G, Marchegiani, F, Marin, D, Marin, A, Marks, I, Marson, E, Martensen, A, Martin, D, Martin Martin, G, Martin-Perez, B, Martinez, P, Marwaha, P, Mashauri, C, Mashbari, H, Masior, L, Masri, R, Masud, L, Masudi, S, Mateu Calabuig, G, Math, S, Matrachisia, A, Mayol, J, Mazingi, D, Mazzotta, A, Mcalinden, J, Mccabe, G, Mccolm, L, Mcelvaney, H, Mcgivern, K, Mcgovern, J, Mcguinness, E, Mcinerney, N, Mckay, S, Mckee, C, Mckenna, M, Mckenna, N, Mclean, 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O., Davies T., Davis C., Davison S., Davletshina V., Dawidziuk A., Dawson A., De Andres Crespo M., De Berker H., De Dieu Ngo P., Dekker E., De La Caridad Espinosa Luis R., De Lacy B., Demartines N., De Montserrat Medina Sifuentes A., De Silva S., Del Rio C., Delaune V., Dell A., Demirbas I., Demirli Atici S., Deniz Tepe M., Derebey M., Desai G., Desai M., Devarakonda S., Deveras N., Di Franco G., Di Martino M., Di Marzo F., Diaz A., Diaz Del Gobbo G., DiazCastrillon C., Dick L., Dickinson K., Diego E., Dimasi I., Ding A., Dingemans S., Dixon L., Dixon B., Doherty W., Dooreemeah D., Donohue C., Dornseifer M., Dossa F., Dossou W., Drake T., Drami I., Drevin G., Du Plessis M. C., Dudi-Venkata N., Dudley R., Duffy S., Duklas D., Dumbrava B. -D., Duygu Avlar F., Dworzynska A., Ebrahim W., Ebrahim A., Efren Lozada Hernandez E., Ehigie N., El Boghdady M., El Hasnaoui C., El Sheikh M., El-Hussuna A., Eldurssi O., Elfeki H., Elhadi M., Elhassan M., Elhissi A., Elliot B., Elsenbroek C., Elsolh B., Elson N., Eltyeb H., Emerson H., Emile S. H., Endalle G., English W., Ercisli C., Espinosa G., Essam Abdelraheem M., Essangri H., Etienne P., Evans M. D., Evans T., Ezeme C., Ezzahraa F., Fadalla T., Fagan J., Fahmy M., Fairfield C., Falade O., Famularo S., Faqar-Uz-Zaman F., Farid Y., Farooq A., Farooq H., Farooqui F., Farquharson B., Faruqi A., Faulder R., Faut M., Fechner K., Feenstra T., Fehervari M., Fernandez L., Fernandez Alberti J., Ferrario L., Field D., Fiore L., Fingerhut S., Finlayson S., Fleming N., Fleming C., Florial E., Fok M., Fokin D., Foley M., Forero M. P., Forgan T., Fornasiero M., Fowler H., Fowler G., Franchi E., Franklin L., Fredriksson A., Fruhling P., Fuentes Navarrette G., Fulop A., Furtado M., Gaarder T., Galbraith N., Gallagher I. T. K., Gallo G., Gana T., Gaskin E., Gasparini M., Gatan R. G., Geary E., Gelaye Wudineh K., Gemenetzis G., Georgi M., Ghalige H., Ghareeb W., Ghatwary Tantawy T., Ghomsi C., Ghuman A., Giannakis P., Giron F., Gjengedal K., Gkotsis E., Glasbey J., Godahewa S., Godula D., Goffredo P., Goh S., Golriz M., Gomez L., Gomez Gomez D., Gonzalez R., Gonzalez D., Gonzalez Gutierrez E., Gopar D., Gordini L., Gori A., Gortazar S., Gousy N., Gowda R., Gowda M., Gqada J., Grechenig M., Greer J., Gregorio L., Grigorova A., Grimes H., Groot V., Grossman R. C., Gruber R., Gruter A., Guest R., Gujjuri R., Gulcek E., Gulcu B., Gull K., Gulmez M., Gupta V., Gutlic A., Guven T., Gwatirisa T., Gwini G., Gwodog P., Gysling S., Habib M., Hafeez Bhatti A. B., Hallesmith J., Halloran S., Hamza Sadiq M., Haney C., Hanna N., Hanna L., Hannington M., Harbjerg J., Haribaskaran D., Harran N., Harrington B., Harrison E., Hasan R., Hashmi S., Hassan M., Hassan A., Haverkamp L., Hazen S., Heer B., Heil J., Helliwell J., Henriksen N., Henshall D., Hermanson M., Hermena S., Hettiarachchi D., Hextall C., Hidalgo M., Hidayat H., Hider A., Higgins P., Hinchliffe R., Hirani D., Hirpara D., Hisham I., Hite M., Hoh S. M., Holmberg C., Holmich E., Holst F., Hossam A., Hossam Elfallal A., Howard P., Huaman E., Huang Y., Huang L., Huang D., Huber T., Hugh J., Hughes J., Huttner F., Huynh R., Hylands A., Iannuzzi J., Ielpo B., Iftikhar Talib A., Ignacio J., Ignatavicius P., Ike S., Ikwu C., Inama M., Ing A., Ingels A., Isik A., Islam N., Ives I. J., Al-Hasan A. J. M. S., Perez Rivera C. J., Jacome F., Jaffer T., Jagiella-Lodise O., Jain M., Jain K., Jakubauskas M., Jalal M., James H., Jang Y., Janssen B., Jansson H., Jariod-Ferrer U., Javanmard H., Javed S., Jayarajah U., Jayasuriya I., Je J., Jessop Z., Jia Lin Tang E., Jiang H., Jiayan Y., Jih Huei T., Jimenez-Rodriguez R., Joh D., Johnson A., Jones N., Jones C., Jordan C., Jose Nunez Ju J., Jose Pizarro M., Jose Salazar C., Joseph J., Justiniano C., Kabir T., Kadhum M., Kalfountzos C., Kalogiannaki E., Kalyanasundaram K., Kamarajah S., Kamil Quraishi M., Kanemitsu Y., Kapila A., Kapila V., Karagiannidis G., Kashif M., Kathiravelupillai S., Kathiravelupillai A., Katsogridakis E., Kaur K., Kaur Sekhon Inderjit Singh H., Kausur N., Kawka M., Keehan G., Kehlet Watt S., Kelly M., Kelly M. E., Kelvin Egbuchulem I., Kembuan G., Khajeh E., Khaled Elfaitur A., Khan M. F., Khan S., Khan M., Khan D., Khan H., Khatkar H., Khatkov E., Khaw R., Kim B., Kishore Siddiraju K., Kitua D., Kirimtay B., Kmezic S., Knight S., Koeter T., Koh A., Koh Hong Xiang F., Kojo Anyomih T., Kok A. I. N., Kokelaar R., Koliarakis I., Kolli S., Kong J., Konig D., Koshy M., Kotze P., Kourdouli A., Kowal M., Kraima A., Kramer F., Kryzauskas M., Kuchynskyi I., Kuemmerli C., Kuiper S., Kumar S., Kumar A., Kumar L., Kumar H., Kumar N., Kumar Bandyopadhyay S., Kumar Garg P., Kumar Venkatappa S., Kung J., Kural S., Kushairi A., Kuuzie E., Kvietkauskas M., Kwek I., La J., Lai L., Lakpriya S., Lam K., Lami M., Lansdorp-Vogelaar I., Lapolla P., Larsen H., Latif J., Laudari U., Laurnezi A., Lawal A., Lawday S., Lederhuber H., Lednev A., Lee R., Van Leerdam M. E., Lefevbre G., Lesmus M., Leyva Moraga F. A., Leyva Moraga E., Leyva Moraga F., Li H. L., Li A., Li Z., Licardie E., Light A., Lightner A. L., Lin A., Lincango E., Litta F., Liu H., Lofthouse B., Londono M. A., Lopes R., Lopes De Freitas R., Lopez L., Lopez A. I., Lopez-Gomez J., Lopez-Pena G., Lowe R., Lowe D., Lowey M., Loy G., Lozanovski V., Luzon J., Lynn P., MacCabe T., MacHielsen A., Mafla Herreria C. A., Maggino L., Mahawar K., Mahmood D., Mahmoud M., Mahtani K., Maitra I., Maji S., Majiet I., Mal L., Malherbe J., Malhotra K., Malkomes P., Man E., Manan Sheikh A., Manjunath S., Manzano Nunez R., Manzoor S., Maqsood R., Marchegiani G., Marchegiani F., Marin D., Marin A., Marks I., Marson E., Martensen A., Martin D., Martin Martin G., Martin-Perez B., Martinez P., Marwaha P., Mashauri C., Mashbari H., Masior L., Masri R., Masud L., Masudi S., Mateu Calabuig G., Math S., Matrachisia A., Mayol J., Mazingi D., Mazzotta A., McAlinden J., McCabe G., McColm L., McElvaney H., McGivern K., McGovern J., McGuinness E., McInerney N., McKay S., McKee C., McKenna M., McKenna N., McLean K., Mediratta S., Medkova Y., Medzhidov O., Mehraj A., Mekhael M., Mekinde O., Mellenthin C., Melucci A., Mentor K., Merchant J., Messias H., Messeha M., Meza C., Mhango P., Miladinov M., Milagros Niquen Jimenez M., Miller P., Mills E., Milton A., Minayeva O. A., MinHua Zheng Z., Mischlinger H., Mockli B., Modi R., Mohamed H. M., Mohamed M., Mohamed Abulghasm T., Mohammad S. A., Mohammed T. O., Mohammed A., Mohan H., Mohan M., Moin I., Mok V., Molina G., Moloney J., Moneim J., Monfort Mira M., Montcusi Ventura B., Montouri M., Moossdorff M., Mora-Guzman I., Moran B., Moran R. A. R., Moreno-Ordaz S., Morera A., Morgan R., Morley R., Moro-Valdezate D., Moros S., Moss J. -L., Morven A., Morton D., Moynihan A., Moyon M., Muduli N., Mugla N., Mugla W., Muller P., Mun G., Mundhada R., Munir I., Munoz F., Munoz E., Munoz A., Munoz Balderas D. C., Murgitroyd E., Murray V., Murthy S., Mushiwokufa W., Mustafa H., Mustakimov B., Mutambanengwe P., Myint P., Nadkarni S., Naess P. A., Nahar S., Naidoo P., Nam R., Nandhra S., Nanjappa N., Narasimhan V., Nardi W., Nasir M., Naughton A., Naumann D., Navarro S., Nawaaz Karimbocus M., Nazir A., Ndereya S., Ndong A., Negoi I., Nel D., Nelson D., Nepal S., Nugent T., Nepogodiev D., Neufeld J., Ng J., Ng D., Ng C. E., Ngaserin S., Ngu L., Ngwenya E., Fhearaigh R. N., Nikolousakis T. -K., Ninkovic M., Nita G., Nitschke C., Noren E., Noton T., Novikova A., Nowinka Z., Nyakunengwa T., Nyalundja A., Nzenwa I., Kristensen H. O., O'Brien C., O'Brien L., O'Brien S., O'Reilly J., O'Rourke S., O'Sullivan M., O'Dwyer M., Ochieng L., Oderoha E., Oh K. E., Ohlberger L., Olcum M., Olkina A., Omkumar M., Omnitel B., Oncel Yakar D., Ong K., Ong Wei Lin L., Ooi R., Ooi S., Oomman A., Oon Tyjet D., Opiyo S., Oscullo Yepez J. 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P., Forgan T., Fornasiero M., Fowler H., Fowler G., Franchi E., Franklin L., Fredriksson A., Fruhling P., Fuentes Navarrette G., Fulop A., Furtado M., Gaarder T., Galbraith N., Gallagher I. T. K., Gallo G., Gana T., Gaskin E., Gasparini M., Gatan R. G., Geary E., Gelaye Wudineh K., Gemenetzis G., Georgi M., Ghalige H., Ghareeb W., Ghatwary Tantawy T., Ghomsi C., Ghuman A., Giannakis P., Giron F., Gjengedal K., Gkotsis E., Glasbey J., Godahewa S., Godula D., Goffredo P., Goh S., Golriz M., Gomez L., Gomez Gomez D., Gonzalez R., Gonzalez D., Gonzalez Gutierrez E., Gopar D., Gordini L., Gori A., Gortazar S., Gousy N., Gowda R., Gowda M., Gqada J., Grechenig M., Greer J., Gregorio L., Grigorova A., Grimes H., Groot V., Grossman R. C., Gruber R., Gruter A., Guest R., Gujjuri R., Gulcek E., Gulcu B., Gull K., Gulmez M., Gupta V., Gutlic A., Guven T., Gwatirisa T., Gwini G., Gwodog P., Gysling S., Habib M., Hafeez Bhatti A. B., Hallesmith J., Halloran S., Hamza Sadiq M., Haney C., Hanna N., Hanna L., Hannington M., Harbjerg J., Haribaskaran D., Harran N., Harrington B., Harrison E., Hasan R., Hashmi S., Hassan M., Hassan A., Haverkamp L., Hazen S., Heer B., Heil J., Helliwell J., Henriksen N., Henshall D., Hermanson M., Hermena S., Hettiarachchi D., Hextall C., Hidalgo M., Hidayat H., Hider A., Higgins P., Hinchliffe R., Hirani D., Hirpara D., Hisham I., Hite M., Hoh S. M., Holmberg C., Holmich E., Holst F., Hossam A., Hossam Elfallal A., Howard P., Huaman E., Huang Y., Huang L., Huang D., Huber T., Hugh J., Hughes J., Huttner F., Huynh R., Hylands A., Iannuzzi J., Ielpo B., Iftikhar Talib A., Ignacio J., Ignatavicius P., Ike S., Ikwu C., Inama M., Ing A., Ingels A., Isik A., Islam N., Ives I. J., Al-Hasan A. J. M. S., Perez Rivera C. J., Jacome F., Jaffer T., Jagiella-Lodise O., Jain M., Jain K., Jakubauskas M., Jalal M., James H., Jang Y., Janssen B., Jansson H., Jariod-Ferrer U., Javanmard H., Javed S., Jayarajah U., Jayasuriya I., Je J., Jessop Z., Jia Lin Tang E., Jiang H., Jiayan Y., Jih Huei T., Jimenez-Rodriguez R., Joh D., Johnson A., Jones N., Jones C., Jordan C., Jose Nunez Ju J., Jose Pizarro M., Jose Salazar C., Joseph J., Justiniano C., Kabir T., Kadhum M., Kalfountzos C., Kalogiannaki E., Kalyanasundaram K., Kamarajah S., Kamil Quraishi M., Kanemitsu Y., Kapila A., Kapila V., Karagiannidis G., Kashif M., Kathiravelupillai S., Kathiravelupillai A., Katsogridakis E., Kaur K., Kaur Sekhon Inderjit Singh H., Kausur N., Kawka M., Keehan G., Kehlet Watt S., Kelly M., Kelly M. E., Kelvin Egbuchulem I., Kembuan G., Khajeh E., Khaled Elfaitur A., Khan M. F., Khan S., Khan M., Khan D., Khan H., Khatkar H., Khatkov E., Khaw R., Kim B., Kishore Siddiraju K., Kitua D., Kirimtay B., Kmezic S., Knight S., Koeter T., Koh A., Koh Hong Xiang F., Kojo Anyomih T., Kok A. I. N., Kokelaar R., Koliarakis I., Kolli S., Kong J., Konig D., Koshy M., Kotze P., Kourdouli A., Kowal M., Kraima A., Kramer F., Kryzauskas M., Kuchynskyi I., Kuemmerli C., Kuiper S., Kumar S., Kumar A., Kumar L., Kumar H., Kumar N., Kumar Bandyopadhyay S., Kumar Garg P., Kumar Venkatappa S., Kung J., Kural S., Kushairi A., Kuuzie E., Kvietkauskas M., Kwek I., La J., Lai L., Lakpriya S., Lam K., Lami M., Lansdorp-Vogelaar I., Lapolla P., Larsen H., Latif J., Laudari U., Laurnezi A., Lawal A., Lawday S., Lederhuber H., Lednev A., Lee R., Van Leerdam M. E., Lefevbre G., Lesmus M., Leyva Moraga F. A., Leyva Moraga E., Leyva Moraga F., Li H. L., Li A., Li Z., Licardie E., Light A., Lightner A. L., Lin A., Lincango E., Litta F., Liu H., Lofthouse B., Londono M. A., Lopes R., Lopes De Freitas R., Lopez L., Lopez A. I., Lopez-Gomez J., Lopez-Pena G., Lowe R., Lowe D., Lowey M., Loy G., Lozanovski V., Luzon J., Lynn P., MacCabe T., MacHielsen A., Mafla Herreria C. A., Maggino L., Mahawar K., Mahmood D., Mahmoud M., Mahtani K., Maitra I., Maji S., Majiet I., Mal L., Malherbe J., Malhotra K., Malkomes P., Man E., Manan Sheikh A., Manjunath S., Manzano Nunez R., Manzoor S., Maqsood R., Marchegiani G., Marchegiani F., Marin D., Marin A., Marks I., Marson E., Martensen A., Martin D., Martin Martin G., Martin-Perez B., Martinez P., Marwaha P., Mashauri C., Mashbari H., Masior L., Masri R., Masud L., Masudi S., Mateu Calabuig G., Math S., Matrachisia A., Mayol J., Mazingi D., Mazzotta A., McAlinden J., McCabe G., McColm L., McElvaney H., McGivern K., McGovern J., McGuinness E., McInerney N., McKay S., McKee C., McKenna M., McKenna N., McLean K., Mediratta S., Medkova Y., Medzhidov O., Mehraj A., Mekhael M., Mekinde O., Mellenthin C., Melucci A., Mentor K., Merchant J., Messias H., Messeha M., Meza C., Mhango P., Miladinov M., Milagros Niquen Jimenez M., Miller P., Mills E., Milton A., Minayeva O. A., MinHua Zheng Z., Mischlinger H., Mockli B., Modi R., Mohamed H. M., Mohamed M., Mohamed Abulghasm T., Mohammad S. A., Mohammed T. O., Mohammed A., Mohan H., Mohan M., Moin I., Mok V., Molina G., Moloney J., Moneim J., Monfort Mira M., Montcusi Ventura B., Montouri M., Moossdorff M., Mora-Guzman I., Moran B., Moran R. A. R., Moreno-Ordaz S., Morera A., Morgan R., Morley R., Moro-Valdezate D., Moros S., Moss J. -L., Morven A., Morton D., Moynihan A., Moyon M., Muduli N., Mugla N., Mugla W., Muller P., Mun G., Mundhada R., Munir I., Munoz F., Munoz E., Munoz A., Munoz Balderas D. C., Murgitroyd E., Murray V., Murthy S., Mushiwokufa W., Mustafa H., Mustakimov B., Mutambanengwe P., Myint P., Nadkarni S., Naess P. A., Nahar S., Naidoo P., Nam R., Nandhra S., Nanjappa N., Narasimhan V., Nardi W., Nasir M., Naughton A., Naumann D., Navarro S., Nawaaz Karimbocus M., Nazir A., Ndereya S., Ndong A., Negoi I., Nel D., Nelson D., Nepal S., Nugent T., Nepogodiev D., Neufeld J., Ng J., Ng D., Ng C. E., Ngaserin S., Ngu L., Ngwenya E., Fhearaigh R. N., Nikolousakis T. -K., Ninkovic M., Nita G., Nitschke C., Noren E., Noton T., Novikova A., Nowinka Z., Nyakunengwa T., Nyalundja A., Nzenwa I., Kristensen H. O., O'Brien C., O'Brien L., O'Brien S., O'Reilly J., O'Rourke S., O'Sullivan M., O'Dwyer M., Ochieng L., Oderoha E., Oh K. E., Ohlberger L., Olcum M., Olkina A., Omkumar M., Omnitel B., Oncel Yakar D., Ong K., Ong Wei Lin L., Ooi R., Ooi S., Oomman A., Oon Tyjet D., Opiyo S., Oscullo Yepez J. J., Osei-Kuffour N., Osunronbi T., Ottlakan A., Oussama Kacimi S., Ovaere S., Ozair A., Pachler F., Pai Oo S., Paiella S., Panaiotti L., Panda N., Pandarinath S., Pandey D., Pandrowala S., Papa Mamadou F., Paranathala M., Park J., Parmar C., Parvez A., Pasovic L., Pasquer A., Pasumarthy N., Pata F., Patel T., Patel P., Patel N., Patel M., Patron Uriburu N., Patrone R., Paul A., Pavan Kumar O. M., Pavithran A., Pedraza Ciro M., Pellino G., Peloso A., Pena Gallardo M. T., Pena Velazquez A., Perea J., Perez-Sanchez L. E., Perra T., Perrotta G., Petersson P., Petra G., Petrucciani N., Pickin C., Pino V., Pinotti E., Pinto F., Plum P., Podesta F., Pollini T., Pompeu Sa M., Ponce Leon F., Ponniah H. S., Ponte De Sousa X., Ponton J., Pontula A., Popa M., Portilla A. L., Posner F., Post S., Potolicchio A., Pouwels S., Povo A., Prasad P., Preciado S., Preece R., Proud D., Pulido Segura J. A., Puliyath N., Qui M., Quimbaya Rodriguez A. S., Raby-Smith W., Racovita A., Rad A., Radwan R., Rafaih Iqbal M., Rafik A., Raguan B., Rahi M., Rahiri J. -L., Rahme J., Rai L., Raj A., Raj Saksena A., Raja M., Ramirez J., Ramzi J., Ranstam J., Rao C., Rashid A., Ratnayake B., Rattanasirivilai K., Raubenheimer K., Ravikumar N., Ravn S., Razoz N., Rea W., Regan A., Rela M., Remme A., Rey Chaves C. E., Reyes A., Riad A., Rice D., Rios Quintana K., Ritter A., Roalso M., Robinson D., Rodriguez J., Rodriguez F., Rodriguez M. C., Rogers A., Rohila J., Romanyuc D., Romic I., Rommaneh M., Rompianesi G., Rosa F., Roscio F., Rose A., Rotimi T., Ruiz H., Ruiz Yucuma J., Ruiz-Ucar E., Ruslan M., Rutegard M., Ryan Harper E., Ryckx A., Rydbeck D., Sa-Marta E., Sadien I., Safari Nteranya D., Sagoo K., Sakata S., Saladino E., Saleem A., Saleem S., Salehi M., Salih S., Sallinen V., Salvans S., Sam Z. H., Samadov E., Sampaio Alves M., Sanad A., Sanchez Fonseca S., Sanchez Teran A., Sanchez Ussa S., Sandli O., Sanfey H., Sanghera J., Sani I., Santafe Guerrero M., Sante Fornasiero M., Santes Jasso O., Santos Pereira I., Santos Sousa H., Saratzis A., Sarmiento Alarcon A., Saumtally T., Sayyed R., Schettino M., Schleimer L., Schmidt T., Schondffelt K., Schwab M., Scott A., Searle H., Sebopelo L., Seeglier B., Seishima R., Semenvov D., Senent-Boza A., Sepulveda J., Serenari M., Serrano Navidad M., Sert I., Sewart E., Sgro A., Shadrina V., Shah K., Shahid F., Shalaby M., Shankar B., Shapiro J., Sharma L., Sheel A., Shenfine A., Shenoy S., Sherif A., Shetty N., Shetty R., Sia T. C., Sichimba D., Siddique H., Siddiqui I., Simkens G., Simoe J., Simon H., Sinan L., Singh T., Singh K., Singh Y., Sinha L., Siragusa L., Sluckin T., Smart Y. W., Smith H., Smith K., Smits L., Sneep-Van Kessel C., Sohrabi C., Solorzano Pineda O., Soma A., Sooriyapiragasam L., Soreide K., Sparavigna M., Spence R., Spencer N., Spiers H., Spinelli A., Sprakel J., Sravanam S., Srinivasan M., Srinivasan R., Staniszewska A., Stanworth S. J., Stasinos K., Steele R. J. C., Steinholt I., Steinruecke M., Stephen B. -J., Stijns J., Still M., Stupalkowska W., Subba S., Subbotin V. V., Sucharitkul P., Sudarsanam A., Sudhamsh Reddy D., Suhardja T., Suliman M., Sund M., Sunilkumar A., Suresh N., Sussmes S., Sutton P., Syltern J., Taha A., Takamizawa Y., Takoutsing Dongmo A. B., Tamas T., Tan L., Tan J. L., Tan K., Tan E., Tan Yong Hui A., Tanase A., Tariverdiev A., Tasnem A., Tatar C., Tay E., Tejedor P., Tesfaye G., Tetinou F., Thorpe C., Thyo A., Tlelo Amastal D., Tolani M., Tolga Saracoglu K., Tolgyes T., Tong J., Torrent Jansa L., Toscano Igartua S., Tovani Palone M. R., Traff H., Trevis J., Tummers W., Tur A., Turchenko I., Uche V., Uddin A., Udonsak N., Ullah M., Urbonas T., Uwins C., Uy Magadia E., Uzair Qureshi A., Uzun K., Vadim P., Valarche G., Valdez Gonzalez R. A., Vallee M., Van Beek D. -J., Van Dalen A. S., Van Den Hondel D., Van Der Stok E., Van Dorp M., Van Oostendorp S., Van Praag E., Van Rees J., Van Silfhout L., Varga Z., Varghese S., Varghese C., Varghese J., Vasilica A. -M., Vasquez Ojeda X., Vega E., Vehler S., Venchiarutti R., Vengatesan S., Venn M., Verma D., Vianey Partida Nava G., Victoria D., Vieira P., Vilar Alvarez M. E., Vinci D., Viscasillas Pallas G., Viswanath M., Vivanco J., Vizcaya Rodriguez V., Vo J., Volchanski D., Voron T., Voronovskyi Y., Vu J., Wadhwa M., Wadhwa S., Wagner G., Wallace M., Wang Y. Y., Wang J., Wani A., Wanigasooriya K., Wanjara S., Wanjiku N., Warner C., Wei Leow T., Weiser T., Weisters M., Wellington M. J., Wells C., Wenzelberg C., Wettstein D., Wezel A., Wheldon L., Widmer L., Wilson M., Wigmore S., Wijayaratne T., Wijeyaratne M., Wijnhoven B. P. L., Wilkin R., Williams E., Willis F., Winter D., Wirsik M. M., Wishah B., Wong G., Wong W. J., Wong K., Wong K. -Y., Worku D., Wright E., Wright J., Wroe Wright O., Xenacki S., Xia W., Xu W., Xu Z., Yalcinkaya A., Yang W., Yang P. -C., Yanishev A., Yanzon De La Torre A., Yao H., Yaqoob E., Yen Ling Quake S., Yeo D., Yeom B., Yershov D., Yiasemidou M., Yildiz A., Yiu A., Yoav M., Yong E., Yoshimura R., Younis M. U., Younis Ringshawl Z., Youssef M., Yue Y., Yuen S., Yuldashev R., Yurttas C., Yves B., Zaborowski A., Zackeri R., Zafar A., Zahra W., Zaidi A., Zainudin S., Zakeri R., Zamora I., Zamora A. T., Zawistowski M., Zbikowska G., Zegers W., Zehra S., Zeyra A., Zhagniyev Z., Zhukova L. G., Zivanovic M., Zmuc J., Zope M., Zubayraeva A., and Zucker B.
- Abstract
Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues experiences and published evidence. Methods: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era.
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- 2021
42. Uterine retroversion and gluteal transposition flap for postoperative perineal evisceration after extralevator abdominoperineal resection.
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Luberto A, Bislenghi G, Wolthuis A, and D'Hoore A
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- Female, Humans, Neoplasm Recurrence, Local surgery, Neoplasm Recurrence, Local etiology, Postoperative Complications etiology, Plastic Surgery Procedures, Uterine Retroversion complications, Uterine Retroversion surgery, Rectal Neoplasms surgery, Rectal Neoplasms pathology, Proctectomy adverse effects, Anus Neoplasms surgery, Anus Neoplasms etiology
- Abstract
Anal squamous cell carcinoma (ASCC) is the most common histological subtype of malignant tumor affecting the anal canal. Chemoradiotherapy (CRT) is the first-line treatment in nearly all cases, ensuring complete clinical response in up to 80% of patients. Abdominoperineal resection (APR) is typically reserved as salvage therapy in those patients with persistent or recurrent tumor after CRT. In locally advanced tumors, an extralevator abdominoperineal excision (ELAPE), which entails excision of the anal canal and levator muscles, might be indicated to obtain negative resection margins. In this setting, the combination of highly irradiated tissue and large surgical defect increases the risk of developing postoperative perineal wound complications. One of the most dreadful complications is perineal evisceration (PE), which requires immediate surgical treatment to avoid irreversibile organ damage. Different techniques have been described to prevent perineal complications after ELAPE, although none of them have reached consensus. In this technical note, we present a case of PE after ELAPE performed for a recurrent ASCC. Perineal evisceration was approached by combining a uterine retroversion with a gluteal transposition flap to obtain wound healing and reinforcement of the pelvic floor at once, when a mesh placement is not recommended., (© 2023. Italian Society of Surgery (SIC).)
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- 2024
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43. European Society of Coloproctology: Guidelines for diagnosis and treatment of cryptoglandular anal fistula.
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Reza L, Gottgens K, Kleijnen J, Breukink S, Ambe PC, Aigner F, Aytac E, Bislenghi G, Nordholm-Carstensen A, Elfeki H, Gallo G, Grossi U, Gulcu B, Iqbal N, Jimenez-Rodriguez R, Leventoglu S, Lisi G, Litta F, Lung P, Millan M, Ozturk E, Sackitey C, Shalaby M, Stijns J, Tozer P, and Zimmerman D
- Subjects
- Adult, Humans, Abscess, Systematic Reviews as Topic, Wound Healing, Treatment Outcome, Rectal Fistula diagnosis, Rectal Fistula surgery, Anus Diseases
- Abstract
Aim: The primary aim of the European Society of Coloproctology (ESCP) Guideline Development Group (GDG) was to produce high-quality, evidence-based guidelines for the management of cryptoglandular anal fistula with input from a multidisciplinary group and using transparent, reproducible methodology., Methods: Previously published methodology in guideline development by the ESCP has been replicated in this project. The guideline development process followed the requirements of the AGREE-S tool kit. Six phases can be identified in the methodology. Phase one sets the scope of the guideline, which addresses the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula in adult patients presenting to secondary care. The target population for this guideline are healthcare practitioners in secondary care and patients interested in understanding the clinical evidence available for various surgical interventions for anal fistula. Phase two involved formulation of the GDG. The GDG consisted of 21 coloproctologists, three research fellows, a radiologist and a methodologist. Stakeholders were chosen for their clinical and academic involvement in the management of anal fistula as well as being representative of the geographical variation among the ESCP membership. Five patients were recruited from patient groups to review the draft guideline. These patients attended two virtual meetings to discuss the evidence and suggest amendments. In phase three, patient/population, intervention, comparison and outcomes questions were formulated by the GDG. The GDG ratified 250 questions and chose 45 for inclusion in the guideline. In phase four, critical and important outcomes were confirmed for inclusion. Important outcomes were pain and wound healing. Critical outcomes were fistula healing, fistula recurrence and incontinence. These outcomes formed part of the inclusion criteria for the literature search. In phase five, a literature search was performed of MEDLINE (Ovid), PubMed, Embase (Ovid) and the Cochrane Database of Systematic Reviews by eight teams of the GDG. Data were extracted and submitted for review by the GDG in a draft guideline. The most recent systematic reviews were prioritized for inclusion. Studies published since the most recent systematic review were included in our analysis by conducting a new meta-analysis using Review manager. In phase six, recommendations were formulated, using grading of recommendations, assessment, development, and evaluations, in three virtual meetings of the GDG., Results: In seven sections covering the diagnostic and therapeutic management of perianal abscess and cryptoglandular anal fistula, there are 42 recommendations., Conclusion: This is an up-to-date international guideline on the management of cryptoglandular anal fistula using methodology prescribed by the AGREE enterprise., (© 2023 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)
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- 2024
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44. Digital postoperative follow-up after colorectal resection: a multi-center preliminary qualitative study on a patient reporting and monitoring application.
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Bertoni S, M M K Magema JP, Van Geluwe B, Abbes Orabi N, Bislenghi G, D'Hoore A, and Wolthuis A
- Subjects
- Female, Humans, Middle Aged, Male, Follow-Up Studies, Prospective Studies, Patient Discharge, Postoperative Complications prevention & control, Postoperative Complications etiology, Length of Stay, Aftercare, Colorectal Neoplasms surgery, Colorectal Neoplasms complications
- Abstract
The development of minimally invasive colorectal surgery in the last decades led to a decrease in length of hospital stay. However, readmission and postoperative complications were still observed. Several studies have shown that close postoperative follow-up is required to decrease postoperative morbidity through patient education and by detecting early signs of complications. To help in this task, multiple monitoring programs have been set up to follow patients at home, allowing detection of several complications at an early stage. To evaluate acceptance, satisfaction, usability, compliance and safety of a mobile application following postoperative colorectal patients during the first 15 days post-discharge from hospital. A mobile application enabling the communication between the patient and medical staff during the recovery phase was developed and tested in four hospitals. Patients who underwent a colorectal resection were included in this prospective qualitative study. Questionnaires to assess satisfaction and usability were handed out to patients at the end of the test period. Overall, 118 patients (52% females, median age 52.5 years) were included. Median adherence-rate during 15 days was 89.6%. Satisfaction-rate for the application was 76% and usability was high. Overall, 1220 notifications were collected, of which 722 were orange, 466 red and 32 purple, colours used to rate the severeness of complaints. We analyzed the most common notifications, showing trends in different subgroups of the study with higher risks of complications (pain (409 notifications), abnormal stools (196 notifications), and wound problems (118 notifications)). A mobile application could be used to follow patients at home after colorectal resection. Future studies should evaluate whether these applications can detect complications and prevent readmission., (© 2023. Italian Society of Surgery (SIC).)
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- 2024
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45. E-consensus on telemedicine in colorectal surgery: a RAND/UCLA-modified study
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Gallo G., Picciariello A., Di Tanna G. L., Santoro G. A., Perinotti R., Aiello D., Avanzolini A., Balestra F., Bianco F., Binda G. A., Bislenghi G., Bondurri A., Bracchitta S., Buonanno A., Caminati F., Celentano V., Coco C., Colombo F., De Nardi P., Di Candido F., Di Saverio S., Ferrara F., Folliero C., Giani I., Giuffrida M. C., Infantino A., La Torre M., Lisi G., Luglio G., Maffioli A., Mancini S., Manigrasso M., Marino F., Martellucci J., Milito G., Milone M., Orlandi S., Ottonello M., Pata F., Pellino G., Pessia B., Rocca A., Romano L., Santoro G., Serventi A., Sica G. S., Spagnuolo R., Spinelli A., Testa A., Trompetto M., Tutino R., Veglia A., Zaffaroni G., Grossi U., Gallo, G., Picciariello, A., Di Tanna, G. L., Santoro, G. A., Perinotti, R., Aiello, D., Avanzolini, A., Balestra, F., Bianco, F., Binda, G. A., Bislenghi, G., Bondurri, A., Bracchitta, S., Buonanno, A., Caminati, F., Celentano, V., Coco, C., Colombo, F., De Nardi, P., Di Candido, F., Di Saverio, S., Ferrara, F., Folliero, C., Giani, I., Giuffrida, M. C., Infantino, A., La Torre, M., Lisi, G., Luglio, G., Maffioli, A., Mancini, S., Manigrasso, M., Marino, F., Martellucci, J., Milito, G., Milone, M., Orlandi, S., Ottonello, M., Pata, F., Pellino, G., Pessia, B., Rocca, A., Romano, L., Santoro, G., Serventi, A., Sica, G. S., Spagnuolo, R., Spinelli, A., Testa, A., Trompetto, M., Tutino, R., Veglia, A., Zaffaroni, G., and Grossi, U.
- Subjects
Adult ,Male ,medicine.medical_specialty ,Telemedicine ,Group based ,Consensus ,Coronavirus disease 2019 (COVID-19) ,Telehealth ,Multidisciplinary approach ,Medicine ,Humans ,COVID-19 ,Colorectal ,RAND/UCLA ,Teleconsultation ,business.industry ,SARS-CoV-2 ,Colorectal surgery ,Settore MED/18 ,Surgery ,Family medicine ,Diverticular disease ,Original Article ,business ,Colorectal surgeons ,Colorectal Surgery - Abstract
Coronavirus disease 2019 (COVID-19) is revolutionizing healthcare delivery. The aim of the study was to reach consensus among experts on the possible applications of telemedicine in colorectal surgery. A group of 48 clinical practice recommendations (CPRs) was developed by a clinical guidance group based on coalescence of evidence and expert opinion. The Telemedicine in Colorectal Surgery Italian Working Group included 54 colorectal surgeons affiliated to the Italian Society of Colo-Rectal Surgery (SICCR) who were involved in the evaluation of the appropriateness of each CPR, based on published RAND/UCLA methodology, in two rounds. Stakeholders’ median age was 44.5 (IQR 36–60) years, and 44 (81%) were males. Agreement was obtained on the applicability of telemonitoring and telemedicine for multidisciplinary pre-operative evaluation. The panel voted against the use of telemedicine for a first consultation. 15/48 statements deemed uncertain on round 1 and were re-elaborated and assessed by 51/54 (94%) panelists on round 2. Consensus was achieved in all but one statement concerning the cost of a teleconsultation. There was strong agreement on the usefulness of teleconsultation during follow-up of patients with diverticular disease after an in-person visit. This e-consensus provides the boundaries of telemedicine in colorectal surgery in Italy. Standardization of infrastructures and costs remains to be better elucidated. Supplementary Information The online version contains supplementary material available at 10.1007/s13304-021-01139-8.
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- 2021
46. Correction to: E-consensus on telemedicine in colorectal surgery: a RAND/UCLA-modified study (Updates in Surgery, (2022), 74, 1, (163-170), 10.1007/s13304-021-01139-8)
- Author
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Gallo, G., Picciariello, A., Di Tanna, G. L., Santoro, G. A., Perinotti, R., Aiello, D., Avanzolini, A., Balestra, F., Bianco, F., Binda, G. A., Bislenghi, G., Bondurri, A., Bracchitta, S., Buonanno, A., Caminati, F., Celentano, V., Coco, C., Colombo, F., De Nardi, P., Di Candido, F., Di Saverio, S., Ferrara, F., Folliero, C., Giani, I., Giuffrida, M. C., Infantino, A., La Torre, M., Lisi, G., Luglio, G., Maffioli, A., Mancini, S., Manigrasso, M., Marino, F., Martellucci, J., Milito, G., Milone, M., Orlandi, S., Ottonello, M., Pata, F., Pellino, G., Pessia, B., Rocca, A., Romano, L., Santoro, G., Serventi, A., Sica, G. S., Spagnuolo, R., Spinelli, A., Testa, A., Trompetto, M., Tutino, R., Veglia, A., Zaffaroni, G., and Grossi, U.
- Published
- 2022
47. Correction to: Practice of proctology among general surgery residents and young specialists in Italy: a snapshot survey.
- Author
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Manzo CA, Annicchiarico A, Valiyeva S, Picciariello A, Gallo G, and Bislenghi G
- Published
- 2023
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48. Single cell dynamics of tumor specificity vs bystander activity in CD8 + T cells define the diverse immune landscapes in colorectal cancer.
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Borràs DM, Verbandt S, Ausserhofer M, Sturm G, Lim J, Verge GA, Vanmeerbeek I, Laureano RS, Govaerts J, Sprooten J, Hong Y, Wall R, De Hertogh G, Sagaert X, Bislenghi G, D'Hoore A, Wolthuis A, Finotello F, Park WY, Naulaerts S, Tejpar S, and Garg AD
- Abstract
CD8
+ T cell activation via immune checkpoint blockade (ICB) is successful in microsatellite instable (MSI) colorectal cancer (CRC) patients. By comparison, the success of immunotherapy against microsatellite stable (MSS) CRC is limited. Little is known about the most critical features of CRC CD8+ T cells that together determine the diverse immune landscapes and contrasting ICB responses. Hence, we pursued a deep single cell mapping of CRC CD8+ T cells on transcriptomic and T cell receptor (TCR) repertoire levels in a diverse patient cohort, with additional surface proteome validation. This revealed that CRC CD8+ T cell dynamics are underscored by complex interactions between interferon-γ signaling, tumor reactivity, TCR repertoire, (predicted) TCR antigen-specificities, and environmental cues like gut microbiome or colon tissue-specific 'self-like' features. MSI CRC CD8+ T cells showed tumor-specific activation reminiscent of canonical 'T cell hot' tumors, whereas the MSS CRC CD8+ T cells exhibited tumor unspecific or bystander-like features. This was accompanied by inflammation reminiscent of 'pseudo-T cell hot' tumors. Consequently, MSI and MSS CRC CD8+ T cells showed overlapping phenotypic features that differed dramatically in their TCR antigen-specificities. Given their high discriminating potential for CD8+ T cell features/specificities, we used the single cell tumor-reactive signaling modules in CD8+ T cells to build a bulk tumor transcriptome classification for CRC patients. This "Immune Subtype Classification" (ISC) successfully distinguished various tumoral immune landscapes that showed prognostic value and predicted immunotherapy responses in CRC patients. Thus, we deliver a unique map of CRC CD8+ T cells that drives a novel tumor immune landscape classification, with relevance for immunotherapy decision-making., (© 2023. The Author(s).)- Published
- 2023
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49. Results of the Eighth Scientific Workshop of ECCO: Pathophysiology and Risk Factors of Postoperative Crohn's Disease Recurrence after an Ileocolonic Resection.
- Author
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Rivière P, Bislenghi G, Hammoudi N, Verstockt B, Brown S, Oliveira-Cunha M, Bemelman W, Pellino G, Kotze PG, Ferrante M, and Panis Y
- Subjects
- Humans, Colon surgery, Colon pathology, Anastomosis, Surgical adverse effects, Anastomosis, Surgical methods, Ileum surgery, Ileum pathology, Retrospective Studies, Risk Factors, Recurrence, Crohn Disease surgery, Crohn Disease pathology
- Abstract
Postoperative recurrence [POR] after an ileocolonic resection with ileocolonic anastomosis is frequently encountered in patients with Crohn's disease. The 8th Scientific Workshop of ECCO reviewed the available evidence on the pathophysiology and risk factors for POR. In this paper, we discuss published data on the role of the microbiome, the mesentery, the immune system and the genetic background. In addition to investigating the causative mechanisms of POR, identification of risk factors is essential to tailor preventive strategies. Potential clinical, surgical and histological risk factors are presented along with their limitations. Emphasis is placed on unanswered research questions, guiding prevention of POR based on individual patient profiles., (© The Author(s) 2023. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2023
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50. Laparoscopic Oblique Rectus Abdominis Myocutaneous Flap Harvest for Perineal Reconstruction After Abdominoperineal Resection.
- Author
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Devriendt S, Van Praet L, Bislenghi G, D'Hoore AJL, and Wolthuis AM
- Subjects
- Humans, Male, Anus Neoplasms surgery, Middle Aged, Female, Tissue and Organ Harvesting methods, Aged, Laparoscopy methods, Myocutaneous Flap transplantation, Perineum surgery, Proctectomy methods, Rectal Neoplasms surgery, Plastic Surgery Procedures methods, Rectus Abdominis transplantation
- Abstract
Background: Treatment of perineal defects after abdominoperineal resection or salvage surgery for either locally advanced rectal cancer or anal carcinoma can be challenging. Myocutaneous flap reconstruction has proven to reduce perineal morbidity and abscess formation in the pelvis; however, it is associated with significant donor-site morbidity. To our knowledge, this is the first report of a laparoscopic oblique rectus abdominis myocutaneous flap harvesting for perineal reconstruction. This technical note aimed to demonstrate the feasibility of the technique., Impact of Innovation: Introduction of a laparoscopic technique in harvesting of this flap can potentially further reduce morbidity associated with this flap creation by minimizing abdominal wall trauma and obviating the need for laparotomy for tunneling of the flap intra-abdominally., Technology, Materials, and Methods: This report describes a technique using a 6-port laparoscopy, in which the harvesting of the myocutaneous flap was performed after a standardized abdominoperineal resection. The flap itself is passed through the rectus sheath toward the pelvis with the help of a retractor., Preliminary Results: Two patients successfully underwent a laparoscopic oblique rectus abdominis flap reconstruction after abdominoperineal resection., Conclusion and Future Directions: This report describes our initial experience with laparoscopic harvesting of an oblique rectus abdominis flap for perineal reconstruction after abdominoperineal resection. We believe the technique is easy and reproducible for laparoscopic surgeons and can reduce donor-site morbidity. However, further studies will be needed to confirm this observation., (Copyright © The ASCRS 2023.)
- Published
- 2023
- Full Text
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