Current treatment of pT1 rectal cancers in Denmark: A retrospective national cohort study.

Aim: Organ preservation strategies for patients with rectal cancer are increasingly common. In appropriately selected patients, local excision (LE) of pT1 cancers can reduce morbidity without compromising cancer-related outcomes. However, determining the need for completion surgery after LE can be challenging, and it is unknown if prior LE compromises subsequent total mesorectal excision (TME).

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Extrapulmonary tuberculosis (TB) in the gastrointestinal tract is a rare, but yet an essential differential diagnosis to patients with complex fistula disease, since the initiation of immunosuppressive therapy for presumed Crohn's disease can lead to a fulminant course of TB. This case report presents a young Danish woman with a progressive complex fistula disease, where cause and treatment were uncovered by interprofessional collaboration between pulmonologists, gastroenterologists and surgeons including a screening test for TB as well as multiple biopsies from the anal fistula tissue.

Fistula development after anal abscess drainage-a multicentre retrospective cohort study.

Purpose: Anal abscesses are common and, despite correct treatment with surgical drainage, carry the risk of developing fistulas. Studies identifying risk factors for the development of anal fistulas are sparse. This study aimed to identify the risk factors for anal fistulas after anal abscess surgery.

European Society of Coloproctology: Guidelines for diagnosis and treatment of cryptoglandular anal fistula.

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.

Robot-assisted TAMIS: a systematic review of feasibility and outcomes.

Background: In the advancement of transanal local excision, robot-assisted transanal minimal invasive surgery is the newest development. In the confined area of the rectum, robot-assisted surgery should, theoretically, be superior due to articulated utensils, video enhancement, and tremor reduction, however, this has not yet been investigated. The aim of this study was to review the evidence reported to-date on experience of using robot-assisted transanal minimal invasive surgery for treatment of rectal neoplasms.

Perianal Crohn's Disease and the Development of Colorectal and Anal Cancer: A Systematic Review and Meta-analysis.

Background And Aims: The aim of this systematic review was to assess the literature on the incidence and risk factors for colorectal cancer and anal cancer in patients with perianal Crohn's disease.

Method: A systematic review of the literature was performed using PubMed, Embase and Google Scholar. A meta-analysis was then conducted using a random-effects model.

[Transanal endoscopic microsurgery for excision of a symptomatic tailgut cyst].

A tailgut cyst is a rare tumour originating from the embryonic remnant of the retrorectal space. The cyst is often asymptomatic, but it can cause abdominal or rectal pain and urogenital symptoms. When diagnosed, resection is the choice of treatment, and traditionally open surgery has been preferred.

[Endoscopic vacuum-assisted treatment of a large supralevator abscess].

Supralevatory abscesses (SA) are rare entities complicating diagnosis and treatment. We present the case report of a 64-year-old male with a large SA and a low transsphincteric fistula requiring surgery. Due to comorbidities and the size of the SA an endoscopic vacuum therapy (EVC) was placed for adequate drainage with good results at the six weeks follow-up.

[Treatment of perianal fistulas with mesenchymal stem cells].

Treatment of perianal fistulas are challenged by insufficient healing and a high rate of relapse. Existing sphincter-sparing procedures have healing rates of around 50%. Treatment with mesenchymal stem cells of both autologous and allogenic origin and freshly collected autologous adipose tissue show both promising healing rates and few complications and may be offered to patients with complicated fistulas not suited for other treatment modalities.

[Cryptoglandular anal fistulas].

Cryptoglandular anal fistulas (AF) cause recurrent anal abscesses and patients risk multiple surgeries due to low healing rates of sphincter-saving procedures. Knowledge of anal anatomy and imaging with MRI or endoanal sonography is crucial to classify AF as simple or complex depending on risk of anal incontinence after fistulotomy as summarised in this review. Fistulotomy has healing rates of > 90%, risks incontinence, and the procedure is reserved for simple fistulas.

Fistula Laser Closure (FiLaC™) for fistula-in-ano-yet another technique with 50% healing rates?

Purpose: Treatment of ano-cutaneous fistulas remains a therapeutic challenge. Fistula Laser Closure (FiLaC™) is a relatively new technique for the treatment of ano-cutaneous fistulas. This study aimed to determine the success rate of fistula closure using FiLaC™.

Effectiveness of infliximab treatment of complex idiopathic anal fistulas.

Objectives: To investigate the effects of infliximab treatment in patients with complex idiopathic anal fistulas refractory to standard surgical treatment.

Materials And Methods: We retrospectively evaluated the effects ofinfliximab treatmentin patients with complex idiopathic anal fistulas refractory to standard surgical intervention. The primary outcome was achievement of substantial clinical improvement defined as sustained, reduced inflammatory activity at perioperativeevaluation, i.

[Treatment of anal abscesses].

Anal abscesses are well-known conditions worldwide. The golden standard of acute treatment is incision and drainage. Knowledge of the anatomy of the anal area and the abscess involvement of perianal spaces is crucial in order to perform safe and correct surgical treatment as summarised in this review.

Treatment of chronic anal fissure: a feasibility study on Levorag® Emulgel versus Diltiazem gel 2.

Purpose: To compare the standard treatment, diltiazem gel 2%, with Levorag® Emulgel for chronic anal fissures.

Methods: This was a single-blinded, randomised, controlled, clinical trial with a non-inferiority design. Patients with a chronic anal fissure were randomised to treatment with diltiazem or Levorag® Emulgel twice daily for 8 weeks.

Incidence of Incisional Hernia Repair After Laparoscopic Compared to Open Resection of Colonic Cancer: A Nationwide Analysis of 17,717 Patients.

Background: It remains unknown whether laparoscopic compared to open surgery translates into fewer incisional hernia repairs (IHR). The objectives of the current study were to compare the long-term incidence of IHR and the size of repaired hernias between patients subjected to laparoscopic or open resection of colonic cancer.

Methods: This was a nationwide cohort study comprised of patients undergoing resection for colonic cancer between January 2007 and March 2016 according to the Danish Colorectal Cancer Group database.

Increased Leak Rates Following Stapled Versus Handsewn Ileocolic Anastomosis in Patients with Right-Sided Colon Cancer: A Nationwide Cohort Study.

Background: Data on anastomotic leak rates after stapled versus handsewn ileocolic anastomosis are conflicting. In a Cochrane review, the combined estimate favored the stapled technique, but recent cohort studies demonstrated a 2-fold increase in anastomotic leak with the stapled approach.

Objective: The purpose of this study was to investigate anastomotic leak rates following stapled versus handsewn ileocolic anastomosis.

Quality of life, performance status, and work capacity after post-endoscopic retrograde cholangiopancreatography pancreatitis.

Objectives: This study evaluated the long-term consequences of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) on health related quality of life (HRQOL), performance status, and work capacity.

Materials And Methods: A follow-up study with prospective outcome measurements on patients with previous PEP and matched controls from a Danish cohort of 772 patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). HRQOL was evaluated by the short form 36 health surveys, performance status by the Zubrod score, and work capacity by employment status.

Pancreatic function following post-endoscopic retrograde cholangiopancreatography pancreatitis: A controlled cohort study with long-term follow-up.

Background: Acute pancreatitis is one of the most common causes of gastrointestinal-related hospitalization and the incidence is increasing. Endo- and exocrine pancreatic function can be compromised after acute pancreatitis.

Objective: The purpose of this study was to explore the long-term consequences of post-endoscopic retrograde cholangiopancreatography pancreatitis (PEP) on pancreatic function.

Oncological outcome following laparoscopic versus open surgery for cancer in the transverse colon: a nationwide cohort study.

Background: The literature on transverse colonic cancer resection is sparse. The optimal surgical approach for this disease is thus unknown. This study aimed to examine laparoscopic versus open surgery for transverse colonic cancer.

[Treatment of anal fissures].

Anal fissure is a common ailment, however, the pathophysiology and optimal treatment strategy is unclear. Anal fissures may be classified as acute or chronic. Acute fissures are effectively treated and prevented with conservative measures, whereas chronic fissures typically require medical or surgical therapy.

Treatment of Complex Fistula-in-Ano With a Nitinol Proctology Clip.

Background: The treatment of complex anocutaneous fistulas remains a major therapeutic challenge balancing the risk of incontinence against the chance of permanent closure.

Objective: The purpose of this study was to investigate the efficacy of a nitinol proctology clip for closure of complex anocutaneous fistulas.

Design: This is a single-center cohort study with retrospective analysis of all of the treated patients.