Examining Utility of Routine Splenic Flexure Mobilization during Colectomy and Impact on Anastomotic Complications.

Background: Despite a lack of supporting data, routine splenic flexure mobilization (SFM) during colectomy has been thought to reduce anastomotic leak (AL). We evaluated the impact of SFM on outcomes in distal colectomy.

Study Design: The 2005-2016 NSQIP database identified 66,068 patients undergoing distal colectomy with anastomosis.

Colonoscopy after Hinchey I and II left-sided diverticulitis: utility or futility?

Background: Modern 64- to 128-slice computed tomography (CT) scanners have questioned the need for routine colonoscopy after hospital admission for presumed uncomplicated diverticulitis.

Methods: This is a retrospective review of all patients (>18 years) who underwent planned colonoscopy after admission for Hinchey I or II acute diverticulitis (January 2009 to January 2014). The findings on the final radiologist report were then correlated with the colonoscopy results.

Fluorescence Angiography in Colorectal Resection.

Background: Intraoperative laser fluorescence angiography is a relatively new tool that can be used by colorectal surgeons to ensure adequate perfusion to bowel that remains after resection. It has been used mostly to determine an appropriate point of transection of the proximal bowel, as well as to ensure perfusion after the anastomosis has been constructed. We propose a different use of the technology in complex cases to ensure the ability to safely transect a major vascular pedicle and to ensure that perfusion will remain adequate.

Biomaterials in the treatment of anal fistula: hope or hype?

Anal fistula (AF) presents a chronic problem for patients and colorectal surgeons alike. Surgical treatment may result in impairment of continence and long-term risk of recurrence. Treatment options for AFs vary according to their location and complexity.

The weekend effect: does time of admission impact management and outcomes of small bowel obstruction?

Aims: To determine whether day and time of admission influences the practice patterns of the admitting general surgeon and subsequent outcomes for patients diagnosed with small bowel obstruction.

Methods: A retrospective database review was carried out, covering patients admitted with the presumed diagnosis of partial small bowel obstruction from 2004-2011.

Results: A total of 404 patients met the inclusion criteria.

Mesenteric irritation as a means to prevent internal hernia formation after laparoscopic gastric bypass surgery.

Introduction: Internal hernias (IHs) occur more frequently in laparoscopic gastric bypass (LGB) surgery than in the classic open procedure. The incidence of small bowel obstruction after LGB ranges from 1.8% and 9.

Future directions for the early detection of colorectal cancer recurrence.

Surgical resection remains a mainstay of treatment and is highly effective for localized colorectal cancer. However, ~30-40% of patients develop recurrence following surgery and 40-50% of recurrences are apparent within the first few years after initial surgical resection. Several variables factor into the ultimate outcome of these patients, including the extent of disease, tumor biology, and patient co-morbidities.

Future directions for monitoring treatment response in colorectal cancer.

Treatment of advanced colon and rectal cancer has significantly evolved with the introduction of neoadjuvant chemoradiation therapy so much that, along with more effective chemotherapy regimens, surgery has been considered unnecessary among some institutions for select patients. The tumor response to these treatments has also improved and ultimately has been shown to have a direct effect on prognosis. Yet, the best way to monitor that response, whether clinically, radiologically, or with laboratory findings, remains controversial.

An evaluation of colonoscopy surveillance guidelines: are we actually adhering to the guidelines?

Background: National guidelines put forth by the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Gastroenterology provide recommendations regarding colorectal cancer screening and follow-up surveillance. Practice patterns may differ from these guidelines. This study analyzes the concordance between a tertiary equal access system and national guidelines for colorectal cancer and polyp surveillance.

Cefazolin-induced neutropenia and thrombocytopenia following trauma: a case report.

Cefazolin, a first generation cephalosporin, is a rare cause of cyclical fevers, neutropenia, and thrombocytopenia following surgical prophylaxis. We present the case of an otherwise healthy 21-year-old male who sustained a 50-cm laceration to his chest and abdomen. He received emergency department prophylaxis with cefazolin and surgical repair.

Nestin reporter transgene labels multiple central nervous system precursor cells.

Embryonic neuroepithelia and adult subventricular zone (SVZ) stem and progenitor cells express nestin. We characterized a transgenic line that expresses enhanced green fluorescent protein (eGFP) specified to neural tissue by the second intronic enhancer of the nestin promoter that had several novel features. During embryogenesis, the dorsal telencephalon contained many and the ventral telencephalon few eGFP+ cells.

Subventricular zone neuroblasts emigrate toward cortical lesions.

Adult subventricular zone (SVZ) neuroblasts migrate in the rostral migratory stream to the olfactory bulbs. Brain lesions generally increase SVZ neurogenesis or gliogenesis and cause SVZ cell emigration to ectopic locations. We showed previously that glia emigrate from the SVZ toward mechanical injuries of the somatosensory cerebral cortex in mice.

Radial glia-like cells at the base of the lateral ventricles in adult mice.

During development radial glia (RG) are neurogenic, provide a substrate for migration, and transform into astrocytes. Cells in the RG lineage are functionally and biochemically heterogeneous in subregions of the brain. In the subventricular zone (SVZ) of the adult, astrocyte-like cells exhibit stem cell properties.

Distribution of doublecortin expressing cells near the lateral ventricles in the adult mouse brain.

Doublecortin (Dcx) is a microtubule-associated protein expressed by migrating neuroblasts in the embryo and in the adult subventricular zone (SVZ). The adult SVZ contains neuroblasts that migrate in the rostral migratory stream (RMS) to the olfactory bulbs. We have examined the distribution and phenotype of Dcx-positive cells in the adult mouse SVZ and surrounding regions.