Results at one year of the TROPIS technique in the treatment of complex anal fistula.

Introduction: It is a priority to find surgical techniques that guarantee acceptable healing rates without sequelae in the treatment of complex anal fistula. The concept of the deep intersphincteric space as the origin of perianal sepsis has provided a new perspective, allowing the emergence of techniques such as TROPIS (Transanal Opening of Intersphincteric Space), with few published series to date. The aim of this study is to evaluate the healing rate and complications one year after the TROPIS technique as a treatment for complex anal fistula without hospitalization.

The influence of supervisor supportive behaviors on subordinate job satisfaction: the moderating effect of gender similarity.

This paper analyses the influence that different supervisor supportive behaviors have on subordinate job satisfaction, while considering the gender of individuals involved (supervisor and subordinate). The empirical evidence provided by a sample of 29,833 subordinates from 35 European countries collected by Eurofound through the European Working Condition Survey allows us to assert the following. First, subordinate job satisfaction depends on their perceptions about the supportive behaviors provided by their supervisors in terms of respect, giving recognition for a job well done, coordinating work, helping get the job done, and encouraging the professional development of the subordinate.

Influence of Preoperative Educational Intervention for Patients Undergoing Fecal Ostomy Surgery: A Comparison Cohort Study.

Purpose: This aim of this study was to compare the impact on hospital stay and short-term overall complications prior to and following the introduction of an outpatient preoperative ostomy education program to an existing inpatient ostomy education program.

Design: A comparison cohort study.

Subjects And Setting: One hundred thirty-eight consecutive patients undergoing ostomy surgery were included.

Efficacy of Sacral Nerve Stimulation in Non-constipated Irritable Bowel Syndrome Patients: A Systematic Review.

Background And Aims: Irritable bowel syndrome (IBS) is a prevalent disorder with a complex and heterogeneous physiopathology, including a dysregulation of gut-brain axis. Treatment for IBS is targeted to the predominant symptom and requires a multidisciplinary approach. This review aims to evaluate the efficacy and safety of sacral nerve stimulation in non-constipated IBS patients Methods: A literature search was carried out on MEDLINE, The Cochrane Central Register of Controlled Trials (CENTRAL) and Web of Science databases for all relevant articles.

Decreasing Surgical Site Infection Associated with the Use of Circular Staplers During Roux-En-Y Gastric Bypass.

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been established as a leading treatment of obesity. Surgical site infections (SSIs) remain the most common complication.

Objective: To compare the incidence of SSIs before and after the implementation of our technique.

Non-classical high harmonic generation in graphene driven by linearly-polarized laser pulses.

Recent studies in high-order harmonic generation (HHG) in solid targets reveal new scenarios of extraordinary rich electronic dynamics, in comparison to the atomic and molecular cases. For the later, the main aspects of the process can be described semiclassically in terms of electrons that recombine when the trajectories revisit the parent ion. HHG in solids has been described by an analogous mechanism, in this case involving electron-hole pair recombinations.

Robotic abdominal wall repair: adoption and early outcomes in a large academic medical center.

Robotic-assisted abdominal wall repair (RAWR) has seen an exponential adoption over the last 5 years. Skepticism surrounding the safety, efficacy, and cost continues to limit a more widespread adoption of the platform. We describe our initial experience of 312 patients undergoing RAWR at a large academic center.

Feasibility and safety of calcium alginate hydrogel sealant for the treatment of cryptoglandular fistula-in-ano: phase I/IIa clinical trial.

Aim: Complex perianal fistulas pose a challenge to the surgeon since the fistulous tract must be eliminated without impairing continence. Although without strong scientific evidence, some bibliography has demonstrated the efficacy of some sealants in the treatment of anal fistulas. We aimed to assess the feasibility and safety of calcium alginate hydrogel injections into the fistulous tract as treatment for trans-sphincteric cryptoglandular fistulas.

Autologous Platelet-Rich Plasma in the Treatment of Perianal Fistula in Crohn's Disease.

Aim: To assess clinical healing in patients with perianal Crohn's disease with local intrafistular injection of autologous platelet-rich plasma.

Method: The pilot study was conducted at a single centre between January 2013 and December 2015. Autologous platelet-rich plasma was prepared in platelet-rich and platelet-poor fractions for local intrafistular injection in patients with proven, established perianal Crohn's disease.

Influence of robotics in surgical complication rate in elderly population with rectal cancer.

Background: Rectal cancer surgery is a technically complex procedure. Moreover, short-term outcomes show high rate of complications especially in elderly and laparoscopic surgery has not demonstrated to be able to reduce this complication rate. Robotics has several advantages in pelvic surgical procedures, which could have an impact in complication rates in elderly patients.

Platelet-rich plasma (PRP) versus fibrin glue in cryptogenic fistula-in-ano: a phase III single-center, randomized, double-blind trial.

Purpose: To compare the clinical outcome of autologous platelet-rich growth factor (PRP) with commercial fibrin glue in the management of high cryptogenic fistulae-in-ano.

Method: The study was conducted at a single center between July 2012 and July 2015 and performed as a phase III, randomized, double-blind comparison of autologously prepared PRP versus fibrin glue for cryptoglandular anal fistulae without active sepsis. Patients were assessed with clinical and endosonographic follow-up.

Is the Institutional Environment a Challenge for the Well-Being of Female Managers in Europe? The Mediating Effect of Work⁻Life Balance and Role Clarity Practices in the Workplace.

The advancement of women to top management positions positively affects firm competitiveness. However, this advancement may also negatively affect individuals as women find themselves forced to overwork to match their male counterparts in organisations, which can cause a decrease in their professional well-being. Although the literature highlights that human resource practices (HRPs) have a positive impact on well-being, it also warns that national institutions may condition the adoption of HRPs by organisations.

Returning to Work after Childbirth in Europe: Well-Being, Work-Life Balance, and the Interplay of Supervisor Support.

Parents returning to work after the arrival of a new son or daughter is an important question for understanding the trajectory of people's lives and professional careers amid current debates about gender equality and work-life balance (WLB). Interestingly, current research concludes that general WLB practices at the workplace may be necessary in the specific case of women returning to work after childbirth because of the particular maternal and infant factors involved. However, WLB practices as a flexible arrangement may work against women because they may be viewed as a lack of organizational commitment.

Fecal incontinence in older patients. A narrative review.

Fecal incontinence is one of the leading causes for the institutionalization of people in the last decades of life, associated with a great psychosocial and economic burden. The literature is scarce in this population group, due to the absence of universally accepted criteria to define "elderly patients" and difficulties in detection and diagnostic. The aim of this article was to conduct a narrative review of the main aspects related to fecal incontinence in older patients, providing management support.

Factibility and security study of the PICS-AF™ plug for the treatment of cryptoglandular anal fistula.

Introduction: The PICS-AF™ (Curaseal Inc.) device is a new plug made of collagen that has a retention system in the internal orifice. This pilot study was designed to assess both the feasibility and safety of this plug in the treatment of trans-sphincteric anal fístulas.

Ultrasonographic evidence of Gatekeeper™ prosthesis migration in patients treated for faecal incontinence: a case series.

Background: Faecal incontinence (FI) is both a medical and social problem, with an underestimated incidence. For patients with internal anal sphincter damage, implantation of biomaterial in the anal canal is a recognised treatment option. One such material, Gatekeeper™, has previously shown promising short- and medium-term results without any major complications, including displacement.

Learning curve in robotic rectal cancer surgery: current state of affairs.

Introduction: Robotic-assisted rectal cancer surgery offers multiple advantages for surgeons, and it seems to yield the same clinical outcomes as regards the short-time follow-up of patients compared to conventional laparoscopy. This surgical approach emerges as a technique aiming at overcoming the limitations posed by rectal cancer and other surgical fields of difficult access, in order to obtain better outcomes and a shorter learning curve.

Material And Methods: A systematic review of the literature of robot-assisted rectal surgery was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Is the interval from surgery to ileostomy closure a risk factor for low anterior resection syndrome?

Aim: Low anterior resection syndrome (LARS) comprises a collection of symptoms affecting patients after restorative surgery for rectal cancer. The aim of the present study was to analyse the incidence of LARS in patients undergoing rectal cancer surgery with and without subsequent ileostomy and to determine whether the interval to ileostomy closure is a factor associated with its occurrence.

Method: All patients undergoing curative anterior resection for rectal cancer from 2008 to 2012 in our institution were included in the study.

Validation of a new scoring system: Rapid assessment faecal incontinence score.

Aim: To implement a quick and simple test - rapid assessment faecal incontinence score (RAFIS) and show its reliability and validity.

Methods: From March 2008 through March 2010, we evaluated a total of 261 consecutive patients, including 53 patients with faecal incontinence. Demographic and comorbidity information was collected.

An Experimental Study on the Use of Calcium Alginate to Heal Colonic Anastomoses.

Background: Anastomotic leak is considered the major complication following abdominal surgery. In recent years, the use of a variety of sealing materials for the prevention of leaks has been analyzed. Different biomaterials have been employed as scaffolds to favour tissue repair and regeneration.

The role of tridimensional dynamic ultrasound for pelvic floor evaluation.

Introduction: Dynamic endoanal ultrasound has emerged in recent years as a test that could replace the now existing tests in the diagnosis of pelvic floor disorders. The aim of this paper is to determine the usefulness of echodefecography in the diagnosis and evaluation of patients with symptoms of anorrectal obstruction, and show the results obtained after its implementation in a pelvic floor unit, as a complementary tool that could replace conventional defecography.

Methods: In this retrospective study we analyzed 66 patients with a mean age of 55 years (19-83), 61 women (92%).

Percutaneous neuromodulation of the posterior tibial nerve for the treatment of faecal incontinence - mid-term results: is retreatment required?

Aim: Posterior tibial nerve stimulation (PTNS) has emerged in recent years as a therapy for faecal incontinence. Its long-term effectiveness is yet to be established, along with what the form of retreatment should be in the event of loss of effectiveness. The present study aimed to establish the mid-term results to identify the proportion of patients who may need further treatment, and if so when.