Current Colorectal Cancer in Thailand.

This article aimed to summarize the current status of colorectal cancer (CRC) in Thailand. In brief, CRC is the third most common cancer and accounts for 11% of the cancer burden in Thailand. It is the only malignancy with an increased incidence in both sexes in Thailand.

Urgent Pelvic Exenteration: Should the Indication Be Extended?

Background: Pelvic exenteration carries significant risks of morbidity and mortality. Preoperative management is therefore crucial, and the exenteration procedure is usually performed in an elective setting. In cases of rectal cancer, however, tumor-related complications may cause a patient's condition to deteriorate rapidly, despite optimal management.

Utility and short-term outcomes of hand-assisted laparoscopic colorectal surgery: a single-institution experience in 1103 patients.

Background: Despite its introduction in 1991, laparoscopic colectomy is performed in <10% of United States patients requiring colectomy. Laparoscopic colectomy is avoided principally because of its technical difficulty, steep learning curve, and increased operative times. Hand-assisted laparoscopic colectomy is an alternative technique that addresses these problems while preserving the short-term benefits of laparoscopic colectomy.

Marsupialization for simple fistula in ano: a randomized controlled trial.

Background: Marsupialization of anal fistulotomy results in less raw-surface wound and may improve postoperative outcomes. The present study was designed to test the benefit of marsupialization for simple fistula in ano.

Material And Method: This was a randomized controlled study conducted at King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Internal sphincter myectomy for adult Hirschsprung's disease: a single institute experience.

Objective: Adult Hirschsprungs disease is a rare disease and frequently misdiagnosed as the long-standing refractory constipation. Almost all cases have short or ultra-short aganglionic segment of distal rectum. The clinical features are different from those in childhood when the diseased segment is long.

A comparison of early postoperative results between urgent closed hemorrhoidectomy for prolapsed thrombosed hemorrhoids and elective closed hemorrhoidectomy.

Objective: To compare the perioperative complications, analgesics requirement, and length of hospital stay between patients undergoing urgent closed hemorrhoidectomy for prolapsed thrombosed hemorrhoid and elective closed hemorrhoidectomy.

Research Design: Retrospective, comparative study.

Material And Method: All records of the patients who underwent urgent and elective hemorrhoidectomy between January 2000 and December 2005 were reviewed.

Minimally invasive subtotal colectomy and ileal pouch-anal anastomosis for fulminant ulcerative colitis: a reasonable approach?

Purpose: This study was designed to evaluate the safety, feasibility, and short-term outcomes of three-stage minimally invasive surgery for fulminant ulcerative colitis.

Methods: Using a prospective database, we identified all patients with ulcerative colitis who underwent minimally invasive surgery for both subtotal colectomy and subsequent ileal pouch-anal anastomosis at our institution from 2000 to 2007. Demographics and short-term outcomes were retrospectively evaluated.

Multimedia article. Laparoscopic restorative proctocolectomy with small McBurney incision for ileal pouch construction without protective ileostomy.

Purpose: Restorative proctocolectomy is a standard treatment for colorectal diseases over decades. At present, this technique is frequently performed via minimal invasive approach. Most reported techniques of laparoscopic restorative proctocolectomy involved a Pfannenstiel incision for the major part of the operation to be performed openly; a double-stapled pouch anal anastomosis technique and protective ileostomy.

Experience with 969 minimal access colectomies: the role of hand-assisted laparoscopy in expanding minimally invasive surgery for complex colectomies.

Background: Laparoscopic-assisted colectomy (LAC) is not performed widely despite numerous patient benefits. LAC is difficult to perform and the learning curve is steep. Hand-assisted laparoscopy (HALS) permits placement of a hand into the abdomen to assist the dissection.

Benefits of povidone-iodine solution in colorectal operations: science or legend.

Povidone-iodine solution (Betadine) has long been accepted as an effective topical broad spectrum antiseptic, disinfectant, and tumoricidal agent. In colorectal operations, this solution generally has been used for the purpose of minimizing postoperative septic complications and reducing cancer recurrence, although the optimal application, advantages, and undesirable side effects have been debated. With limited prospective, randomized, controlled trials and insufficient data available, this article examines the safe and effective clinical applications of this solution for colorectal operations.

Antibiotics and early post operative complications of closed hemorrhoidectomy: a retrospective matched pair study.

Objective: The purpose of the present study was to compare early post-operative complications and length of hospital stay of hemorrhoidectomy patients between those who had and had not received metronidazole perioperatively.

Research Design: Retrospective, matched pair case-control study.

Material And Method: Medical records of all hemorrhoidal patients hospitalized between January 2000 and December 2005 were reviewed.

Outcome of familial adenomatous polyposis: a retrospective study.

Background: Familial adenomatous polyposis (FAP) is characterized by the presence of numerous colorectal adenomatous polyps that progress to colorectal cancer if left untreated. Following colorectal cancer, periampullary cancer and aggressive desmoid tumor are also the common causes of death. The purpose of the present study was to describe the clinical course of FAP patients.

Closed lateral internal sphincterotomy using endoshere cut scissors.

Background: Internal sphincterotomy remains the gold standard for treatment of chronic anal fissure but it is associated with immediate wound bleeding and hematoma, which is usually corrected by a pressure dressing for half an hour.

Objective: This procedure was the initial study to decrease intra-operative and immediate postoperative wound bleeding, hematoma, and duration of pressure by using Endoshere cut scissors for closed lateral internal sphincterotomy.

Material And Method: Closed lateral internal sphincterotomy was performed on patients with chronic anal fissures by using Endoshere cut scissors in standard technique.

New concept of ileocecal junction: intussusception of the terminal ileum into the cecum.

Aim: To prove that the terminal ileum is intussuscepted into the cecum creating the ileocecal junction, contrary to previous valvular concept which has been widely believed.

Methods: This study is based on gross and microscopic examinations of fresh specimens derived from colonic operations (right hemicolectomy or subtotal colectomy). Data compiled from observing and dissecting of specimens of seven patients are used to examine both gross and microscopic appearance of ileocecal junction.

Closed vs ligasure hemorrhoidectomy: a prospective, randomized clinical trial.

Objective: To compare the operative time, postoperative complications, and analgesic requirement between closed hemorrhoidectomy and Ligasure hemorrhoidectomy.

Material And Method: The study was conducted in a prospectively randomized controlled fashion. Forty-seven patients with grade 3 or 4 hemorrhoids plus external component or skin tag were operated on by either hemorrhoidectomy with Ligasure (24 patients) or closed hemorrhoidectomy (23 patients).

Minimally invasive surgery training in soft cadaver (MIST-SC).

Objectives: The purpose of this study was to evaluate the surgical anatomy, tissue plane, organ consistency of soft cadaver and the possibility of minimally invasive surgery training in soft cadaver.

Setting: Surgical Training Center. Department of Anatomy and Department of Surgery Faculty of Medicine, Chulalongkorn University.

The new laparoscopic proctocolectomy training (in soft cadaver).

Objectives: The purpose of the present study was to evaluate the quality of preservation (tissue plane, named vessels identification, consistency of colon and rectum), quality of performing procedures, difficulties and problems and finally the satisfaction of surgeons in laparoscopic proctocolectomy in soft cadaver.

Setting: Colorectal Division, Department of Surgery and Surgical Training Center Department of Anatomy, Faculty of Medicine, Chulalongkorn University.

Design: Prospective descriptive study

Material And Method: 10 soft cadavers were scheduled for laparoscopic proctocolectomy.

Laparoscopic versus open surgery for rectosigmoid and rectal cancer.

Objectives: The aim of this study was to evaluate feasibility and safety of laparoscopic surgery for rectosigmoid cancer and rectal cancer.

Material And Method: Twenty four patients who underwent laparoscopic surgery for rectosigmoid cancer or rectal cancer were retrospectively evaluated. Results were compared with those of 25 patients who had open surgery at the same period.

The location and contents of the lateral ligaments of the rectum: a study in human soft cadavers.

Purpose: This study was designed to identify the location of the lateral ligaments of the rectum and to reveal its contents.

Methods: From 18 human soft cadavers (9 males), 18 pelves were sagittally sectioned into 36 hemipelvic specimens affording good anatomic view of the lateral aspect of the rectum. All of them were dissected and mobilized by using sharp technique under direct vision by one surgeon to avoid confounding factor.