[Transanal Tumor Resection: Indication, Surgical Technique and Management of Complications].

Transanal resection procedures are special operations for the minimally invasive treatment of rectal tumours. Apart from benign tumours, this procedure is suitable for the excision of low-risk T1 rectal carcinomas, if these can be completely removed (R0 resection). With stringent patient selection, very good oncological results are achieved.

[Slow transit constipation].

Slow transit constipation (STC) is a rare condition almost exclusively encountered in middle-aged women. Pathophysiology and aetiology are poorly understood but a multi-factorial pathogenesis seems likely. With regard to differential diagnoses mechanical, drug induced, degenerative, metabolic, endocrinologic, neurologic, and psychiatric causes of constipation must be excluded by an interdisciplinary approach.

[Transanal resection procedures-current status].

Transanal resection procedures are special surgical methods for the minimally invasive treatment of rectal tumors. Apart from benign tumors, this operative procedure is suitable for the excision of so-called low-risk T1 rectal carcinomas, if these can be completely removed up to healthy tissue (R0 resection) due to the size and localization. With stringent patient selection very good oncological results are achieved.

[Slow Transit Constipation].

Slow transit constipation is a rare condition that is almost exclusively encountered in middle-aged women. The pathophysiology and aetiology are poorly understood, but a multi-factorial pathogenesis seems likely. In the course of the differential diagnosis, mechanical, drug-induced, degenerative, metabolic, endocrinological, neurological and psychiatric causes of constipation must be excluded by an interdisciplinary approach.

Groin hernia diagnostics: dynamic inguinal ultrasound (DIUS).

Purpose: Although clinical examination is the gold standard for the diagnosis of groin hernia, imaging procedures can improve the detection of femoral hernias, incipient hernias, and less-common types of hernias (e.g., an obturator hernia).

TST36 stapling for rectocele and hemorrhoidal prolapse - early results of the prospective German multicenter study.

The aim of the study was to evaluate the safety and feasibility of stapled transanal procedures performed by a 36 mm stapling device, the so-called TST36 stapler. From September 2013 to June 2014 a prospective observational study was carried out by 8 proctology centers in Germany. The Cleveland Clinic Incontinence Score (CCIS) for incontinence and the Altomare ODS score were determined preoperatively.

German S3-Guideline: rectovaginal fistula.

Background: Rectovaginal fistulas are rare, and the majority is of traumatic origin. The most common causes are obstetric trauma, local infection, and rectal surgery. This guideline does not cover rectovaginal fistulas that are caused by chronic inflammatory bowel disease.

German S3 guideline: anal abscess.

Background: The incidence of anal abscess is relatively high, and the condition is most common in young men.

Methods: A systematic review of the literature was undertaken.

Results: This abscess usually originates in the proctodeal glands of the intersphincteric space.

Cryptoglandular anal fistulas.

Background: Cryptoglandular anal fistula arises in 2 per 10 000 persons per year and is most common in young men. Improper treatment can result in fecal incontinence and thus in impaired quality of life.

Method: This S3 guideline is based on a systematic review of the pertinent literature.

Prospective phase II study of preoperative short-course radiotherapy for rectal cancer with twice daily fractions of 2.9 Gy to a total dose of 29 Gy--long-term results.

Background: To evaluate clinical outcome after preoperative short-course radiotherapy for rectal cancer with twice daily fractions of 2.9 Gy to a total dose of 29 Gy and adjuvant chemotherapy for pathological stage UICC >or= II.

Methods: 118 patients (median age 64 years; male : female ratio 2.

The concurrence of histologically positive resection margins and sessile morphology is an important risk factor for lymph node metastasis after complete endoscopic removal of malignant colorectal polyps.

Introduction: The optimal procedure to be followed after colonoscopic polypectomy of malignant colorectal polyps with nontumour-free resection margins at histology is a matter of controversy. While some authors recommend merely local or segmental follow-up resection, others favour an oncological resection.

Patients And Methods: One hundred five patients, each with a single malignant polyp, were investigated.

Impact of biopsy on the accuracy of endorectal ultrasound staging of rectal tumors.

Purpose: Endorectal ultrasound is a well-established method for the preoperative staging of rectal tumors. This prospective study was performed to establish whether obtaining a biopsy before endorectal ultrasound has an influence on staging accuracy.

Methods: Between 1990 and 2003, a total of 333 rectal tumors were examined preoperatively by using endorectal ultrasound.

Effect of cholecystectomy on gastric and esophageal bile reflux in patients with upper gastrointestinal symptoms.

Epidemiologic data have shown that cholecystectomy is associated with a moderately increased risk of esophageal adenocarcinoma. The study objective was to evaluate the role of refluxed bile. A total of 696 patients with upper gastrointestinal symptoms were included in the study, of whom 55 had a history of cholecystectomy (CHE).

Radiation-induced sequelae affecting the continence organ: incidence, pathogenesis, and treatment.

Introduction: Incontinence is a late complication that causes symptoms years after radiation treatment and is difficult to deal with; it poses a particular challenge for care-providing physicians.

Review: This review looks at our current knowledge of the incidence, symptoms, and treatment of fecal incontinence induced by radiation treatment. An approximate estimation based on retrospective data suggests an incidence of fecal incontinence of up to one-third of patients.

Association of anorectal dose-volume histograms and impaired fecal continence after 3D conformal radiotherapy for carcinoma of the prostate.

Purpose: The late toxicity of fecal incontinence after pelvic radiotherapy is now frequently recognized but the etiology poorly understood. We therefore investigated associations between dose-volume histogram (DVH) parameters of the rectum and the anal canal with fecal continence as measured by an established 10-item questionnaire.

Methods And Materials: Forty-four patients treated for carcinoma of the prostate with 58-72 Gy of 3D conformal radiotherapy between 1995 and 1999 who completed the questionnaire formed the study population.

Measuring quality of life in rectal cancer patients.

Quality of life assessment in rectal cancer patients is necessary to provide a more comprehensive understanding of the outcome of surgery and other forms of treatment. Quality of life aspects must be placed in broader concept and should provide complementary information to healthcare professionals, together with classical outcomes, such as mortality, morbidity and long-term survival. There is a general lack of well-designed quality of life trials in rectal cancer patients.

Gastric bilirubin monitoring to assess duodenogastric reflux.

Duodenogastric reflux (DGR) was assessed with 24-hour gastric bilirubin monitoring in 345 patients (219 men; 49 +/- 13 years) with foregut symptoms and 41 healthy subjects (24 men, 28 +/- 5 years). Bilirubin exposure was measured as percent time above absorbance level 0.25 and excessive DGR was defined above the 95th percentile of normal values (>24.

Chronic fatigue after radiotherapy for carcinoma of the prostate: correlation with anorectal and genitourinary function.

In an investigation of chronic fatigue in patients treated with radical or post-operative radiotherapy for carcinoma of the prostate, the Brief Fatigue Inventory, urinary and anorectal function questionnaires were completed by 103 patients 2.1 years (median) after treatment. The mean fatigue score (2.

Endoscopic ultrasound-guided transrectal biopsies of pelvic tumors.

The aim of this study was to evaluate the feasibility, safety, and diagnostic accuracy of endorectal ultrasound-guided biopsies in patients with extrarectal lesions. Data from all patients with suspicious pelvic pathology who underwent endorectal ultrasound-guided biopsies were collected prospectively. To evaluate the accuracy of the diagnosis, all patients with benign histology but primary suspicion of a malignant lesion were followed up for at least 12 months.