Transanal endoscopic microsurgery versus conventional transanal excision for patients with early rectal cancer.

Objective: To compare transanal endoscopic microsurgery (TEMS) with conventional transanal excision (TAE) in terms of the quality of resection, local recurrence, and survival rates in patients with stage I rectal cancer.

Background: Although TEMS is often considered a superior surgical technique to TAE, it is poorly suited for excising tumors in the lower third of the rectum. Such tumors may confer a worse prognosis.

Viral and fungal infectious colitides.

Viral and fungal colitides are rare in the immunocompetent host but are most clinically significant in populations with compromised immune function. They may be associated with high mortality, particularly when treatment is delayed. It is important to be aware of these diseases when treating patients with colitis to allow early diagnosis and treatment, which will improve outcome.

Contemporary indications for and early outcomes of abdominoperineal resection.

The purpose of this study was to review and characterize the indications and early outcomes of abdominoperineal resection (APR) when used in a colorectal practice in an academic setting. Data was collected from the charts of all patients undergoing APR in a retrospective manner. Data collected included demographic information and details regarding the clinical presentation.

Factors affecting the successful management of intra-abdominal abscesses with antibiotics and the need for percutaneous drainage.

Purpose: There is no definite consensus on the management of intra-abdominal abscesses in adults. This retrospective study evaluated the use of antibiotic therapy and percutaneous image-guided drainage in adult patients with intra-abdominal abscesses.

Methods: A retrospective chart review of 114 patients with intra-abdominal abscesses was conducted.

Colonic histoplasmosis presenting as colon cancer in the nonimmunocompromised patient: report of a case and review of the literature.

Histoplasma capsulatum is an important pathogen that is the most commonly diagnosed endemic mycosis in the gastrointestinal tract of immunocompromised hosts. Failure to recognize and treat disseminated histoplasmosis in AIDS patients invariably leads to death. Gastrointestinal manifestations frequently involve the terminal ileum and cecum, and depending on the layer of bowel wall involved present as bleeding, obstruction, perforation, or peritonitis.

Diverticulitis: truly minimally invasive management.

The purpose of this study is to evaluate the treatment of patients with acute diverticulitis in the inpatient setting using minimal intervention. This was a retrospective study of 75 patients admitted over a 3-year period with acute diverticulitis as evidenced by computed tomography (CT) and clinical scenario. Of the patients enrolled, 24 (32%) had abscesses identified on their initial CT scan.

Strategies for palliative care in advanced colorectal cancer.

Palliative care has appropriately been receiving increased attention in recent years. From the surgeon's standpoint, therapy is considered palliative when resection of all known tumor sites is no longer possible or advisable. Since a cure, as commonly defined, is not possible, the goal of treatment and eventually the success of therapy becomes judged by the control of symptoms and alleviation of suffering.

An assessment of the severity of recurrent appendicitis.

Background: This study examines the clinical characteristics of patients who developed recurrent appendicitis after previous nonoperative management of perforated appendicitis.

Methods: Retrospective chart review was performed, and data from the recurrent and initial episode of appendicitis were collected.

Results: In all, 237 patients from 1989 to 2001 were managed nonoperatively for perforated appendicitis and 32 (14%) were readmitted for recurrent appendicitis.

Stapled hemorrhoidectomy: a review of our early experience.

Treatment of hemorrhoids may safely be accomplished by using a circular stapler instead of the conventional open procedure for large symptomatic hemorrhoids. Our purpose was to assess the safety and early post-op results of this new surgical technique as it was introduced into clinical practice. Medical records from 62 patients treated by circumferential mucosectomy/stapled hemorrhoidectomy were obtained from 6 surgeons.

Carcinoembryonic antigen and albumin predict survival in patients with advanced colon and rectal cancer.

Hypothesis: Patients with stage IV colon or rectal cancer at initial diagnosis have characteristics that will predict subsequent survival time.

Design: Retrospective cohort study.

Setting: Urban county teaching hospital providing tertiary care.