Ambulatory colectomy: a pathway for advancing the enhanced recovery protocol.

Enhanced recovery after surgery (ERAS) protocols employ multiple factors to decrease surgical stress and improve recovery (Lyon et al., World J Gastroenterol 18(40):5661-5663, 2012). These protocols use multimodal approaches to improve outcomes, including length of stay and morbidities (Lyon et al.

Ambulatory colectomy: A pilot protocol for same day discharge in minimally invasive colorectal surgery.

Background: Since its inception colectomy has routinely been performed in the inpatient setting. The advent of Enhanced Recovery After Surgery (ERAS) protocols has led improved outcomes, including decreased length of stay (LOS). These improvements have introduced the possibility of ambulatory colectomy.

Enterocele Reduction in the Prone Position: New Horizons for Safer Stapled Transanal Rectal Resections.

Aim: The presence of enterocele may interfere with the surgical approach for obstructed defecation syndrome (ODS) as it may represent a contraindication to stapled transanal rectal resection (STARR), and tactics to overcome this problem have been debated. A change in the patient's position during surgery may be a means to overcome an enterocele. We sought to determine whether an enterocele could be completely reduced when the patient is placed in the prone position during fluoroscopic defecography (FD).

Results from a novel modification to the ligation intersphincteric fistula tract.

Background: The ligation of intersphincteric fistula tract (LIFT) procedure for trans-sphincteric fistula-in-ano has been studied with variable success rates compared with initial reports. Failures occur mostly in the intersphincteric wound. Recently, we proposed a modification to LIFT, unroofing the fistula from internal opening to intersphincteric groove, ligating the fistula tract, but preserving the external sphincter.

Hemorrhoid management in patients with radiation proctitis.

Purpose: Management of rectal bleeding in patients with radiation proctitis presents a conundrum for practitioners. Surgeons are appropriately concerned about using conventional methods of treatment in these patients, such as cautery for bleeding areas in the rectum, rubber band ligation, or excision of internal and/or external hemorrhoids, for fear of poor healing and possible exacerbation of the original problem. Few randomized controlled trials are available on the treatment of radiation proctitis alone, and no literature exists pertaining to the management of symptomatic hemorrhoids in the radiated patient.