Long-term functional and quality-of-life outcomes after IPAA in children.

Background: The impact of IPAA on long-term outcomes in adults is favorable. Studies on functional outcome and quality of life in children are sparse.

Objective: The aim of this study was to evaluate the functional and quality-of-life outcomes after IPAA in children and to investigate the possible correlations between the two.

[Identifying ways to address the crisis facing a medical specialty: a case study of general surgery].

Background: In a previous study we defined criteria for a medical specialty in crisis' and measures to assess the scale of the problem, and possible resolutions suggested based on experience abroad. This study seeks to gain further knowledge by exploring how front-line Israeli surgeons envisage the problems and possible solutions.

Objectives: To identify ways to address the workforce crisis in general surgery (GS) white focusing on issues that can be dealt with at the department and the hospital levels.

Evaluation of the NiTi Shape Memory BioDynamix ColonRing™ in colorectal anastomosis: first in human multi-center study.

Background: Shape-memory compression bowel anastomosis using a nickel and titanium alloy may reduce leak rates and eliminate foreign anastomotic material. Its safety and efficacy had been demonstrated by animal studies. We conducted the first prospective multi-center clinical evaluation of the safety and effectiveness of BioDynamix anastomosis with ColonRing™ for large-bowel end-to-end or side-to-end anastomosis.

A longitudinal study of quality of life and functional outcome of patients with ulcerative colitis after proctocolectomy with ileal pouch-anal anastomosis.

Purpose: Ileal pouch-anal anastomosis is considered the surgical treatment of choice for patients with ulcerative colitis. It is safe and effective but associated with long-term complications, making functional outcome and quality of life important factors in determining patient outcome. Longitudinal studies on long-term functional outcome and quality of life are sparse.

In vitro large diameter bowel anastomosis using a temperature controlled laser tissue soldering system and albumin stent.

Background And Objective: In today's age of advancing surgical technology, there is a need for better and simpler methods of tissue bonding. The use of lasers for tissue welding or soldering is one of these sutureless methods. In 30 years of laser tissue bonding (LTB) research, published reports of cylindrical organ anastomosis were limited to small diameters.

Long-term results of local excision for T1 rectal carcinoma: the experience of two colorectal units.

Background: Local excision for early rectal cancer has low morbidity and good functional results. Its use is limited by the inability to assess regional lymph nodes and by the uncertainty of oncologic outcome.

Methods: We conducted a retrospective chart review of all patients who underwent local excision of early rectal cancer in two colorectal units between 1995 and 2007.

An interval >7 weeks between neoadjuvant therapy and surgery improves pathologic complete response and disease-free survival in patients with locally advanced rectal cancer.

Background: We assessed whether the time interval between neoadjuvant therapy and surgery affects the operative and postoperative morbidity and mortality, the pathologic complete response (pCR) rate, and disease recurrence in locally advanced rectal cancer.

Methods: One-hundred and thirty-two patients with locally advanced low- and mid-rectal cancer underwent neoadjuvant chemoradiation followed by radical resection (October 2000 to December 2006). Data on the neoadjuvant regime, neoadjuvant-surgery interval, final pathology, type of operation, operative time, intraoperative blood transfusions, postoperative complications, length of hospital stay, disease recurrence, and mortality were reviewed.

Comprehensive pouch clinic concept for follow-up of patients after ileal pouch anal anastomosis: report of 3 years' experience in a tertiary referral center.

Background: We designed and evaluated a novel concept in enhancing postoperative care of patients following restorative proctocolectomy (RPC) for ulcerative colitis (UC) and determined the risk factors, incidence, and nature of RPC-associated complications in this population.

Methods: The study cohort consisted of consecutive UC patients post-RPC attending a comprehensive pouch clinic run by a gastroenterologist and a colorectal surgeon in a tertiary care medical center (from January 2003 to December 2005). Data were collected on their medical history, physical examination, laboratory tests, pouch endoscopy and biopsies, and anonymous in-house patient satisfaction questionnaires mailed to the first 90 patients.

Compression gastrointestinal anastomosis.

The creation of anastomoses between various parts of the GI tract is a major task in the daily practice of oncological, reconstructive and transplant surgery. The most widely used anastomosing techniques today involve the use of sutures or metal titanium staples. Both techniques involve foreign material penetrating the tissue and evoking localized inflammatory response, tissue injury and breaking of mucosal barriers that may facilitate bacterial growth within the anastomotic line, increasing the propensity to anastomotic-related morbidity.

Immunomodulatory effects of ciprofloxacin in TNBS-induced colitis in mice.

Background: Crohn's exacerbation and pouchitis are commonly treated with ciprofloxacin and metronidazole. Few studies have shown an advantage of this regimen compared with other antibiotics. Most attributed the effect to its better antibacterial coverage.

Recto-vaginal/urethral fistula: repair with gracilis muscle transposition.

Unlabelled: This study was designed to assess the efficacy of gracilis muscle transposition in repairing recto-vaginal and rectourethral fistula. All patients had fecal diversion as a preliminary or concurrent step to fistula repair. Success was defined as healed fistula after stoma closure.

Gracilis muscle transposition for fistulas between the rectum and urethra or vagina.

Purpose: This study was designed to assess the efficacy of gracilis muscle transposition in repairing rectovaginal and rectourethral fistulas.

Methods: Data were retrieved from a retrospective chart review of patients who underwent gracilis muscle transposition for fistulas between the rectum and urethra/vagina. All patients had fecal diversion as a preliminary or concurrent step to fistula repair.

Can rectal cancers with pathologic T0 after neoadjuvant chemoradiation (ypT0) be treated by transanal excision alone?

Background: Patients with rectal cancer who have complete rectal wall tumor regression after neoadjuvant chemoradiation probably have eradication of tumor cells in the mesorectum as well, thus raising the possibility of transanal excision.

Methods: All pathology reports of all patients with locally advanced low and mid rectal cancer who underwent preoperative chemoradiation followed by radical resection from May 2000 to June 2004 were reviewed to evaluate the correlation between complete tumor response (ypT0) and nodal response.

Results: One hundred one consecutive patients had neoadjuvant chemoradiation followed by definitive operation.

Prospective, multicenter evaluation of highly concentrated fibrin glue in the treatment of complex cryptogenic perianal fistulas.

Purpose: The surgical management of complex perianal fistulas is challenging and may be associated with the risk of sphincter injury. Instillation of fibrin glue to the fistula tract is a simple procedure that does not involve any muscle division, and potentially results in healing of the fistula. This study was designed to assess the use of highly concentrated fibrin glue with intra-adhesive antibiotics in the treatment of complex cryptogenic perianal fistulas.

Surgical treatment and long-term outcome of patients with familial adenomatous polyposis: 16 years experience at the Tel Aviv Sourasky Medical Center.

Background: Restorative proctocolectomy eliminates the risk of colorectal cancer in patients with familial adenomatous polyposis. Complications and extra-intestinal manifestations are inherent to the procedure.

Objectives: To evaluate operative procedures, complications, early and late results and long-term functional outcome in FAP patients operated in our department.

Extracolonic manifestations of familial adenomatous polyposis after proctocolectomy.

Hypothesis: Extracolonic manifestations have a major effect on the morbidity and mortality of patients with familial adenomatous polyposis following proctocolectomy.

Design: Case review study.

Setting: Colorectal unit, university-affiliated hospital.

Detection of recurrence in patients with rectal cancer: PET/CT after abdominoperineal or anterior resection.

Purpose: To assess diagnostic accuracy of combined positron emission tomography (PET) and computed tomography (CT) in detection of pelvic recurrence in patients with rectal cancer who underwent abdominoperineal or anterior resection.

Materials And Methods: Sixty-two patients were enrolled; 37 were men, and 25 were women. Seventeen patients underwent abdominoperineal resection and 45 underwent anterior resection with an anastomosis in the pelvic region before referral for PET/CT.

Presacral tumors: a practical classification and treatment of a unique and heterogeneous group of diseases.

Background: Presacral tumors are a rare and diverse group of diseases that originate from the different tissues that comprise the potential presacral space. Because of their relative rarity, confusion exists regarding their clinical presentation, natural history, and treatment. The aim of this study is to describe a single institution's experience with the management of presacral tumors and to suggest a practical method of classification.

[Comparison between colonic J-pouch anal anastomosis and straight coloanal anastomosis following low anterior resection of the rectum].

Background: Low anterior resection, colo-anal anastomosis with anal sphincters preservation has become the routine procedure for the treatment of low rectal cancer. This method avoids the need for a permanent colostomy without compromising oncological principles. However, many of these patients experience symptoms of fecal frequency, urgency and variable degree of incontinence.

Role of (18)F-FDG dual-head gamma-camera coincidence imaging in recurrent or metastatic colorectal carcinoma.

Unlabelled: (18)F-FDG PET has been shown to be of high diagnostic accuracy for the evaluation of recurrent colorectal cancer. However, the limited availability of PET scanners precludes (18)F-FDG assessment of many patients for whom the study is indicated. An alternative is the SPECT system in coincidence mode.