Long-term outcomes of sacral neuromodulation for low anterior resection syndrome after rectal cancer surgery.

Purpose: This study assessed the long-term outcomes and quality of life in patients who underwent sacral neuromodulation (SNM) due to low anterior resection syndrome (LARS).

Methods: This single-center retrospective study, conducted from 2005 to 2021, included 30 patients (21 men; median age, 70 years) who had undergone total mesorectal excision with stoma closure and had no recurrence at inclusion. All patients were diagnosed with LARS refractory to conservative treatment.

Comparative retention and effectiveness of migraine preventive treatments: A nationwide registry-based cohort study.

Background And Purpose: Little is known about the comparative effects of migraine preventive drugs. We aimed to estimate treatment retention and effectiveness of migraine preventive drugs in a nationwide registry-based cohort study in Norway between 2010 and 2020.

Methods: We assessed retention, defined as the number of uninterrupted treatment days, and effectiveness, defined as the reduction in filled triptan prescriptions during four 90-day periods after the first preventive prescription, compared to a 90-day baseline period.

Community matters: Heterogeneous impacts of a sanitation intervention.

Sanitation is at the heart of public health policies in most of the developing world, where around 85% of the population still lack access to safe sanitation. We study the effectiveness of a widely adopted participatory community-level information intervention aimed at improving sanitation. Results from a randomized controlled trial, implemented at scale in rural Nigeria, reveal stark heterogeneity in impacts: the intervention has immediate, strong and lasting effects on sanitation practices in less wealthy communities, realized through increased sanitation investments.

Complications from the primary tumour are not related with survival in patients with synchronous stage IV colorectal cancer receiving chemotherapy without primary tumour resection.

Background: The aim of this study was to evaluate the rate of complications from the primary tumour (CPT) requiring surgical or endoscopic intervention during chemotherapy treatment in patients with incurable synchronous stage IV colorectal cancer, the possibility of predicting such complications and their influence on survival.

Methods: One hundred and twenty-five patients were initially treated with chemotherapy. Patients were grouped on the basis of appearance or not of CPT.

Functional outcome of sacral nerve stimulation in patients with severe constipation.

Background: Sacral nerve stimulation has been reported as an effective treatment for constipation.

Objective: This study aimed to evaluate the therapeutic efficacy of permanent sacral nerve stimulation on the treatment of idiopathic constipation resistant to medical and behavioral management over a median follow-up period of 25.6 (range, 6-96) months.

Comparative study of one-stage colectomy of the descending colon in emergency and elective surgery without mechanical preparation.

Purpose: The aim of this study was to compare one-stage colectomy of the descending colon without mechanical preparation in emergency and elective surgery.

Methods: From January 2004 to September 2009, 327 consecutive patients underwent surgery in a coloproctology unit for several conditions of the descending colon, 122 on an emergency basis and 205 as elective surgery. In the emergency surgery group, patients with septic shock, multiorgan failure, immunodeficiency or corticoid treatment, ASA IV stage, generalized fecal peritonitis (Hinchey IV stage), nonviable cecum or unresectable tumors were excluded (n = 54).

Sacral nerve stimulation for the treatment of faecal incontinence following low anterior resection for rectal cancer.

Aim: The aim of this study was to assess the effectiveness of sacral nerve stimulation (SNS) in the management of faecal incontinence following neoadjuvant therapy and low anterior resection (LAR) for rectal cancer.

Method: In a prospective single-centre study, 15 patients (12 men, median age 72 years) were enrolled between 2005 and 2008. All had severe incontinence after total mesorectal excision, and 14 had received preoperative full-course chemoradiotherapy.

Randomized clinical trial of anal fistula plug versus endorectal advancement flap for the treatment of high cryptoglandular fistula in ano.

Background: The aim of this randomized study was to compare the results of anal fistula plug and endorectal advancement flap in the treatment of high fistula in ano of cryptoglandular origin.

Methods: Consecutive patients with high trans-sphincteric fistula in ano of cryptoglandular aetiology were randomized to treatment with either an anal fistula plug or endorectal advancement flap. Patients agreed to participate in a follow-up programme, which included scheduled visits at 2, 4, 8, 12 and 24 weeks and at 1 year after surgery.

Comparative study to determine the need for intraoperative colonic irrigation for primary anastomosis in left-sided colonic emergencies.

Objective: To compare the outcome of resection and primary anastomoses in patients undergoing emergency surgery of the left colon with and without intraoperative colonic irrigation.

Method: From January 2004 to December 2006, 102 consecutive patients with acute occlusion or perforation of the left colon were operated on an emergency basis in two Coloproctology units. According to the sample size calculation, 61 patients from one unit underwent surgery with intraoperative colonic irrigation, whereas 41 patients from the second unit underwent surgery without intraoperative colonic irrigation.

Length of follow-up after fistulotomy and fistulectomy associated with endorectal advancement flap repair for fistula in ano.

Background: The length of follow-up required after surgical repair of cryptoglandular fistula in ano has not been established. This prospective study determined the follow-up time needed to establish that an anal fistula has been cured after elective fistulotomy or fistulectomy associated with endorectal advancement flap (ERAF) repair.

Methods: Between January 2001 and June 2004, consecutive patients with anal fistula of cryptoglandular aetiology were included provided that they lived within the catchment area of the hospital and agreed to participate in a follow-up programme, which comprised scheduled visits every month until complete wound healing and annually thereafter.

Simultaneous presentation of oesophageal and renal cancer.

Oesophageal cancer has been documented to be often associated with other primary tumours. However, concurrent oesophageal and renal cell carcinoma is extremely uncommon. We report a case of synchronous oesophageal and kidney cancer that was successfully treated at our hospital by a one-stage surgical procedure.

[Treatment of perianal Crohn's disease].

Perianal affectation due to Crohn's disease includes a wide spectrum of lesions involving different management and prognosis. A thorough exploration of the patient, under anaesthetic if necessary, a rectoscope to evaluate the possible affectation of the rectum by the disease, and on occasions evaluation through endoanal echography or magnetic resonance, are the bases for a correct diagnostic and therapeutic focus. Pharmacology and surgery must be complementary in the treatment of perianal Crohn's disease and must pursue a double aim: to alleviate the symptomology of the patient and prevent possible complications.

[Incidence of psychiatric disorders in patients with fecal incontinence].

Objective: To evaluate the presence of psychiatric alterations in patients with fecal incontinence.

Patients And Method: Eighty consecutive patients (67 women) with fecal incontinence were evaluated. All the patients completed the the specific GHQ-28 questionnaire to evaluate psychiatric symptoms.

[Introduction of laparoscopy in the treatment of rectal cancer in a coloproctology unit].

Introduction: The application of the laparoscopic approach to the treatment of rectal cancer is controversial. The aim of the present study was to evaluate whether the introduction of this technique in a coloproctology unit modified the quality of rectal cancer surgery.

Material And Method: We performed a prospective, nonrandomized study of all patients with rectal cancer who underwent surgery with curative intent in 2003 and 2004.

[The surgical treatment of hemorrhoids].

Surgery is the most effective treatment in patients with symptomatic grade III-IV hemorrhoids who have not responded to outpatient treatment, when there is associated abnormalities (anal fissure, anal fistula, skin tags) and in thrombosed hemorrhoids. Hemorrhoidectomy is currently the "gold standard" treatment. Randomized controlled trials comparing open with closed hemorrhoidectomy show no significant differences in pain scores.

[Should hernia operations be carried out on elderly patients? ].

Background: To evaluate whether treatment of the inguinal hernia in patients over 70 years has different connotations with respect to patients of a lower age.

Material And Methods: Prospective study of 299 patients who had undergone intervention for an uncomplicated unilateral inguinal hernia during the year 2002. Group 1 included 90 patients with an age equal to, or higher than 70 years, and group 2 included the 209 patients who did not exceed this age.

Nonobstructive dysphagia and recovery of motor disorder after antireflux surgery.

Background: Changes in motor disorder after Nissen 360 degrees surgery were studied based on clinical signs of preoperative nonobstructive dysphagia.

Materials And Methods: Forty-seven patients undergoing Nissen 360 degrees fundoplication for gastroesophageal reflux were studied with pH recording and esophageal manometry before and 1 year after fundoplication. Amplitude of contraction of the distal third of the esophagus (ACDTE) and the presence of primary propulsive waves were studied.

The value of D1 lymphadenectomy as prognostic marker in gastric cancer.

Background/aims: To assess if the study on the involvement of perigastric lymph nodes, the only ones resected in D1 lymphadenectomy, is a valid prognostic marker in patients undergoing curative resection for gastric cancer.

Methodology: A retrospective study was performed in 101 patients with gastric cancer, 34 women and 67 men, with a mean age of 61 years, undergoing curative resection by gastrectomy and D1 lymphadenectomy. Tumor size, the depth of tumoral invasion of the wall, nodal involvement and 5-year survival were assessed.

Congenital esophageal cysts--two cases in adult patients.

Esophageal cysts are a rare clinicopathological condition. They usually cause respiratory symptoms in children, while they are often asymptomatic in adults. Two cases of esophageal cysts in adults, recently diagnosed and treated in our department, are reported.