Bundles reduce anastomosis leak in patients undergoing elective colorectal surgery. A propensity score-matched study.

Background: anastomosis leak still being a handicap in colorectal surgery. Bowel mechanical preparation and oral antibiotics are not a practice recommended in many clinical practice guides. The aim is to analyse the decrease in frequency and severity of postoperative complications, mainly related to anastomotic leak, after the establishment of a bundle.

Early diagnosis of anastomotic leakage in colorectal surgery: prospective observational study of the utility of inflammatory markers and determination of pathological levels.

Procalcitonin (PCT) and C-Reactive Protein (CRP) are acute-phase reactants that indicate the presence and severity of an infection. The aim of this study was to verify the utility of CRP and PCT as tools for early diagnosis of anastomotic leakage (AL) in patients undergoing elective colorectal surgery. A prospective observational study including 95 patients undergoing elective colorectal surgery with anastomosis, where patients were divided into two groups according to whether or not AL happened.

Population-based screening improves histopathological prognostic factors in colorectal cancer.

Introduction: Diagnosis of colorectal cancer (CRC) based on clinical symptoms is usually established in its advanced stages. One strategy for reducing mortality is the early detection and removal of preneoplastic and initial neoplastic lesions, even before the first symptoms appear, by means of population-based screening campaigns. The aim of the present study is to determine whether CRC diagnosed via a screening campaign has more favourable histopathological prognostic factors than when diagnosed in the symptomatic phase.

The use of coffee, chewing-gum and gastrograffin in the management of postoperative ileus: A review of current evidence.

Postoperative ileus is one of the main complications in the postoperative period. New measures appeared with the introduction of «fast-track surgery» to accelerate recovery: coffee, chewing gum and gastrograffin. We performed a summary of current evidence, reviewing articles from MEDLINE, Cochrane Database of Systematic Reviews, ISI Web of Science, and SCOPUS databases.

Increased survival and decreased recurrence in colorectal cancer patients diagnosed in a screening programme.

Introduction: Population-based screening programmes for colorectal cancer (CRC) allow an early diagnosis, even before the onset of symptoms, but there are few studies and none in Spain on the influence they have on patient survival. The aim of the present study is to show that patients receiving surgery for CRC following diagnosis via a screening programme have a higher survival and disease-free survival rate than those diagnosed in the symptomatic stage.

Material And Methods: Prospective study of all the patients undergoing programmed surgery for CRC at the JM Morales Meseguer Hospital in Murcia (Spain) between 2004 and 2010.

Malignant degeneration of rectal endometriosis.

Background: Endometriosis is a relatively common disease among women with child-bearing potential, and rare before puberty or following menopause. It consists of the presence of hormone-responsive endometrium outside the endometrial cavity.

Case Report: We report the case of a patient with a rectal lesion, initially approached as a primary rectal malignancy, where histopathology eventually revealed an adenocarcinoma arising from endometrial tissue in the colonic wall.

[Presacral tumor as a differential diagnosis of recurrent pilonidal sinus].

Background: Retrorectal or presacral space is occupied during embryological stem cell development and therefore may contain a heterogeneous group of tumors.

Clinical Case: We report the case of a 22-year-old male with a pilonidal cyst operated due to recurrent pilonidal sinus cyst. Final diagnosis after pelvic computed tomography is large retrorectal cystic tumor and magnetic resonance diagnosis of a presacral cystic compatible wtih germ cell tumor.

Single-port transanal endoscopic microsurgery: a developing technique.

Introduction: Transanal endoscopic microsurgery is a widely used and valid technique with established indications. However, the cost of surgical anoscopes is not available in all centers. Many authors have described transanal resection of rectal tumors through a single laparoscopy port such as the SILS system.

[Colorectal stents: efficacy and complications in our center].

Background: in emergency surgery, colorectal mortality is very high compared with elective surgery. An alternative is placement of endoscopic stents to correct the bowel obstruction and then allow elective surgery. Moreover, it is possible to use stents in the palliative treatment of patients at high surgical risk or with unresecable tumors.

Protective ileostomy: complications and mortality associated with its closure.

Introduction: diverting loop ileostomies are widely used in colorectal surgery to protect low rectal anastomoses. However, they may have various complications, among which are those associated with the subsequent stoma closure. The present study analyses our experience in a series of patients undergoing closure of loop ileostomies.

Is intravenous iron useful for reducing transfusions in surgically treated colorectal cancer patients?

Background: The goal of the present study was to determine whether the intravenous administration of iron in the postoperative period of colon cancer surgical patients suffices to reduce the number of transfusions necessary.

Method: The study was designed as a retrospective observational study conducted over a three-year period. A paired case-control design was used to analyze the effect of postoperative iron on patients' blood transfusion needs.

Evaluation of a clinical pathway to improve colorectal cancer outcomes.

The aims of this preintervention and postintervention study were to monitor and evaluate the clinical pathway (CP) for colorectal cancer (CRC) over a 5-year period and to compare 2 groups of patients (before and after the intervention) with regard to different variables of effectiveness. Group I comprised 68 patients who underwent planned surgery between January 2002 and January 2003. Group II comprised a sample of 202 patients who underwent surgery between January 2004 and December 2008.

[Improvement in the quality of life of faecal incontinent patients after sacral root stimulation treatment].

Introduction: Faecal incontinence (FI) is a highly prevalent disorder that severely affects the health related quality of life (HRQOL) of the patients who suffer from it. Neuromodulation is a minimally invasive treatment that has demonstrated its efficacy in the treatment of FI symptoms over the past 10 years. The aim of this study is to check whether there is an improvement in the quality of life, using EuroQuol (EQ-5D), in patients with faecal incontinence treated with sacral root neuromodulation.

[Fournier's gangrene. Descriptive analysis of 20 cases and literature review].

Background: Fournier's gangrene is a necrotising fasciitis that usually affects the external genitalia and perineal area and may extend to the abdomen, lower limbs and chest. It hasa high fatality rate and must be treated aggressively within a few hours of being diagnosed. It is believed that debilitating diseases such as diabetes mellitus or obesity are conducive to its appearance.

[CT colonography vs. barium enema for the preoperative study of colorectal cancer in patients with incomplete colonoscopy].

Background And Objective: The complete preoperative evaluation of the colon is necessary in colorectal cancer owing to the frequency of synchronous tumors. The objective of this paper was to evaluate the utility of the computed tomography colonography (CTC) as opposed to barium enema (BEDC) when the colonoscopy was incomplete or impossible to perform.

Patients And Method: Group A: 50 patients with colorectal cancer with subsequent incomplete colonoscopy and BEDC.

[Computed tomographic colonography: applications, advantages and disadvantages].

Introduction: Complete preoperative study of the colon is required in the management of colorectal cancer, due to the frequent association of primary colonic neoplasms with colonic adenomas (28%) and/or synchronous carcinomas (5%) of the colon. We present a series of patients who underwent computed tomographic colonography, the indications for this procedure, and the results.

Patients And Methods: We performed a descriptive prospective study.

Treatment of long-standing extensive perianal hidradenitis suppurativa using double rotation plasty, V-Y plasty and free grafts.

Background: Perianal hidradenitis suppurativa is a chronic recurrent inflammatory, suppurating, and fistulizing disease of apocrine glands, adjacent anal canal skin, and soft tissues. The standard treatment used for extensive cases is a staged surgical procedure allowing the wound to heal by secondary intention or the delayed use of skin grafts.

Case Presentation: A long-standing case, disabling for the patient, with extensive involvement of the buttock region, treated in one stage, which for reconstruction required the use of sliding plasties and free skin grafts, is reported.