An analysis of randomized controlled trials on anal fistula conducted between 2000 and 2020 based on the Fragility Index and Reverse Fragility Index.

Aim: The aim of this work was to evaluate the robustness of randomized controlled trials (RCTs) on anal fistula management using the news tools of Fragility Index (FI), Reverse Fragility Index (RFI) and their corresponding fragility quotients.

Method: A systematic search was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines which utilized MEDLINE, EMBASE, Cochrane Library and Web of Science databases. Inclusion criteria included RCTs related to the management of anal fistula published from 2000 to 2022 with dichotomous outcomes measures and 1:1 allocation.

Characteristics and oncological results of epidermoid anal carcinoma: Comparison analysis between immunocompetent and immunosuppressed patients.

Objective: Most evidence, including recent randomized controlled trials, analysing anal squamous cell carcinoma (SCC) do not consider immunocompromise patient population. The aim of this study was to compare clinical and oncological outcomes among immunocompetent and immunocompromised patients with anal squamous cell carcinoma.

Method: Multicentric retrospective comparative study including 2 cohorts of consecutive patients, immunocompetent and immunocompromised, diagnosed with anal SCC.

Characteristics and oncological results of epidermoid anal carcinoma: Comparison analysis between immunocompetent and immunosuppressed patients.

Objective: Most evidence, including recent randomized controlled trials, analysing anal squamous cell carcinoma (SCC) do not consider immunocompromise patient population. The aim of this study was to compare clinical and oncological outcomes among immunocompetent and immunocompromised patients with anal squamous cell carcinoma.

Method: Multicentric retrospective comparative study including 2 cohorts of consecutive patients, immunocompetent and immunocompromised, diagnosed with anal SCC.

LIFT procedure for posterior fistula-in-ano. Are outcomes good enough? A systematic review and meta-analysisis of observational studies.

Introduction: Efficacy of the ligation of intersphincteric fistula tract (LIFT) procedure for posterior fistula-in-ano remains under debate. However, there is scarcity of quality evidence analysing this issue. Thus, the aim of this study is to evaluate outcomes of LIFT surgery in patients with posterior anal fistula.

Early-rectal Cancer Treatment: A Decision-tree Making Based on Systematic Review and Meta-analysis.

Local excision (LE) has arisen as an alternative to total mesorectal excision for the treatment of early rectal cancer. Despite a decreased morbidity, there are still concerns about LE outcomes. This systematic-review and meta-analysis design is based on the "PICO" process, aiming to answer to three questions related to LE as primary treatment for early-rectal cancer, the optimal method for LE, and the potential role for completion treatment in high-risk histology tumors and outcomes of salvage surgery.

A randomized trial comparing transanal irrigation and percutaneous tibial nerve stimulation in the management of low anterior resection syndrome.

Aim: To assess the effectiveness of transanal irrigation (TAI) compared with posterior tibial nerve stimulation (PTNS) in severe and chronic low anterior resection syndrome (LARS).

Method: A two-group parallel, open-label randomized controlled trial carried out in a single university hospital. The study population included patients with a LARS scale score of more than 29 points who had undergone rectal surgery more than 1 year previously.

Laparoscopy-induced severe renal failure after appendectomy.

Laparoscopy has gained importance in the abdominal emergency surgery field. Acute appendicitis is one of the major indications for emergency surgery, being laparoscopy the gold standard approach. We report a case of a 39-years-old female presenting with acute kidney injury (AKI) after laparoscopy.

Patterns of recurrence/persistence of criptoglandular anal fistula after the LIFT procedure. Long-term observacional study.

Objective: To study the recurrence/persistence rate of complex cripotoglandular anal fistula after the LIFT procedure and analyse the patterns of recurrence/persistence.

Patients And Methods: Observational study of patients with transe-sphincteric or supra-sphincteric anal fistula treated using the LIFT procedure from December 2008 to April 2016. Variables studied included clinical characteristics, surgical technique and results.

[A single rectal diclofenac dose reduces post-haemorrhoidectomy urine retention: results of a randomised, controlled clinical study].

Introduction: Post-surgical urinary retention requiring a catheter has a mean incidence of 15% (1% to 52%) in the post-operative period after anal surgery. The primary objective of this study was to assess the efficacy of topical rectal Diclofenac in reducing post-surgical haemorrhoidectomy urinary retention. Its impact on the reduced need for post-surgery analgesia has also been assessed as a secondary objective.

[Acute abdomen caused by transmural eosinophilic enteritis].

A 45 year old man with personal history of B-Lactamic antibiotics allergy and one episode of hemochezia was admitted to hospital because of abdominal pain in the lower right quadrant and nausea, and diagnosed of acute appendicitis. At laparotomy he was found to have histological evidence of transmural eosinophilic enteritis in the terminal ileon and ascitis. After an intestinal resection a full evaluation was performed.

[Focal steatosis of the liver].

We present a case of focal hepatic steatosis, presenting with longstanding and poorly defined discomfort. The exploratory methods could not exclude the presence of a tumor mass in the liver; for this reason the patient was submitted to surgery, which allowed the histological diagnosis. We call attention to the existence of this lesion and the convenience of using all the available diagnostic methods to obtain the diagnosis in order to avoid the risks of an unnecessary major surgical procedure.

[Hepatic hydatid cyst with destruction of the biliary confluent. Apropos of 2 cases treated by direct reconstruction].

The authors present two cases of hepatic echinococcus cyst with destruction of the biliary confluent. The severity of this exceptional lesion requires uncommon treatment. Experience with treatment of biliary fistulas when there is a residual cystic cavity, provides arguments for and against primary suture of these fistulas.

A simplified technique for surgical management of echinococcal cyst.

A new technique has been described for the surgical management of Hydatid cyst of the liver. The cystpericystectomy is the treatment of choice, but if used alone it may be dangerous because of the high risk of hemorrhage.