Long-term results of ligation of intersphincteric fistula tract (LIFT) for fistula-in-ano.

Background: Ligation of intersphincteric fistula tract is a novel surgical technique in the treatment of transsphincteric fistula-in-ano that has been shown to be successful in the short term. Median follow-up in current literature ranges from 5 to 9 months. However, the long-term success rate is unknown.

Early result of ligation of the intersphincteric fistula tract for fistula-in-ano.

Purpose: The ligation of the intersphincteric fistula tract is a new surgical procedure without any use of biologic material. The purpose of this study is to present our early results with this novel technique.

Methods: A retrospective review of patients who underwent the procedure for high transsphincteric fistulas was analyzed.

Successful enhanced recovery program after colorectal surgery in a county institution.

Enhanced recovery programs after colorectal surgery have gained acceptance recently as they have shown a decrease length of hospital stay. However, these pathways require strict adherence to standardized programs with patient education and high compliance. This study was designed to assess the feasibility of such a program in a large county hospital.

Role of water-soluble enema before takedown of diverting ileostomy for low pelvic anastomosis.

The integrity of a low pelvic anastomosis is often studied radiographically before takedown of a diverting ileostomy. The aim of this study is to determine the impact of routine water-soluble enema studies (WSE) in our patient population with low pelvic anastomosis. We retrospectively reviewed the operative database for a county teaching hospital from 1998 to 2008.

Characteristics of colorectal cancer in young patients at an urban county hospital.

Colorectal cancer (CRC) is a disease primarily affecting an older population. The incidence of CRC in young patients has been rising. The purpose of this study was to evaluate the characteristics of CRC in an ethnically diverse, young population.

Prevalence of left-sided colorectal cancer and benefit of flexible sigmoidoscopy: a county hospital experience.

The best way to evaluate the colon for both diagnosis of symptoms and surveillance is colonoscopy. However, access to colonoscopy is often restricted. Our objective was to assess the anatomic distribution and stage at presentation of colorectal cancer (CRC) in a county hospital population, the prevalence and distribution of CRC in younger patients, and the utility of flexible sigmoidoscopy for early diagnosis of left-sided cancers in this population.

Outcome analysis of patients undergoing colorectal resection for emergent and elective indications.

Despite advances in perioperative care and operative techniques, urgent colorectal operations are associated with higher morbidity and mortality. To evaluate our rate of complications in elective and urgent colorectal operations, we performed retrospective chart review of 209 consecutive patients who underwent colorectal resection between 1998 and 2002 at Harbor-UCLA Medical Center. One hundred, forty-three (71%) patients underwent elective colorectal resection.

Selective treatment of rectal cancer with single-stage coloanal or ultralow colorectal anastomosis does not adversely affect morbidity and mortality.

Background And Aims: The surgical treatment of low rectal cancer commonly includes low pelvic anastomoses with coloanal or ultralow colorectal anastomoses. Anastomotic leak rates in low pelvic anastomoses range from 4 to 26%. Many surgeons opt to routinely create a diverting ostomy to reduce the extent of morbidity should an anastomotic leak occur.

Reoperation for stoma-related complications.

Stoma complications are common. Most do not require reoperation, but when surgery is indicated, numerous options are available. Complications can arise early or late, and they can vary from benign to life-threatening.

Number of lymph nodes examined and its impact on colorectal cancer staging.

The status of lymph nodes is the most important prognosticator in colorectal cancer patients. Patients with lymph node involvement have a lower survival rate and are candidates for adjuvant therapy. The purpose of our study was to determine the number of lymph nodes that needs to be examined to accurately detect nodal metastasis.

The role of carcinoembryonic antigen as a predictor of the need for preoperative computed tomography in colon cancer patients.

A retrospective study of 117 patients with the diagnosis of colon cancer was performed to evaluate the clinical utility of the preoperative computed tomography (CT) scan and to assess the role of carcinoembryonic antigen (CEA) as a predictor of the need for CT scan in colon cancer patients. Forty-nine patients had a CT scan that altered their treatment. One hundred per cent of stage IV patients versus only 26.

Factors affecting the successful management of intra-abdominal abscesses with antibiotics and the need for percutaneous drainage.

Purpose: There is no definite consensus on the management of intra-abdominal abscesses in adults. This retrospective study evaluated the use of antibiotic therapy and percutaneous image-guided drainage in adult patients with intra-abdominal abscesses.

Methods: A retrospective chart review of 114 patients with intra-abdominal abscesses was conducted.

Colonic histoplasmosis presenting as colon cancer in the nonimmunocompromised patient: report of a case and review of the literature.

Histoplasma capsulatum is an important pathogen that is the most commonly diagnosed endemic mycosis in the gastrointestinal tract of immunocompromised hosts. Failure to recognize and treat disseminated histoplasmosis in AIDS patients invariably leads to death. Gastrointestinal manifestations frequently involve the terminal ileum and cecum, and depending on the layer of bowel wall involved present as bleeding, obstruction, perforation, or peritonitis.

Diverticulitis: truly minimally invasive management.

The purpose of this study is to evaluate the treatment of patients with acute diverticulitis in the inpatient setting using minimal intervention. This was a retrospective study of 75 patients admitted over a 3-year period with acute diverticulitis as evidenced by computed tomography (CT) and clinical scenario. Of the patients enrolled, 24 (32%) had abscesses identified on their initial CT scan.

An assessment of the severity of recurrent appendicitis.

Background: This study examines the clinical characteristics of patients who developed recurrent appendicitis after previous nonoperative management of perforated appendicitis.

Methods: Retrospective chart review was performed, and data from the recurrent and initial episode of appendicitis were collected.

Results: In all, 237 patients from 1989 to 2001 were managed nonoperatively for perforated appendicitis and 32 (14%) were readmitted for recurrent appendicitis.

Stapled hemorrhoidectomy: a review of our early experience.

Treatment of hemorrhoids may safely be accomplished by using a circular stapler instead of the conventional open procedure for large symptomatic hemorrhoids. Our purpose was to assess the safety and early post-op results of this new surgical technique as it was introduced into clinical practice. Medical records from 62 patients treated by circumferential mucosectomy/stapled hemorrhoidectomy were obtained from 6 surgeons.

Carcinoembryonic antigen and albumin predict survival in patients with advanced colon and rectal cancer.

Hypothesis: Patients with stage IV colon or rectal cancer at initial diagnosis have characteristics that will predict subsequent survival time.

Design: Retrospective cohort study.

Setting: Urban county teaching hospital providing tertiary care.