Colonic preparation before colonoscopy in constipated and non-constipated patients: a randomized study.

Aim: To compare the efficacy of different doses of sodium phosphate (NaP) and polyethylenglicol (PEG) alone or with bisacodyl for colonic cleansing in constipated and non-constipated patients.

Methods: Three hundred and forty-nine patients, older than 18 years old, with low risk for renal damage and who were scheduled for outpatient colonoscopy were randomized to receive one of the following preparations (prep): 90 mL of NaP (prep 1); 45 mL of NaP + 20 mg of bisacodyl (prep 2); 4 L of PEG (prep 3) or 2 L of PEG + 20 mg of bisacodyl (prep 4). Randomization was stratified by constipation.

[Prevalence of serrated adenomas of the colon and association with synchronic and metachronic neoplastic lesions].

Objective: To determine the prevalence of serrated adenomas (SA), the frequency of high grade dysplasia (HGD) and adenocarcinoma in these polyps, and the association with synchronic (SNL) and metachronic neoplastic lesions (MNL).

Methods: Reports from patients undergoing colonoscopy and polypectomy from January 2003 to April 2010, were obtained from our electronic database. SA were reanalyzed by two pathologists and classified on the basis of Snover's diagnostic criteria.

[Surveillance colonoscopy before scheduled: is it worthwhile?].

Objective: To determine de incidence of colonic polyps in colonoscopies performed before scheduled and to identifY the clinical and endoscopic features that predicted this finding.

Methods: All patients who underwent at least two complete colonoscopies less than three years apart were retrospectively identified in our computerized database. We excluded patients with high risk of colonic neoplasm requiring a new colonoscopy in less than three years.

Laparoscopic approach to colonic perforation due to colonoscopy.

Background: Iatrogenic perforation due to colonoscopy is the most serious complication of this procedure. Usually, resolution of this event requires segmental resection. The laparoscopic approach could be an option to minimize the outcome of this complication.

Rectal bleeding in Klippel-Trénaunay syndrome: treatment with laparoscopic ultralow anterior resection with intersphincteric dissection.

Klippel-Trénaunay syndrome is a rare congenital vascular disorder characterized by varicose veins, hypertrophy of the soft tissues and bones, and hemangiomas. Although colorectal angiomatosis is uncommon, this association can lead to life-threatening complications because of acute or chronic bleeding. We report a patient with Klippel-Trénaunay syndrome who presented with transfusion-dependent anemia secondary to chronic rectal bleeding.

Patients with less than three episodes of diverticulitis may benefit from elective laparoscopic sigmoidectomy.

Background: This study was designed to asses the predictive factors of postoperative complications in patients who underwent a laparoscopic elective approach for recurrent diverticulitis and to determine the relationship between the number of acute episodes and surgical morbidity.

Methods: A retrospective analysis was performed on patients with colonic diverticular disease treated by an elective laparoscopic approach between July 2000 and November 2007. The variables studied were age, sex, BMI, ASA, number of previous acute episodes, local severity, abdominal surgery history, comorbidity, and laparoscopic training of the surgeon.

Is a laparoscopic approach useful for treating complications after primary laparoscopic colorectal surgery?

Purpose: Although the use of laparoscopy for the management of postoperative complications has been previously well documented for different pathologies, there is scarce information regarding its use after laparoscopic colorectal surgery.

Methods: Data were prospectively collected from all patients undergoing laparoscopic colorectal surgery between June 2000 to October 2007. Patients were divided into two groups according to the approach used for the reoperation: laparoscopy (Group I) or laparotomy (Group II).

Laparoscopic colectomy: medial versus lateral approach.

Background: Laparoscopic colectomy can be performed using 2 approaches: lateral or medial. However, it is unknown if one of these techniques provides better results. Thus, the object of the present study is to assess whether one of the approaches has any potential benefits over the other.

Laparoscopic-assisted proctocolectomy using complete intracorporeal dissection.

Purpose: Although many studies have demonstrated good results using laparoscopic proctocolectomy in patients with ulcerative colitis (UC), most surgical procedures require at least one additional incision larger than 5 cm to complete the surgery. The aim of this study was to evaluate the use of laparoscopic proctocolectomy with ileoanal J pouch, with a complete intracorporeal dissection using a 4-5 cm right lower quadrant (RLQ) incision.

Methods: Data were collected prospectively from all patients with UC that were subjected to a proctocolectomy with ileoanal J pouch between August 2003 and December 2006.