Publications by authors named "Thomas Golda"

Objective: To assess the effect of high inferior mesenteric artery tie on defecatory, urinary, and sexual function after surgery for sigmoid colon cancer. Performing a sigmoidectomy poses a notable risk of causing injury to the preaortic sympathetic nerves during the high ligation of the inferior mesenteric artery, as well as to the superior hypogastric plexus during dissection at the level of the sacral promontory. Postoperative defecatory and genitourinary dysfunction after sigmoid colon resection are often underestimated and underreported.

View Article and Find Full Text PDF

Background: Stenosis is one of the most common complications in patients with Crohn's disease (CD). Endoscopic balloon dilation (EBD) is the treatment of choice for a short stenosis adjacent to the anastomosis from previous surgery. Self-expandable metal stents (SEMS) may be a suitable treatment option for longer stenoses.

View Article and Find Full Text PDF

Objective: The aim of this study was to evaluate whether extended complete mesocolic excision (e-CME) for sigmoid colon cancer improves oncological outcomes without compromising morbidity or functional results.

Background: In surgery for cancer of the sigmoid colon and upper rectum, s-CME removes the lymphofatty tissue surrounding the inferior mesenteric artery (IMA), but not the lymphofatty tissue surrounding the portion of the inferior mesenteric vein that does not run parallel to the IMA. Evidence about the safety and efficacy of extending CME to include this tissue is lacking.

View Article and Find Full Text PDF

Background: Combined-Endoscopic-Laparoscopic-Surgery (CELS) was developed for benign colonic polyps, endoscopically unresectable, to avoid segmental colectomy. This observational study aims to compare surgical outcomes of endoscopically unresectable colonic polyps treated laparoscopically before and since the institutional introduction of CELS. Primary endpoint was postoperative morbidity and mortality; secondary endpoints were time of hospitalization and histopathological findings.

View Article and Find Full Text PDF

Background: Anastomotic leak (AL) after ileocolic anastomosis influences morbidity, mortality, length of hospitalization and costs. This study analyzes risk and protective factors for AL on ileocolic anastomoses.

Methods: We retrospectively analyzed our single institution patients' series undergoing elective ileocolic anastomosis for AL between 1/2008-12/2017.

View Article and Find Full Text PDF
Article Synopsis
  • The study evaluates how the choice of surgical technique for left colonic perforation differs between colorectal specialists (CS) and general surgeons (GS) over time.
  • Colorectal specialists tend to perform more primary anastomoses with covering ileostomies compared to general surgeons, who often resort to Hartmann procedures.
  • There are no significant differences in overall morbidity and mortality between the two groups, but anastomotic dehiscence rates are higher in GS, and mortality is greater after Hartmann procedures compared to primary anastosis.
View Article and Find Full Text PDF

Background: The aims of this study were to analyze the relationship between the different causes of immunosuppression (IMS) and diverticulitis.

Methods: IMS patients admitted for colonic diverticulitis were included in the study. Patients were divided in 5 groups according to the reasons of IMS: group I, chronic corticosteroid therapy; group II, transplant patients; group III, malignant neoplasm disease; group IV, chronic renal failure; group V, others immunosuppressant treatment.

View Article and Find Full Text PDF
Article Synopsis
  • Postoperative ileus (PPI) is a common complication after colorectal surgery, and this trial aimed to see if oral Gastrografin could help speed up recovery.
  • The study was a randomized, double-blinded trial with a focus on comparing recovery times and hospital stays between patients given Gastrografin and those given a placebo.
  • Results showed no significant difference in the resolution time of PPI between the two groups, although Gastrografin did appear to improve some recovery aspects, suggesting potential clinical benefits despite lacking statistical significance.
View Article and Find Full Text PDF

Background: The evidence is sparse concerning the natural history of acute diverticulitis after successful conservative management. This observational study aimed to evaluate the rate, severity, and need of surgery for recurrence after a first episode of acute diverticulitis successfully managed conservatively.

Methods: All patients admitted for acute diverticulitis between 1994 and 2011 were considered for inclusion in the study.

View Article and Find Full Text PDF
Article Synopsis
  • The study compares hospitalization and outpatient management strategies for patients with uncomplicated left colonic diverticulitis, focusing on treatment failure rates, quality of life, and economic costs.
  • In a randomized trial with 132 patients, both groups experienced similar treatment failure rates, while outpatient care significantly reduced healthcare costs by €1124.70 per patient.
  • The findings suggest that outpatient treatment is a safe and cost-effective option for selected patients, without negatively impacting their quality of life.
View Article and Find Full Text PDF

Despite recent advances in the medical treatment of ulcerative colitis (UC), approximately 25-40% of patients will need surgery during their disease. The aim of elective surgical treatment of UC is to remove the colon/and rectum with minimal postoperative morbidity, and to offer a good long-term quality of life. There are several technical options for the surgical treatment of UC; at present, the most frequently offered is restorative proctocolectomy and ileal pouch-anal anastomosis.

View Article and Find Full Text PDF

Background: The colonic pouch is considered as an alternative to the standard straight low anastomosis after resection for rectal cancer. The aim of this prospective randomized trial was to compare short- and long-term functional results of colonic J-pouch (CJP) and transverse coloplasty (TCP) after low anterior resection for rectal cancer.

Methods: Between 2000 and 2005, patients with mid or low rectal cancer scheduled for an elective sphincter-preserving resection were eligible.

View Article and Find Full Text PDF

Background: To evaluate the probability of recurrence and the virulence of colonic diverticulitis correlated with immunocompromised status.

Methods: Nine hundred thirty-one patients admitted in a single tertiary referral university hospital over a 14-year period were included. Patients were divided into 2 groups: group 1, 166 immunosuppressed patients, and group 2, 765 nonimmunosuppressed patients.

View Article and Find Full Text PDF

Background: The aim of this study was to analyze factors contributing to prolonged postoperative ileus (POI) after elective bowel resection in patients with colorectal cancer.

Methods: This was a retrospective review of a prospectively maintained database of patients operated on for colorectal cancer during 2006-2009. Patients with abdominal procedures and bowel resection without anastomotic leakage were included.

View Article and Find Full Text PDF

Introduction: The high morbidity and mortality of emergency surgery, has led to the use of endoluminal self-expanding metal implants (stents) in the management of intestinal occlusion. The purpose of this study was to review the results of the management of intestinal occlusion treatment in a Colorectal Surgery Unit in those patients who had a stent implant, and the relationship between chemotherapy and complications.

Material And Methods: A retrospective study was carried out on patients treated with a stent in a university hospital between 2004 and 2010.

View Article and Find Full Text PDF

Background: The aim of this study was to evaluate and compare the morbidity associated with 2 strategies of treatment of colorectal anastomotic leakage: surgical drainage of anastomosis with loop ileostomy versus anastomotic takedown.

Methods: An observational study of patients operated on for ileocolic or colorectal anastomotic leakage between 2001 and 2009. Patients were classified into 2 groups: group 1, salvage of the anastomosis, and group 2, anastomotic takedown.

View Article and Find Full Text PDF
Article Synopsis
  • Hartmann's procedure (HP) is commonly used for treating diffuse peritonitis from perforated diverticulitis, but resection with primary anastomosis (RPA) is being evaluated for feasibility and safety.
  • A study of 87 patients indicated that RPA was associated with fewer post-operative complications compared to HP, with only 11.1% of RPA patients experiencing clinical anastomotic leakage.
  • The findings suggest that RPA is a safe option for treating diverticular peritonitis and should be preferred over HP, which should only be used for high-risk patients; specialization in colorectal surgery can improve outcomes.
View Article and Find Full Text PDF

Purpose: Double-barreled wet colostomy consists of simultaneous urinary and fecal diversions into a lateral colostomy and is indicated after pelvic exenteration or in palliative operations, when complete intestinal and urinary reconstruction is not possible. We report experience at our institution with Double-barreled wet colostomy regarding postoperative and long-term morbidity and mortality.

Methods: All patients who underwent double-barreled wet colostomy construction at our institution from 1980 through 2008 were included in the study.

View Article and Find Full Text PDF
Article Synopsis
  • The study evaluated how the specialization of surgeons affects outcomes after emergency colorectal surgery, focusing on mortality, morbidity, and the types of operations performed.
  • Patients were divided into two groups: those treated by colorectal surgeons (CS) and general surgeons (GS), with the study conducted over a period from 1993 to 2006 at a hospital in Barcelona.
  • Results revealed that patients operated on by CSs had better outcomes, including lower morbidity and mortality rates, as well as lower rates of anastomotic dehiscence compared to those treated by GSs, highlighting the importance of surgical specialization in improving patient care.
View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the role of soluble HLA-G (sHLA-G) in improving graft acceptance in kidney and kidney/pancreas transplant patients, comparing it to other soluble HLA class I molecules.
  • Pretransplantation levels of sHLA-G were found to be significantly lower in patients who experienced graft rejection compared to those who did not, highlighting its potential as a biomarker for transplant success.
  • The findings suggest that high sHLA-G levels are associated with better graft acceptance, making it an independent risk factor for graft rejection, unlike other soluble HLA class I molecules.
View Article and Find Full Text PDF

Background: The aim of this observational study was to analyze the differences between patients with obstructive and perforated colonic cancer who managed with emergency curative surgery.

Methods: Between January 1994 and December 2000, patients deemed to have undergone curative resection for complicated colonic cancer were considered for inclusion in the study. They were classified into 2 groups: patients with obstructive cancer (OC) and patients with perforated cancer (PC).

View Article and Find Full Text PDF