James Church

..In order to document the learning curve and better define normal progress for the early learning experience, the performance of trainees during their first 100-125 cases was recorded...

..In addition, we found that complication rates and length of hospitalization were similar between handsewn and stapled closures...

..A scoring system for family history of colorectal cancer can make risk assessment easier and facilitate both collaborative studies and patient triage into appropriate screening programs...

..Although defining and measuring quality in colonoscopy is important, further work needs to be done to arrive at a practical, clinically meaningful way of quality assessment...

..A recent staging system categorizes desmoids according to size, symptoms, and complications. We applied the staging system to determine whether it separates patients into clinically significant groups...

..Optimal care of these high-risk families involves a center with expertise in the syndromes. This study was performed to see how many such centers exist in the United States and to learn something of how they work...

..The purpose of the present study is to describe a large consecutive series of colonic polyps evaluated endoscopically, to determine the chances of performing a safe, effective endoscopic polypectomy...

..FAP patients and families should be involved in a registry or genetic center, not to the exclusion of local practitioners but to their benefit. In this way the best of care is given and the best of outcomes ensured...

..We performed this study to see whether the quality of delivery has improved pari passu with technical advances in presentation of data...

..We performed this study to see whether American colonoscopists interpret the shape of lesions of the colorectal mucosa differently from their Japanese colleagues...

..Definitive resection in the form of pancreaticoduodenectomy, pancreas-sparing duodenectomy, or segmental duodenectomy offers the best chance for polyp eradication and prevention of carcinoma, regardless of polyp etiology...

..A juvenile polyposis-hereditary hemorrhagic telangiectasia overlap syndrome has previously been reported in 22% of patients with juvenile polyposis due to a SMAD4 mutation...

..This is related, at least in part, to a greater number of patients with severe polyposis having their rectum initially spared...

..The study aim is to review the prevalence, management, and outcomes for patients diagnosed with ileal pouch prolapse after restorative proctocolectomy...

..The aim of this study is to determine whether the omission of an ileostomy in patients undergoing ileal pouch surgery offers cost savings to the hospital...

..This study investigates the polyp and cancer burden of this population and demonstrates relationships with a family history score (FHS)...

..Patients may be protected by changing surgical strategy. We designed a formula to predict desmoid risk and tested the value of adding genotype to the formula...

..The aim of the present study was to evaluate the influence of a younger age at the time of ileal pouch-anal anastomosis (IPAA) on functional outcome and quality of life in patients with familial adenomatous polyposis (FAP)...

..CONCLUSION: A way of staging intra-abdominal desmoid tumors is proposed to facilitate stratification by disease severity during collaborative studies of various treatments...

..There are multiple genetic routes to colorectal cancer, including chromosomal instability, mismatch repair dysfunction, and global hypermethylation. Few consider the possibility that multiple pathways are synchronously active...

..Although early outcomes vary, concerns remain about postoperative continence, long-term healing, and its role in patients with Crohn's disease and anovaginal fistulas...

..CONCLUSIONS: Ileal pouch-anal anastomosis is an acceptable surgical option for selected healthy, motivated septuagenarians with ulcerative colitis who are eager to preserve fecal continence...

..Long-term surveillance of the anal transitional zone needs to be emphasized...

..No studies report how this process is implemented on a health system-wide basis...

..The aim of this study was to identify the incidence, management, and outcomes for familial adenomatous polyposis associated intra-abdominal desmoids causing ureteric obstruction...

..This study analyzes characteristics of precursor polyps occurring within different molecular subtypes of sporadic colorectal cancer...

..This study was undertaken to investigate the clinical presentation and implications of portal vein thrombi (PVT)...

..Our aim was to evaluate 30-day postoperative outcomes for Crohn's patients treated with infliximab within 3 months prior to ileocolonic resection...

..To assess long-term outcomes after ileal pouch-anal anastomosis (IPAA) in Crohn's disease (CD)...

..Therefore, the aim of this study is to evaluate preoperative and operative factors that might be associated with septic complications after restorative proctocolectomy...

..To report the risk of metachronous colorectal neoplasia after colectomy for cancer in Hereditary Nonpolyposis Colorectal Cancer (HNPCC) syndrome...

..Identifying biologic factors that predict the subset prone to recur could allow more directed therapy. This study identifies a tumor gene expression profile that accurately predicts disease recurrence...

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..Fast track rehabilitation programs reduce stay, but there are concerns that readmission and complication rates may be increased. This study evaluated a fast track pathway after ileoanal pouch surgery...

..This study seeks to describe molecular characteristics of colon cancer hepatic metastases in terms of oncogenic pathway...

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..The purpose of this study was to compare the quality of life, functional outcome, and complications between patients undergoing coloplasty, colonic J-pouch, or straight anastomosis...

..This study was designed to evaluate the impact of childbirth on anal sphincter integrity and function, functional outcome, and quality of life in females with restorative proctocolectomy and ileal pouch-anal anastomosis...

..This study evaluated the disparity in neoplastic changes between colon and rectal cancers...

..Coating of the cecum with sticky bile causes a problem with inspection of the mucosa during colonoscopy...

..Endoscopic treatment of ileal adenomas is likely to be difficult, reducing the options for their control to excising the entire pouch or chemoprevention...

..The dearth of evidence supporting the safety of laparoscopy for these patients led to a comparison of outcomes between LC and open colectomy (OC) for patients with American Society of Anesthesiology (ASA) classifications 3 and 4...

..This study evaluated the impact of microsatellite instability pathology findings on Lynch syndrome evaluation by clinicians...

..Patients with colonic polyps that are difficult or potentially dangerous to remove endoscopically should be sent for a second opinion before surgery is performed...

..Both restorative proctocolectomy and subtotal colectomy with ileorectal anastomosis need endoscopic follow-up because of the high recurrence rates of juvenile polyps in the remnant rectum or pouch...

..This study evaluates molecular differences between primary colorectal cancers and matched lymph node (LN) metastases...

..The ability to accurately predict postoperative mortality is expected to improve preoperative decisions for elderly patients considered for colorectal surgery...

..Few studies describe the technique or outcomes of serrated polypectomy. We sought to present outcomes of a series of polypectomies of large serrated polyps in comparison to a series of endoscopic resections of large adenomas...

..Genetic testing can offer a precise diagnosis. It allows for risk stratification and focused management and surveillance...

..Genetic counseling is indicated for all patients younger than 50 with colorectal cancer. Before surgery, the tumor and the patient must be evaluated as fully as possible, so that optimal treatment, follow-up, and surveillance are used...

..Type of operation a patient undergoes could be an inevitable nonmodifiable risk factor in the development of UTI...

..We performed this study to document this difficulty and to determine whether sigmoid colectomy prevents it...

..As a result, the "true" incidence of flat lesions is unknown. The aim of this study was to report the incidence and character of flat adenomas in a large series of patients in the United States...

..Pancreas-sparing duodenectomy represents a definitive treatment for advanced duodenal polyposis and can obviate the need for pancreaticoduodenectomy...

..We hypothesized that this may represent a unique group of patients, and this study investigates a possible association between the two syndromes...

..The purpose of this study was to determine whether complete colonoscopy is necessary in the evaluation of patients with "outlet" rectal bleeding...

..We have reviewed the adenoma detection rates of six colorectal surgeons to provide insight into the range of adenoma detection rates and the factors that influence them...

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..This study is intended to discover how often small colorectal adenomas have unfavorable histologic features...

..Three patients died of causes unrelated to PJP. Five patients are alive and polyp free. CONCLUSION: Solitary PJP do not carry a risk of gastrointestinal cancer and are not an indication for specific high-risk screening...

..Patients with adenomas are offered surgery sometime in that decade. There is a concern about the risk of cancer in teenagers if such surgery is deferred. We conducted this study to investigate that risk...

..Long-term surveillance is recommended to monitor dysplasia. If repeat biopsy confirms persistent dysplasia, mucosectomy with perineal pouch advancement and neo-ileal pouch-anal anastomosis is recommended...

..CONCLUSIONS: Although glucagon and hyoscyamine remain options for treatment of colonic spasm, the results of this study suggest that warm water is also effective. It has no side effects and costs practically nothing...

..The aim of this study was to review all the index surgeries for familial adenomatous polyposis performed at our institution to assess the changes in surgical techniques...

..The aim of this study was to evaluate the results of episioproctotomy and rectal-advancement flap on healing, postoperative continence, and sexual function...

..CE should replace radiographic SI surveillance for PJS patients. CE is safe in polyposis patients who have undergone major intestinal surgery...

..However, this risk can be lowered by performing a total colectomy at the time of index surgery, or possibly by effective postoperative surveillance...

..With adequate training, supervision, and monitoring, the learning curve in IPAA surgery may be reduced even further...

..The hypotheses of this study are that these patients often have direct perineal involvement with Crohn's disease and that this involvement can be recognized clinically...

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..The achievements to date and the ongoing vigorous debates regarding standard care continue to highlight the importance of quality ongoing research in a rapidly changing clinical environment...

..Although functional outcome after IPAA is not as good in older patients, appropriate case selection confers acceptable function and quality of life to patients of all ages...

..CONCLUSIONS: Among the different methods of rectal reconstruction now available after total rectal resection for cancer, the colonic J-pouch may be the optimal choice...

..Our study examined the prevalence of FGPs and FGP dysplasia in FAP and identified endoscopic or demographic features associated with FGPs and dysplasia...