C P Delaney

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..Resection forms the basis for surgical treatments, but strictureplasty, abscess drainage, intestinal and diversion bypasses also are used, selectively...

..This case-matched study compares outcomes after open and laparoscopic colectomy...

..To examine the effect of preoperative radiotherapy (PRT) on patients who undergo rectal resection with total mesorectal excision (TME) for stage T3 low rectal cancers...

..This study evaluated a 'fast track' protocol in patients undergoing major colonic and rectal surgery...

..1 for the OR patients (p = 0.17). CONCLUSIONS: The hospital stay is shorter for LR than for OR. Both functional results and recurrent full-thickness rectal prolapse were similar for LR and OR during a mean follow-up period of 5 years...

..A laparoscopic approach to subtotal colectomy is recommended for suitable patients when an experienced team is available...

..This should be balanced against a 28 percent incidence of adenomas in the anal transitional zone...

..The aim of this study was to compare skills sets during a hand-assisted and straight laparoscopic colectomy on an augmented reality simulator...

..The aim of our study was to compare outcomes for single-incision laparoscopic colectomy with laparoscopic-assisted colectomy...

..This randomized clinical trial compared the use of thoracic epidural anaesthesia-analgesia (TEA) with morphine patient-controlled analgesia (PCA) for pain relief after laparoscopic colectomy...

..A thoracic epidural appears to be an important component of a postoperative care protocol, which adds further advantage to LAC without the need for labor-intensive and costly patient care plans...

..We reviewed our experience in this scenario to determine whether selected patients with Crohn's disease may be candidates for ileal pouch-anal anastomosis...

..A low threshold toward early conversion is useful in these difficult cases to reduce delays in the operating room and the unnecessary use of hospital resources...

..Reductions in stay may be associated with factors other than a change in the level of physical activity after surgery...

..This paper presents our initial experience of single incision laparoscopic total colectomy and proctocolectomy...

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..This randomized controlled trial evaluated the cost-effectiveness of bipolar vessel sealer (BVS) compared with clips and vascular stapler (CVS) in straight laparoscopic colorectal resection...

..This approach provides a potential guideline for teaching and mastering laparoscopic sigmoid colectomy, reducing the learning curve, and optimizing results...

..This operative approach may become very important in an era of increasing constraints on hospital occupancy rates and access to nursing services in many regions of the country...

..Conversion during laparoscopic colectomy varies in frequency according to the surgeon's experience and case selection. However, there remains concern that conversion is associated with increased morbidity and higher hospital costs...

..005), and during the entire hospital stay (P =.003) were significantly higher in the open colectomy group. CONCLUSION: A laparoscopic approach for colorectal surgery led to significantly less blood loss than matched open colectomy cases...

..Robot-assisted laparoscopic colectomy requires further evaluation to establish clinical and financial benefits before introduction to routine practice. Such techniques may, in the future, facilitate complex laparoscopic techniques...

..2,985; P < 0.05, Student's t-test). CONCLUSION: The laparoscopic-assisted approach to ileocecal Crohn's disease results in a shortened length of stay and seems economically advantageous to open surgery...

..However, the use of LC in the emergency setting is relatively unstudied. The authors describe their experience with a series of emergent and urgent LC cases for a variety of colorectal pathologies...

..To clarify national clinical and economic laparoscopic colectomy outcomes, we conducted a study of patients who underwent colectomy by laparoscopic or open approaches...

..Although LRR may be associated greater morbidity than LWP, both procedures offer good functional outcome, with short LOS and low recurrence rates...

..The aim of this study was to evaluate the applicability of these systems to a cohort of colon cancer patients undergoing surgery in the United States...

..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...

..laparoscopic) regarding the reasons for disease-related group assignment to disease-related group 148, and institutional cost under Part A of the U.S. Medicare system...

..A prospective, observational, multicenter study was planned to investigate GI recovery, length of hospital stay (LOS), and postoperative ileus (POI)-related morbidity after LC...

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..The aim of this study was to assess risk factors for inflammatory and noninflammatory diseases of IPAA in a tertiary care setting...

..The laparoscopic model described can be used as the basis for performance monitoring between or within institutions...

..The aims of this study were to perform histology-correlated OCT on surgical specimens of CD and UC and to determine its diagnostic accuracy...

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..We performed an in vivo colonoscopic OCT in patients with a clinical diagnosis of CD or UC using the previously established, histology-correlated OCT imaging criterion...

..We compared short-term outcomes in age-matched cohorts of patients undergoing laparoscopic vs open segmental colectomy managed with the Controlled Rehabilitation With Early Ambulation and Diet program...

..A controlled septic condition should not preclude salvage surgery. Although pouch failure occurs more frequently than after primary ileal pouch-anal anastomosis, patient satisfaction and quality of life are high...

..Comparison of outcome and costs after laparoscopic and open colectomy...

..Nevertheless, laparoscopic proctectomy remains a challenging procedure. An embedded didactic video demonstrates a step-by-step laparoscopic total mesorectal excision with coloanal anastomosis for a low rectal cancer...

..Increasing clinical experience with these systems, further technological developments, and continuous research are required before robotic technology can be routinely incorporated into surgical procedures on the colon and rectum...

..The risk factors and incidence of anastomotic leak following colorectal surgery are well reported in the literature. However, the management of the multiple clinical scenarios that may be encountered has not been standardized...

..On this basis, we feel that patients with IndC should not be precluded from having IPAA surgery...

..Evaluation of surgical trainee operative performance is rarely objective. A rating system is proposed that assesses trainee performance objectively and quantifies technical improvement...

..The Cleveland Clinic Foundation (CCF) laparoscopic conversion rate model is a simple additive score that can be used in everyday practice to evaluate outcomes for laparoscopic colorectal surgery...

..TAS is a novel T-tag system for endoscopic placement of sutures, facilitating closure of larger defects from advanced endoluminal or transluminal endoscopic procedures. Such novel instrumentation may reduce risk and accelerate recovery...

..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...

..Over 93% of IndC patients would undergo the same procedure again, and 98% would recommend IPAA to others with IndC. Patients with IndC should not be precluded from having IPAA surgery...

..Laparoscopic colectomy has become the standard of care for elective resections; however, there are few data regarding laparoscopy in the emergency setting...

..This is partly because accelerated recovery programs with early discharge are associated with high readmission and complication rates, especially after open colorectal surgery...

..016). CONCLUSIONS: ALUs seen on endoscopy are suggestive of CD in patients with inflammatory bowel disease who are not taking NSAIDs...

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..A policy of starting most suitable cases laparoscopically may offer patients the potential benefits of a laparoscopic approach without increasing morbidity...

..It may play an important role in providing risk estimates for patients wishing to make informed choices on the type of treatment offered to them...

..Large flat polyps may be more amenable to endoscopic resection if an endoluminal method for full-thickness closure were available...

..We analysed potential organizational characteristics that might influence rectal cancer decision-making by an experienced surgeon...

..Relocation of the stoma is reserved for persistent ulceration failing other therapies, because peristomal pyoderma gangrenosum may recur at the new stoma site...

..Conclusion. SILC is feasible. A single incision around the umbilical scar represents cosmetic progress. Comparative studies are needed to assess potential abdominal wall and recovery benefits to justify the increased cost of SILC...

..Intraoperative radiation therapy (IORT) may be useful in the treatment of patients who have a locally advanced primary and recurrent abdominopelvic neoplasm with colorectal involvement...

..In this review, we define postoperative ileus, describe the pathogenesis and briefly discuss clinical management before detailing potential pharmacologic management options...

..CONCLUSIONS: Symptoms largely overlapped among the disease groups of IPAA. Endoscopy is valuable for diagnosis. Inflammatory or noninflammatory sequelae of IPAA adversely affected patients' QOL...

..CONCLUSIONS: Results indicate that a structured approach to laparoscopic right colectomy is associated with reasonable operative times, acceptable morbidity, and reductions in hospital stay...

..CONCLUSION: TE offers no advantage over PCA for patients undergoing major intestinal resections who are on a fast-track postoperative care plan using PCA...

..This approach eradicates the polyp and allows an oncologic resection should the polyp prove to be malignant. The purpose of this study was to assess outcomes of a laparoscopic approach for the management of these polyps...

..Patients younger than 70 years of age derive the optimal benefit, and increased surgeon experience improves outcome...

..CGQL and SF-36 correlated similarly with CDAI. Neither patient age, gender, or smoking history were associated with CGQL. CONCLUSIONS: CGQL correlates with disease activity and is a simple measure of QOL in Crohn's disease...

..This study prospectively validates PQL, a novel prospective scoring system in patients having laparoscopic or open major abdominal colorectal surgery...

..The aim of this study was to compare the human cadaver model with an augmented reality simulator for straight laparoscopic colorectal skills acquisition...

..Laparoscopic rectal resection (LRR) has not gained the same acceptance as laparoscopic segmental colonic resection because of technical challenges, increased operating time and costs, and concerns about the oncological outcome...

..Laparoscopic repair of rectal prolapse has similar morbidity and recurrence rates to open surgery, with attendant benefits of reduced length of hospital stay, postoperative pain and wound complications...

..This report attempts to define the incidence of these access-related complications in a large group of patients undergoing laparoscopic-assisted bowel resection (LABR) and open bowel operation (OPEN)...

..It is not affected by other patient characteristics, nature of disease, indication, or procedure performed. Most patients who undergo surgery for Crohn's disease feel that surgery has helped them and would undergo surgery again...

..CONCLUSIONS: In patients undergoing major abdominal surgery, alvimopan accelerated gastrointestinal recovery and time to the hospital discharge order written compared with placebo and was well tolerated...

..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...

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..Measurement of interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-alpha) is a validated method to quantify surgical stress. The physiologic and immunologic impact of NOTES is unknown...

..Readmission within 30 days of a patient who has attained standardized discharge criteria may not be a valid indicator of poor quality of care...

..This study assessed the current state of perioperative care for elective BRs and the effect of pathway components on length of stay...

..Further efficacy in alleviating opioid-induced bowel dysfunction in patients with chronic opioid usage has also been demonstrated. This evidence-based review assesses this new drug and discusses its potential role in clinical practice...

..However, an association between SCIP performance and clinical outcomes has not been demonstrated...

..This analysis examines gastrointestinal recovery in patients who underwent bowel resection (BR) in 3 recent trials...

..Improving functional status before surgery, decreasing the adverse impact of steroids, and/or stratifying perioperative anticoagulant use may decrease unexpected readmissions in this patient population...

..With the development of natural orifice translumenal endoscopic surgery (NOTES) techniques, the authors describe a new method of proctectomy using a combination of TEM and NOTES principles...

..While unresectable, metastatic colorectal cancer remains incurable at the current time, continued advances will inevitably challenge this presumption and it is crucial to outline the role of laparoscopy in this patient population...

..In this study we evaluated the outcome of a standardized enhanced recovery program in patients undergoing ileostomy closure...

..To obtain further analysis regarding specific outcomes and alvimopan doses in bowel resection (BR) patients...

..Patients with incontinence, diarrhea, or otherwise normal function can be offered a rectopexy without resection...

..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...

..The effect of alvimopan on POI-related morbidity for patients who underwent bowel resection was evaluated in a post-hoc analysis...

..The ability to identify colon cancer patients with an unfavorable outcome may help patients at high risk for recurrence to seek more aggressive therapy...

..Strategies to correct preoperative anemia, refine indications for transfusion, and define the use of blood salvage techniques may be helpful in decreasing this risk...

..A critical outcome analysis of a large, single-institution experience provides a better frame of reference for an assessment of the role of laparoscopic colectomy for colorectal pathology...

..Alpha-GST monitoring is a useful tool for the diagnosis of intestinal ischemia. A normal alpha-GST and WBC may exclude the presence of AMI...

..Successful repair can be achieved in a majority of patients with minimal morbidity, short length of stay, and a good postoperative quality of life...

..Continent ileostomy may be offered as an attractive long-term option to select patients whose only alternative is an end ileostomy...

..The impact of MLN on both recurrence and survival was assessed...

..Neither massively dilated bowel nor multiple previous abdominal operations precluded safe conduct of the operation laparoscopically...

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