Annals of Colorectal Research Annals of Colorectal Research Ann Colorectal Res http://www.colorectalresearch.com 2322-5262 2322-5289 10.5812/acr. en jalali 2017 6 26 gregorian 2017 6 26 1 2
en 10.17795/acr-12966 Minimally Invasive Treatments of Hemorrhoidal Disease Minimally Invasive Treatments of Hemorrhoidal Disease review-article review-article Conclusions

Minimally invasive procedures are used depending on surgeons experience and preference. These modalities are comparable from different aspects. The cost of treatment and availability of equipment may affect the choice of modality. All of these techniques could be used in patients resulting in maximum success rate and minimum complications.

Results

Upon the articles, 881 were treated with RBL, 454 with IRC, 1203 with DCE, and 2372 with sclerotherapy. Postoperative pain, which is a common complication of hemorrhoidectomy, was 3-25% in RBL, 2.13-4.3% in DCE, and 1.8-7% in sclerotherapy. Pain was mild to moderate and rarely needed analgesic. Postoperative rectal bleeding was seen in 1.26-32.4% of patients treated with RBL. Recurrence of preoperative symptoms was 1.9-39% for RBL, 6.9-21% for sclerotherapy, and 2.9-3% for DCE. Postoperative complications were minor in all procedures and for sclerotherapy it was seen in 6.9-21% of patients. Success rate was 69.4-96.4% in RBL, 80% in IRC, 89.3-99.7% in sclerotherapy, and 98.2% in DCE. Patients satisfaction was 98% for DCE versus 99% for RBL and IRC. Operation time for each tag of hemorrhoid was 4.5-10 minutes for DCE, regarding different amplitudes of currency and degrees of hemorrhoid, and 13 minutes for sclerotherapy and not reported for other methods.

Context

Minimally invasive procedures are used for treatment of nonresponsive hemorrhoids to conservative therapy. These OPD (Out-Patient Department) procedures are effective to eradicate the hemorrhoid symptoms with minimal postoperative pain and complications.

Evidence Acquisition

In this review, PubMed, and MEDLINE were searched with a time limitation (2002- 2012). Recent articles in English journals were reviewed to evaluate and compare these minimally invasive procedures including Rubber band ligation (RBL), Infrared coagulation (IRC), Direct current Electrotherapy (DCE), and Sclerotherapy.

Conclusions

Minimally invasive procedures are used depending on surgeons experience and preference. These modalities are comparable from different aspects. The cost of treatment and availability of equipment may affect the choice of modality. All of these techniques could be used in patients resulting in maximum success rate and minimum complications.

Results

Upon the articles, 881 were treated with RBL, 454 with IRC, 1203 with DCE, and 2372 with sclerotherapy. Postoperative pain, which is a common complication of hemorrhoidectomy, was 3-25% in RBL, 2.13-4.3% in DCE, and 1.8-7% in sclerotherapy. Pain was mild to moderate and rarely needed analgesic. Postoperative rectal bleeding was seen in 1.26-32.4% of patients treated with RBL. Recurrence of preoperative symptoms was 1.9-39% for RBL, 6.9-21% for sclerotherapy, and 2.9-3% for DCE. Postoperative complications were minor in all procedures and for sclerotherapy it was seen in 6.9-21% of patients. Success rate was 69.4-96.4% in RBL, 80% in IRC, 89.3-99.7% in sclerotherapy, and 98.2% in DCE. Patients satisfaction was 98% for DCE versus 99% for RBL and IRC. Operation time for each tag of hemorrhoid was 4.5-10 minutes for DCE, regarding different amplitudes of currency and degrees of hemorrhoid, and 13 minutes for sclerotherapy and not reported for other methods.

Context

Minimally invasive procedures are used for treatment of nonresponsive hemorrhoids to conservative therapy. These OPD (Out-Patient Department) procedures are effective to eradicate the hemorrhoid symptoms with minimal postoperative pain and complications.

Evidence Acquisition

In this review, PubMed, and MEDLINE were searched with a time limitation (2002- 2012). Recent articles in English journals were reviewed to evaluate and compare these minimally invasive procedures including Rubber band ligation (RBL), Infrared coagulation (IRC), Direct current Electrotherapy (DCE), and Sclerotherapy.

Minimally Invasive, Hemorrhoids, Treatment Minimally Invasive, Hemorrhoids, Treatment 40 5 http://www.colorectalresearch.com/index.php?page=article&article_id=12966 Ahmad Izadpanah Ahmad Izadpanah Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel.: +98-7112306972, Fax: +98-7112330724 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel.: +98-7112306972, Fax: +98-7112330724
en 10.17795/acr-11985 Malignant Neoplasms of the Anal Canal Malignant Neoplasms of the Anal Canal research-article research-article Conclusions

This study indicated that squamous cell carcinoma, adenocarcinoma, and malignant melanoma are the most frequent malignant neoplasms in the anal canal. Histological subtype and disease stage are the most important prognostic factors for overall survival in this region.

Background

Malignant neoplasms of the anal canal are rare, accounting for approximately 4% of all colorectal malignancies.

Objectives

The present study aimed to report the clinicopathological characteristics and treatment outcomes of 41 cases with malignant neoplasms of the anal canal.

Patients and Methods

Between 1999 and 2012, 41 consecutive patients were diagnosed with primary malignant neoplasm of the anal canal, who were treated and followed up at Namazi hospital. Only primary malignant tumors arising from the anal canal were included. Patients with secondary anal canal involvement from rectal or perianal skin cancers and metastatic tumors were excluded.

Results

There were 22 women and 19 men, aged 33 to 83 years, with a median age of 57 years at diagnosis. Sixteen patients (39%) had localized disease, 21 (51%) had regional disease, and 4 (10%) had metastatic disease at diagnosis. Squamous cell carcinoma (61%) was the most frequent histologic subtype, followed by adenocarcinoma (27%), malignant melanoma (10%), and gastrointestinal stromal tumor (2%). After a median follow-up of 51 (11-169) months for surviving patients, 22 patients were alive and without disease, three were alive with disease, and 19 patients died due to the disease. Histological subtype (P = 001), and stage of disease (P = 0.002) were prognostic factors for overall survival. The 5-year local control, disease-free, and overall survival rates for all patients were 63.9%, 53%, and 59.4% respectively.

Conclusions

This study indicated that squamous cell carcinoma, adenocarcinoma, and malignant melanoma are the most frequent malignant neoplasms in the anal canal. Histological subtype and disease stage are the most important prognostic factors for overall survival in this region.

Background

Malignant neoplasms of the anal canal are rare, accounting for approximately 4% of all colorectal malignancies.

Objectives

The present study aimed to report the clinicopathological characteristics and treatment outcomes of 41 cases with malignant neoplasms of the anal canal.

Patients and Methods

Between 1999 and 2012, 41 consecutive patients were diagnosed with primary malignant neoplasm of the anal canal, who were treated and followed up at Namazi hospital. Only primary malignant tumors arising from the anal canal were included. Patients with secondary anal canal involvement from rectal or perianal skin cancers and metastatic tumors were excluded.

Results

There were 22 women and 19 men, aged 33 to 83 years, with a median age of 57 years at diagnosis. Sixteen patients (39%) had localized disease, 21 (51%) had regional disease, and 4 (10%) had metastatic disease at diagnosis. Squamous cell carcinoma (61%) was the most frequent histologic subtype, followed by adenocarcinoma (27%), malignant melanoma (10%), and gastrointestinal stromal tumor (2%). After a median follow-up of 51 (11-169) months for surviving patients, 22 patients were alive and without disease, three were alive with disease, and 19 patients died due to the disease. Histological subtype (P = 001), and stage of disease (P = 0.002) were prognostic factors for overall survival. The 5-year local control, disease-free, and overall survival rates for all patients were 63.9%, 53%, and 59.4% respectively.

Malignant Neoplasms;Anal canal Carcinoma Squamous Cell;Adenocarcinoma;Melanoma;Gastrointestinal Stromal Tumor Malignant Neoplasms;Anal canal Carcinoma Squamous Cell;Adenocarcinoma;Melanoma;Gastrointestinal Stromal Tumor 47 54 http://www.colorectalresearch.com/index.php?page=article&article_id=11985 Shapour Omidvari Shapour Omidvari Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Sayed Hasan Sayed Hasan Mohammad Mohammadianpanah Mohammad Mohammadianpanah Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran, Tel.: +98-7116125170, Fax: +98-7116474320 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran, Tel.: +98-7116125170, Fax: +98-7116474320 Samira Razzaghi Samira Razzaghi Student Research Committee, Resident of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Student Research Committee, Resident of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Hamid Nasrolahi Hamid Nasrolahi Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Ahmad Mosalaei Ahmad Mosalaei Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, IR Iran Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, IR Iran Niloofar Ahmadloo Niloofar Ahmadloo Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Mansour Ansari Mansour Ansari Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Radiation Oncology, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.17795/acr-11979 Evaluation of the Growth Parameters in Children with Chronic Functional Constipation Evaluation of the Growth Parameters in Children with Chronic Functional Constipation research-article research-article Results

Both case and control groups consisted of the same age (P = 0.725) and gender (P = 0.777) individuals. The BMI (P < 0.0001) and BMI z-scores (P < 0.0001) of constipated children were significantly higher than the control group. Also, weight (P = 0.004) and weight z-scores (P < 0.0001) were significantly higher in the study group. There was no significant difference in height between the two groups (P = 0.1), but constipated children had higher height z-scores than control group (P = 0.027). The rate of obesity (define as BMI z-score > 2) in children with chronic constipation was 40% that was significantly higher than the normal control group (11%) (P < 0.0001).

Objectives

The aim of this study was to evaluate the growth parameters in children with chronic functional constipation and compare them with healthy individuals.

Patients and Methods

One hundred children with chronic functional constipation (defined as Rome III criteria) referred to Pediatric Gastroenterology Clinic enrolled in this study. Control group consisted of 100 children who referred for well-child visits, without constipation. Weight, height, body mass index (BMI) and z-score weight, z-score height and z-score BMI were calculated for each patient and control group.

Conclusions

We found a higher obesity rate and also higher BMI and weight z-scores in children with functional constipation compared with healthy control group. The reasons for the association between obesity and constipation are not clear and many factors including diet, activity level, or hormonal influences, are involved that require additional studies.

Background

Chronic functional constipation is an epidemic problem in children affects the children's growth.

Results

Both case and control groups consisted of the same age (P = 0.725) and gender (P = 0.777) individuals. The BMI (P < 0.0001) and BMI z-scores (P < 0.0001) of constipated children were significantly higher than the control group. Also, weight (P = 0.004) and weight z-scores (P < 0.0001) were significantly higher in the study group. There was no significant difference in height between the two groups (P = 0.1), but constipated children had higher height z-scores than control group (P = 0.027). The rate of obesity (define as BMI z-score > 2) in children with chronic constipation was 40% that was significantly higher than the normal control group (11%) (P < 0.0001).

Objectives

The aim of this study was to evaluate the growth parameters in children with chronic functional constipation and compare them with healthy individuals.

Patients and Methods

One hundred children with chronic functional constipation (defined as Rome III criteria) referred to Pediatric Gastroenterology Clinic enrolled in this study. Control group consisted of 100 children who referred for well-child visits, without constipation. Weight, height, body mass index (BMI) and z-score weight, z-score height and z-score BMI were calculated for each patient and control group.

Conclusions

We found a higher obesity rate and also higher BMI and weight z-scores in children with functional constipation compared with healthy control group. The reasons for the association between obesity and constipation are not clear and many factors including diet, activity level, or hormonal influences, are involved that require additional studies.

Background

Chronic functional constipation is an epidemic problem in children affects the children's growth.

Children;Constipation;Growth Parameters;Obesity Children;Constipation;Growth Parameters;Obesity 54 8 http://www.colorectalresearch.com/index.php?page=article&article_id=11979 Seyed Mohsen Dehghani Seyed Mohsen Dehghani Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel.: +98-7116125849, Fax: +98-7116474298 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel.: +98-7116125849, Fax: +98-7116474298 Hamdollah Karamifar Hamdollah Karamifar Department of Pediatric Endocrinology, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Pediatric Endocrinology, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Mohammad Hadi Imanieh Mohammad Hadi Imanieh Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Elham Mohebbi Elham Mohebbi Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Abdorrasoul Malekpour Abdorrasoul Malekpour Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Mahmood Haghighat Mahmood Haghighat Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Gastroenterohepatology Research Center, Nemazee Teaching Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.17795/acr-12555 Pathology of Colorectal Polyps, A Study from South of Iran Pathology of Colorectal Polyps, A Study from South of Iran research-article research-article Results

During these years, 990 patients with colorectal polyps were refered to the center. The most common types of polyps were adenomatous (603), followed by hyperplastic (300), juvenile (80), inflammatory (5) and Peutz-Jeghers (2). The most common site of polyp was rectosigmoid.

Material and Methods

We retrospectively analyzed pathology reports of colonoscopies during five years (2005 - 2011). Histologic reports and demographic findings were recorded and compared with published studies in the literatures of other countries from different geographic regions of the world.

Objectives

We conducted this retrospective study to evaluate the predominant colorectal polyps in our center as the largest referral center of the South region of Iran.

Background

: In western countries with high prevalence of colorectal cancers, colonic polyps are usually adenomatous. There are few studies from Iran regarding to the predominant type of polyps in colorectal area.

Discussion

The type and distribution of colorectal polyps in Iran is very similar to western countries.

Results

During these years, 990 patients with colorectal polyps were refered to the center. The most common types of polyps were adenomatous (603), followed by hyperplastic (300), juvenile (80), inflammatory (5) and Peutz-Jeghers (2). The most common site of polyp was rectosigmoid.

Material and Methods

We retrospectively analyzed pathology reports of colonoscopies during five years (2005 - 2011). Histologic reports and demographic findings were recorded and compared with published studies in the literatures of other countries from different geographic regions of the world.

Objectives

We conducted this retrospective study to evaluate the predominant colorectal polyps in our center as the largest referral center of the South region of Iran.

Background

: In western countries with high prevalence of colorectal cancers, colonic polyps are usually adenomatous. There are few studies from Iran regarding to the predominant type of polyps in colorectal area.

Discussion

The type and distribution of colorectal polyps in Iran is very similar to western countries.

Colorectal Polyp;South of Iran Colorectal Polyp;South of Iran 60 62 http://www.colorectalresearch.com/index.php?page=article&article_id=12555 Bita Geramizadeh Bita Geramizadeh Department of Pathology, Shiraz University of Medical Sciences, Shiraz, IR Iran; Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Pathology, Shiraz University of Medical Sciences, PO BOX: 71345-1864, Shiraz, Iran , Tel.: +98-7116474331 Department of Pathology, Shiraz University of Medical Sciences, Shiraz, IR Iran; Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Pathology, Shiraz University of Medical Sciences, PO BOX: 71345-1864, Shiraz, Iran , Tel.: +98-7116474331 Marzieh Keshtkar-Jahromi Marzieh Keshtkar-Jahromi Department of Pathology, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Pathology, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.17795/acr-12267 Comparative Study of Staging Rubber Band Ligation (RBL) and Hemorrhoidectomy in Treatment of Forth Degree Hemorrhoids Comparative Study of Staging Rubber Band Ligation (RBL) and Hemorrhoidectomy in Treatment of Forth Degree Hemorrhoids research-article research-article Conclusions

This study showed that staging rubber band ligation is effective for treating grade four hemorrhoids. Few complications and low recurrence rates were noted, which enable us to recommend this modality as the procedure of choice for the management of selected patients with grade four symptomatic hemorrhoids.

Results

Pain existed in 100% of the H group and 67.7% of the R group in the first visit one week postoperation (P < 0.05). There was a statistically significant difference between the two groups regarding the days off work. Patients’ satisfaction and recurrence were similar in the both groups after a period of six months.

Patients and Methods

A prospective randomized clinical trial was performed on all patients diagnosed with grade four symptomatic internal hemorrhoids from August 2011 to March 2013. Sixty four patients with grade four hemorrhoids were divided into two groups and underwent hemorrhoidectomy (H group) and rubber band ligation (R group).These patients were compared for any complications and recurrence in a six month period.

Objectives

This study aimed to analyze the efficacy of the staging rubber band ligation in the treatment of grade four hemorrhoids and compare it to hemorrhoidectomy.

Background

Rubber band ligation is one of the most worldwide used treatments of hemorrhoids because of its effectiveness and low complication rate. Hemorrhoidectomy is the procedure of choice for treatment of grade four hemorrhoids, which is a painful method for a relatively benign disease. There are a few studies available analyzing the effectiveness of RBL as an initial treatment for grade four symptomatic internal hemorrhoids.

Conclusions

This study showed that staging rubber band ligation is effective for treating grade four hemorrhoids. Few complications and low recurrence rates were noted, which enable us to recommend this modality as the procedure of choice for the management of selected patients with grade four symptomatic hemorrhoids.

Results

Pain existed in 100% of the H group and 67.7% of the R group in the first visit one week postoperation (P < 0.05). There was a statistically significant difference between the two groups regarding the days off work. Patients’ satisfaction and recurrence were similar in the both groups after a period of six months.

Patients and Methods

A prospective randomized clinical trial was performed on all patients diagnosed with grade four symptomatic internal hemorrhoids from August 2011 to March 2013. Sixty four patients with grade four hemorrhoids were divided into two groups and underwent hemorrhoidectomy (H group) and rubber band ligation (R group).These patients were compared for any complications and recurrence in a six month period.

Objectives

This study aimed to analyze the efficacy of the staging rubber band ligation in the treatment of grade four hemorrhoids and compare it to hemorrhoidectomy.

Background

Rubber band ligation is one of the most worldwide used treatments of hemorrhoids because of its effectiveness and low complication rate. Hemorrhoidectomy is the procedure of choice for treatment of grade four hemorrhoids, which is a painful method for a relatively benign disease. There are a few studies available analyzing the effectiveness of RBL as an initial treatment for grade four symptomatic internal hemorrhoids.

Rubber band ligation;Hemorrhoidectomy;Hemorrhoids Rubber band ligation;Hemorrhoidectomy;Hemorrhoids 62 6 http://www.colorectalresearch.com/index.php?page=article&article_id=12267 Mahmoud Aghaei Mahmoud Aghaei Hadi Hadavi Hadi Hadavi Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran Mehrdad Vahedian Mehrdad Vahedian Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran Bahram Poorseyedi Bahram Poorseyedi Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran Hamid Zeynali Hamid Zeynali Mohammad Reza Lashkari Zadeh Mohammad Reza Lashkari Zadeh Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran Maryam Kouhestani Parizi Maryam Kouhestani Parizi Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran; Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran , +98-3413222250 Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran; Department of Surgery, Kerman University of Medical Sciences, Kerman, IR Iran , +98-3413222250
en 10.17795/acr-12649 A Pilot study on Prediction of Pouchitis in Ulcerative Colitis Patients by Decision Tree Method Versus Logistic Regression Analysis A Pilot study on Prediction of Pouchitis in Ulcerative Colitis Patients by Decision Tree Method Versus Logistic Regression Analysis research-article research-article Conclusions

The results are not in favor of none of these two methods. However, the simplicity of decision tree for clinical experts and theoretical assumptions of logistic regression method make the choice clear. But more sample size may be needed to choose the best model with more confident.

Results

The accuracy rate in prediction is 0.6 for logistic regression method and 0.45 for decision tree algorithm. In addition, the mean squared error is lower for logistic regression (0.41 versus 0.48). However, the area under the ROC is more for decision tree than logistic regression (0.52 and 0.45 respectively).

Background

Pouchitis is a non-specific inflammation of the ileal reservoir and the most frequent complication that patients experience in long periods. Diagnosis should be made based on the clinical, endoscopic, and histological aspects. Prediction of pouchitis is an important issue for the physician.

Objectives

The study was aimed to identify the predictive factors of pouchitis as well as their importance.

Patients and Methods

In the present study, two classification techniques entitled decision trees method and logistic regression analysis were used to help the physician in prediction of pouchitis in ulcerative colitis (UC) patients. These patients are submitted to a specific surgery. The ability of these two methods in prediction is achieved by comparison of the accuracy of the correct predictions (the minimum error rate) and the interpretability and simplification of the results for clinical experts.

Conclusions

The results are not in favor of none of these two methods. However, the simplicity of decision tree for clinical experts and theoretical assumptions of logistic regression method make the choice clear. But more sample size may be needed to choose the best model with more confident.

Results

The accuracy rate in prediction is 0.6 for logistic regression method and 0.45 for decision tree algorithm. In addition, the mean squared error is lower for logistic regression (0.41 versus 0.48). However, the area under the ROC is more for decision tree than logistic regression (0.52 and 0.45 respectively).

Background

Pouchitis is a non-specific inflammation of the ileal reservoir and the most frequent complication that patients experience in long periods. Diagnosis should be made based on the clinical, endoscopic, and histological aspects. Prediction of pouchitis is an important issue for the physician.

Objectives

The study was aimed to identify the predictive factors of pouchitis as well as their importance.

Patients and Methods

In the present study, two classification techniques entitled decision trees method and logistic regression analysis were used to help the physician in prediction of pouchitis in ulcerative colitis (UC) patients. These patients are submitted to a specific surgery. The ability of these two methods in prediction is achieved by comparison of the accuracy of the correct predictions (the minimum error rate) and the interpretability and simplification of the results for clinical experts.

Pouchitis;Ulcerative Colitis;Decision Trees;Logistic Regression Pouchitis;Ulcerative Colitis;Decision Trees;Logistic Regression 67 70 http://www.colorectalresearch.com/index.php?page=article&article_id=12649 Saeedeh Pourahmad Saeedeh Pourahmad Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran Ali Reza Safarpour Ali Reza Safarpour Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran , +98-7112357282 Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran , +98-7112357282 Alimohammad Bananzadeh Alimohammad Bananzadeh Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Salar Rahimikazerooni Salar Rahimikazerooni Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Zahra Zabangirfard Zahra Zabangirfard Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
en 10.17795/acr-14446 Mesenteric Vein Thrombosis Complicating Pneumatosis Intestinalis, A Case Report Mesenteric Vein Thrombosis Complicating Pneumatosis Intestinalis, A Case Report case-report case-report Introduction

Pneumatosis intestinalis is usually considered as a benign condition. Here we report the association of this condition with mesenteric vein thrombosis leading to gangrenous bowel which, to our best knowledge, is the first reported association.

Case Presentation

The patient was a 71-year old Iranian smoker man, who was diagnosed with pneumatosis intestinalis for 11 months and then developed the abdominal pain which was confirmed to be due to the mesenteric vein thrombosis complicated by bowel gangrene.

Discussion

Although pneumatosis intestinalis is not usually threatening in adults, its new onset in the abdomen of these patients should prompt the complications such as mesenteric vein thrombosis.

Introduction

Pneumatosis intestinalis is usually considered as a benign condition. Here we report the association of this condition with mesenteric vein thrombosis leading to gangrenous bowel which, to our best knowledge, is the first reported association.

Case Presentation

The patient was a 71-year old Iranian smoker man, who was diagnosed with pneumatosis intestinalis for 11 months and then developed the abdominal pain which was confirmed to be due to the mesenteric vein thrombosis complicated by bowel gangrene.

Discussion

Although pneumatosis intestinalis is not usually threatening in adults, its new onset in the abdomen of these patients should prompt the complications such as mesenteric vein thrombosis.

Mesenteric vein thrombosis, Pneumatosis intestinalis;Case report Mesenteric vein thrombosis, Pneumatosis intestinalis;Case report 71 2 http://www.colorectalresearch.com/index.php?page=article&article_id=14446 Kamran Bagheri Lankarani Kamran Bagheri Lankarani Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; , Health Policy Research Center, Shiraz University of Medical Sciences, Zand Blvd, Zip code: 71348, Shiraz, IR Iran , +98-7112302799 Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; , Health Policy Research Center, Shiraz University of Medical Sciences, Zand Blvd, Zip code: 71348, Shiraz, IR Iran , +98-7112302799
en 10.17795/acr-14321 Inflammatory Bowel Diseases, A Long Way Ahead Inflammatory Bowel Diseases, A Long Way Ahead letter letter Crohn’s; Ulcerative Colitis; Epidemiology Crohn’s; Ulcerative Colitis; Epidemiology 73 http://www.colorectalresearch.com/index.php?page=article&article_id=14321 John F.Mayberry John F.Mayberry Department of Gastroenterology, University Hospitals of Leicester, Leicester, UK; Department of Gastroenterology, University Hospitals of Leicester, Leicester, UK. Tel.: +44-1162584786 Department of Gastroenterology, University Hospitals of Leicester, Leicester, UK; Department of Gastroenterology, University Hospitals of Leicester, Leicester, UK. Tel.: +44-1162584786
en 10.17795/acr-11900 Epidemiology of Inflammatory Bowel Diseases , Where are the Iranian Cases ? Epidemiology of Inflammatory Bowel Diseases , Where are the Iranian Cases ? letter letter Ulcerative colitis; Cohn's disease; inflammatory bowel disease; Iran Ulcerative colitis; Cohn's disease; inflammatory bowel disease; Iran 74 http://www.colorectalresearch.com/index.php?page=article&article_id=11900 Fatemeh Malekzadeh Fatemeh Malekzadeh Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran Homayoon Vahedi Homayoon Vahedi Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran; Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran , +98-9121094160 Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran; Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran , +98-9121094160
en 10.17795/acr-13171 Caution in Use of Synthetic Mesh in Repairing the Incisional Hernia Caution in Use of Synthetic Mesh in Repairing the Incisional Hernia letter letter Ventral incisional hernia; Hernia repair; Mesh graft Ventral incisional hernia; Hernia repair; Mesh graft http://www.colorectalresearch.com/index.php?page=article&article_id=13171 Ahmad Izadpanah Ahmad Izadpanah Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel.: +98-7112306972, Fax:+98-7112330724 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran. Tel.: +98-7112306972, Fax:+98-7112330724
en 10.17795/acr-14444 Response to the Letter about “Modified Sandwich Technique Mesh Implantation in Repair of Incisional Hernia” Response to the Letter about “Modified Sandwich Technique Mesh Implantation in Repair of Incisional Hernia” letter letter Hernia repair;Mesh graft Hernia repair;Mesh graft 76 http://www.colorectalresearch.com/index.php?page=article&article_id=14444 Seyed Vahid Hosseini Seyed Vahid Hosseini Salar Rahimikazerooni Salar Rahimikazerooni Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran, Tel./Fax: +98-7112306972 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran; Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran, Tel./Fax: +98-7112306972
en 10.17795/acr-14314 Oral Psyllium Herbal Laxative, Clinical Trial in a Difficult Group Oral Psyllium Herbal Laxative, Clinical Trial in a Difficult Group letter letter Pregnancy;Psyllium;Haemorrhoids;Fissures;Trials Pregnancy;Psyllium;Haemorrhoids;Fissures;Trials http://www.colorectalresearch.com/index.php?page=article&article_id=14314 John F. Mayberry John F. Mayberry Department of Gastroenterology, University Hospitals of Leicester NHS Trust, Leicester, UK , +44-1162584786; Department of Gastroenterology, University Hospitals of Leicester NHS Trust, Leicester, UK , +44-1162584786 Department of Gastroenterology, University Hospitals of Leicester NHS Trust, Leicester, UK , +44-1162584786; Department of Gastroenterology, University Hospitals of Leicester NHS Trust, Leicester, UK , +44-1162584786