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 24 gregorian 2017 6 24 4 3
en 10.17795/acr-41527 The Correlation Between Single Nucleotide Polymorphism Patterns and Colorectal Cancer in the Iranian Population The Correlation Between Single Nucleotide Polymorphism Patterns and Colorectal Cancer in the Iranian Population review-article review-article Conclusions

Various single nucleotide polymorphisms of critical genes indicated significant association with colorectal cancer in the Iranian population. New polymorphism markers for high risk individuals have been recognized through further investigations to reduce the incidence and mortality of colorectal cancer.

Context

The incidence of colorectal cancer has significantly increased in Iran during the last decade. Accumulating evidence suggests that there is a significant correlation between genetic variations such as polymorphisms and colorectal cancer. Therefore, identification of critical polymorphisms related to colorectal cancer can contribute to find individuals at high risk of CRC.

Evidence Acquisition

The focus of this review was on published articles in English about the association between different single nucleotide polymorphisms and colorectal cancer in the Iranian population. Evidences were gathered by searching online medical databases including Google scholar, Pubmed, Scopus and Science Direct.

Conclusions

Various single nucleotide polymorphisms of critical genes indicated significant association with colorectal cancer in the Iranian population. New polymorphism markers for high risk individuals have been recognized through further investigations to reduce the incidence and mortality of colorectal cancer.

Context

The incidence of colorectal cancer has significantly increased in Iran during the last decade. Accumulating evidence suggests that there is a significant correlation between genetic variations such as polymorphisms and colorectal cancer. Therefore, identification of critical polymorphisms related to colorectal cancer can contribute to find individuals at high risk of CRC.

Evidence Acquisition

The focus of this review was on published articles in English about the association between different single nucleotide polymorphisms and colorectal cancer in the Iranian population. Evidences were gathered by searching online medical databases including Google scholar, Pubmed, Scopus and Science Direct.

Single Nucleotide Polymorphism;Colorectal Cancer;Iranian Population Single Nucleotide Polymorphism;Colorectal Cancer;Iranian Population http://www.colorectalresearch.com/index.php?page=article&article_id=41527 Mozhdeh Zamani Mozhdeh Zamani Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Seyed Vahid Hosseini Seyed Vahid Hosseini Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran Pooneh Mokarram Pooneh Mokarram Gasteroenterohepatology Research Center, Nemazee Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Biochemistry, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Biochemistry, Shiraz University of Medical Sciences, P.O. Box: 1167, Shiraz, IR Iran. Tel/Fax: +98-7112303029 Gasteroenterohepatology Research Center, Nemazee Hospital, School of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Biochemistry, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, IR Iran; Department of Biochemistry, Shiraz University of Medical Sciences, P.O. Box: 1167, Shiraz, IR Iran. Tel/Fax: +98-7112303029
en 10.17795/acr-37919 Security and Feasibility of Laparoscopic Rectal Cancer Resection in Morbidly Obese Patients <bold>Security and Feasibility of Laparoscopic Rectal Cancer Resection in Morbidly</bold> Obese Patients research-article research-article Conclusions

This study suggests that laparoscopic rectal resection for cancer in morbidly obese patients is challenging and associated with a higher rate of conversion compared to patients with lower BMI. Mortality, morbidity and readmission rates are similar to the literature showing the same benefit for laparoscopic procedure.

Results

Thirteen patients underwent laparoscopic approach. The median BMI was 42.4 kg/m2. There were 4 conversions (30%). Anastomotic leak occurred in 2 patients (15.4%). TME was complete in only 9 patients (69.2%), with 3 patients with incomplete TME being also in the conversion group. There was no mortality. There was no recurrence.

Methods

All morbidly obese patients, defined as a body mass index (BMI) of 40 kg/m2 or greater, undergoing laparoscopic rectal cancer resection for primary cancer between January 2006 and July 2013, were identified using medical records in a single academic hospital center.

Background

Rectal resection for cancer can be technically challenging, especially in the obese patient. While some have investigated the impact of laparoscopic surgery on rectal cancer, no study looked at the subgroup of morbidly obese patients.

Objectives

Our goal was to evaluate feasibility and safety of laparoscopic rectal resection for cancer in this population.

Conclusions

This study suggests that laparoscopic rectal resection for cancer in morbidly obese patients is challenging and associated with a higher rate of conversion compared to patients with lower BMI. Mortality, morbidity and readmission rates are similar to the literature showing the same benefit for laparoscopic procedure.

Results

Thirteen patients underwent laparoscopic approach. The median BMI was 42.4 kg/m2. There were 4 conversions (30%). Anastomotic leak occurred in 2 patients (15.4%). TME was complete in only 9 patients (69.2%), with 3 patients with incomplete TME being also in the conversion group. There was no mortality. There was no recurrence.

Methods

All morbidly obese patients, defined as a body mass index (BMI) of 40 kg/m2 or greater, undergoing laparoscopic rectal cancer resection for primary cancer between January 2006 and July 2013, were identified using medical records in a single academic hospital center.

Background

Rectal resection for cancer can be technically challenging, especially in the obese patient. While some have investigated the impact of laparoscopic surgery on rectal cancer, no study looked at the subgroup of morbidly obese patients.

Objectives

Our goal was to evaluate feasibility and safety of laparoscopic rectal resection for cancer in this population.

Rectal Cancer;Mordid Obesity;Laparoscopic Surgery Rectal Cancer;Mordid Obesity;Laparoscopic Surgery http://www.colorectalresearch.com/index.php?page=article&article_id=37919 Alexandre Brind'Amour Alexandre Brind'Amour Department of Surgery, Laval University, Quebec City, Canada; Department of Surgery, Laval University, Quebec City, Canada. Tel: +1-4185802539 Department of Surgery, Laval University, Quebec City, Canada; Department of Surgery, Laval University, Quebec City, Canada. Tel: +1-4185802539 Francois Letarte Francois Letarte Department of Surgery, Laval University, Quebec City, Canada Department of Surgery, Laval University, Quebec City, Canada Alexandre Bouchard Alexandre Bouchard Department of Surgery, Laval University, Quebec City, Canada Department of Surgery, Laval University, Quebec City, Canada Sebastien Drolet Sebastien Drolet Department of Surgery, Laval University, Quebec City, Canada Department of Surgery, Laval University, Quebec City, Canada
en 10.17795/acr-37979 Use of CT Imaging in Acute Diverticulitis Use of CT Imaging in Acute Diverticulitis research-article research-article Conclusions

There is an overuse of CT in the investigation of acute diverticulitis with limited change in clinical management as only 6.3% of patients required surgical or radiological intervention. We suggest medical management with intravenous antibiotics and bowel rest with imaging indicated after 72 hours if no clinical improvement (or earlier if warranted by the clinical status).

Methods

Retrospective audit of all patients admitted to Flinders Medical Centre with a clinical diagnosis of acute colonic diverticulitis in ED or following investigation with CT between July 2011 and February 2012.

Results

A total of 79 patients were suspected of having diverticulitis. 57 (72.2%) patients were confirmed to have diverticulitis following imaging of which 46 (80.7%) patients had simple diverticulitis and 11 (19.3%) patients had complicated diverticulitis (perforation n = 7 [12.3%]; abscess n = 4 [7.0%]). Overall only 6.3% of patients required radiological or surgical management for their presentation.

Background

Acute colonic diverticulitis is generally considered to be a clinical diagnosis, however the use of CT (computed tomography) imaging in diverticulitis is becoming more common to exclude complicated diverticulitis.

Objectives

To assess the use of CT imaging in the acute presentation of suspected colonic diverticulitis and whether clinical management was altered depending on imaging findings.

Conclusions

There is an overuse of CT in the investigation of acute diverticulitis with limited change in clinical management as only 6.3% of patients required surgical or radiological intervention. We suggest medical management with intravenous antibiotics and bowel rest with imaging indicated after 72 hours if no clinical improvement (or earlier if warranted by the clinical status).

Methods

Retrospective audit of all patients admitted to Flinders Medical Centre with a clinical diagnosis of acute colonic diverticulitis in ED or following investigation with CT between July 2011 and February 2012.

Results

A total of 79 patients were suspected of having diverticulitis. 57 (72.2%) patients were confirmed to have diverticulitis following imaging of which 46 (80.7%) patients had simple diverticulitis and 11 (19.3%) patients had complicated diverticulitis (perforation n = 7 [12.3%]; abscess n = 4 [7.0%]). Overall only 6.3% of patients required radiological or surgical management for their presentation.

Background

Acute colonic diverticulitis is generally considered to be a clinical diagnosis, however the use of CT (computed tomography) imaging in diverticulitis is becoming more common to exclude complicated diverticulitis.

Objectives

To assess the use of CT imaging in the acute presentation of suspected colonic diverticulitis and whether clinical management was altered depending on imaging findings.

Colonic;Computed Tomography;Diverticulitis;Imaging;Laparotomy Colonic;Computed Tomography;Diverticulitis;Imaging;Laparotomy http://www.colorectalresearch.com/index.php?page=article&article_id=37979 Anton Mare Anton Mare Department of General Surgery, Flinders Medical Centre, the Canberra Hospital, Garran, Australia; Department of General Surgery, Flinders Medical Centre, the Canberra Hospital, Garran, Australia. Tel: +61-262442222, Fax: +61-262813935 Department of General Surgery, Flinders Medical Centre, the Canberra Hospital, Garran, Australia; Department of General Surgery, Flinders Medical Centre, the Canberra Hospital, Garran, Australia. Tel: +61-262442222, Fax: +61-262813935 Neil Jones Neil Jones Division of Medical Imaging, Flinders Medical Centre, Adelaide, Australia Division of Medical Imaging, Flinders Medical Centre, Adelaide, Australia
en 10.17795/acr-37452 Method for Management of Perianal Fistula with New Device: Progressive Curettage of the Tract and Sealing with Platelet-Rich Fibrin Method for Management of Perianal Fistula with New Device: Progressive Curettage of the Tract and Sealing with Platelet-Rich Fibrin brief-report brief-report

Surgical treatment of high perianal fistulas, which affect a significant proportion of the sphincter apparatus, is difficult and associated with considerable risk of impaired anal continence. The diversity of approaches proposed for the treatment of complex perianal fistulas reflects the fact that no method has yet been shown to be fully satisfactory. We believe the successful treatment of this condition is directly proportional to the amount of fibrous tissue that can be removed. We used a kit of small curettes, of different thicknesses and sizes, incorporating spicules that enable the physician to remove fibrous tissue from the fistula tract. The small size and varying thicknesses of the curettes enable them to mold to the curves of the fistula tract and to remove tissue by de-roofing from the shallowest to the deepest layers, thus excising the entire fibrous tract. The tract is then sealed using autologous fibrin, applied through a catheter, with the help of a monitor indicating the amount of product remaining at all times. Finally, the internal orifice is closed by simple suturing.

Surgical treatment of high perianal fistulas, which affect a significant proportion of the sphincter apparatus, is difficult and associated with considerable risk of impaired anal continence. The diversity of approaches proposed for the treatment of complex perianal fistulas reflects the fact that no method has yet been shown to be fully satisfactory. We believe the successful treatment of this condition is directly proportional to the amount of fibrous tissue that can be removed. We used a kit of small curettes, of different thicknesses and sizes, incorporating spicules that enable the physician to remove fibrous tissue from the fistula tract. The small size and varying thicknesses of the curettes enable them to mold to the curves of the fistula tract and to remove tissue by de-roofing from the shallowest to the deepest layers, thus excising the entire fibrous tract. The tract is then sealed using autologous fibrin, applied through a catheter, with the help of a monitor indicating the amount of product remaining at all times. Finally, the internal orifice is closed by simple suturing.

Anal Fistula;Sealant;Curettage;Platelet Rich Fibrin Anal Fistula;Sealant;Curettage;Platelet Rich Fibrin http://www.colorectalresearch.com/index.php?page=article&article_id=37452 Francisco Javier Perez Lara Francisco Javier Perez Lara Digestive Surgery Department, Antequera Hospital, Malaga, Spain; Digestive Surgery Department, Antequera Hospital, Malaga, Spain. Tel: +34-668830533 Digestive Surgery Department, Antequera Hospital, Malaga, Spain; Digestive Surgery Department, Antequera Hospital, Malaga, Spain. Tel: +34-668830533 Arminda Ferrer Berges Arminda Ferrer Berges Digestive Surgery Department, Antequera Hospital, Malaga, Spain Digestive Surgery Department, Antequera Hospital, Malaga, Spain Jose Manuel Hernandez Gonzalez Jose Manuel Hernandez Gonzalez Digestive Surgery Department, Antequera Hospital, Malaga, Spain Digestive Surgery Department, Antequera Hospital, Malaga, Spain Elena Sanchis Cardenas Elena Sanchis Cardenas Digestive Surgery Department, Antequera Hospital, Malaga, Spain Digestive Surgery Department, Antequera Hospital, Malaga, Spain Arturo del Rey Moreno Arturo del Rey Moreno Digestive Surgery Department, Antequera Hospital, Malaga, Spain Digestive Surgery Department, Antequera Hospital, Malaga, Spain Horacio Oliva Munoz Horacio Oliva Munoz Digestive Surgery Department, Antequera Hospital, Malaga, Spain Digestive Surgery Department, Antequera Hospital, Malaga, Spain
en 10.17795/acr-38307 Giant Condyloma Acuminatum: A Surgical Riddle Giant Condyloma Acuminatum: A Surgical Riddle case-report case-report

Giant condyloma acuminatum (GCA) commonly known as Buschke-Lowenstein tumor (BLT) is a rare sexually transmitted disease, which is always preceded by condyloma accuminata and linked to human papillomavirus (HPV). Most commonly affected sites are male and female genitalia, anal and perianal regions. Giant condyloma acuminatum is well-known as slow growing but locally destructive with a high rate of recurrence and increased frequency of malignant transformation. Surgical management is considered to be the best among all the options.

Giant condyloma acuminatum (GCA) commonly known as Buschke-Lowenstein tumor (BLT) is a rare sexually transmitted disease, which is always preceded by condyloma accuminata and linked to human papillomavirus (HPV). Most commonly affected sites are male and female genitalia, anal and perianal regions. Giant condyloma acuminatum is well-known as slow growing but locally destructive with a high rate of recurrence and increased frequency of malignant transformation. Surgical management is considered to be the best among all the options.

Buschke-Lowenstein Tumor;Giant Condyloma Acuminatum Buschke-Lowenstein Tumor;Giant Condyloma Acuminatum http://www.colorectalresearch.com/index.php?page=article&article_id=38307 Ankit Shukla Ankit Shukla Senior Resident, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India; Department of General Surgery, Dr. Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India. Tel: +91-9418989680 Senior Resident, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India; Department of General Surgery, Dr. Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India. Tel: +91-9418989680 Ramesh Bharti Ramesh Bharti Professor & Head, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India Professor & Head, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India Amar Verma Amar Verma Assistant Professor, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India Assistant Professor, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India Rajesh Chaudhry Rajesh Chaudhry Senior Resident, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India Senior Resident, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India Rakesh B Anand Rakesh B Anand Junior Resident, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India Junior Resident, Department of General Surgery, Dr Rajendra Prasad Government Medical College, Kangra, Tanda Himachal Pradesh, India