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HPB Surgery
Published in Tjun Tang, Elizabeth O'Riordan, Stewart Walsh, Cracking the Intercollegiate General Surgery FRCS Viva, 2020
London Lucien Ooi Peng Jin, Teo Jin Yao
There are several issues to consider here: Is the sigmoid colon cancer symptomatic and are the symptoms debilitating, e.g. is there impending obstruction or significant bleeding? This will affect the considerations for timing of resection/management of the primary lesion.What is the tumour burden in the liver and the relative residual liver remnant volume? This has relevance to operability as well as prognosis.Has complete staging been done to determine if this is liver-only metastases or are there metastases elsewhere?
The Digestive (Gastrointestinal) System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Normally, the waste products remain in the large intestine from twelve to thirty-six hours. Feces are usually stored in the sigmoid colon. The impulse to defecate, a response to the gastrocolic reflex, occurs when the rectum becomes distended with feces. Defecation is controlled by the anal sphincter muscles.
Serrated Polyposis Syndrome
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Extending from the cecum (which connects the ileum of the small intestine) to the anal canal, the colon (large intestine) is a tube of 150 cm in length that can be separated into ascending, transverse, descending, and sigmoid sections. The ascending colon (sometimes referred to as the proximal or right colon) starts from the cecum, ascends to the right lobe of the liver, and turns 90° at the right colic flexure (or hepatic flexure) to become the transverse colon, which crosses the abdomen horizontally to the spleen. The transverse colon then turns another 90° at the left colic flexure (or splenic flexure) to become the descending colon, which moves inferiorly and connects the sigmoid colon. The sigmoid colon (sometimes referred to as the distal or left colon) is a 40-cm long tube forming a characteristic “S” shape that connects the rectum, then the anus.
Changes in colonic enteroendocrine cells of patients with irritable bowel syndrome following fecal microbiota transplantation
Published in Scandinavian Journal of Gastroenterology, 2022
Tarek Mazzawi, Trygve Hausken, Magdy El-Salhy
The participants’ selection, screening and transplantation process are detailed in a previous publication [22]. Briefly, 83 patients with diarrhea-predominant and mixed type IBS according to Rome III criteria who were referred to the University Hospital of North Norway at Harstad, were included. They were allocated to receive donor-FMT (either fresh or frozen feces) or placebo FMT (own feces), in a ratio 2:1, by colonoscope to cecum in a double-blinded, randomized, placebo-controlled study after a serial of medical and physical tests to establish eligibility. To standardize the transplantation procedure, feces were collected from only two donors who fulfilled predetermined inclusion criteria. The randomization sequence was sealed in non-transparent envelopes and reveled to researchers when all participants completed a 12-month follow-up. Biopsy samples were obtained from sigmoid colon at baseline as part of the FMT procedure. Using the same cohort of IBS patients in the REFIT study [22], 10 recipients among of the best responders (6 females and 4 males, age range 19–66, mean 44 years old), defined by >100 points improvement in IBS-symptom severity score (IBS-SSS) after FMT compared to baseline, and 10 non-responders (5 females and 5 males, age range 32–69, mean 53 years old) without any changes in IBS-SSS (<100 point change), consented to a new biopsy one year after FMT. They had diarrhea-predominant IBS (n = 10) and mixed-IBS (n = 10) subtypes. Out of these participants (n = 20), 16 received donor-FMT and four received placebo FMT.
Detection rates for adenomas, serrated polyps and clinically relevant serrated polyps can be easily estimated by individually calculated detection rate ratios
Published in Scandinavian Journal of Gastroenterology, 2020
Martin Buerger, Philipp Kasper, Ingo Scheller, Jan-Hinnerk Hofer, Hans Toermer, Annette Stelzer, Frank Stenschke, Michael Stollenwerk, Gabriel Allo, Tobias Goeser, Hans-Michael Steffen, Christoph Schramm
Experienced endoscopists were defined as endoscopists who performed ≥300 colonoscopies annually for various indications during the study period. Time period (months) per endoscopists, during which procedures were obtained, was presented as median and range. The quality of bowel preparation was retrospectively evaluated on the basis of the endoscopy report and classified into adequate (excellent, good, fair) and poor. Histological evaluation was based on the original diagnosis of colorectal polyps, reported by the participating center, without central histopathological evaluation. SPs included HPs, SSAs and TSAs. CrSPs were defined as SPs ≥10 mm throughout the whole colon and/or SPs >5 mm located proximal to the splenic flexure as previously published [17]. To compare our results with other outcomes of large studies, we have calculated further subgroups concerning the definitions of proximal SPs analogous to the studies of Anderson et al. [19] and Ijspeert et al. [18]. In this concern, the proximal colon was defined as (i) proximal to the sigmoid colon (sc) and (ii) proximal to the descending colon (dc) (additionally listed in all tables and figures).
Elective surgery should be considered after successful conservative treatment of recurrent diverticular abscesses
Published in Scandinavian Journal of Gastroenterology, 2020
J. Sigurdardottir, A. Chabok, A. Thorisson, K. Smedh, M. Nikberg
In total, 1188 patients were treated for acute diverticulitis during the 5-year inclusion period, and 75 patients were diagnosed with diverticulitis that was complicated by an abscess (30 men and 45 women, Table 1). The median age was 62 years (range: 23–88 years). The median body mass index (BMI) was 27 kg/m2 (range: 17–44). Comorbidities such as diabetes, chronic obstructive pulmonary disease and/or cardiovascular disease were found in 46 patients (61%) and 15 (20%) were on immunosuppressive medication. Diverticulitis was located in the sigmoid colon in 68 (91%) patients, the descending colon in four patients, the transverse colon in two patients and the ascending colon in one patient. A pericolic abscess was present in 42 patients (59%) and an abscess in the pelvis in 33 patients (41%).