1,721,232 research outputs found
The 2017 European Society of Coloproctology (ESCP) international snapshot audit of left colon, sigmoid and rectal resections - Executive Summary
Full text linkBackground: Left hemicolectomy, sigmoid, and rectal resections are commonly performed colorectal operations. There is significant variability in the techniques utilised to undertake these operationsat patient, surgeon and unit level. Aim: To explore differences in patients, techniques and outcomes across an international cohort to identify areas of practice variability resulting in apparent differences in outcome warranting further study. Endpoints: A three-stage data collection strategy collecting patient demographics, operative details and outcome markers. Several outcomes measures will be used including mortality, surgical morbidity (including anastomotic leak) and length of hospital stay. Methods: A two-month prospective audit to be performed across Europe in early 2017, co-ordinated by the European Society of Coloproctology. The main audit will be preceded by a one-week, five centre pilot. Sites will be asked to pre-register for the audit and obtain appropriate regional or national approvals. During the study period all eligible operations will be recorded contemporaneously and followed-up through to 30 days. The audit will be performed using a standardised pre-determined protocol and a secure online database. In the first ESCP conducted audit in 2015, 38 countries registered 3208 patients undergoing right hemi-colectomy, while in the second audit 2441 patients undergoing stoma closure were recruited from 48 countries. It is expected that equivalent numbers will be obtained in this audit. The report of this audit will be prepared in accordance with guidelines set by the STROBE (strengthening the reporting of observational studies in epidemiology) statement for observational studies. Discussion: This multicentre, pan-European audit will be delivered by colorectal surgeons and trainees in an organised and homogenous manner. The data obtained about areas of variability in provision or practice, and how this may impact upon outcomes, will serve to improve overall patient care as well as being hypothesis generating and inform areas needing future prospective study. Colorectal Disease © 2018 The Association of Coloproctology of Great Britain and Irelan
Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis
Full text linkAim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease
Physiological parameters predicting the outcome of surgical and nonsurgical treatment of fecal incontinence
No full textFecal incontinence is a multifactorial disease. Anorectal physiology studies play an outstanding role in the evaluation of its etiology and severity, the two main factors that constitute the basis for the correct choice of treatment. However, the prognostic role of clinical factors and anorectal physiological tests in predicting the outcome to either conservative or surgical treatment is questionable. © 2007 Springer-Verlag Italia
Cutting-Edge Research Trends in Colorectal Disease
No full text: The scientific effort in improving colorectal disease treatment and outcomes has allowed for a continuous shift of burdens that were previously thought to be unassailable [...]
The role of food contamination by mycotoxins in human diseases: A review
No full textDirect or indirect (by animals) contamination of food by mycotoxins produced by fungi is very common and should be considered a major problem in this era of globalization because it can severely affect human health and sometimes produce cancer. Some of the mycotoxins are well known and widely studied, but many others have not been evaluated yet for their potential toxicity. In this study we review the best-known human diseases induced by the most common mycotoxins such as aflatoxin B1, ochratoxin A, fumonisins and zearalenone and their mechanism of action. © SINPE-GASAPE
Comment: Is a Large-Scale Screening for Alzheimer's Disease Possible? Yes, in a Few Years
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