Colorectal Disease (Colorectal Dis)

Publisher: Association of Coloproctology of Great Britain and Ireland, Wiley

Journal description

Colorectal Disease is a new journal publishing original research in any discipline relating to colorectal pathology. The journal will further education and inter-professional development by including regular review articles, discussions of current controversies, occasional highly selected case reports, and question and answer features.Colorectal Disease is the official organ of the Association of Coloproctology of Great Britain and Ireland. The journal will report news of the Association and take a major interest in coloproctological matters across Europe as a whole.

Current impact factor: 2.35

Impact Factor Rankings

2015 Impact Factor Available summer 2016
2014 Impact Factor 2.351
2013 Impact Factor 2.017
2012 Impact Factor 2.081
2011 Impact Factor 2.927
2010 Impact Factor 2.728
2009 Impact Factor 2.41
2008 Impact Factor 2.293
2007 Impact Factor 2.059

Impact factor over time

Impact factor

Additional details

5-year impact 2.36
Cited half-life 4.10
Immediacy index 0.74
Eigenfactor 0.02
Article influence 0.73
Website Colorectal Disease website
Other titles Colorectal disease (Online)
ISSN 1463-1318
OCLC 45907159
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author can archive a pre-print version
  • Post-print
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  • Restrictions
    • 12 months embargo
  • Conditions
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    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • Non-Commercial
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Aim: Many perianal fistulae in Crohn's disease do not respond to conventional surgical and medical management and recurrence rates are high. The study evaluated the safety and feasibility of allogeneic adipose-derived stem cells for the treatment of perianal fistula in Crohn's disease. Method: A multicentre, open-label, dose escalation pilot study was performed. The first three patients (group 1) were administered 1 x 10(7) cells/mL based on the size of the fistula tract. Four weeks later, after which time this dose had been confirmed to be safe, the next three patients (group 2) were administered 3 x 10(7) cells/mL. The end point was complete closure at eight weeks after the injection. Patients who attended for the eight week assessment were followed for an additional six months. Results: There were no adverse events of grade 3 or 4 severity and no adverse events related to the treatment with allogeneic adipose-derived stem cells. Two patients in group 1 achieved complete closure of the fistula at month 4 and month 6, and one patient in group 2 achieved complete closure at 8 weeks. The closure was sustained up to month 8 in all 3 of those patients. Conclusion: These data suggest that allogeneic adipose-derived stem cells may be a feasible treatment option for perianal fistula in Crohn's disease. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13223
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    ABSTRACT: Aim: Historically, postoperative deaths have been reported up to thirty days following surgery. There is, however, emerging evidence that deaths attributable to surgery continue to occur much later than this time frame. This aim of this study was to analyse the timing and causes of mortality following colorectal resection. Methods: Data were obtained from the Hospital Episode Statistics database with linkage with mortality data from the Office for National Statistics. Patients who underwent colorectal resectional surgery between April 2001 and February 2007 were included. Causes of death were classified into colorectal cancer (CRC), other malignancy, cardiac, respiratory, gastrointestinal, neurological and other. Results: During the study period 171,791 patients underwent a colorectal resection. Thirty-day mortality rates for elective procedures were 1.3%, 3.5%, 7.0% and 12.1% for <=65 years, 66-75 years, 76-85 years and >85 years groups respectively, compared with 2.2%, 5.4%, 9.8% and 16.7% at 90 days. For elective operations, at 30 days, 38.6% of patients who died had colorectal cancer recorded as the primary cause of death, whilst 25.4% died of cardiac causes. In the younger population undergoing a resection, deaths due to cardiac causes were significantly higher than the national average for the same age group even beyond thirty days (13.5% at 30 days, 11.1% at 90 days and 5.7% at one year). Conclusions: This study shows that deaths attributable to colorectal surgery occur beyond the conventionally utilised 30-day period. Information presented to patients on the basis of 30-day mortality estimates is likely to underestimate the true risk of surgical intervention. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13224
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    ABSTRACT: Background: Laparoscopic total mesorectal excision (LaTME) has improved short-term outcomes of rectal cancer surgery with comparable oncological results to open approach. LaTME can be difficult in the lower most part of the rectum, leading potentially to higher rates of complications, conversion to open surgery and probably suboptimal oncological quality. Transanal TME (TaTME) can potentially solve these problems. The aim of this study was to compare the short-term results after TaTME with those after LaTME. Methods: A prospectively collected database of consecutive patients who underwent TaTME was maintained. Results were compared with those underwent LaTME in the preceding period. Patients who underwent low anterior resection or intersphincteric abdominoperineal excision (APE) were included. Primary end-points were radical resection and specimen quality. Secondary end-points were complications, rates of conversion, operating time and hospital stay. Results: In total, 50 patients were included (TaTME = 25, LaTME = 25). The groups were comparative in demographic data and tumour characteristics. Circumferential resection margin was positive in one patient in TaTME group versus four patients in LaTME group (P=0.349). All patients in TaTME group had either complete or nearly complete specimen quality, while four patients in LaTME group had incomplete specimen quality (P=0.113). Less blood loss, shorter operating time and shorter hospital stay were found in TaTME group (P values 0.016, 0.002 and 0.020 respectively). Intraoperative complications were comparable (P=0.286). Conclusion: TaTME procedure had comparable pathological results and acceptable short-term postoperative outcomes compared to LaTME. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13225
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    ABSTRACT: Aim: Little is known about the long-term outcome of T1 colorectal cancer (CRC) following curative resection. The present study addressed determine the long-term outcome of locally or radically resected T1 CRCs. Method: A total of 430 patients with T1 CRC who underwent local or radical resection. The unfavorable histologic factors were defined as positive resection margin, deep submucosal invasion, vascular invasion, grade 3 and budding. The patients were classified as low-risk (unfavorable histologic factor negative, n=65) or high-risk (unfavorable histologic factor positive, n=365). Results: Over a median follow-up of 78.4 months, disease recurred in 16 (3.7%) patients in the high-risk group, and no recurrence in the low-risk group. Resection type and vascular invasion were significantly associated with recurrence. In the vascular invasion (+) high-risk group, both 5-year disease-free survival rate and 5-year overall survival rate were significantly associated with resection type (radical 94.6%, local 43.8%, P <0.001 and radical 99.1%, local 66.7%, P <0.001). In the vascular invasion (-) high-risk group, 5-year disease-free survival rate was also significantly associated with resection type (radical 98.9%, local 84.7%, P = 0.001). However, 5-year overall survival rate was not associated with resection type (radical 98.9%, local 95.2%, P =0.816). Conclusion: Local resection may be effective and oncologically safe in the low-risk T1 CRC. Although additional surgery should be recommended for the locally resected high-risk T1 CRC cases, intensive surveillance without additional surgery and timely salvage operation may offer another treatment option, if vascular invasion is negative. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13221
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    ABSTRACT: Aim: Tumour neoangiogenesis is a key factor for tumour progression and metastatic spread. The possibility to assess tumour angiogenesis might provide prognostic information. Aim of the study was to establish the role of probe-based Confocal Laser Endomicroscopy (p-CLE) in the identification of vascular architecture and specific morphological patterns in normal colorectal mucosa and malignant lesions, during routine endoscopy. Method: Fourteen consecutive patients with colorectal cancer were included. The following features were identified and then compared between normal and neoplastic mucosa on p-CLE images: vessel shape (straight vs irregular); vessel diameter; the "branching patterns"; vessel permeability (fluorescein leakage) and blood flow (normal vs defective flux). Immunohistochemistry was used to confirm the presence and to study the morphology of vascular structures (CD-34 staining) and "neo-vessels" (WT-1 staining) on tumour and normal mucosa sections. Results: Tumour vessels appeared as irregular, ectatic and with a highly variable caliber and branching patterns on p-CLE images. Mean diameter of tumour vessels was significantly larger when compared with normal mucosa (WMD, 3.38, 95% CI 2.65, 4.11, p=0.01). Similarly, "vessel branching" (OR, 2.74, 95% CI 1.23, 6.14, p=0.01), fluorescent dye "extravasation" (OR, 3.46, 95% CI 1.39, 8.57, p=0.01) were significantly more frequent in colorectal cancer than in normal colorectal mucosa. Immunohistochemistry corroborated p-CLE findings, showing higher vascularity in tumour sections due to neo-formed vessels, presenting irregular patterns. Conclusion: P-CLE provides a non-invasive characterization of the microvascular architecture of colonic mucosa. Different morphological patterns have been described, discriminating from normal and malignant microvascular networks in colorectal mucosa. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13222
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    ABSTRACT: Aim: To externally validate previously published predictive models of the risk of developing metachronous peritoneal carcinomatosis (PC) after resection of non-metastatic colon or rectal cancer; and to update the predictive model for colon cancer by adding new predictors of prognosis. Method: Data from all patients with stage I to III colorectal cancer identified from a population-based database in Stockholm between 2008 and 2010 was used. We assessed the concordance between the predicted and observed probabilities of PC and utilized proportional-hazard regression to update the predictive model for colon cancer. Results: When applied to the new validation dataset (n = 2011), the colon and rectal cancer risk-score models predicted metachronous PC with a concordance index of 79% and 67%, respectively. After adding the subclasses of pT3 and pT4 stage and mucinous tumour to the colon cancer model, the concordance index increased to 82%. Conclusion: In validation of external and recent cohorts, the predictive accuracy was strong in colon cancer and moderate in rectal cancer patients. The model can be used to identify high-risk patients for planned second look laparoscopy/laparotomy for possible subsequent cytoreductive surgery and hypertermic intraperitoneal chemotherapy. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13219
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    ABSTRACT: Aim: Prolonged postoperative ileus (PPOI) after colorectal surgery remains a leading cause of delayed postoperative recovery and prolonged hospital stay. Its exact incidence is unknown. The aim of this systematic review is to investigate the definitions and incidence incidence of PPOI previously described. Method: Medline, Embase, and the Cochrane Database of Systematic Reviews (up to July 2014) were searched. Two authors independently reviewed citations using predefined inclusion and exclusion criteria. Results: The search strategy yielded 3,233 citations; 54 were eligible, comprising 18,983 patients. Twenty-six studies were prospective (17 of these being randomized controlled trials (RCTs)) and 28 were retrospective. Meta-analysis revealed an incidence of PPOI of 10.3 per cent (95 per cent confidence interval (CI) 8.4 to 12.5) and 10.2 per cent (CI: 5.6 to 17.8) for non-RCTs and RCTs, respectively. Significant heterogeneity was observed for both non-RCTs and for RCTs. Used definition of PPOI, type of surgery and access (laparoscopic, open), and duration of surgery lead to significant variability of reported PPOI incidence between studies. A lower The incidence PPOI is lower after laparoscopic colonic resection. Conclusion: There is a large variation in the reported incidence of PPOI. A uniform definition of PPOI is needed to allow meaningful inter-study comparisons and to evaluate strategies to prevent PPOI. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13210
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    ABSTRACT: Aim: Anastomotic leak is one of the most feared complications after colonic resection. Many risk factors for anastomotic leakage have been reported, but the impact of an individual surgeon as a risk factor has scarcely been reported. The aim of this study was to assess if an individual surgeon is an independent risk factor for anastomotic leaks in colonic cancer surgery. Method: This was a retrospective analysis of prospectively collected data of patients who underwent elective resections for colon cancer with anastomosis at a specialized colorrectal unit from January 1993 to December 2010. Anastomotic leaks were diagnosed according to standardized criteria. Patient and tumour characteristics, surgical procedure, and operating surgeons were analysed. A logistic regression model was used to discriminate statistical variation and identify risk factors for anastomotic leakage. Results: A total of 1,045 patients underwent elective colon cancer resection with primary anastomosis. Anastomotic leak occurred in 6.4% of patients. Ileocolic anastomosis had an AL rate of 7.2%, colo-colonic/colorectal anastomosis 5.2%, and ileorectal anastomosis 12.7%, with intersurgeon variability. The independent risk factors associated to AL were the use of perioperative blood transfusion (OR 2.83; CI: 1.59-5.06; p<0.0001), and the individual surgeon performing the procedure (OR up to 8.44; p<0.0001). Conclusion: In addition to perioperative blood transfusion, the individual surgeon was identified as an important risk factor for anastomotic leaks. Efforts should be made in order to reduce performance variability amongst surgeons. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13212
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    ABSTRACT: Aim: Precise information regarding the location of an anal fistula and its relationship to adjacent structures is necessary for selecting the best surgical strategy. Retrospective and cross-sectional studies were performed to determine predictive factors for recurrence of anal fistula from preoperative examination by endoanal ultrasound (EAUS). Method: Patients in our tertiary centre and in a private centre specialised in proctology undergoing preoperative 3D-EAUS for cryptoglandular anal fistulae between 2002 and 2012 were included. A questionnaire was sent in September 2013 to assess the patient's condition with regard to recurrence. Variables checked for association with recurrence were gender, type of centre, previous fistula surgery, secondary track formation and classification of the fistula. Results: There were 143 patients of whom 96 had a low fistula treated by fistulotomy, 28 a high fistula treated by fistulectomy and 19 a high fistula treated by fistulectomy combined with a mucosal advancement flap. The median duration of follow up was 26 (2- 118) months. The fistula recurred in 40 (27%) of patients. Independent risk factors included the presence of secondary track formation (HR, 2.4 (1.2 - 51), p = 0.016) and previous fistula surgery (HR, 1.2 (CI 1.0 - 4.6), p = 0.041). Agreement between the 3D-EAUS examination and the evaluation under anaesthesia (EUA) regarding the site of the internal opening, classification of the fistula and the presence of secondary tracks was 97%, 98% and 78%. Conclusion: The identification of secondary tracks by preoperative 3D-EAUS examination was the strongest independent risk factor for recurrence. This stresses the importance of preoperative 3D-EAUS in mapping the pathological anatomy of the fistula and a thorough search for secondary track formation during surgery. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13211
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    ABSTRACT: After colectomy, in some patients with Crohn's proctitis, completion proctectomy is ultimately needed [1,2]. Close rectal dissection may lower the risk of presacral abscesses and autonomic nerve damage. This can be done by an intersphincteric transperineal approach, avoiding an abdominal procedure [2]. If a uniquely perineal approach is not possible (e.g. in the case of a pre-existing ileorectal anastomosis), an abdominal single port can be added. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13214
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    ABSTRACT: Aim: There is ambiguity with regard to the optimal management of AIN III. The aim of this review was to assess and compare international/national society guidelines currently available in the literature on the management, treatment and surveillance of AIN III. We also aimed to assess the quality of the studies used to compile the guidelines and to clarify the terminology used in histological assessment. Method: An electronic search of PubMed and Embase was performed using the search terms 'anal intraepithelial neoplasia', 'AIN', 'anal cancer', 'guidelines', 'surveillance' and 'management'. Literature reviews and guidelines or practice guidelines in peer reviewed journals from 1(st) January 2000 to 31(st) December 2014, assessing the treatment, surveillance or management of patients with AIN related to HPV were included. The guidelines identified by the search were assessed for the quality of evidence behind them using the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. Results: The database search identified 5159 articles and two further guidelines were sourced from official body guidelines. After inclusion criteria were applied, 28 full text papers were reviewed. Twenty-five of these were excluded, leaving three guidelines for inclusion in the systematic review including those published by the Association of Coloproctology of Great Britain and Ireland (ACPGBI), the American Society of Colon and Rectal Surgeons (ASCRS) and the Italian Society of Colorectal Surgery (SICCR). There were no guidelines identified on the management of AIN III from HIV associations and societies. All three guidelines agree that a high index of clinical suspicion is essential for diagnosing AIN with a disease-specific history, physical examination, digital rectal examination and anal cytology. There is interchange of terminology from High Grade AIN (HGAIN) (which incorporates AIN II/III) and AIN III between the literature leading to confusion in therapy use. Treatment varies from immunomodulation and photodynamic therapy to targeted destruction of areas of HGAIN/AIN II/III using infrared coagulation, electrocautery, cryotherapy or surgical excision but with little consensus between the guidelines. Recommendations on surveillance strategies were similarly discordant, ranging from six-monthly physical examination to annual anoscopy +/- biopsy. Over 50% of the recommendations are based on Level 3 or Level 4 evidence and many were compiled using studies that were greater than 10 years old. Conclusion: Despite concordance regarding diagnosis, there is significant variation amongst the guidelines over recommendations on the treatment and surveillance of patients with HGAIN/AIN II/III. All three sets of guidelines are based on low level, out-dated evidence originating from the 1980s and 1990s. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13215

  • Colorectal Disease 11/2015; 17(12):1112-1113. DOI:10.1111/codi.13140
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    ABSTRACT: Aim: Anal melanoma is a rare malignancy with a poor prognosis. Methods: All patients with a diagnosis of anal melanoma treated at a single institution between 2000 and 2012 were identified and their treatment and outcome were evaluated. Results: Sixteen patients had a median survival of 2.9 years. Fourteen had stage I or II disease with a median survival of 4.0 years and progression-free survival of 1.5 years. When used for disease staging, whole body PET/CT identified an additional three sites of metastasis in 5 patients compared with computed tomography (CT) of the chest, abdomen and pelvis. Surgery involved wide local excision (WLE) or abdominoperineal resection (APR) with respective local recurrence rates of 50% and 66%. Eleven patients underwent testing for c-Kit mutations, of whom five were positive. Four of these were treated with the tyrosine kinase inhibitor, Imatinib, and showed rapid response of metastases outside the central nervous system (CNS). Discussion: The outcome of this malignancy remains poor. PET is the modality of choice for disease staging. Testing tumours for c-Kit mutations may allow selected patients to participate in trials of tyrosine kinase inhibitors. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13209
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    ABSTRACT: Aim: Recent advances in the treatment of fistula-in-ano have focused on surgical techniques that preserve sphincter integrity. Plugs that obliterate the lumen of the fistula track have been proposed as one such method and may be derived from biologic or delayed absorbable synthetic materials. Biologic plugs have highly variable results and have not been widely adopted. The aim of this systematic review was to assess the effectiveness and safety of delayed absorbable synthetic plug (GORE(®) BIO-A) for treatment of anal fistula. Method: A systematic review of all English language literature relevant to the use of a plug to treat anal fistula, published between 1 January 2008 and 15 February 2015 was carried out using MEDLINE, EMBASE and the Cochrane Library of Systematic Reviews/Controlled Trials for relevant literature. Relevant articles were identified, quality assessed using the MINORS criteria and data extracted by two independent researchers (SKN and NNA). The identified articles were assessed with regards to fistula healing rate, duration of follow up and complication rates related to the use of delayed absorbable synthetic fistula plugs. Results: Twenty six potential articles were identified from the literature search. Using the pre-defined inclusion and exclusion criteria, six were included for the final analysis, data extraction and data synthesis. Of these included in the review only three were prospective in design. Complete data were available for 187 of the 221 patients who underwent this treatment. The age of the participants ranged from 19 to 82 years. The fistula healing rates were reported to be between 15.8% and 72.7% at a follow up ranging between two and 19 months. Early or delayed plug extrusion occurred in 16 (8.5%) of the 187 patients. Deterioration in continence was reported in 11 (5.8%) of 187 patients. Conclusion: The delayed absorbable synthetic (GORE(®) BIO-A) fistula plug has insufficient high quality data to draw meaningful conclusions regarding its effectiveness. It does, however, appear to be a simple and safe technique associated with low complication rates and a minor deterioration in continence in a few cases. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13208
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    ABSTRACT: Aim: The frequent presence of acellular mucin in specimens showing pathologic complete responses to preoperative chemoradiotherapy (CRT) and the poor response to preoperative CRT in mucinous rectal cancer have been reported. However, the prevalence and prognostic significance of cellular and acellular mucin have not been evaluated in resected specimens of mucinous rectal cancer patients who undergo preoperative CRT. Methods: We retrospectively evaluated the clinicopathologic features and prognostic significance of mucin in resected specimens from 59 consecutive mucinous rectal cancer patients who underwent long-course CRT followed by resection between January 2000 and December 2009. Patients were categorized according to the presence of mucin, as identified by pathological analysis. The clinicopathologic findings and oncologic results were compared. Results: Mucin was identified in 25 of 59 mucinous rectal cancer patients (42.4%). Mucin was more frequent in males (hazard ratio = 23.94, 95% confidence interval = 1.875-305.504, P = 0.015) and in specimens showing a good tumour response grade (hazard ratio = 64.26, 95% confidence interval = 6.940-595.045, P < 0.001). With a median follow-up of 67.7 (range, 8.6-133.2) months, the 5-year overall (60.7% without mucin vs. 51.4% with mucin; P = 0.898) and disease-free (59.9% without mucin vs. 56.9% with mucin; P = 0.813) survivals did not differ between the groups. Conclusions: The presence of mucin in rectal cancer with mucinous differentiation after preoperative CRT and resection is associated with male gender and a good tumour response grade, without significant impact on oncologic outcomes. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13169
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    ABSTRACT: Aim: Anal intraepithelial neoplasia (AIN) precedes the development of anal squamous cell carcinoma. Detection of the lesion is essential to management. This paper describes a prospective study to detect and ablate anal squamous intraepithelial lesions (SIL) using white light (WL) narrow band imaging (NBI) and NBI with acetic acid (NBIA). Method: Sixty patients with abnormal anal cytology and risk factors for anal dysplasia, underwent examination of the anoderm with a high definition gastroscope and NBIA. Targeted biopsies were taken and the lesions ablated and characterized histopathologically. Visualisation of the anal transitional zone (ATZ) was facilitated by retroflexion and examination through a disposable anoscope. Results: Targeted biopsies were taken from lesions in 58 patients. No lesion was seen in two patients. Histopathology showed SIL in 48 (80.0%) of 60 biopsies. One biopsy showed lymphoid aggregates. Biopsies in 9 (15%) of the 60 patients showed normal mucosa. Lesions were seen in white light in 27 (45%) of the 60 cases, NBI in 39(65%) and NBIA in 57(95%) . There was no major morbidity. Sensitivity analysis showed that all methods were significantly different from each other. Conclusion: Anal SIL in the ATZ and anal canal can be identified by NBIAPatient selection influences findings. Limitations include small sample size and non-randomization. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13170
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    ABSTRACT: Reversal of Hartmann's procedure can be associated with high morbidity and mortality, therefore frequently instestinal continuity is not restored [1, 2]. A minimal invasive approach can be technically demanding, but is considered preferable to an open approach [3]. Single port reversal of Hartmann may provide more benefit than multiport laparoscopy [4]. Besides the well-known benefits of laparoscopy, there is potentially less risk of morbidity by avoiding the need for midline and right sided adhesiolysis [5]. The technique can be used after a previous open or laparoscopic operation. This article is protected by copyright. All rights reserved.
    Colorectal Disease 11/2015; DOI:10.1111/codi.13217

  • Colorectal Disease 11/2015; 17(11). DOI:10.1111/codi.13116