Colorectal Disease (Colorectal Dis )

Publisher: Association of Coloproctology of Great Britain and Ireland, Blackwell Publishing

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.

  • Impact factor
    2.08
  • 5-year impact
    2.39
  • Cited half-life
    3.90
  • Immediacy index
    0.64
  • Eigenfactor
    0.01
  • Article influence
    0.69
  • 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

Blackwell Publishing

  • Pre-print
    • Author can archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • Some journals impose embargoes typically of 6 or 12 months, occasionally of 24 months
    • no listing of affected journals available as yet
  • Conditions
    • See Wiley-Blackwell entry for articles after February 2007
    • Publisher's version/PDF cannot be used
    • On author's server, institutional server or subject-based server
    • Server must be non-commercial
    • Publisher copyright and source must be acknowledged with set statement ("The definitive version is available at www.blackwell-synergy.com")
    • Articles in some journals can be made Open Access on payment of additional charge
    • 'Blackwell Publishing' is an imprint of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • Colorectal Disease 01/2015; 17(s1).
  • Colorectal Disease 01/2015; 17 Suppl s1:20-24.
  • Colorectal Disease 01/2015; 17(s1).
  • Colorectal Disease 01/2015; 17(s1).
  • Colorectal Disease 01/2015; 17(s1).
  • Colorectal Disease 01/2015; 17 Suppl s1:61-66.
  • Colorectal Disease 01/2015; 17(s1).
  • Jonathan M Buscaglia, Jordan Fakhoury, Jameson Loyal, Paula I Denoya, Eman Kazi, Seth A Stein, Richard Scriven, Roberto Bergamaschi
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    ABSTRACT: Surgery residents are required to become proficient in colonoscopy before completing training. The aim of this study was to evaluate the responsiveness of surgery interns to simulated colonoscopy training. Interns defined as postgraduate year 1 residents without exposure to endoscopy underwent training in a physical model including colonoscopy, synthetic anatomy trays with luminal tattoos and a hybrid simulator. After baseline testing and mentored training, final testing was performed using five predetermined proficiency criteria. Content-valid metrics defined by extent of departure from clinical reality were evaluated by two blinded assessors. Responsiveness was defined as change in performance over time and assessed comparing baseline testing with non-mentored final testing. Twelve interns (eight male, mean age 26, 80% right-handed) performed 48 colonoscopies each over one year. Improvement was seen in the overall procedure time (24:46 vs. 20:54 min; p=0.03), passing the splenic flexure (20:33 vs. 10:45 min; p=0.007), passing the hepatic flexure (23:31 vs. 12:45 min; p=0.003), caecal intubation time (23:38 vs. 13:26 min; p=0.008),the duration of loss of view of the lumen (75% vs. 8.3%; p= 0.023), incomplete colonoscopy (100% vs. 33.3%; p=0.042), 'scope withdrawal less than 6 min (16.7% vs. 8.3%; p=0.052). Tattoo identification time (9:16 vs. 12:25; p=0.50), colon looped time (2:12 vs. 1:45; p=0.50), and rate of colon perforation (8.3% vs. 8.3%; p = 1) remained unchanged. Inter-rater reliability was 1.0 for all measures. Simulated colonoscopy training in a low-cost physical model improved the performance of surgery interns with decreased procedure time, increased rates of complete colonoscopy and appropriate scope withdrawal. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: We read with interest the study entitled "Should anastomotic assessment with flexible sigmoidoscopy be routine following laparoscopic restorative left colorectal resection?" from Kamal et al, who reporteded promising results regarding prevention of anastomotic leakage (AL) during intraoperative flexible sigmoidoscopy (IOFS) [1]. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: Pathologic response to chemotherapy without pelvic irradiation is not well defined in rectal cancer. This study aimed to evaluate objective pathologic response to preoperative chemotherapy without pelvic irradiation in middle or low locally advanced rectal cancer (LARC). Between 2008 and 2013, 22 patients with middle or low LARC (T3/4 and/or N+ and circumferential resection margin <2 mm) and synchronous metastatic disease or a contraindication to pelvic irradiation underwent rectal resection after preoperative chemotherapy. Pathologic response of rectal tumour was analyzed according to the Rödel Tumor Regression Grading (TRG) system. Predictive factors of objective pathologic response (TRG2-4) were analyzed. All patients underwent rectal surgery after a median of six cycles of preoperative chemotherapy. Of these, 20 (91%) had sphincter saving surgery and an R0-resection. Twelve (55%) patients had an objective pathologic response (TRG2-4), including one complete response. Poor response (TRG0-1) to chemotherapy was noted in ten (45%) patients. In univariate analyses, none of the factors examined was found to be predictive of an objective pathologic response to chemotherapy. At a median follow-up of 37.2 months, none of the 22 patients experienced local recurrence. Of the 19 patients with stage IV rectal cancer, 15 (79%) had liver surgery with curative intent. Preoperative chemotherapy without pelvic irradiation is associated with objective pathologic response and adequate local control in selected patients with LARC. Further prospective controlled studies will address the question of whether it can be used as a valuable alternative to radiochemotherapy in LARC. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: Only 12-49% of CRC patients and their first-degree relatives with an increased familial colorectal cancer (CRC) risk are referred for cancer prevention measures (surveillance colonoscopies or genetic counselling). The study was performed to evaluate the effectiveness and feasibility of a novel strategy to improve the uptake of genetic counselling for high-risk individuals and surveillance colonoscopy for moderate-risk groups. Eighteen hospitals participated in a clustered randomised controlled trial. Patients in nine hospitals received usual care (group A). Nine other hospitals received the novel strategy (group B) including access to a website for patients and clinicians, patient-targeted brochures and clinician-targeted education and pocket referral cards. Data before and after the dissemination of the strategy were collected from questionnaires and medical records. Data were complete for 358 (44%) of 820 CRC patients and 50 (36%) of 137 clinicians before dissemination of the strategy and 392/862 patients (45%) and 47/137 clinicians (34%) after. Referral for cancer prevention measures was assessed at a median of 8 (2-12) months after CRC diagnosis in group A and B before the dissemination of the strategy and in group A after. In group B referral was assessed at a median of 9 (4-11) months after the dissemination of the strategy. Uptake of genetic counselling by high-risk patients was equal in groups A and B being 33% before and 15% after (p=0.003). Uptake of surveillance colonoscopy by moderate-risk relatives did not change significantly (group A: 36% before versus 41% after; group B: 33% before versus 19% after). In group B 94/140 patients (67%) and 25/72 clinicians (35%) visited the website and 34/140 (24%) patients read the brochure. Patients valued clinicians' information as most useful, followed by patient brochure. Clinicians preferred pocket cards and education. Our strategy did not improve referral for cancer prevention measures. Although the newly offered strategy elements were appreciated, patients preferred clinicians' advice regarding referral for cancer prevention measures. It may be useful to aim future interventions at healthcare professionals rather than patients to improve the prevention of familial cancer. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: Traditionally, pelvic floor retraining for faecal incontinence or obstructed defaecation has been delivered to patients through individual sessions with a specialist pelvic floor nurse; a resource-intensive practice. This study aimed to assess whether a similar outcome can be achieved by delivering retraining to patients in small-groups, allowing considerable savings in the use of resources. Data were collected prospectively in a pelvic floor database. Patients received pelvic floor retraining either individually or in a small-group setting and completed baseline and follow-up questionnaires. 215 patients were treated; 119 individually and 96 in a small-group setting. Scores before and after treatment for the two settings were compared for the Gastrointestinal Quality of Life Index, Fecal Incontinence Severity Index and Patient Assessment of Constipation Symptoms. Additionally patients receiving group treatment completed a short questionnaire on their experience. The median change in Gastrointestinal Quality of Life Index score was 5 (range: -62 - 73) for individual treatment, and 4 (range: -41 - 47) for group treatment; both showing statistically significant improvement. However there was no significant difference between the settings. Similar results were obtained with the Fecal Incontinence Severity Index and Patient Assessment of Constipation Symptoms scores for the faecal incontinence and obstructed defaecation subgroups respectively. The majority of patients experienced symptomatic improvement following pelvic floor retraining and there was no significant difference in the resulting improvement according to treatment setting. As treatment costs are considerably less in a group setting, group pelvic floor retraining is more cost-effective than individual treatment. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: Hyponatremia is a common in surgical practice, but its clinical impact in patients with colorectal cancer has not been evaluated. We retrospectively assessed 2944 patients who had been admitted to Chonnam National University Hwasun Hospital with a diagnosis of colorectal cancer. In order to determine the relationship between the serum sodium level and 3-year mortality, we categorized the patients as having normonatremia (135-147 mEq/L), or mild (130-134 mEq/L), moderate (125-129 mEq/L) or severe hyponatremia (<125 mEq/L). Hyponatremia, defined as a serum sodium level of <135 mEq/L, was evident in 27.6% of patients during hospitalization. Declining serum sodium levels were associated with increasing age, a higher number of comorbidities, a more advanced TNM stage and worsening biochemical parameters. In a multivariate Cox-proportional regression analysis, the mortality risk was correlated with the severity of hyponatremia (hazard ratio [HR]: 1.65, 95% confidence interval [CI]: 1.38-1.96; HR: 2.24, 95% CI: 1.69-2.98; HR: 2.20, 95% CI: 1.25-3.90, for patients with mild, moderate, and severe hyponatremia compared with patients with normonatremia). An independent association between hyponatremia and long-term mortality was sustained among various subpopulations and patients with persistent hyponatremia had a worse prognosis compared with those with hyponatremia that resolved. A substantial proportion of patients developed hyponatremia during hospitalization and the long-term mortality risk increased even in mild cases of hyponatremia. Hyponatremia should be considered as an important prognostic factor in colorectal cancer. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: Transanal endoscopic microsurgery (TEM) enables organ-preservation after rectal tumour surgery. Its application is being expanded using adjuvant and neo-adjuvant treatments. Our object was to evaluate the changes over time in anorectal function, urinary symptoms and quality of life (QOL) in patients who had TEM surgery for a rectal tumour. Between September 2009 and October 2012, a consecutive series of 102 patients underwent TEM surgery at a single institution. Patients were asked to fill out standardized questionnaires at baseline and then at 6, 12, 26 and 52 weeks. The QOL among these patients was assessed using one generic (EQ-5D) and two disease-specific questionnaires (EORTC QLQ-C30 and QLQ-CR29). Anorectal and urinary symptoms were studied using the COlo-REctal Functional Outcome questionnaire (COREFO) and International Prostate Score Symptom questionnaire (IPSS) respectively. The response rate was 90% (92 /102 patients). Postoperative complications occurred in 14% (13 / 92 patients). The general QOL (EQ-5D) was lower at 6 and 12 weeks after TEM compared with baseline QOL (P<0.05) but returned towards baseline after 26 weeks. Anorectal function (COREFO) was worse six weeks postoperatively (P<0.01) but normalised by 12 weeks. Urinary function (IPSS) was not affected at any time-points after surgery. The total COREFO-score and the ASA-score were correlated with the deterioration in QOL. The study demonstrates that TEM surgery has a temporary and reversible impact on QOL and anorectal function. Intensive interrogation of QOL and function using these questionnaires will help define the role of organ-preserving surgery for rectal cancer before and after chemoradiotherapy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: The long-term outcome of sacral nerve stimulation (SNS) for chronic functional constipation was assessed. Patients who received a definitive SNS implant for chronic functional constipation only (according to the Rome III criteria) and were followed up for at least three years were included in this study. Slow transit constipation (STC) was distinguished from obstructed defecation (OD) and mixed/undetermined constipation (MU). Constipation features, Cleveland Clinic Constipation score (CCCS), and SF36 questionnaire data were collected; physiology tests were performed. Forty-two out of 61 patients suitable for SNS received a definitive implant (14 for STC, 15 for OD, 13 for MU). Following SNS device implantation (mean follow-up: 51±15 months), the baseline CCCS (17±6) dropped to 9±6 (p<0.001) and 47% of patients had a CCCS improvement of more than 50%. Such improvement was more significant in patients with OD. Anal pressures did not change, while threshold and urgency rectal sensation significantly decreased, in particular in OD patients. All aspects of patients' health status (SF36) improved significantly following SNS; this was more marked in OD patients. Data from this study suggest that the clinical efficacy of SNS can be prolonged in constipated patients, but in both the preliminary diagnostic assessment and pathophysiologic interpretation, every effort should be made to select patients for SNS. Although SNS showed efficacy in a low percentage of STC patients, OD patients were more responsive. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: We enjoyed the video vignette clearly demonstrating the benefits of a laparoscopic modified Sugarbaker repair for ileal conduit herniation (1), yet could not help but be reminded of Benjamin Franklin's (1706-1790) quote "an ounce of prevention is worth a pound of cure". This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: The laparoscopic approach to colorectal resections is well established, however to enable deep pelvic dissections, patients are often placed in a steep Trendelenburg position, to ensure that bowel does not fall into the operative field. This position impacts negatively on respiratory and cardiac function due to higher intra-thoracic pressure. This position also increases intra-cranial pressure and intra-ocular pressure. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;
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    ABSTRACT: AimLaparoscopic colon and rectal cancer surgery is oncologically equivalent to open resection, but the impact of conversion is undetermined. The aim of this study was to assess the oncological outcome and predictive factors associated with conversion.MethodA comprehensive search for published studies examining the associated factors and outcome of conversion from laparoscopic to open colorectal cancer resection was performed adhering to PRISMA guidelines. Only randomised control trials and prospective studies were included. Each study was reviewed and the data extracted. Random-effects methods were used to combine data.ResultsFifteen studies met the inclusion criteria including 5,293 patients. Of these 4,391 patients had a completed laparoscopic resection and 902 were converted to an open resection. The average conversion rate of the studies was 17·9 +/- 10·1%. Meta-analysis showed completed laparoscopic surgery favoured lower 30 day mortality (OR:0·134, 95% CI 0·047-0·385, P<0·0001), lower long term disease recurrence (OR:0·634, 95% CI 0·421-0·701, p<0·023) and lower overall mortality (OR:0·512, 95% CI 0·417-0·629, P<0·0001). Factors negatively associated with completion of laparoscopic surgery were male gender (P=0·011), rectal tumour (P=0·017), T3/T4 tumour (P=0·009) and node positive disease (P=0·009). Completed laparoscopic surgery was also associated with a lower BMI (mean difference -0·93 SI units, P=0·004).Conclusion The results suggest that conversion from laparoscopic to open colorectal cancer resection is influenced by patient and tumour characteristics and is associated with an adverse peri-operative outcome. Although confounding factors such as advanced tumour stage and elevated BMI are present, unsuccessful laparoscopic surgery appears to be associated with an adverse long term oncological outcome.This article is protected by copyright. All rights reserved.
    Colorectal Disease 12/2014;