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 version cannot be used
    • On author or institutional 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-Blackwell'
  • Classification
    ​ yellow

Publications in this journal

  • Colorectal Disease 10/2014; 16(10).
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    ABSTRACT: Quality of life varies in anal incontinence patients. The severity of symptoms is a surprisingly modest predictor, but they reliably elicit disgust. The current work assessed prospectively whether dispositional sensitivity to disgust predicted quality of life in patients with anal incontinence.
    Colorectal Disease 09/2014;
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    ABSTRACT: There is evidence of significant growth in UK healthcare professional engagement with "open" social media platforms, such as Twitter and LinkedIn. Social media communication provides many opportunities and benefits for medical education, interaction with patients and colleagues. This study was undertaken to evaluate the uptake of public social media membership and characteristics of use of such media channels amongst contemporary UK consultant colorectal surgeons.
    Colorectal Disease 09/2014;
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    ABSTRACT: This multicentre study, based on the largest patient population ever published, aims to evaluate the efficacy of a Doppler guided THD (THD(®) Doppler) in the treatment of symptomatic haemorrhoids and to identify predictive failure factors for an effective mid-term outcome.
    Colorectal Disease 09/2014;
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    ABSTRACT: The aim of this study was to demonstrate a laparoscopic technique for the excision of retrorectal tumours and report on a series of ten patients. Seven patients were female; median age 45 yrs(range 23-79). All had sucessful laparoscopic excision with no major morbidity and two minor wound infections. The procedure was deemed to be safe and we include a video to show the operative technique. This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: In the associated video, we describe a novel minimally invasive robotic approach to perform extralevator abdominoperineal excision of rectum (ELAPE) carried out exclusively in the lithotomy position. The technique shown in the video includes sigmoid mobilisation, division of the inferior mesenteric vessels, total mesorectal excision and transection of the levator muscles from the abdomen to open the ischiorectal fossae.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: AimThe OTSC Proctology is a surgical device for anorectal fistula closure. It consists of a super-elastic nitinol clip which is placed with the aid of a transanal applicator on the internal fistula opening to achieve healing of the fistula track. A prospective, two-centre clinical pilot study was undertaken to assess the efficacy and safety of the OTSC Proctology in patients with a complex high anorectal fistula.Method In patients with a complex anorectal fistula the primary track was debrided using a special brush and a clip was applied to the internal fistula opening. After 6 months the postoperative clinical course and fistula healing was assessed.ResultsTwenty patients with a cryptoglandular anorectal fistula (14 transsphincteric, 6 suprasphincteric) were included in the study. There were no intraoperative technical or surgical complications. Postoperatively no patient reported intolerable discomfort or a sensation of a foreign body in the anal region. At six months after surgery, 18 (90%) patients had no evidence of fistula and were considered healed, while in two the fistula persisted. Of the 18, the clip was still in place without causing problems in 13 (72%) patients and in three, the clip had spontaneously detached. In the two remaining patients it was necessary to remove the clip owing to discomfort and delayed wound healing.Conclusion Anorectal fistula closure with the OTSC Proctology is an innovative sphincter-preserving minimally invasive technique with promising initial results and a high rate of patient satisfaction.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: AimThe indications for intersphincteric (ISR) anterior resection are not clearly defined. The aim of this study was to evaluate vertical extension of T2 or T3 low rectal cancer treated by rectal amputation to optimize patient selection for ISR.Method The abdominoperineal excision specimens of T2 or T3 low rectal cancer from 53 patients treated between 1992 and 2004 were retrospectively reviewed. Vertical invasion was quantified by measuring the shortest distance between the tumour and the striated muscle (T-SM), assuming that this represented the surgical margin that would have be achieved had an ISR been performed.ResultsInvolvement of the dentate line (DL) and intramural distal spread were independent risk factors for T-SM ≤2 mm. T-SM was less when the inferior border of the tumour was on the distal side of the DL (r =0.572, p <0.001). The probability of involvement of the DL, intramural distal spread, or either one of these being associated with T-SM ≤2 mm was 43%, 46%, and 43%. All patients without both intramural distal spread and involvement of the DL had a T-SM greater than 2 mm.Conclusion We recommend that ISR be performed only for patients with T2 or T3 low rectal cancer in whom the lowest edge of the tumour is above the DL and there is no intramural distal spread. Such patients are relatively unlikely to have a T-SM of or equal to 2 mm.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: AimThe study evaluated, in a proof of concept the usefulness of a prosthesis (plug) in addition to Video Assisted Ablation of Pilonidal Sinus for pilonidal sinus.Method This is a case series of recurrent complex pilonidal sinus treated by VAAPS plus plug positioning.ResultsFour patients were analysed. All were successfully treated by this new approach. No difficulties in inserting the plug were identified. Complete healing was achieved in all cases. No infection or recurrence was reported during a limited follow-up.Conclusion This new technique allows a minimally invasive scarless approach to recurrent pilonidal sinus.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: AimPouch-vaginal fistula is an uncommon but unpleasant complication. The chance of successful repair with various surgical procedures is around 50 per cent and the early promise of collagen button plugs was not followed by good long term results. We report a series of patients who underwent transvaginal repair of pouch-vaginal fistula after failed collagen plugs accompanied by a video to show the operative technique.Method Patients were identified from a prospectively maintained database. Patient demographics, operation notes, complications and ultimate outcome were recorded.ResultsEleven patients, each of whom had previously undergone an attempt to close the fistula with a collagen button plug, underwent transvaginal repair. Nine (81%) were successful at a median follow up of 14 (6-56) months. The remaining two patients reported symptomatic improvement.Conclusion Pouch-vaginal fistula can be successfully closed by the transvaginal technique after a failed button plug procedure.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: AimLaparoscopic ventral rectopexy (VR) with the use of prosthesis has been advocated for both overt rectal prolapse (ORP) and obstructed defaecation syndrome (ODS). The present study reviews the short-term and functional results of laparoscopic VR.MethodA MEDLINE, Embase, Ovid, and Cochrane database search was performed on all studies reporting on VR for ORP, ODS and other pelvic floor anatomical abnormalities from 2004 until February 2013. No language restrictions were made. All studies on VR were reviewed systematically. The main outcomes were intraoperative complications, conversion, procedure duration, short-term mortality and morbidity, length of stay, ORP recurrence, anatomical disorder recurrence, faecal incontinence and constipation, quality of life (QoL) score and patient satisfaction. Quality assessment and data extraction were performed independently by three observers.ResultsTwenty three studies including 1,460 patients were eligible for analysis. The conversion rate ranged from 0 to 14.3%. No mortality was reported. The immediate postoperative morbidity rate was 8.6%. Length of stay ranged from 1 to 7 days. A significant improvement in constipation and incontinence symptoms was observed in the postoperative period for both ORP and ODS (chi-square test, p<0.0001).Conclusion Laparoscopic VR is a safe and effective procedure for ORP and ODS. Longer follow-up is required and studies comparing VR to standard rectopexy and STARR are not yet available.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: AimLaparoscopic ventral mesh rectopexy (LVMR) has been used to treat rectal prolapse, obstructive defaecation (OD), faecal incontinence (FI) and multi-compartment pelvic floor dysfunction. Its value in treating males has been questioned. The aim of the present study was to assess the results in these patients.MethodA password protected electronic database was examined of all LVMRs carried out between 2002-13. In addition to the clinical outcome, quality of life (QoL), Cleveland Clinic Incontinence Score (CCIS), Obstructive Defecation Syndrome (ODS) score, visual analogue score (VAS) for the severity of bowel and urinary symptoms, Numerical Rating Scale (NRS) for pain and patient-reported outcome measures (PROMs) were evaluatedResults68 males of median age 35 years and BMI 26 kg/m2 underwent LVMR for external rectal prolapse (18) or grade III-V rectal intussusception (50) presenting with OD, FI and pelvic pain. 10% had been labelled “chronic idiopathic pelvic pain” and 60% had undergone previous haemorrhoidal surgery. Complications were minor and included urinary retention (10%). 80% of patients had an uncomplicated recovery with 24% performed as day cases. There was no cases of impotence or retrograde ejaculation. Median FU was 42 (IQR 26-61) months. CCIS improved from 4 (IQR 0-8) to 0 (IQR 0-0) [p < 0.001] and the ODS score from 18.5 (IQR 16-22) to 6 (IQR 5-8) [p<0.001]. Patients reported significant improvement in NRS for pain and QoL (BBSQ-22) at three months (p=0.000). The QoL and the VAS for bowel symptoms were maintained at 4 years. At the last follow up 56 (82%) of patients were asymptomatic and 6 (8.8%) had persisting symptoms. There was no case of recurrent ERP.ConclusionLVMR is an effective treatment of external and symptomatic internal rectal prolapse in males leading to significant improvement in QoL and function.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: AimColonic surveillance reduces life time risk of colorectal cancer from 60-80% to 10% and confers a seven-year survival advantage in patients with Lynch syndrome (HNPCC). The British Society of Gastroenterologists recommends colonoscopy at least every two years from age 25. Currently in the UK, genetic diagnosis is made by a regional genetics service and screening recommendations are made to the referring clinician. The aim of this study was to investigate compliance with and the effectiveness of large bowel surveillance in Lynch syndrome.MethodA retrospective longitudinal study of Lynch syndrome mutation carriers on the Regional Familial Colorectal Cancer Registry under and not under screening was conducted. To investigate screening compliance, patients were included if alive at the start of the study. Data were gathered on timeliness, quality and outcome of screening. To examine the effectiveness of screening, the cumulative incidence of colorectal cancer was estimated using Kaplan-Meier and the screened population compared to that in patients not being screened.Results227 Lynch Syndrome mutation carriers were under screening at 26 hospitals. 439 colonoscopies were assessed for timeliness of which 68% were compliant (interval <27 months). Compliance on 01/11/2011 was 87%. Cumulative incidence of colorectal cancer to age 70 was 25% (95% CI 17-32%) in the surveillance population and 81% (95% CI 78-84%) in 689 mutation positive patients not being screened (p<0.0001).Conclusion Overall 68% of colonoscopies were on time. The incidence of colorectal cancer was greatly reduced by screening but remained significant. Lynch syndrome patients need pro-active surveillance management.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: AimColorectal cancer (CRC) screening programmes detect early cancers but unfortunately they have limited sensitivity and specificity. Mass spectrometry-based determination of serum peptide- and protein profiles provide a new approach for improved screening.Method Serum samples from 126 CRC pretreatment patients and 277 control individuals were obtained. An additional group of samples from 50 CRC patients and 82 controls was used for validation. Peptide and protein enrichments were carried out using reversed-phase (RP) C18 and weak-cation exchange (WCX) magnetic beads (MBs) in an automated solid-phase extraction (SPE) and spotting procedure. Profiles were acquired on a matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) system. Discriminant rules using logistic regression were calibrated for the peptide and protein signatures separately, followed by combining the classifications to obtain double cross-validated predicted class probabilities. Results were validated on an identical patient set.ResultsA discriminative power was found for patients with CRC representative for all histopathological stages compared with controls with an area under the curve (AUC) of 0.95 in the test set (0.93 for the validation set) and with a high specificity (94-95%).Conclusion The study has shown that a serum peptide and protein biomarker signature can be used to distinguish CRC patients from healthy controls with high discriminative power. This relatively simple and cheap test is promising for CRC screening.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: Several randomized clinical trials on pilonidal sinus disease have been published, but the ideal treatment is still debated and there are no clear guidelines(1). This may be because there is no unanimity owing to differences in attitudes to the pathology of the condition. We think that the following considerations should be highlighted.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: An appreciation of the distinction between surgical anatomy and cadaver-based anatomy is the key to successful surgery. The evolution of Miles’ operation for rectal cancer (1) to the current-day “total mesorectal excision” (TME) has been possible by a desire to understand better the anatomical pathology of the disease and its relation to the surgical anatomy of the rectum. TME involves excision of the tumour and its surrounding fascial package en-bloc producing a characteristic specimen (2, 3). The principles of TME combine anatomy, the embryological origin of the hindgut and the pathological spread of rectal cancer.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: AimStrain elastography is a novel approach to rectal tumour evaluation. Primary aim of this study was to correlate elastography to pT-stages of rectal tumours and to assess the ability of the method to differentiate rectal adenomas (pT0) from early rectal cancer (pT1-2). Secondary aims were to compare elastography with endorectal ultrasonography (ERUS) and to propose a combined strain elastography and ERUS staging algorithm.Method120 consecutive patients with a suspected rectal tumour were examined in this staging study. Patients receiving surgery without neo-adjuvant radiotherapy were included (n=59). All patients were examined with ERUS and elastography. Treatment decisions were made by multidisciplinary team (MDT) assessment, without considering the strain elastography examination.ResultsHistopathology identified 21 adenomas, 13 pT1, 9 pT2, 15 pT3 and one pT4. Mean elastography strain ratios (SR) were predictive of T stage (p=0.01). Differentiation of adenomas from early rectal cancer (pT1-2) had sensitivity, specificity and accuracy of 0.82, 0.86 and 0.84 for elastography and 0.82, 0.62 and 0.72 for ERUS. A combined staging algorithm was developed to identify tumours eligible for local resection. Based on MDT evaluation 32% tumours later identified as pT0 or pT1 were treated with total mesorectal excision, even though a local excision might have sufficed. Combined ERUS and elastography evaluation would have significantly reduced this number to 9% (p = 0.008).Conclusion Elastography may improve the staging of adenomas and early rectal cancer compared to ERUS alone. Combined ERUS and elastography assessment is likely to further improve the selection of patients for local resection.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: Synchronous colorectal cancers occur in 2%-5% of patients. The operative approach is dependent on the tumour locations and the stage of the disease, Recent technological developments, and in particular the use of robotic systems, have made possible a minimally invasive approach, even in complex cases.We report a case of synchronous caecal and low rectal carcinomas associated with liver metastasis.A 76-year-old woman was admitted to our unit due to rectal bleeding.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
  • Christos Kontovounisios, Yiannis Baloyiannis, James Kinross, Emile Tan, Shahnawaz Rasheed, Paris Tekkis
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    ABSTRACT: AimA tension-free well vascularised colorectal or colo-anal anastomosis is not always possible following rectal or sigmoid resection. The study reports on the short-term and long-term outcome of a modified right colon inversion technique as a means of facilitating a low colorectal or anal anastomosis.Method All patients who underwent right colonic inversion, a modified Deloyer's procedure, were identified retrospectively from the prospective database of the Colorectal Department of the Royal Marsden Hospital from October 2008 to December 2013.ResultsThere were fourteen (9 male) patients of median age 58.7 (45-75) years. The main indication was extensive diverticular disease (50%) and previous colonic surgery (21.4%). A defunctioning stoma was performed in 64.3% which was reverved in all within 3 to 6 months. Three (21.4%) patients developed postoperative complications (Clavien-Dindo 1-2) and none required reoperation. The median duration of follow was 11 months. One (7.2%) patients had one bowel movement per day, ten patients (71.4%) had two bowel movements per day and three patients (21.4%) had three per day.Conclusion The modified right colonic inversion technique is safe and achieves intestinal continuity with a tension-free well vascularised anastomosis. Good function and low morbidity show that the procedure is a credible alternative to ileorectal or ileoanal anastomosis.This article is protected by copyright. All rights reserved.
    Colorectal Disease 09/2014;
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    ABSTRACT: Two recent articles have prompted this short communication. A Dutch group (1) studied the anterior abdominal wall in patients some 19 months after stoma formation and observed atrophy of the rectus muscles and a midline shift to the contra-lateral side. They concluded that these findings led to a weaker abdominal wall and, at least in part, explained the increased incidence of incisional herniation after stoma formation. In a similar vein, a retrospective UK study (2) documents that parastomal herniation is more prevalent (but midline herniation similar) even after laparoscopic colorectal resection (2). The stomas in these series, to the best of our knowledge, were raised using the traditional ‘through’ rectus abdominis muscle trephine.This article is protected by copyright. All rights reserved.
    Colorectal Disease 08/2014;

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