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[PMID]:28891852
[Au] Autor:Fazendin EA; Crean AJ; Fazendin JM; Kucejko RJ; Gill HS; Poggio JL; Stein DE
[Ad] Endereço:1 Department of Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania 2 Division of Colorectal Surgery, Department of Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania 3 Department of Ophthalmology, Drexel University College of Medicine, Philadelphia, Pennsylvania.
[Ti] Título:Condyloma Acuminatum, Anal Intraepithelial Neoplasia, and Anal Cancer in the Setting of HIV: Do We Really Understand the Risk?
[So] Source:Dis Colon Rectum;60(10):1078-1082, 2017 Oct.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The gold standard for surveillance of patients with anal lesions is unclear. OBJECTIVE: The aim of this study was to stratify patients for risk of progression of disease and to determine appropriate intervals for surveillance of patients with anal disease. DESIGN: This was a retrospective chart review for patients treated for anal lesions between 2007 and 2014. Only patients with ≥1 year of follow-up from index evaluation, pathology, documented physical examination, and anoscopy findings were included for analysis. SETTINGS: The study was conducted at an urban university hospital. PATIENTS: HIV-positive patients with anal lesions treated with excision and fulguration were included. MAIN OUTCOME MEASURES: Recurrence of anal lesions, progression of disease, and progression to cancer were measured. RESULTS: Ninety-one patients met inclusion criteria. The mean age was 41.6 years, and mean follow-up was 38.6 months (range, 11.0-106.0 mo). On initial pathology, 8 patients (8.8%) had a diagnosis of condyloma acuminatum without dysplasia, 20 patients (22%) had anal intraepithelial neoplasia I, 32 (35.2%) had anal intraepithelial neoplasia II, and 31 (34.1%) had anal intraepithelial neoplasia III. Sixty-nine patients (75.8%) had repeat procedures. Seven (87.5%) of 8 patients with condyloma and 6 (30%) of 20 patients with anal intraepithelial neoplasia I progressed to high-grade lesions. Five (15.6%) of 32 patients progressed from anal intraepithelial neoplasia II to III, and 2 patients with anal intraepithelial neoplasia III (6.5%) developed squamous cell carcinoma (2.3% for the entire cohort). LIMITATIONS: This was a single institution study. High-resolution anoscopy was not used. CONCLUSIONS: All of the HIV-positive patients with condyloma or anal intraepithelial neoplasia, regardless of the presence of dysplasia, should be surveyed at equivalent 3-month time intervals, because their risk of progression of disease is high. Video Abstract at http://links.lww.com/DCR/A389.
[Mh] Termos MeSH primário: Neoplasias do Ânus
Carcinoma de Células Escamosas
Condiloma Acuminado
Infecções por HIV/complicações
HIV/isolamento & purificação
[Mh] Termos MeSH secundário: Adulto
Canal Anal/diagnóstico por imagem
Canal Anal/patologia
Neoplasias do Ânus/etiologia
Neoplasias do Ânus/patologia
Neoplasias do Ânus/cirurgia
Biópsia/métodos
Carcinoma de Células Escamosas/patologia
Carcinoma de Células Escamosas/cirurgia
Condiloma Acuminado/complicações
Condiloma Acuminado/diagnóstico
Condiloma Acuminado/virologia
Progressão da Doença
Feminino
Seguimentos
Infecções por HIV/diagnóstico
Seres Humanos
Masculino
Estadiamento de Neoplasias
Avaliação de Processos e Resultados (Cuidados de Saúde)
Lesões Pré-Cancerosas/patologia
Proctoscopia/métodos
Recidiva
Risco Ajustado/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170912
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000890


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[PMID]:28682973
[Au] Autor:Yang JL; Gan T; Zhu LL; Wang YP; Yang L; Wu JC
[Ad] Endereço:Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
[Ti] Título:Endoscopic Submucosal Tunnel Dissection: A Feasible Solution for Large Superficial Rectal Neoplastic Lesions.
[So] Source:Dis Colon Rectum;60(8):866-871, 2017 Aug.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Although endoscopic submucosal tunnel dissection has been used for the resection of esophageal and stomach neoplastic lesions, there are still no reports about large superficial rectal neoplastic lesions. Compared with esophageal and stomach endoscopic submucosal dissection, the dissection of large superficial rectal neoplastic lesions is more difficult because of the flimsy bowel wall with abundant vasculature in the submucosal region, which results in poor endoscopic maneuverability and serious complications, such as bleeding and perforation. OBJECTIVE: The study aimed to assess the efficacy and safety of endoscopic submucosal tunnel dissection for large superficial rectal neoplastic lesions over 5 to 24 months in selected patients. DESIGN: This was a prospective, single-center evaluation. SETTINGS: The study was conducted at a digestive endoscopic center. PATIENTS: Patients with large superficial rectal neoplastic lesions were included. INTERVENTIONS: Endoscopic submucosal tunnel dissection was performed in all of the patients with large, superficial rectal neoplastic lesions. The submucosal tunnel was created via a submucosal incision from the anal incision to the oral incision. Next, tunnel wall resection was performed to completely remove the lesion. MAIN OUTCOME MEASURES: Dissection speed, complications, and recurrence rate were measured. RESULTS: A total of 19 patients, including 13 men and 6 women, with an average age of 60.1 ± 12.2 years (range, 34.0-75.0 y) underwent endoscopic submucosal tunnel dissection. The average size of lesions was 17.54 ± 13.47 cm. The mean operative time was 84.84 ± 53.49 minutes, and the operating speed was 21.01 ± 9.00 mm/min. En bloc resections with negative basal margins were achieved in all cases without serious intraoperative complications. No recurrence was observed in any patient within 5 to 24 months after the operations. LIMITATIONS: This was a single-center study. CONCLUSIONS: Endoscopic submucosal tunnel dissection is feasible, safe, and effective for the treatment of large, superficial rectal neoplastic lesions in selected patients. See Video Abstract at http://links.lww.com/DCR/A321.
[Mh] Termos MeSH primário: Adenocarcinoma/cirurgia
Adenoma/cirurgia
Ressecção Endoscópica de Mucosa/métodos
Endoscopia do Sistema Digestório/métodos
Proctoscopia/métodos
Neoplasias Retais/cirurgia
[Mh] Termos MeSH secundário: Adenocarcinoma/patologia
Adenoma/patologia
Adulto
Idoso
Carcinoma/patologia
Carcinoma/cirurgia
Estudos de Viabilidade
Feminino
Seres Humanos
Masculino
Meia-Idade
Duração da Cirurgia
Complicações Pós-Operatórias/epidemiologia
Estudos Prospectivos
Neoplasias Retais/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170828
[Lr] Data última revisão:
170828
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170707
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000805


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[PMID]:28660835
[Au] Autor:Meister FA; Amygdalos I; Neumann UP; Lurje G
[Ad] Endereço:Department of Surgery and Transplantation, University Hospital RWTH-Aachen , Aachen , Germany.
[Ti] Título:Rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury.
[So] Source:Ann R Coll Surg Engl;99(6):e191-e192, 2017 Jul.
[Is] ISSN:1478-7083
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Rectal foreign body insertion is a common condition in emergency surgery, which often requires surgical intervention. Here we report a clinical case of rectal foreign body insertion as a rare cause of persistent lumbosacral plexus injury. A 72-year-old man presented to the emergency department complaining of acute bilateral paraplegia with loss of sensation in both legs, as well as total urinary retention. The patient underwent abdominal computed tomography, which showed a rectal foreign body measuring 13 × 11.5 × 10 cm in the lower abdomen and pelvis. Extraluminal assistance through a median laparotomy was required after unsuccessful attempts at transanal recovery alone. After removal of the foreign body, the rectal wall and anorectal sphincter were massively dilated, with severe bruising of the rectal mucosa on proctoscopy. A protective loop-ileostomy was performed. The sacral plexus is located posteriorly in the pelvis. Physiologically, the nerves are well protected by surrounding anatomical structures. Post-traumatic lumbosacral plexus injuries with paraplegia, urinary retention and anorectal sphincter insufficiency occur quite frequently after heavy traffic accidents. Lumbosacral plexus injury as a result of rectal foreign body insertion is rare. Severe neurological deficits through rectal foreign body insertion are rare but known medical conditions. To the best of our knowledge, this is the first reported case of severe and persistent post-traumatic lumbosacral plexus injury through a rectal foreign body.
[Mh] Termos MeSH primário: Corpos Estranhos
Plexo Lombossacral/lesões
Traumatismos dos Nervos Periféricos/etiologia
Reto
[Mh] Termos MeSH secundário: Idoso
Incontinência Fecal
Corpos Estranhos/complicações
Corpos Estranhos/diagnóstico por imagem
Corpos Estranhos/cirurgia
Seres Humanos
Ileostomia
Masculino
Proctoscopia
Reto/diagnóstico por imagem
Reto/lesões
Reto/cirurgia
Incontinência Urinária
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170630
[St] Status:MEDLINE
[do] DOI:10.1308/rcsann.2017.0109


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[PMID]:28530494
[Au] Autor:Wasserman P; Rubin DS; Turett G
[Ad] Endereço:1 Division of Infectious Diseases, Department of Medicine, New York-Presbyterian Queens , Flushing, New York.
[Ti] Título:Review: Anal Intraepithelial Neoplasia in HIV-Infected Men Who Have Sex with Men: Is Screening and Treatment Justified?
[So] Source:AIDS Patient Care STDS;31(6):245-253, 2017 Jun.
[Is] ISSN:1557-7449
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Anal squamous cell carcinoma (SCC) is the fourth most prevalent cancer in human immunodeficiency virus (HIV)-infected men who have sex with men (MSM). Human papillomavirus (HPV) has been detected in over 90% of anal carcinoma biopsy specimens from MSM, and is considered a necessary, but alone, insufficient factor for carcinogenesis. Anal intraepithelial neoplasia (AIN) may be precursive for SCC, and screening cytology with referral of persons with abnormality for high-resolution anoscopy-guided biopsy, and AIN treatment, has been recommended for prevention. In the absence of either randomized controlled trials or surveillance data demonstrating a reduction in anal SCC incidence, these recommendations were based on analogy with cervical cancer. HPV-mediated genetic changes associated with cervical cancer, and aneuploidy, have been documented in AIN. However, little data exist on the rate of AIN progression to SCC. The treatment of AIN is frequently prolonged and not curative, and if routinized in the care of HIV-infected MSM, would likely be recurring well into their sixth decade of life. Clinical trials demonstrating a reduction in invasive anal carcinoma incidence, as well as acceptable morbidity with repeated AIN destruction, are needed before asking our patients to commit to routine treatment.
[Mh] Termos MeSH primário: Canal Anal/patologia
Neoplasias do Ânus/diagnóstico
Neoplasias do Ânus/virologia
Infecções por HIV/complicações
Homossexualidade Masculina
Programas de Rastreamento
[Mh] Termos MeSH secundário: Neoplasias do Ânus/complicações
Neoplasias do Ânus/patologia
Biópsia
Carcinoma de Células Escamosas/complicações
Carcinoma de Células Escamosas/patologia
Carcinoma de Células Escamosas/virologia
Citodiagnóstico
Progressão da Doença
Infecções por HIV/patologia
Seres Humanos
Incidência
Masculino
Recidiva Local de Neoplasia
Infecções por Papillomavirus/complicações
Infecções por Papillomavirus/diagnóstico
Lesões Pré-Cancerosas/diagnóstico
Prevalência
Proctoscopia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170630
[Lr] Data última revisão:
170630
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170523
[St] Status:MEDLINE
[do] DOI:10.1089/apc.2017.0063


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[PMID]:28415928
[Au] Autor:Lee JY; Kim HC; Huh JW; Sim WS; Lim HY; Lee EK; Park HG; Bang YJ
[Ad] Endereço:1 Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University, School of Medicine, Seoul, Korea.
[Ti] Título:Incidence and risk factors for rectal pain after laparoscopic rectal cancer surgery.
[So] Source:J Int Med Res;45(2):781-791, 2017 Apr.
[Is] ISSN:1473-2300
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective This study was performed to investigate the incidence of and potential risk factors for rectal pain after laparoscopic rectal cancer surgery. Methods We retrospectively analyzed data from 300 patients who underwent laparoscopic rectal cancer surgery. We assessed the presence of rectal pain and categorized patients into Group N (no rectal pain) or Group P (rectal pain). Results In total, 288 patients were included. Of these patients, 39 (13.5%) reported rectal pain and 14 (4.9%) had rectal pain that persisted for >3 months. Univariate analysis revealed that patients in Group P had more preoperative chemoradiotherapy, more ileostomies, longer operation times, more anastomotic margins of <2 cm from the anal verge, more anastomotic leakage, and longer hospital stays. Multivariate analysis identified an anastomotic margin of <2 cm from the anal verge and a long operation time as risk factors. The presence of diabetes mellitus was a negative predictor of rectal pain. Conclusions In this study, the incidence of rectal pain after laparoscopic rectal cancer surgery was 13.5%. An anastomotic margin of <2 cm from the anal verge and a long operation time were risk factors for rectal pain. The presence of diabetes mellitus was a negative predictor of rectal pain. Thus, the possibility of postoperative rectal pain should be discussed preoperatively with patients with these risk factors.
[Mh] Termos MeSH primário: Canal Anal/cirurgia
Diabetes Mellitus/diagnóstico
Dor/diagnóstico
Proctoscopia/efeitos adversos
Neoplasias Retais/cirurgia
Reto/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Canal Anal/patologia
Fístula Anastomótica/diagnóstico
Fístula Anastomótica/etiologia
Fístula Anastomótica/patologia
Complicações do Diabetes
Diabetes Mellitus/patologia
Feminino
Seres Humanos
Ileostomia/estatística & dados numéricos
Tempo de Internação/estatística & dados numéricos
Masculino
Meia-Idade
Duração da Cirurgia
Dor/etiologia
Dor/patologia
Neoplasias Retais/patologia
Reto/patologia
Estudos Retrospectivos
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170419
[St] Status:MEDLINE
[do] DOI:10.1177/0300060517693421


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[PMID]:28373770
[Au] Autor:Park SB; Kim DJ; Kim HW; Choi CW; Kang DH; Kim SJ; Nam HS
[Ad] Endereço:Su Bum Park, Dong Jun Kim, Hyung Wook Kim, Cheol Woong Choi, Dae Hwan Kang, Su Jin Kim, Hyeong Seok Nam, Department of Internal Medicine, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospit
[Ti] Título:Is endoscopic ultrasonography essential for endoscopic resection of small rectal neuroendocrine tumors?
[So] Source:World J Gastroenterol;23(11):2037-2043, 2017 Mar 21.
[Is] ISSN:2219-2840
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:AIM: To evaluate the importance of endoscopic ultrasonography (EUS) for small (≤ 10 mm) rectal neuroendocrine tumor (NET) treatment. METHODS: Patients in whom rectal NETs were diagnosed by endoscopic resection (ER) at the Pusan National University Yangsan Hospital between 2008 and 2014 were included in this study. A total of 120 small rectal NETs in 118 patients were included in this study. Histologic features and clinical outcomes were analyzed, and the findings of endoscopy, EUS and histology were compared. RESULTS: The size measured by endoscopy was not significantly different from that measured by EUS and histology ( = 0.914 and = 0.727 respectively). Accuracy for the depth of invasion was 92.5% with EUS. No patients showed invasion of the muscularis propria or metastasis to the regional lymph nodes. All rectal NETs were classified as grade 1 and demonstrated an L-cell phenotype. Mean follow-up duration was 407.54 ± 374.16 d. No patients had local or distant metastasis during the follow-up periods. CONCLUSION: EUS is not essential for ER in the patient with small rectal NETs because of the prominent morphology and benign behavior.
[Mh] Termos MeSH primário: Endossonografia
Tumores Neuroendócrinos/cirurgia
Proctoscopia/métodos
Neoplasias Retais/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Seres Humanos
Mucosa Intestinal/patologia
Mucosa Intestinal/cirurgia
Linfonodos/patologia
Masculino
Meia-Idade
Gradação de Tumores
Tumores Neuroendócrinos/patologia
Neoplasias Retais/patologia
Reto/patologia
Reto/cirurgia
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170405
[St] Status:MEDLINE
[do] DOI:10.3748/wjg.v23.i11.2037


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[PMID]:28251355
[Au] Autor:Junginger T; Goenner U; Hitzler M; Trinh TT; Heintz A; Blettner M; Wollschlaeger D
[Ad] Endereço:Department of General and Abdominal Surgery, University Medical Centre of the Johannes Gutenberg-University, Langenbeckstr. 1, 55131, Mainz, Germany. Junginger@uni-mainz.de.
[Ti] Título:Long-term results of transanal endoscopic microsurgery after endoscopic polypectomy of malignant rectal adenoma.
[So] Source:Tech Coloproctol;21(3):225-232, 2017 Mar.
[Is] ISSN:1128-045X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: There is no consensus on the treatment and prognosis of malignant rectal polyps. The aim of the present study was to determine the role of transanal endoscopic microsurgery (TEM) after endoscopic complete polypectomy of malignant rectal adenomas with long-term follow-up. METHODS: Of 105 patients with pT1 rectal carcinoma in 32 patients TEM followed complete endoscopic polypectomy while 73 had primary TEM. Local recurrence (LR), distant metastasis, overall and cancer-specific survival were determined by the Kaplan-Meier method. RESULTS: Median follow-up was 9.1 years. In 32 patients with TEM following complete polypectomy no residual cancer was found. LR occurred in 3/28 (11%) patients with low-risk carcinoma (pT1 G1/2/X, L0/X, R0) and in 1/4 (25%) with high-risk carcinoma (pT1 G3/4 or L1). After primary TEM with complete resection (minimal distance >1 mm) LR occurred in 6/60 (10%) with low-risk carcinoma. After incomplete TEM resection (minimal distance ≤1 mm) LR occurred in 3/8 (38%) patients with low-risk and in 1/5 (20%) patients with high-risk carcinoma. Grading was the only significant risk factor for LR after endoscopic polypectomy followed by TEM (p = 0.002). At all outcomes did not differ between postpolypectomy TEM and primary TEM. CONCLUSIONS: Patients with malignant rectal polyps removed by endoscopic polypectomy have a substantial risk of LR even if TEM of polyp site is cancer free. Risk of LR depends on tumor characteristics. In low-risk carcinoma long-term follow-up is necessary. The high LR rate in patients with high-risk rectal carcinoma restricts the use of TEM alone.
[Mh] Termos MeSH primário: Adenocarcinoma/cirurgia
Pólipos/cirurgia
Proctoscopia/métodos
Neoplasias Retais/cirurgia
Microcirurgia Endoscópica Transanal/métodos
[Mh] Termos MeSH secundário: Idoso
Carcinoma/cirurgia
Terapia Combinada
Feminino
Seguimentos
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Recidiva Local de Neoplasia/etiologia
Estudos Retrospectivos
Fatores de Risco
Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170303
[St] Status:MEDLINE
[do] DOI:10.1007/s10151-017-1595-y


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[PMID]:28177987
[Au] Autor:Marks JH; Salem JF; Valsdottir EB; Yarandi SS; Marks GJ
[Ad] Endereço:1 Division of Colorectal Surgery, Lankenau Hospital, Wynnewood, Pennsylvania 2 Department of Surgery, University of Iceland, Reykjavik, Iceland.
[Ti] Título:Quality of Life and Functional Outcome After Transanal Abdominal Transanal Proctectomy for Low Rectal Cancer.
[So] Source:Dis Colon Rectum;60(3):258-265, 2017 Mar.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Transanal abdominal transanal proctectomy is a sphincter-preserving procedure designed to avoid colostomy in patients with cancer in the distal third of the rectum. Oncologic outcomes of this procedure have been established. However, data regarding patient satisfaction and quality of life are scant. OBJECTIVE: The purpose of this study was to evaluate the quality of life and functional outcomes of patients after transanal abdominal transanal proctectomy. DESIGN: This is a cross-sectional study. SETTINGS: The study was conducted at a tertiary referral colorectal center. PATIENTS: Patients who underwent transanal abdominal transanal proctectomy were included and surveyed using the Fecal Incontinence Quality of Life Scale, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30, the Quality of Life Questionnaire CR38 module, and a questionnaire designed by the authors to assess satisfaction with quality of life. MAIN OUTCOME MEASURES: Quality of life, functional outcomes, and patient satisfaction were measured and compared by age, tumor level, and stage of the disease. RESULTS: A total of 133 surveys were mailed, and 90 patients responded and were included in the study. Patient quality of life was not significantly different after surgery. Patients with more proximal tumors had better lifestyle, physical, and emotional scores. Older patients performed better on multiple levels, including coping, emotional, body image, future perspective, and digestive. Stage of disease had no impact on quality of life. Compared with reference values, patients who underwent transanal abdominal transanal proctectomy performed better on most of the components. All of patients preferred transanal abdominal transanal proctectomy over having a stoma based on their current anal sphincter function, and >97% of patients preferred transanal abdominal transanal proctectomy based on their current quality of life, sexual function, and level of activities. LIMITATIONS: This study is limited by the lack of a comparison group and a potential selection bias. CONCLUSIONS: Satisfaction with quality of life and functional outcomes is high after transanal abdominal transanal proctectomy. Older patients and those with more proximal tumors performed better. This patient population clearly preferred a sphincter-preserving option for treatment of their rectal cancer.
[Mh] Termos MeSH primário: Incontinência Fecal/etiologia
Complicações Pós-Operatórias/etiologia
Proctoscopia/métodos
Qualidade de Vida
Neoplasias Retais/cirurgia
Reto/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Bolsas Cólicas
Estudos Transversais
Incontinência Fecal/psicologia
Feminino
Seguimentos
Seres Humanos
Estilo de Vida
Masculino
Meia-Idade
Satisfação do Paciente
Complicações Pós-Operatórias/psicologia
Estudos Prospectivos
Qualidade de Vida/psicologia
Neoplasias Retais/psicologia
Inquéritos e Questionários
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170217
[Lr] Data última revisão:
170217
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170209
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000762


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[PMID]:28169931
[Au] Autor:Neuvonen MI; Kyrklund K; Rintala RJ; Pakarinen MP
[Ad] Endereço:Department of Pediatric Surgery, Children's Hospital, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
[Ti] Título:Bowel Function and Quality of Life After Transanal Endorectal Pull-through for Hirschsprung Disease: Controlled Outcomes up to Adulthood.
[So] Source:Ann Surg;265(3):622-629, 2017 Mar.
[Is] ISSN:1528-1140
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to define controlled outcomes up to adulthood for bowel function and quality of life (QoL) after transanal endorectal pull-through (TEPT) for Hirschsprung disease (HD). SUMMARY OF BACKGROUND DATA: Although TEPT is the surgical standard for HD, controlled long-term follow-up studies evaluating bowel function and QoL are lacking. METHODS: Patients aged ≥4 years operated for HD with TEPT between 1987 and 2011 answered detailed questionnaires on bowel function and QoL [Pediatric Quality of Life Inventory (PedsQL, age <18 yrs) or Gastrointestinal Quality of Life Index (GIQLI) and SF-36]. Patients were compared with 3 age- and gender-matched controls each randomly selected from the general population. RESULTS: Seventy-nine patients (64%) responded (median age 15, range 4-32 years; 86% rectosigmoid aganglionosis). Compared with controls, patients reported impairment of all aspects of fecal control (P < 0.05), except constipation. In cross-section, 75% of patients were socially continent (vs 98% of controls; P < 0.001). Soiling, fecal accidents, rectal sensation, and ability to withhold defecation improved with age to levels comparable to controls by adulthood (P = NS), but stooling frequency remained higher in 44% of patients (P < 0.05 vs controls). PedsQL domains in childhood were equal to controls (P = NS), except for proxy-reports of sadness/depression. Adults exhibited lower emotional scores, limitation of personal, and sexual relationships (P < 0.05). CONCLUSION: Compared with matched peers, significant impairment of fecal control prevails after TEPT in HD patients during childhood, but symptoms diminish with age. Although overall QoL appeared comparable to controls, impairment of emotional and sexual domains may prevail in adulthood.
[Mh] Termos MeSH primário: Canal Anal/cirurgia
Doença de Hirschsprung/cirurgia
Procedimentos Cirúrgicos Minimamente Invasivos/métodos
Proctoscopia/métodos
Qualidade de Vida
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Estudos de Casos e Controles
Criança
Pré-Escolar
Defecação/fisiologia
Feminino
Finlândia
Doença de Hirschsprung/diagnóstico
Doença de Hirschsprung/psicologia
Seres Humanos
Masculino
Satisfação do Paciente/estatística & dados numéricos
Recuperação de Função Fisiológica
Valores de Referência
Estudos Retrospectivos
Medição de Risco
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170609
[Lr] Data última revisão:
170609
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170208
[St] Status:MEDLINE
[do] DOI:10.1097/SLA.0000000000001695


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[PMID]:28141783
[Au] Autor:Goeieman BJ; Firnhaber CS; Jong E; Michelow P; Kegorilwe P; Swarts A; Williamson AL; Allan B; Smith JS; Wilkin TJ
[Ad] Endereço:*Right to Care, Johannesburg, South Africa; †Clinical HIV Research Unit, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; ‡Julius Clinical Research, Zeist, the Netherlands; §Cytology Unit, Department of Anatomical Pathology, Faculty of Health Sciences, National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa; ‖Division of Medical Virology, Department of Pathology, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa; ¶National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa; #Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC; and **Division of Infectious Diseases, Weill Cornell Medicine, New York, NY.
[Ti] Título:Prevalence of Anal HPV and Anal Dysplasia in HIV-Infected Women From Johannesburg, South Africa.
[So] Source:J Acquir Immune Defic Syndr;75(3):e59-e64, 2017 Jul 01.
[Is] ISSN:1944-7884
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Anal cancer is a relatively common cancer among HIV-infected populations. There are limited data on the prevalence of anal high-risk human papillomavirus (HR-HPV) infection and anal dysplasia in HIV-infected women from resource-constrained settings. METHODS: A cross-sectional study of HIV-infected women aged 25-65 years recruited from an HIV clinic in Johannesburg, South Africa. Cervical and anal swabs were taken for conventional cytology and HR-HPV testing. Women with abnormal anal cytology and 20% of women with negative cytology were seen for high-resolution anoscopy with biopsy of visible lesions. RESULTS: Two hundred women were enrolled. Anal HR-HPV was found in 43%. The anal cytology results were negative in 51 (26%); 97 (49%) had low-grade squamous intraepithelial lesions (SIL), 32 (16%) had atypical squamous cells of unknown significance, and 19 (9.5%) had high-grade SIL or atypical squamous cells suggestive of high-grade SIL. On high-resolution anoscopy, 71 (36%) had atypia or low-grade SIL on anal histology and 17 (8.5%) had high-grade SIL. Overall, 31 (17.5%) had high-grade SIL present on anal cytology or histology. Abnormal cervical cytology was found in 70% and cervical HR-HPV in 41%. CONCLUSIONS: We found a significant burden of anal HR-HPV infection, abnormal anal cytology, and high-grade SIL in our cohort. This is the first study of the prevalence of anal dysplasia in HIV-infected women from sub-Saharan Africa. Additional studies are needed to define the epidemiology of these conditions, as well as the incidence of anal cancer, in this population.
[Mh] Termos MeSH primário: Canal Anal/patologia
Doenças do Ânus/epidemiologia
Doenças do Ânus/patologia
Infecções por HIV/epidemiologia
Infecções por Papillomavirus/epidemiologia
Infecções por Papillomavirus/patologia
Lesões Pré-Cancerosas/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Canal Anal/virologia
Doenças do Ânus/virologia
Biópsia
Carcinoma de Células Escamosas/epidemiologia
Carcinoma de Células Escamosas/patologia
Carcinoma de Células Escamosas/virologia
Estudos Transversais
Citodiagnóstico
Feminino
Infecções por HIV/patologia
Seres Humanos
Infecções por Papillomavirus/diagnóstico
Lesões Pré-Cancerosas/patologia
Lesões Pré-Cancerosas/virologia
Prevalência
Proctoscopia
África do Sul/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM; X
[Da] Data de entrada para processamento:170201
[St] Status:MEDLINE
[do] DOI:10.1097/QAI.0000000000001300



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