Management of Large Sessile Cecal Polyps
Polyp Characteristics Very large size is a relative contraindication for endoscopic removal (the skill set of the endoscopist is also a factor); polyps that involve the great majority of the…
Reservoir Construction After Low Anterior Resection: Who and What?
Patient population Intervention Comparators Outcomes studied Rectal cancer patients undergoing low anterior resection with coloanal anastomosis Colonic reservoir creation: J-pouch, transverse coloplasty, or side-to-end anastomosis Straight coloanal anastomosis Postoperative morbidity…
Laparoscopic Versus Robotic Versus Open Surgery for Rectal Cancer
(a) Patient population Intervention Comparator Outcomes studied Rectal cancer, post neoadjuvant chemo-radiotherapy Laparoscopically performed TME Open TME Procedure related morbidity Length of stay, complications – grade 3/4/5, anastomotic leak,…
Quality Improvement: Are Fast Track Pathways for Laparoscopic Surgery Needed?
P (patients) I (intervention) C (comparator) O (outcomes) Patients undergoing colorectal surgery 1. Laparoscopic- assisted approach or 2. Enhanced recovery program/fast track pathway 1. Traditional open surgery or 2. Conventional…
Utility of Primary Tumor Resection in Asymptomatic, Unresectable Metastatic Colon and Rectal Cancer
P Patient population Unresectable, metastatic colon cancer with an asymptomatic primary tumor I Intervention Primary tumor resection (colectomy) followed by 1st line chemotherapy, C Comparator 1st line chemotherapy with primary…
Benign Anal Disease: When to Operate on the Patient with an Anal Fissure
P (patients) I (intervention) C (comparator) O (outcomes) Patients with chronic anal fissure Surgical management Medical management Cure, recurrence, postoperative incontinence Results Lifestyle modifications consisting of sitz baths, implementing a…
Rectal Prolapse: What Is the Best Approach for Repair?
Patient population Intervention Comparator Outcomes Patients’ with rectal prolapse Abdominal approach to correction of prolapse Perineal approach to correction of prolapse Recurrence of prolapse Functional outcomes Quality of life Morbidity…
Introduction
Fig. 1.1 PubMed entries with keywords ‘evidence based medicine’ Without a doubt evidence-based medicine provides surgeons with a rational basis to support guidelines for treatment modalities and contributes to standardization…
Who Needs Elective Surgery for Recurrent Diverticulitis?
Patient population Intervention Comparator Outcomes studied Patients with recurrent diverticulitis Resection Expectant management Risk of recurrence, morbidity, quality of life We performed a systematic literature search with the aim of…
Deciding on an IRA vs. IPAA for FAP
Ileorectal anastomosis (IRA) Ileal pouch-anal anastomosis (IPAA), mucosectomy and handsewn anastomosis Ileal pouch-anal anastomosis (IPAA), stapled anastomosis Indications <20 rectal adenomas Young patient High desmoid risk Woman >20 rectal…
