Patients Undergoing Ileoanal Pouch Surgery Experience a Constellation of Symptoms and Consequences Representing a Unique Syndrome: A Report from the Patient-Reported Outcomes After Pouch Surgery (PROPS) Delphi Consensus Study
Paul M. Cavallaro, M.D. • Nicola S. Fearnhead, D.M. • Ian P. Bissett, M.D. Mantaj S. Brar, M.D., M.Sc. • Thomas E. Cataldo, M.D. • Rasheed Clarke, B.S. • Paula Denoya, M.D. • Amber L. Elder, B.A. • Krisztina B. Gecse, M.D., Ph.D. • Samantha Hendren, M.D., M.P.H. • Stefan Holubar, M.D. • Nimalan Jeganathan, M.D. • Myrelid, M.D., Ph.D. • Beth-Anne Norton, N.P. • Steven D. Wexner, M.D. • Lauren Wilson, M.D. • Karen Zaghiyan, M.D. • Liliana Bordeianou, M.D., M.P.H. • On Behalf of the PROPS Delphi Study Expert Panels
This study is the first to identify key functional outcomes after pouch surgery with direct input from a large panel of ileoanal pouch patients. The inclusion of patients in all stages of the consensus process allowed for a true patient-centered approach in defining the core domains that should be focused on in future studies of pouch function.
Prevalence of High-Grade Anal Dysplasia and Anal Cancer in Veterans Living With HIV and CD4/CD8 Ratio as a Marker For Increased Risk: A Regional Retrospective Cohort Study
Cristina B. Sanger, M.D. • Yiwei Xu, M.H.S. • Evie Carchman, M.D. • Elise H. Lawson, M.D., M.S.H.S. • Charles P. Heise, M.D. • Rob Striker, M.D., Ph.D. • Corrine I. Voils, Ph.D.
In a regional cohort of veterans with HIV, 15% were formally assessed for anal dysplasia. Advanced anal disease was present in 33% of those screened, 5% of the HIV-positive population. A strong predictor of advanced disease in this cohort is the CD4/ CD8 ratio, which is a promising marker to stratify screening practices. Risk stratification using CD4/CD8 has the potential to decrease burdensome invasive examinations for low-risk patients and to intensify examinations for those at high risk.
Robot Surgery Shows Similar Long-term Oncologic Outcomes as Laparoscopic Surgery for Mid/Lower Rectal Cancer but Is Beneficial to ypT3/4 After Preoperative Chemoradiation
Soo Yeun Park, M.D. • Sung Min Lee, M.D. • Jun Seok Park, M.D., Ph.D. Hye Jin Kim, M.D. • Gyu-Seog Choi, M.D., Ph.D.
Robotic surgery for mid/low rectal cancer shows similar long-term oncologic outcomes with laparoscopic surgery but is beneficial to a certain group of patients with advanced rectal cancer with poor response to neoadjuvant chemoradiation. Additional studies are required to confirm our results.
Functional Outcomes and Quality of Life after Redo Anastomosis in Patients With Rectal Cancer: An International Multicenter Comparative Cohort Study
Emma Westerduin, M.D., Ph.D. • Hossam Elfeki, M.D., Ph.D. • Alice Frontali, M.D. • Zaher Lakkis, M.D., Ph.D. • Søren Laurberg, M.D., D.M.Sc. • Pieter J. Tanis, M.D., Ph.D. • Albert M. Wolthuis, M.D., Ph.D. • Yves Panis, M.D., Ph.D. • Andre D’Hoore, M.D., Ph.D. • Willem A. Bemelman, M.D., Ph.D. • Therese Juul, M.H.Sc., Ph.D.
Redo anastomosis is associated with significantly worse quality of life compared with primary successful anastomosis. However, major low anterior resection syndrome was comparable between groups and should not be a reason to preclude restoration of bowel continuity in highly motivated patients.
A Prospective Randomized Trial of Surgeon-Administered Intraoperative Transversus Abdominis Plane Block With Bupivacaine Against Liposomal Bupivacaine: The TINGLE Trial
Adam Truong, M.D. • Phillip R. Fleshner, M.D. • James M. Mirocha, M.S. Hai P. Tran, Pharm.D. • Rita Shane, Pharm.D. • Karen N. Zaghiyan, M.D.
This first randomized trial comparing laparoscopic transversus abdominis plane block with liposomal bupivacaine or bupivacaine with epinephrine and dexamethasone showed that a liposomal bupivacaine block does not provide superior or extended analgesia in the era of standardized multimodal analgesia protocols.
