Lower GI - British Journal of Surgery

Surgery type: All

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Case of coconutention (January 2023 [2])

A 56-year-old man presented with a 2-day history of severe abdominal pain, anuria, and absolute constipation. Abdominal CT showed a large foreign body in the rectum, which compressed the prostatic urethra, causing urinary retention. A coconut was removed from the rectum via exploratory laparotomy.

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Colonic lipoma (January 2023 [1])

A 46-year-old woman presented with abdominal pain. A computed tomography scan found colonic intussusception. She underwent a laparoscopic colectomy at which a giant lipoma was found.

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Taenia saginata: unexpected finding during laparoscopic Roux-en-Y gastric bypass (October 2022 [1])

While performing the jejuno-jejunal anastomosis during a laparoscopic Roux-en-Y gastric bypass to treat morbid obesity, a yellowish filamentous structure appeared from the bowel lumen. It was removed, and subsequent microbiological analysis reported it to be a Taenia saginata (a tapeworm).

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Colostomy granulomas, not always what they seem (July 2022)

A 53-year-old patient with a history of Crohn’s disease had experienced painful bleeding from colostomy granulomas for 7 years. Repeat biopsies diagnosed a stomal adenocarcinoma; multiple previous biopsies had been negative for malignancy. A left colectomy was performed. Definitive histopathology showed a mucinous pT2N0 adenocarcinoma with a complete resection.

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Snapshot quiz (March 2022)

A 60-year-old man presented with acute epigastric pain and diarrhoea. His medical history included chronic obstructive pulmonary disease with recent exacerbation for which he was taking glucocorticoid therapy. What is the name of the clinical sign found on CT scan and correlated intraoperatively?

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Snapshot quiz (September 2021 [1])

A middle-aged man presents with a long history of rectal bleeding and intermittent constipation. What is shown in this intraoperative image?

Scientific Surgery

Efficacy and safety of nonantibiotic outpatient treatment in mild acute diverticulitis (DINAMO-study). A multicentre, randomised, open-label, noninferiority trial. Results from a multicenter randomized controlled trial (HOPE ECD-DBD). Ann Surg 2021; 274: e435-e442.

Authors: Mora-López L, Ruiz-Edo N, Estrada-Ferrer O, Piñana-Campón ML, Labró-Ciurans M, Escuder-Perez J et al.

Scientific Surgery

Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): 10-year follow-up of an open-label, non-inferiority, randomised controlled trial. Lancet Gastro Hepatol 2021; 6: 569-577.

Authors: Park JW, Kang S-B, Hao J, Lim S-B, Choi HS, Kim D-W et al.

Scientific Surgery

Perioperative systemic therapy vs cytoreductive surgery and hyperthermic intraperitoneal chemotherapy alone for resectable colorectal peritoneal metastases. A phase 2 randomized clinical trial. JAMA Surg 2021; 156: 710-720.

Authors: Rovers KP, Bakkers C, Nienhuijs SW, Burger JWA, Creemers G-JM, Thijs AMJ et al.

Scientific Surgery

A randomized Phase II trial of adjuvant hepatic arterial infusion and systemic therapy with or without panitumumab after hepatic resection of KRAS wild-type colorectal cancer. Ann Surg 2021; 274: 248-254.

Authors: Kemeny NE, Chou JF, Capanu M, Chatila WK, Shi H, Sanchez-Vega F et al.

Scientific Surgery

Surgical management of idiopathic perianal fistulas: a systematic review and meta-analysis. Dig Surg 2021; 38: 104-119.

Authors: Cheung XC, Fahey T, Rogers AC, Pemberton JH, Kavanagh DO

Scientific Surgery

Feasibility and safety of laparoscopic complete mesocolic excision (CME) for right-sided colon cancer. Short-term Outcomes. A Randomized Clinical Study. Ann Surg 2021; 274: 57-62.

Authors: Di Buono G , Buscemi S, Cocorullo G, Sorce V, Amato G, Bonventre G et al.

Scientific Surgery

Early versus late preventive ileostomy closure following colorectal surgery: systematic review and meta-analysis with trial sequential analysis of randomized controlled trials. Dis Colon Rectum 2021; 64: 128-137.

Authors: Cheng Z, Dong S, Bi D, Wang Y, Dai Y, Zhang XM et al.

Scientific Surgery

Preoperative hepatic and regional arterial chemotherapy in patients who underwent curative colorectal cancer resection. A prospective, multi-center, randomized controlled trial. Ann Surg 2021; 273: 1066-1075.

Authors: Zhu D, Xia J, Gu Y, Lin J, Ding K, Zhou B et al.

Scientific Surgery

Long-term outcomes of a randomized controlled trial of single-incision versus multi-port laparoscopic colectomy for colon cancer. Ann Surg 2021; 273: 1060-1065.

Authors: Watanabe J, Ishibe A, Suwa H, Ota M, Fujii S, Kubota K et al.

Scientific Surgery

Comparing laparoscopic elective sigmoid resection with conservative treatment in improving quality of life of patients with diverticulitis. The Laparoscopic Elective Sigmoid Resection Following Diverticulitis (LASER) randomized clinical trial. JAMA Surg 2021; 156: 129-136.

Authors: Santos A, Mentula P, Pinta T, Ismael S, Rautio T, Juusela R et al.

Scientific Surgery

Laparoscopic lavage vs primary resection for acute perforated diverticulitis. Long-term outcomes from the Scandinavian Diverticulitis (SCANDIV) randomized clinical trial. JAMA Surg 2021; 156: 121-127.

Authors: Azhar N, Johanssen A, Sundstrom T, Folkesson J, Wallon C, Korner H et al.

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Snapshot quiz (July 2021)

What has caused the stricture in the small bowel and what has developed in the lumen of the bowel as a result?