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    题名 作者 年代 出处 被引量
1Primary and recurrent retroperitoneal soft tissue sarcoma: Prognostic factors affecting survival显示文摘AntonioChiappa Andrew P.Zbar EmilioBertani RobertoBiffi FabrizioLuca CristianoCrotti AlessandroTestori GianlucaLazzaro TommasoDe Pas PaceUgo BrunoAndreoni 2006J Surg Oncol2006,,6:1
2Commentary on neoadjuvant therapy followed by local excision and two-stage total mesorectal excision:a new strategy for sphincter preservation in locally advanced ultra-low rectal cancer显示文摘The authors have provided a novel hybrid approach in a selected group of locally advanced ultra-low rectal cancers,using neoadjuvant chemoradiation followed by local excision in responders and a delayed Total Mesorectal Excision(TME)and restorative proctectomy,showing that mediumterm survival is possible with acceptable functional outcome[1].Although it is clear that the neoadjuvant approach has acceptable toxicity—with the majority of patients showing significant tumor downsizing and creating a better chance for sphincter preservation—the selection criteria for these patients still remain subjective.Here,the alternatives in those showing a partial clinical response(pCR)include radical resection,transanal local excision and a‘wait and see’policy but the data are contradictory in the matter of assisting individual patient management[2].One problem is that some data show relatively high recurrence rates in clinical complete responders when a‘wait and see’strategy is followed,while studies are heterogeneous in their staging and inclusion criteria and there are differences in what constitutes a pCR.In this respect,there is only partial agreement between pcR and complete clinical response(cCR)cases[3].This inconsistency of cCR diagnosis most probably also explains some reportedly high rates of local perirectal lymph node metastases in some series,which precludes either a‘wait and see’plan of action or one combined with local excision[4].Andrew P.Zbar 2014Gastroenterology Report2014,2,2:1
3Modern management of anal incontinence显示文摘Anal incontinence(AI)reflects the final common pathway of a multitude of aetiological factors and,as an underestimated clinical problem,it represents a major social and economic burden.Its epidemiology and objective assessment of the severity of the problem are discussed in this Special Edition by Nevler from Israel.In the 1980s,the management of AI included some form of sphincter repair or scaffold,as discussed by Pescatori and Pescatori,with the construction of a colostomy as the only other surgical option.The development of a series of complicated muscle transposition procedures ensued and was supplemented by electrical stimulation,following an improvement in our understanding of the basic functioning of the voluntary myocyte.These procedures are discussed by Barisˇic′and Krivokapic′.This approach was followed by the adoption,from urological practice,of an artificial bowel sphincter that could be used to augment a perineal colostomy,in some cases of total anorectal reconstruction,and in patients with complex congenital anomalies after failed reconstruction.Neither of these more complex approaches has effectively stood the test of time,resulting in high complication rates,and the frequent need for operative revision and ultimate explantation of the device.Andrew P.Zbar 2014Gastroenterology Report2014,2,2:0
4Sacral neuromodulation and peripheral nerve stimulation in patients with anal incontinence:an overview of techniques,complications and troubleshooting显示文摘Sacral neuromodulation(SNM)therapy has revolutionized the management of many forms of anal incontinence,with an expanded use and a medium-term efficacy of 75%overall.This review discusses the technique of SNM therapy,along with its complications and troubleshooting and a discussion of the early data pertaining to peripheral posterior tibial nerve stimulation in incontinent patients.Future work needs to define the predictive factors for neurostimulatory success,along with the likely mechanisms of action of their therapeutic action.Andrew P.Zbar 2014Gastroenterology Report2014,2,2:0
5The antegrade continence enema procedure and total anorectal reconstruction显示文摘Patients may present with anal incontinence(AI)following repair of a congenital anorectal anomaly years previously,or require total anorectal reconstruction(TAR)following radical rectal extirpation,most commonly for rectal cancer.Others may require removal of their colostomy following sphincter excision for Fournier’s gangrene,or in cases of severe perineal trauma.Most of the data pertaining to antegrade continence enema(the ACE or Malone procedure)comes from the pediatric literature in the management of children with AI,but also with supervening chronic constipation,where the quality of life and compliance with this technique appears superior to retrograde colonic washouts.Total anorectal reconstruction requires an anatomical or physical supplement to the performance of a perineal colostomy,which may include an extrinsic muscle interposition(which may or may not be‘dynamized’),construction of a neorectal reservoir,implantation of an incremental artificial bowel sphincter or creation of a terminal,smooth-muscle neosphincter.The advantages and disadvantages of these techniques and their outcome are presented here.Andrew P.Zbar 2014Gastroenterology Report2014,2,2:0
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