ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Advances in our understanding of transport and epithelial functions of the colon occurred in several areas during the past year: 1) elucidation of the role of cystic fibrosis transmembrane conductance regulator in colonic chloride secretion, 2) identification of novel transport pathways for sodium, chloride, and bicarbonate in the colon, 3) delineation of the intricacies of intracellular regulation by second messengers and their surrogates, and 4) recognition of the importance of luminal and subepithelial factors in regulating and, perhaps, controlling epithelial function.

ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Biofeedback therapy is a major advance in the treatment of intractable constipation; several recent publications testify to its effectiveness. The irritable bowel syndrome is increasingly regarded as a problem of sensory function and perception; psychologically based treatments offer more sustained success than drug treatment. The prevalence of constipation following hysterectomy has been prospectively determined and associated sensory changes documented. The roles of 5-hydroxytryptamine and erythromycin in the regulation of colonic motility are discussed. Defecation has been characterized by high-amplitude propagated contraction, rectal contraction, and early relaxation of the anal sphincter. Other recent observations on colonic motor function are highlighted.

ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The incidence of colorectal cancer continues to increase or at least remains stable. Epidemiologic data are defining hereditary colorectal cancer as an important part of the spectrum. The most exciting recent development has been the identification of the adenomatous polyposis coli gene on chromosome 5, thought responsible for adenomatous polyposis coli. Increasing numbers of studies are further characterizing the gene as well as its mutations, found in polyposis patients, and are using gene markers to identify affected family members. Risk assessment for colorectal cancer continues to be refined. Patients with only a single small tubular adenoma may not have a significantly increased risk of subsequent colorectal cancer. Patients with chronic ulcerative colitis are at increased risk, but the optimal surveillance schedule, as well as whether surveillance reduces colorectal cancer mortality, remains undetermined. Fecal occult blood testing, recommended in most screening strategies, may have an unacceptably low sensitivity and high false-negative rate in screening studies. Screening by means of sigmoidoscopy may reduce mortality from cancer of the distal colon, and screening once every 10 years may be as efficacious as more frequent screening. The debate over whether colonoscopy or sigmoidoscopy should be used in screening continues. Proximal neoplasms do occur even when they are absent distally, but colonoscopy is more invasive and expensive than sigmoidoscopy. Results from large-scale prospective screening trials are eagerly awaited over the next several years. Until then, following the current recommendations is justified in high-risk groups as well as for average-risk individuals upon request, but it is probably not useful for large-scale general population screening.

ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Adjuvant therapy for colorectal cancer continues to excite significant interest, particularly for “high-risk” patients in whom systemic 5-fluorouracil and leucovorin should be considered. However, intraportal 5-fluorouracil and intraperitoneal chemotherapy require further assessment. For rectal cancer, combined chemo- and radiotherapy have demonstrated survival advantages. In patients with advanced or recurrent disease, modification of 5-fluorouracil with folinic acid and locoregional infusion treatment have both demonstrated efficacy. In general immunotherapy, studies have so far proved disappointing for advanced colorectal cancer.

ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This review highlights the past year's literature that pertains to the appropriate use and effectiveness of colorectal endoscopy for the screening and surveillance of neoplasia. Treatment of colorectal neoplasms by electrothermal, photothermal, and photodynamic techniques is discussed. Technologies to extend our current diagnostic capabilities, such as electronic endoscopy and endoscopic ultrasound, are covered. Studies are summarized on the diagnostic yield of colonoscopy in patients with occult and overt bleeding. New information on tissue sampling, bowel preparation, procedure safety, and patient monitoring is presented.

ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This review of the past year's literature on major surgical advances in colorectal cancer and inflammatory bowel disease highlights perioperative and intraoperative strategies, new techniques, and finally a short review on laparoscopic bowel surgery—an area certain to grow in the years ahead. As in previous editions, editorial comments pervade the text.

ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

This article reviews several recent studies on effects of medications on the colon. Nonsteroidal anti-inflammatory drug-associated diseases, including colitis, stercoral perforations of the colon, and complications of diverticular disease are presented. The toxic effects to the colon of South African tribal enemas and methamphetamines are detailed. Inhibition of colonic prostaglandin synthesis by sulindac with a reduction in polyps in patients with polyposis coli is noted. Other studies discussed include information about the following: colonic prostaglandin levels after laxative use, mechanism of action of simethicone, the role of different fiber diets in the generation of colonic short-chain fatty acids, fiber in infant formulas, the role of dietary calcium in reducing fecal water cytotoxicity, short-chain fatty acid therapy, and polypeptide diets. New reports of Dieulafoy's lesions and some other vascular abnormalities of the colon and two studies on colonic injury from radiation are discussed.

ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In the past year's literature on colorectal surgical conditions, the topics most frequently addressed are rectal prolapse, techniques of stapled anastomosis, surgery of intestinal stomas, and the diagnosis of lower gastrointestinal bleeding. Also included are articles on sigmoid volvulus, various surgical techniques, gut ischemia, surgery for colorectal emergencies, and colorectal surgery in older patients. Some instructive case reports are reviewed.

ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

There continues to be a considerable amount of high-quality research in coloproctology. Several excellent studies have discussed the management of rectal prolapse and fecal incontinence. Moreover, there is increasing interest in the functional outcome of operations for these conditions. Restorative proctocolectomy is topical and different techniques have been evaluated. There are exciting developments in the management of incontinence following unsuccessful surgery. The stimulated graciloplasty described in this review offers great hope to patients thus afflicted. Reconstruction following excision of the rectum for cancer is a continuing challenge. The technical aspects have been largely resolved, but function is often unfortunately less than satisfactory. The relationship between anal cancer, cervical malignancy, and the human papilloma virus is important. Moreover it appears that cervical cancer per se is a risk factor predisposing patients to an increased probability of developing anal malignancy.

ISSN:0267-1379    

出版商:OVID    

年代:1993

数据来源: OVID