LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 32

Search options

  1. Article: Emerging Data on Fistula Laser Closure (FiLaC) for the Treatment of Perianal Fistulas; Patient Selection and Outcomes.

    Adegbola, Samuel O / Sahnan, Kapil / Tozer, Phillip / Warusavitarne, Janindra

    Clinical and experimental gastroenterology

    2021  Volume 14, Page(s) 467–475

    Abstract: Fistula laser closure (FiLaC) is a relatively new sphincter-sparing technique in fistula surgery that was initially reported in 2011. It involves the radial dissipation of laser energy in the fistula tract and, through a combination of coagulation and ... ...

    Abstract Fistula laser closure (FiLaC) is a relatively new sphincter-sparing technique in fistula surgery that was initially reported in 2011. It involves the radial dissipation of laser energy in the fistula tract and, through a combination of coagulation and shrinkage of the tract, is proposed to result in progressive sealing of fistulas. Early studies have suggested minimal impact on continence and touted the advantage of minimal morbidity with potential of repeat procedures if the technique fails initially. Despite early promising results, ten years on, questions remain on the technique, patient selection and long-term outcomes. This narrative review assesses the evidence reported to-date of radially emitting laser fistula surgery in the treatment of perianal fistulas.
    Language English
    Publishing date 2021-12-06
    Publishing country New Zealand
    Document type Journal Article ; Review
    ZDB-ID 2520690-4
    ISSN 1178-7023
    ISSN 1178-7023
    DOI 10.2147/CEG.S269464
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  2. Article ; Online: Factors associated with stoma formation in ileocolic resection for Crohn's disease and the development of a predictive scoring system.

    Wickramasinghe, Dakshitha / Carvello, Michele / Di Candido, Francesca / Maroli, Annalisa / Adegbola, Samuel / Sahnan, Kapil / Morar, Pritesh / Spinelli, Antonino / Warusavitarne, Janindra

    Langenbeck's archives of surgery

    2022  Volume 407, Issue 7, Page(s) 2997–3003

    Abstract: Purpose: The likelihood of a stoma following ileocolic resection (ICR) for Crohn's disease (CD) is an important consideration. This study aims to identify the factors associated with an increased likelihood of a stoma and develop a predictive scoring ... ...

    Abstract Purpose: The likelihood of a stoma following ileocolic resection (ICR) for Crohn's disease (CD) is an important consideration. This study aims to identify the factors associated with an increased likelihood of a stoma and develop a predictive scoring system (SS).
    Methods: Patient data were collected from St. Marks Hospital, London, UK and Humanitas Clinical and Research Center, Milan, Italy, on all patients who underwent an ICR for CD from 2005 to 2017. A logistic regression analysis was used for multivariate analysis. The SS was developed from the logistic regression model. The performance of the SS was evaluated using receiver operating characteristics area under the curve (AUROC).
    Results: A total of 628 surgeries were included in the analysis. Sixty-nine surgeries were excluded due to missing data. The remaining 559 were divided into two cohorts for the scoring system's development (n = 434) and validation (n = 125). The regression model was statistically significant (p < 0.0001). The statistically significant independent variables included sex, preoperative albumin and haemoglobin levels, surgical access and simultaneous colonic resection. The AUROC for the development and validation cohorts were 0.803 and 0.905, respectively (p < 0.0001). Youden's index suggested the cut-off score of - 95.9, with a sensitivity of 87.6% and a specificity of 62.9%.
    Conclusions: Male sex, low preoperative albumin, anaemia, laparoscopic conversion and simultaneous colonic resection were associated with an increased likelihood of requiring a stoma and were used to develop an SS. The calculator is available online at https://rebrand.ly/CrohnsStoma .
    MeSH term(s) Humans ; Male ; Crohn Disease/surgery ; Colectomy ; Anastomosis, Surgical ; Colon/surgery ; Albumins ; Retrospective Studies
    Chemical Substances Albumins
    Language English
    Publishing date 2022-07-29
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1423681-3
    ISSN 1435-2451 ; 1435-2443
    ISSN (online) 1435-2451
    ISSN 1435-2443
    DOI 10.1007/s00423-022-02626-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  3. Article ; Online: A scoring system to predict a prolonged length of stay after surgery for Crohn's disease.

    Wickramasinghe, Dakshitha / Adegbola, Samuel / Sahnan, Kapil / Morar, Pritesh / Carvello, Michele / Di Candido, Francesca / Maroli, Annalisa / Spinelli, Antonino / Warusavitarne, Janindra

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2021  Volume 23, Issue 5, Page(s) 1205–1212

    Abstract: Aim: Many factors influence the postoperative length of stay (LOS) in Crohn's disease (CD). This study aims to identify the factors associated with a prolonged LOS after ileocolic resection (ICR) for CD and to develop a scoring system to predict the ... ...

    Abstract Aim: Many factors influence the postoperative length of stay (LOS) in Crohn's disease (CD). This study aims to identify the factors associated with a prolonged LOS after ileocolic resection (ICR) for CD and to develop a scoring system to predict the postoperative LOS in CD.
    Method: Patient data were collected from St Marks Hospital, London, UK, and the Humanitas Clinical and Research Center Milan, Italy, for all patients who underwent an ICR for CD from 2005 to 2017. Logistic regression was used for multivariate analysis. The scoring system was developed from the logistic regression model. The performance of the scoring system was evaluated using the area under the receiver operating characteristic curve (AUROC).
    Results: A total of 628 surgeries were included in the analysis. Eighty eight surgeries were excluded due to missing data. The remaining 543 were divided into two cohorts for the development (n = 418) and validation (n = 125) of the scoring system. The regression model was statistically significant (p < 0.0001). The statistically significant independent variables included the time since diagnosis, American Society of Anesthesiologists (ASA) grade, perioperative use of steroids, surgical access, strictureplasty and platelet count. The AUROCs for the development and validation cohorts were 0.732 and 0.7, respectively (p < 0.0001). The cut-off score suggested by Youden's index was 50, with a sensitivity of 65.6% and a specificity of 73.3%.
    Conclusion: The time since diagnosis, ASA grade, steroid use, surgical access, strictureplasty and platelet count were associated with a prolonged LOS and were used to develop a scoring system. The calculator is available online at https://rebrand.ly/Crohnscal.
    MeSH term(s) Anastomosis, Surgical ; Colectomy ; Crohn Disease/surgery ; Humans ; Length of Stay ; Postoperative Period ; Retrospective Studies
    Language English
    Publishing date 2021-02-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.15567
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  4. Article ; Online: Is fistulotomy with immediate sphincter reconstruction (FISR) a sphincter preserving procedure for high anal fistula? A systematic review and meta-analysis.

    Iqbal, Nusrat / Dilke, Stella Maye / Geldof, Jeroen / Sahnan, Kapil / Adegbola, Samuel / Bassett, Paul / Tozer, Philip

    Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland

    2021  Volume 23, Issue 12, Page(s) 3073–3089

    Abstract: Aim: This systematic review aimed to assess the outcomes of fistulotomy or fistulectomy and immediate sphincter repair (FISR) in relation to healing, incontinence and sphincter dehiscence both overall and in patients with high anal fistulae.: Methods!# ...

    Abstract Aim: This systematic review aimed to assess the outcomes of fistulotomy or fistulectomy and immediate sphincter repair (FISR) in relation to healing, incontinence and sphincter dehiscence both overall and in patients with high anal fistulae.
    Methods: Medline, Embase and The Cochrane library were searched for studies of patients undergoing FISR for anal fistula. Data regarding healing, continence and sphincter dehiscence were extracted overall and for high anal fistulae. The DerSimonian-Laird random-effects method was used for pooled analysis, heterogeneity between studies was assessed based on the significance of between-study heterogeneity, and on the size of the I
    Results: We identified 21 studies evaluating 1700 patients. Pooled analysis of healing reached 93% (95% CI: 91%-95%, I
    Conclusion: The evidence suggests FISR is a safe, effective procedure. However, data are limited by inconsistencies in reporting of continence and definition of fistula height, particularly high anal fistulae. Significant heterogeneity means that outcomes in high fistulae remain uncertain.
    MeSH term(s) Anal Canal/surgery ; Fecal Incontinence/etiology ; Humans ; Organ Sparing Treatments ; Rectal Fistula/etiology ; Rectal Fistula/surgery ; Treatment Outcome ; Urinary Incontinence
    Language English
    Publishing date 2021-10-22
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.15945
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  5. Article ; Online: Medical-surgical Combined Approach in Perianal Fistulizing Crohn's Disease (CD): Doing it Together.

    Sahnan, Kapil / Adegbola, Samuel O / Fareleira, Ana / Hart, Ailsa / Warusavitarne, Janindra

    Current drug targets

    2019  Volume 20, Issue 13, Page(s) 1373–1383

    Abstract: Fistulising perianal Crohn's disease (pCD) is an aggressive phenotype, and patients not only suffer from perianal manifestations but also a worsening course for their luminal disease. This article describes the 6 key steps clinicians need to consider ... ...

    Abstract Fistulising perianal Crohn's disease (pCD) is an aggressive phenotype, and patients not only suffer from perianal manifestations but also a worsening course for their luminal disease. This article describes the 6 key steps clinicians need to consider when managing patients with pCD which include; (i) ensuring a prompt diagnosis, (ii) multi-disciplinary management, (iii) psychological support, (iv) using multimodal medical and surgical treatment strategies, (v) continually monitoring and optimising therapy and (vi) ensuring that patients have a way of accessing care if required. Patients with fistulising pCD often have an unpredictable disease course and complete remission can be elusive. As such, a considered and nuanced approach is essential keeping the wider multi-disciplinary team and the patient involved in all decision making.
    MeSH term(s) Combined Modality Therapy/methods ; Crohn Disease/complications ; Crohn Disease/therapy ; Disease Progression ; Fistula/etiology ; Fistula/therapy ; Humans ; Remission Induction ; Severity of Illness Index
    Language English
    Publishing date 2019-05-29
    Publishing country United Arab Emirates
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2064859-5
    ISSN 1873-5592 ; 1389-4501
    ISSN (online) 1873-5592
    ISSN 1389-4501
    DOI 10.2174/1389450120666190520103454
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  6. Article ; Online: Laparoscopic subtotal colectomy with double-end ileosigmoidostomy in right iliac fossa facilitates second-stage surgery in patients with inflammatory bowel disease.

    Mege, Diane / Frontali, Alice / Pellino, Gianluca / Adegbola, Samuel / Maggiori, Léon / Warusavitarne, Janindra / Panis, Yves

    Surgical endoscopy

    2019  Volume 34, Issue 1, Page(s) 186–191

    Abstract: Background: There is no consensus about the most appropriate management of rectal stump in laparoscopic subtotal colectomy (STC) performed for inflammatory bowel disease (IBD). The objective is to report our experience of laparoscopic STC with double- ... ...

    Abstract Background: There is no consensus about the most appropriate management of rectal stump in laparoscopic subtotal colectomy (STC) performed for inflammatory bowel disease (IBD). The objective is to report our experience of laparoscopic STC with double-end ileosigmoidostomy in the right iliac fossa for IBD.
    Methods: All patients undergoing laparoscopic STC and double-end ileosigmoidostomy in the right iliac fossa for IBD in 2 European expert centres were included.
    Results: From 1999 to 2017, laparoscopic STC and double-end ileosigmoidostomy in right iliac fossa was performed in 213 consecutive patients, including 74 patients in an emergency setting (35%). Conversion to laparotomy was necessary in 9 patients (4%). One patient died postoperatively (0.5%). Postoperative morbidity occurred in 53 patients (25%) after STC, and was major in 18 patients (8%). A second stage was performed in 199 patients (94%), with a mean delay of 4.7 ± 6 months (range 1.4-77). The second stage was an ileorectal anastomosis (n = 50/199; 25%), performed by an elective open incision in the right iliac fossa in 68% of cases; an ileal pouch-anal anastomosis (IPAA) (n = 139; 70%) successfully performed by laparoscopy in 96% of cases; or an abdominoperineal excision with end ileostomy (n = 10; 5%) successfully performed by laparoscopy in 8 cases. After this second stage, postoperative morbidity occurred in 53 patients (27%), and was major in 15 patients (8%). After a mean follow-up of 3.7 ± 3 years (range 0.1-15), stoma rate (end ileostomy and diverting stoma not closed) was 17%, and small bowel obstruction and incisional hernia occurred in 10 (5%) and 25 (12%) patients, respectively.
    Conclusions: Laparoscopic STC and double-end ileosigmoidostomy in right iliac fossa is safe, feasible, and facilitates the second stage for intestinal continuity by either elective incision or laparoscopy in 100% of ileorectal anastomoses and by laparoscopy in 96% of IPAA.
    MeSH term(s) Adult ; Colectomy/methods ; Colon, Sigmoid/surgery ; Enterostomy/methods ; Female ; Follow-Up Studies ; Humans ; Ileum/surgery ; Inflammatory Bowel Diseases/surgery ; Laparoscopy/methods ; Male ; Middle Aged ; Proctocolectomy, Restorative/methods ; Reoperation/methods ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2019-03-14
    Publishing country Germany
    Document type Journal Article ; Observational Study
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-019-06749-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  7. Article: Managing non-IBD fistulising disease.

    Sahnan, Kapil / Adegbola, Samuel / Iqbal, Nusrat / Twum-Barima, Charlene / Reza, Lillian / Lung, Phillip / Warusavitarne, Janindra / Hart, Ailsa / Tozer, Phil

    Frontline gastroenterology

    2020  Volume 12, Issue 6, Page(s) 524–534

    Language English
    Publishing date 2020-07-28
    Publishing country England
    Document type Journal Article
    ZDB-ID 2521857-8
    ISSN 2041-4137
    ISSN 2041-4137
    DOI 10.1136/flgastro-2019-101234
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  8. Article: Current review of the management of fistulising perianal Crohn's disease.

    Adegbola, Samuel O / Sahnan, Kapil / Twum-Barima, Charlene / Iqbal, Nusrat / Reza, Lillian / Lung, Phillip / Warusavitarne, Janindra / Tozer, Phil / Hart, Ailsa

    Frontline gastroenterology

    2020  Volume 12, Issue 6, Page(s) 515–523

    Abstract: Perianal manifestations of Crohn's disease constitute a distinct disease phenotype commonly affecting patients and conferring an increased risk of disability and disease burden. Much research has gone into management of fistulising manifestations, with ... ...

    Abstract Perianal manifestations of Crohn's disease constitute a distinct disease phenotype commonly affecting patients and conferring an increased risk of disability and disease burden. Much research has gone into management of fistulising manifestations, with biological therapy changing the landscape of treatment. In this article, we discuss the up-to-date surgical and medical management of perianal fistulas, highlighting current consensus management guidelines and the evidence behind them, as well as future directions in management.
    Language English
    Publishing date 2020-08-13
    Publishing country England
    Document type Journal Article
    ZDB-ID 2521857-8
    ISSN 2041-4137
    ISSN 2041-4137
    DOI 10.1136/flgastro-2020-101489
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  9. Article ; Online: Anti-TNF Therapy in Crohn's Disease.

    Adegbola, Samuel O / Sahnan, Kapil / Warusavitarne, Janindra / Hart, Ailsa / Tozer, Philip

    International journal of molecular sciences

    2018  Volume 19, Issue 8

    Abstract: Crohn's disease (CD) accounts for a variety of clinical manifestations or phenotypes that stem from chronic inflammation in the gastrointestinal tract. Its worldwide incidence is increasing including younger or childhood-onset of disease. The natural ... ...

    Abstract Crohn's disease (CD) accounts for a variety of clinical manifestations or phenotypes that stem from chronic inflammation in the gastrointestinal tract. Its worldwide incidence is increasing including younger or childhood-onset of disease. The natural history of Crohn's disease is characterized by a remitting and relapsing course that progresses to complications and surgery in most patients. The goals of treatment are to achieve clinical and endoscopic remission, to avoid disease progression and minimise surgical resections. Medical treatment usually features antibiotics, corticosteroids, immunomodulators (thiopurines, methotrexate). Anti-TNF (tumour necrosis factor) therapy was approved for use in Crohn's disease in 1998, and has changed the paradigm of treatment, leading to improved rates of response and remission in patients. There are significant considerations that need to be borne in mind, when treating patients including immunogenicity, safety profile and duration of treatment.
    MeSH term(s) Adrenal Cortex Hormones/therapeutic use ; Animals ; Antibodies, Monoclonal/therapeutic use ; Crohn Disease/drug therapy ; Crohn Disease/immunology ; Gastrointestinal Agents/therapeutic use ; Humans ; Immunologic Factors/therapeutic use ; Methotrexate/therapeutic use
    Chemical Substances Adrenal Cortex Hormones ; Antibodies, Monoclonal ; Gastrointestinal Agents ; Immunologic Factors ; Methotrexate (YL5FZ2Y5U1)
    Language English
    Publishing date 2018-07-31
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2019364-6
    ISSN 1422-0067 ; 1422-0067 ; 1661-6596
    ISSN (online) 1422-0067
    ISSN 1422-0067 ; 1661-6596
    DOI 10.3390/ijms19082244
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

  10. Article: Medical and surgical management of perianal Crohn's disease.

    Adegbola, Samuel O / Pisani, Anthea / Sahnan, Kapil / Tozer, Phil / Ellul, Pierre / Warusavitarne, Janindra

    Annals of gastroenterology

    2018  Volume 31, Issue 2, Page(s) 129–139

    Abstract: Crohn's disease is increasingly thought to encompass multiple possible phenotypes. Perianal manifestations account for one such phenotype and represent an independent disease modifier. In its more severe form, perianal Crohn's disease confers a higher ... ...

    Abstract Crohn's disease is increasingly thought to encompass multiple possible phenotypes. Perianal manifestations account for one such phenotype and represent an independent disease modifier. In its more severe form, perianal Crohn's disease confers a higher risk of a severe and disabling disease course, relapses, hospital admissions and operations. This, in turn, imposes a considerable burden and disability on patients. Identification of the precise manifestation is important, as management is nuanced, with both medical and surgical components, and is best undertaken in a multidisciplinary setting for both diagnosis and ongoing treatment. The introduction of biologic medication has heralded a significant addition to the management of fistulizing perianal Crohn's disease in particular, albeit with modest results. It remains a very challenging condition to treat and further work is required to optimize management in this group of patients.
    Language English
    Publishing date 2018-02-08
    Publishing country Greece
    Document type Journal Article ; Review
    ZDB-ID 2032850-3
    ISSN 1108-7471
    ISSN 1108-7471
    DOI 10.20524/aog.2018.0236
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

To top