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Book: Anal and rectal diseases

Ehrenpreis, Eli D. / Avital, Shmuel / Singer, Marc

a concise manual

2012

Author's details	Eli D. Ehrenpreis ; Shmuel Avital ; Marc Singer ed
Keywords	Anus--Diseases ; Rectum--Diseases ; Anorektale Krankheit ; Anorektale Missbildung ; Coloskopie ; Hämorrhoiden ; Darmkrebs
Subject	Intestinalcarcinom ; Darmkarzinom ; Hämorriden ; Koloskopie ; Colonoskopie ; Kolonoskopie ; Anorektale Fehlbildung ; Anorectale Krankheit
Subject code	616.35
Language	English
Size	XIII, 277 S. : zahlr. Ill., graph. Darst., 24 cm
Publisher	Springer
Publishing place	New York u.a.
Publishing country	United States
Document type	Book
HBZ-ID	HT017068368
ISBN	978-1-4614-1101-7 ; 1-4614-1101-7 ; 9781461411024 ; 1461411025
Database	Catalogue ZB MED Medicine, Health

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Article: Appendiceal actinomycosis mimicking malignant tumor: a rare case report.

Khabyeh-Hasbani, Nathan / Zino, Sivan / Dima, Elena / Avital, Shmuel

Annals of medicine and surgery (2012)

2024 Volume 86, Issue 2, Page(s) 1076–1079

Abstract: Introduction: Actinomycosis is an uncommon bacterial infection caused by : Presentation of case: Upon initial presentation, a 53-year-old woman with type II diabetes mellitus and no prior surgical history, displayed abnormal appendiceal uptake during ...

Abstract	Introduction: Actinomycosis is an uncommon bacterial infection caused by Presentation of case: Upon initial presentation, a 53-year-old woman with type II diabetes mellitus and no prior surgical history, displayed abnormal appendiceal uptake during a PET-computed tomography (CT) scan conducted for a suspected spinal tumour. Colonoscopy did not indicate any notable observations, and the patient chose to defer immediate action. Several months later, a CT scan revealed an increased mass-like appearance of the appendix compared to the previous PET-CT scan. After multidisciplinary discussions, a right laparoscopic hemicolectomy was recommended due to suspected malignancy. However, histological staining on microscopy confirmed actinomycosis originating from the appendix. Discussion: Chronic appendicitis with radiologic features similar to appendiceal carcinoma, or abdominal masses located in the ileocecal area, in patients with or without a previous surgical history should raise suspicion of actinomycosis. Conclusion: Appendiceal actinomycosis should be considered in the differential diagnosis in the aetiology of chronic appendicitis mimicking appendiceal carcinoma. Awareness and accurate diagnosis of appendiceal actinomycosis can prevent unnecessary extended surgery as was performed in this case.
Language	English
Publishing date	2024-01-03
Publishing country	England
Document type	Case Reports
ZDB-ID	2745440-X
ISSN	2049-0801
ISSN	2049-0801
DOI	10.1097/MS9.0000000000001564
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: A three layered repair of a large perineal hernia: case report and review of the literature.

Soback, Hagai / Lahav, Lauren / Franko, Rotem / Avital, Shmuel

Surgical case reports

2023 Volume 9, Issue 1, Page(s) 58

Abstract: Background: A symptomatic perineal hernia is an uncommon complication after abdominoperineal resection (APR). Repairs of such hernias can be achieved by usage of autologous flaps, synthetic mesh, or biologic mesh, which reduce bowel adhesions. Studies ... ...

Abstract	Background: A symptomatic perineal hernia is an uncommon complication after abdominoperineal resection (APR). Repairs of such hernias can be achieved by usage of autologous flaps, synthetic mesh, or biologic mesh, which reduce bowel adhesions. Studies have shown that prophylactic repair of the pelvic floor with biologic mesh during APR, can reduce the incidence of perineal hernia. Case presentation: A 71-year-old woman, after extended APR (eAPR) with primary closure of pelvic floor with absorbable mesh, presented to our outpatient clinic with a symptomatic, extensive perineal hernia. The patient underwent repair of the perineal hernia using a synthetic mesh and a bilateral gluteal flap procedure. In post operative care, signs of surgical site infection and a fluid collection demonstrated in a CT-scan, compelled a surgical drainage. A clear fluid negative for bacterial growth was drained and antibiotic treatment was initiated. After drainage, surgical site showed signs of significant improvement and patient was eventually discharged. Conclusion: The rise in reported incidence of perineal hernia after eAPR coupled with the scarcity of data regarding the preferable repair technique suggests that there is a significant need for further prospective comparative studies.
Language	English
Publishing date	2023-04-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2809613-7
ISSN	2198-7793
ISSN	2198-7793
DOI	10.1186/s40792-023-01636-5
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Article ; Online: The Effect of Different Staple Sizes on Leak Pressure Among Patients Undergoing Sleeve Gastrectomy: a Pilot Study.

Hajeychia, Ihav / Avital, Shmuel / Tyomkin, Vitaly / Goldberg, Nitzan / Inbar, Roye

Obesity surgery

2023 Volume 33, Issue 4, Page(s) 1292–1294

Abstract: Gastric leak after LSG is a devastating complication, reported in less than 1% of cases. Consensus is lacking regarding the best approach to construct the sleeve, staple sizes, and reinforcement methods on potential leak development. In this study, we ... ...

Abstract	Gastric leak after LSG is a devastating complication, reported in less than 1% of cases. Consensus is lacking regarding the best approach to construct the sleeve, staple sizes, and reinforcement methods on potential leak development. In this study, we have compared the leak pressure of two different staple sizes in the resected portion of the stomach, immediately after its removal. Fifteen patients were enrolled. Leak pressure of a vascular, small-size stapler was significantly higher than that of a medium-size one. All leaks appeared in the proximal third of the resected stomach. These results may have clinical implication. Since other factors may play a role in the risk for leaks following sleeve gastrectomy, a large, prospective clinical trial should be performed comparing the two staple sizes in laparoscopic sleeve gastrectomy.
MeSH term(s)	Humans ; Pilot Projects ; Surgical Stapling/adverse effects ; Prospective Studies ; Anastomotic Leak/etiology ; Obesity, Morbid/surgery ; Laparoscopy/methods ; Gastrectomy/adverse effects ; Gastrectomy/methods
Language	English
Publishing date	2023-02-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-023-06491-9
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Article: Succinylcholine Induced Rhabdomyolysis in a Heavy Marijuana Smoker: A Case Report.

Shenfeld, Itamar / Nativ, Hilli / Avital, Shmuel

The Israel Medical Association journal : IMAJ

2022 Volume 24, Issue 10, Page(s) 687–688

MeSH term(s)	Humans ; Succinylcholine/adverse effects ; Cannabis ; Smokers ; Rhabdomyolysis/chemically induced ; Rhabdomyolysis/diagnosis ; Anesthesia, General ; Cannabinoid Receptor Agonists ; Analgesics
Chemical Substances	Succinylcholine (J2R869A8YF) ; Cannabinoid Receptor Agonists ; Analgesics
Language	English
Publishing date	2022-10-12
Publishing country	Israel
Document type	Case Reports ; Journal Article
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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Article ; Online: NF-kappa B expression in resected specimen of colonic cancer is higher compared to its expression in inflammatory bowel diseases and polyps.

Berkovich, Liron / Gerber, Mirit / Katzav, Aviva / Kidron, Debora / Avital, Shmuel

Scientific reports

2022 Volume 12, Issue 1, Page(s) 16645

Abstract: NF-Kappa B has a significant role in inflammatory processes as well as in colorectal cancer. The aim of this study was to compare the expression of NF-kappa B in colonic adenocarcinoma specimen, colonic adenomas and inflammatory colonic tissues. Patients ...

Abstract	NF-Kappa B has a significant role in inflammatory processes as well as in colorectal cancer. The aim of this study was to compare the expression of NF-kappa B in colonic adenocarcinoma specimen, colonic adenomas and inflammatory colonic tissues. Patients with colorectal cancer (CRC), colonic adenomas and inflammatory processes undergoing surgery were recruited. Following a routine pathological evaluation tissue samples were stained using anti NF-κB monoclonal antibodies. Expression of NF-κB was quantified using IMAGEJ program for immunohistochemistry staining. Samples were also stained and quantified for CEA expression. Fifty-six patients were included. 30 cancers, 6 polyps and 20 inflammatory processes. Expression of NF-κB was similar between polypoid and inflammation etiologies. However, it was significantly higher in CRC compared to both (p < 0.05). In cancer patients, NF-κB expression in the resection margins was correlated with positive node status. CEA expression was higher in the cancer group, less in the IBD group and the lowest in the colonic non diseased margins. Our results provide a supportive evidence that NF-κB pathway is strongly involved in colon cancer development and metastasis. Interestingly, expression of NF-κB in benign polypoid lesions was as high as in inflammatory etiologies. This support the role of NF-κB early in the adenoma to carcinoma sequence. Further research is needed to evaluate the exact role of NF-κB in tumor progression in order to look for diagnostic and therapeutic possibilities.
MeSH term(s)	Adenoma/surgery ; Antibodies, Monoclonal ; Colonic Neoplasms/pathology ; Humans ; Inflammatory Bowel Diseases/pathology ; NF-kappa B/metabolism
Chemical Substances	Antibodies, Monoclonal ; NF-kappa B
Language	English
Publishing date	2022-10-05
Publishing country	England
Document type	Journal Article
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-022-21078-7
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Article ; Online: The author replies.

Avital, Shmuel

Diseases of the colon and rectum

2013 Volume 56, Issue 4, Page(s) e50

MeSH term(s)	Colon/surgery ; Crohn Disease/pathology ; Crohn Disease/surgery ; Cutaneous Fistula/etiology ; Female ; Humans ; Ileum/surgery ; Intestinal Fistula/etiology ; Male
Language	English
Publishing date	2013-04
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	212581-x
ISSN	1530-0358 ; 0012-3706
ISSN (online)	1530-0358
ISSN	0012-3706
DOI	10.1097/DCR.0b013e3182821dc1
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Article ; Online: The impact of COVID-19 pandemic lockdown on the incidence and outcome of complicated appendicitis.

Rudnicki, Yaron / Soback, Hagai / Mekiten, Ori / Lifshiz, Guy / Avital, Shmuel

Surgical endoscopy

2021 Volume 36, Issue 5, Page(s) 3460–3466

Abstract: Background: Patient attendance at emergency departments (EDs) during the COVID-19 pandemic outbreak has decreased dramatically under the "stay at home" and "lockdown" restrictions. By contrast, a notable rise in severity of various surgical conditions ... ...

Abstract	Background: Patient attendance at emergency departments (EDs) during the COVID-19 pandemic outbreak has decreased dramatically under the "stay at home" and "lockdown" restrictions. By contrast, a notable rise in severity of various surgical conditions was observed, suggesting that the restrictions coupled with fear from medical facilities might negatively impact non-COVID-19 diseases. This study aims to assess the incidence and outcome of complicated appendicitis (CA) cases during that period. Methods: A retrospective study comparing the rate and severity of acute appendicitis (AA) cases during the COVID-19 initial outbreak in Israel during March and April of 2020 (P20) to the corresponding period in 2019 (P19) was conducted. Patient data included demographics, pre-ED status, surgical data, and postoperative outcomes. Results: Overall, 123 patients were diagnosed with acute appendicitis, 60 patients during P20 were compared to 63 patients in P19. The rate of complicated appendicitis cases was significantly higher during the COVID-19 Lockdown with 43.3% (26 patients) vs. 20.6% (13 patients), respectively (p < 0.01). The average delay in ED presentation between P20 and P19 was 3.4 vs. 2 days (p = 0.03). The length of stay was 2.6 days in P20 vs. 2.3 days in P19 (p = 0.4), and the readmission rate was 12% (7 patients) vs. 4.8% (3 patients), p = 0.17, respectively. Logistic regression demonstrated that a delay in ED presentation was a significant risk factor for complicated appendicitis (OR 1.139, CI 1.011-1.284). Conclusion: The effect of the COVID-19 initial outbreak and Lockdown coupled with hesitation to come to medical facilities appears to have discouraged patients with acute appendicitis from presenting to the ED as complaints began, causing a delay in diagnosis and treatment, which might have led to a higher rate of complicated appendicitis cases and a heavier burden on health care systems.
MeSH term(s)	Acute Disease ; Appendectomy/adverse effects ; Appendicitis/diagnosis ; Appendicitis/epidemiology ; Appendicitis/surgery ; COVID-19/epidemiology ; Communicable Disease Control ; Humans ; Incidence ; Length of Stay ; Pandemics ; Retrospective Studies
Language	English
Publishing date	2021-07-26
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-021-08667-9
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Article: Considerations for Improved Technique Survival Following Insertion of a Peritoneal Dialysis Catheter.

Slavin, Moran / Avital, Shmuel / Einbinder, Yael / Benjamin, Barak / Inbar, Roye

The Israel Medical Association journal : IMAJ

2021 Volume 23, Issue 3, Page(s) 174–179

Abstract: Background: Peritoneal dialysis (PD) is a treatment option for patients with end-stage renal disease (ESRD) and cardiorenal syndrome (CRS).: Objectives: To evaluate the outcome of this patient population.: Methods: A retrospective study was ... ...

Abstract	Background: Peritoneal dialysis (PD) is a treatment option for patients with end-stage renal disease (ESRD) and cardiorenal syndrome (CRS). Objectives: To evaluate the outcome of this patient population. Methods: A retrospective study was conducted of patients who underwent an open or laparoscopic insertion of a PD catheter at our institution between 2009 and 2017. Data included demographics, peri-operative parameters, and long-term outcome. Patient and technique survival curves are presented, including subgroup analysis by method of catheter insertion and techniques for infection prevention. Results: The study population included 95 men and 42 women, aged 65.7 ± 12.4 years. Mean follow-up was 34.6 ± 27.3 months. Open insertion was performed in 113 cases, while 24 underwent laparoscopic insertion. There was no difference in technique survival between these groups (P = 0.943). Removal of the catheter was required in 66% of patients. Median technique survival was 12.1 months. Two-year technique survival was 37% and 5-year technique survival was 12%. The leading cause for catheter removal was infection (69%). Application of measures for prevention of infections were significantly associated with prolonged technique survival (P = 0.001). Technique survival after 2 years was 38% with the application of a single measure and 57% with the application of two measures (P = 0.001). CRS patients (n=24) had a significantly lower overall survival rate (2-year survival 20% vs. 74%, P = 0.001). Conclusions: The method of catheter insertion has no effect on technique survival. Prevention of infections is the most significant factor for improving the technique survival rates.
MeSH term(s)	Aged ; Catheters, Indwelling ; Device Removal ; Equipment Failure ; Female ; Humans ; Kaplan-Meier Estimate ; Kidney Failure, Chronic/therapy ; Laparoscopy ; Male ; Middle Aged ; Peritoneal Dialysis/instrumentation ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-03-18
Publishing country	Israel
Document type	Journal Article
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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Article: Postoperative CRP Levels Can Rule out Anastomotic Leaks in Crohn's Disease Patients.

Slavin, Moran / Goldstein, Avigayil / Raguan, Barak / Rudnicki, Yaron / Avital, Shmuel / White, Ian

Journal of personalized medicine

2022 Volume 12, Issue 1

Abstract: Background: In colorectal cancer, C-reactive protein (CRP) levels on postoperative days 3-4 have a strong negative predictive value for an anastomotic leak, with threshold values of ~15 on post-operative day (POD) 3 and ~13 on POD 4. In Crohn's disease, ...

Abstract	Background: In colorectal cancer, C-reactive protein (CRP) levels on postoperative days 3-4 have a strong negative predictive value for an anastomotic leak, with threshold values of ~15 on post-operative day (POD) 3 and ~13 on POD 4. In Crohn's disease, CRP levels are perceived as unreliable in the postoperative period because of the underlying inflammatory process. The aim of this study was to determine whether postoperative CRP levels can be used to rule out anastomotic leaks in patients with Crohn's disease and to set CRP threshold values for this population. Methods: This was a retrospective study of a population of Crohn's disease patients who underwent surgery with bowel anastomoses at a single high-volume center between 1/2012 and 12/2017. The operations were performed by a single colorectal consultant who is an inflammatory bowel disease specialist. Results: Ninety-two operations were performed. A CRP level of 19.56 mg/dL on postoperative day 3 had an area under the curve of 0.865 (sensitivity 88%, specificity 73%) and a negative predictive value (NPV) of 98% for an anastomotic leak. Patients with an anastomotic leak showed a trend towards decreased postoperative albumin levels (p = 0.06). Conclusions: Mean CRP levels and CRP threshold values were indeed higher in the study population compared with those in colorectal cancer patients. Threshold values were set at 20.3 mg/dL on POD 3, 19.5 mg/dL on POD 4 and 16.7 mg/dL on POD 5. These values had high NPVs and can be used to rule out anastomotic leaks in patients with Crohn's disease after surgery with bowel anastomosis.
Language	English
Publishing date	2022-01-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm12010054
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