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  1. Article ; Online: Parks retractor.

    Nordholm-Carstensen, Andreas

    The British journal of surgery

    2023  Volume 110, Issue 10, Page(s) 1298–1299

    Language English
    Publishing date 2023-09-05
    Publishing country England
    Document type Journal Article
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1093/bjs/znad027
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  2. Article ; Online: [Endoscopic vacuum-assisted treatment of a large supralevator abscess].

    Khalaf, Zerin / Nordholm-Carstensen, Andreas

    Ugeskrift for laeger

    2022  Volume 184, Issue 17

    Abstract: Supralevatory abscesses (SA) are rare entities complicating diagnosis and treatment. We present the case report of a 64-year-old male with a large SA and a low transsphincteric fistula requiring surgery. Due to comorbidities and the size of the SA an ... ...

    Abstract Supralevatory abscesses (SA) are rare entities complicating diagnosis and treatment. We present the case report of a 64-year-old male with a large SA and a low transsphincteric fistula requiring surgery. Due to comorbidities and the size of the SA an endoscopic vacuum therapy (EVC) was placed for adequate drainage with good results at the six weeks follow-up. EVC is minimally invasive with continual drainage, it promotes granulation and reduces the cavity. EVC could be a new method of treating SA in multimorbid patients. However, these patients should be chosen by an experienced surgeon.
    MeSH term(s) Abscess/surgery ; Anus Diseases/surgery ; Drainage/methods ; Endoscopy ; Humans ; Male ; Middle Aged
    Language Danish
    Publishing date 2022-04-29
    Publishing country Denmark
    Document type Case Reports ; Journal Article
    ZDB-ID 124102-3
    ISSN 1603-6824 ; 0041-5782
    ISSN (online) 1603-6824
    ISSN 0041-5782
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  3. Article ; Online: Fistula development after anal abscess drainage-a multicentre retrospective cohort study.

    Skovgaards, Daniel Mark / Perregaard, Helene / Dibbern, Christian Bakholdt / Nordholm-Carstensen, Andreas

    International journal of colorectal disease

    2023  Volume 39, Issue 1, Page(s) 4

    Abstract: Purpose: Anal abscesses are common and, despite correct treatment with surgical drainage, carry the risk of developing fistulas. Studies identifying risk factors for the development of anal fistulas are sparse. This study aimed to identify the risk ... ...

    Abstract Purpose: Anal abscesses are common and, despite correct treatment with surgical drainage, carry the risk of developing fistulas. Studies identifying risk factors for the development of anal fistulas are sparse. This study aimed to identify the risk factors for anal fistulas after anal abscess surgery.
    Methods: This was a multicentre, retrospective cohort study of patients undergoing acute surgery for anal abscesses in the Capital Region of Denmark between 2018 and 2019. The patients were identified using ICD-10 codes for anal abscesses. Predefined clinicopathological factors and postoperative courses were extracted from patient records.
    Results: A total of 475 patients were included. At a median follow-up time of 1108 days (IQR 946-1320 days) following surgery, 164 (33.7%) patients were diagnosed with an anal fistula. Risk factors for developing fistulas were low intersphincteric (OR 2.77, 95CI 1.50-5.06) and ischioanal (OR 2.48, 95CI 1.36-4.47) abscesses, Crohn's disease (OR 5.96, 95CI 2.33-17.2), a history of recurrent anal abscesses (OR 4.14, 95CI 2.47-7.01) or repeat surgery (OR 5.96, 95CI 2.33-17.2), E. coli-positive pus cultures (OR 4.06, 1.56-11.4) or preoperative C-reactive protein (CRP) of more than 100 mg/L (OR 3.21, 95CI 1.57-6.71).
    Conclusion: Several significant clinical risk factors were associated with fistula development following anal abscess surgery. These findings are clinically relevant and could influence the selection of patients for specialised follow-up, facilitate expedited diagnosis, and potentially prevent unnecessarily long treatment courses.
    MeSH term(s) Humans ; Abscess/complications ; Abscess/diagnosis ; Retrospective Studies ; Escherichia coli ; Anus Diseases/complications ; Anus Diseases/surgery ; Rectal Fistula/complications ; Rectal Fistula/surgery ; Drainage/adverse effects ; Treatment Outcome
    Language English
    Publishing date 2023-12-13
    Publishing country Germany
    Document type Multicenter Study ; Journal Article
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-023-04576-6
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  4. Article ; Online: [Transanal endoscopic microsurgery for excision of a symptomatic tailgut cyst].

    Skovgaards, Daniel Mark / Schlesinger, Nis Hallundbæk / Nordholm-Carstensen, Andreas

    Ugeskrift for laeger

    2022  Volume 184, Issue 17

    Abstract: A tailgut cyst is a rare tumour originating from the embryonic remnant of the retrorectal space. The cyst is often asymptomatic, but it can cause abdominal or rectal pain and urogenital symptoms. When diagnosed, resection is the choice of treatment, and ... ...

    Abstract A tailgut cyst is a rare tumour originating from the embryonic remnant of the retrorectal space. The cyst is often asymptomatic, but it can cause abdominal or rectal pain and urogenital symptoms. When diagnosed, resection is the choice of treatment, and traditionally open surgery has been preferred. In this case report, we present a 30-year-old female patient with a painful tailgut cyst. She was found to be candidate for transanal endoscopic microsurgery, which was successfully performed.
    MeSH term(s) Adult ; Cysts/diagnostic imaging ; Cysts/pathology ; Cysts/surgery ; Female ; Humans ; Microsurgery ; Rectal Neoplasms/diagnosis ; Rectum/surgery ; Transanal Endoscopic Microsurgery
    Language Danish
    Publishing date 2022-04-29
    Publishing country Denmark
    Document type Case Reports ; Journal Article
    ZDB-ID 124102-3
    ISSN 1603-6824 ; 0041-5782
    ISSN (online) 1603-6824
    ISSN 0041-5782
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  5. Article ; Online: Perianal Crohn's Disease and the Development of Colorectal and Anal Cancer: A Systematic Review and Meta-analysis.

    Johansen, Martha Pollen / Wewer, Mads Damsgaard / Nordholm-Carstensen, Andreas / Burisch, Johan

    Journal of Crohn's & colitis

    2022  Volume 17, Issue 3, Page(s) 361–368

    Abstract: Background and aims: The aim of this systematic review was to assess the literature on the incidence and risk factors for colorectal cancer and anal cancer in patients with perianal Crohn's disease.: Method: A systematic review of the literature was ... ...

    Abstract Background and aims: The aim of this systematic review was to assess the literature on the incidence and risk factors for colorectal cancer and anal cancer in patients with perianal Crohn's disease.
    Method: A systematic review of the literature was performed using PubMed, Embase and Google Scholar. A meta-analysis was then conducted using a random-effects model.
    Results: Five studies were included in the systematic review. Of the total patients, 26.5% had perianal Crohn's disease. The median follow-up was 6 years. In total, 127 cases of colorectal cancer were found [0.43% of the included Crohn's disease patients]. Perianal involvement was present in 50% of colorectal cancer patients [0.89% of the population]. Three of the studies specified the cancer to be rectal or anal, which were present in 68 and 24 cases [0.3% and 0.1% of patients], respectively. In a subgroup analysis of rectal and anal cancer, perianal involvement was most frequent in anal cancer, accounting for 46% of the cases. In the rectal cancer group, 37% had perianal involvement. The higher incidence of colorectal cancer in patients with perianal Crohn's disease was confirmed in a meta-analysis.
    Conclusion: Half of the patients with colorectal cancer and anal cancer were found to have perianal Crohn's disease. In patients with perianal involvement, there was a higher percentage of anal cancer compared with rectal cancer. These results support the theory that patients with perianal Crohn's disease are at increased risk for developing colorectal and anal cancer. Studies collecting more detailed data regarding patients and their cancers are needed to further specify the disease course.
    MeSH term(s) Humans ; Crohn Disease/complications ; Crohn Disease/epidemiology ; Anus Neoplasms/epidemiology ; Anus Neoplasms/etiology ; Rectal Neoplasms/etiology ; Rectal Neoplasms/complications ; Rectum ; Anal Canal ; Rectal Fistula/etiology
    Language English
    Publishing date 2022-09-21
    Publishing country England
    Document type Meta-Analysis ; Systematic Review ; Journal Article
    ZDB-ID 2390120-2
    ISSN 1876-4479 ; 1873-9946
    ISSN (online) 1876-4479
    ISSN 1873-9946
    DOI 10.1093/ecco-jcc/jjac143
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    Zs.A 6634: Show issues Location:
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  6. Article ; Online: Robot-assisted TAMIS: a systematic review of feasibility and outcomes.

    Jakobsen, P Cornelius H / Krarup, Peter-Martin / Jensen, Kristian K / Nordholm-Carstensen, Andreas

    Surgical endoscopy

    2023  Volume 37, Issue 5, Page(s) 3398–3409

    Abstract: Background: In the advancement of transanal local excision, robot-assisted transanal minimal invasive surgery is the newest development. In the confined area of the rectum, robot-assisted surgery should, theoretically, be superior due to articulated ... ...

    Abstract Background: In the advancement of transanal local excision, robot-assisted transanal minimal invasive surgery is the newest development. In the confined area of the rectum, robot-assisted surgery should, theoretically, be superior due to articulated utensils, video enhancement, and tremor reduction, however, this has not yet been investigated. The aim of this study was to review the evidence reported to-date on experience of using robot-assisted transanal minimal invasive surgery for treatment of rectal neoplasms.
    Methods: A comprehensive literature search of Embase and PubMed from May to August 2021were performed. Studies including patients diagnosed with rectal neoplasia or benign polyps who underwent robot-assisted transanal minimal invasive surgery were included. All studies were assessed for risk of bias through assessment tools. Main outcome measures were feasibility, excision quality, and complications.
    Results: Twenty-five studies with a total of 322 local excisions were included. The studies included were all retrospective, primarily case-reports, -series, and cohort studies. The median distance from the anal verge ranged from 3.5 to 10 cm and the median size was between 2.5 and 5.3 cm. Overall, 4.6% of the resections had a positive resection margin. The overall complication rate was at 9.5% with severe complications (Clavien-Dindo score III) at 0.9%.
    Conclusion: Based on limited, retrospective data, with a high risk of bias, robot-assisted transanal minimal invasive surgery seems feasible and safe for local excisions in the rectum.
    MeSH term(s) Humans ; Robotics ; Retrospective Studies ; Feasibility Studies ; Rectum/surgery ; Rectal Neoplasms/surgery ; Anal Canal/surgery ; Transanal Endoscopic Surgery ; Margins of Excision ; Treatment Outcome
    Language English
    Publishing date 2023-01-27
    Publishing country Germany
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-022-09853-z
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    Zs.A 2214: Show issues Location:
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  7. Article ; Online: Pulmonary nodules and metastases in colorectal cancer.

    Nordholm-Carstensen, Andreas

    Danish medical journal

    2016  Volume 63, Issue 1, Page(s) B5190

    Abstract: Patients with newly diagnosed colorectal cancer (CRC) are subjected to a preoperative thoraco-abdominal CT scan to determine the cancer stage. This staging is of relevance with regard to treatment and prognosis. About 20% of the patients have distant ... ...

    Abstract Patients with newly diagnosed colorectal cancer (CRC) are subjected to a preoperative thoraco-abdominal CT scan to determine the cancer stage. This staging is of relevance with regard to treatment and prognosis. About 20% of the patients have distant metastatic spread at the time of diagnosis, i.e. synchronous metastases. Most common are hepatic metastases followed by pulmonary involvement. The optimal staging modality for detecting synchronous pulmonary metastases is debated. It has been argued, that synchronous pulmonary metastases (SPCM) are rare in CRC and that the consequence of detecting SPCM is minimal. Furthermore, the current staging practice is complicated by a high number of incidental findings on the thoracic CT, so-called indeterminate pulmonary nodules (IPN). IPN can potentially represent SPCM. The purpose of this thesis was to estimate the prevalence, characteristics and clinical significance of IPN and SPCM detected at the primary staging in CRC. Study I was a systematic review of published studies on IPN in CRC focusing on the prevalence and radiological characteristics of IPN proving to be malignant. This knowledge would be of value in management strategies for IPN. On average 9% of all patients staged with a thoracic CT had IPN, however, the prevalence varied significantly between patients series. This was mainly attributed to varying/lacking definitions on IPN and variable radiological expertise in the assessment of the scans. Data were too inconsistently reported in the case series for a robust statement to be made on potential radiological characteristics suggestive of malignancy in IPN. Lymph node metastasis was the most common clinicopathological finding associated with malignancy of IPN. In conclusion, one patient of every 100 scanned patients had an IPN proving to a SPCM at follow-up, but we found no evidence that IPN should result in intensified diagnostic work-up besides routine follow-up for CRC. Study II was an analysis of the prevalence of and risk factors for SPCM in a Danish nationwide cohort of patients with newly diagnosed CRC from 2001 to 2011. SPCM were detected in 7.5% of the patients and in 37% of these cases the metastatic spread was confined to the lungs. The prevalence of SPCM increased with the implementation of thoracic CT in CRC staging. SPCM impaired survival significantly and was associated with increasing age and rectal cancer. Resection of the primary tumour, resection of the SPCM and treatment with chemotherapy were associated with improved survival. Unfortunately, however, only very few patients were subjected to all three treatment measures, and the improved prognosis could simply be the result of a selection bias. The inter-observer variation in classification of findings at thoracic CT scans was investigated in study III and was based on staging CT scans from a local cohort of patients with newly diagnosed CRC. Based on an experienced thoracic radiologist's assessment of the scans, we searched for radiological characteristics of IPN that could predict malignancy of the nodule. There was a significant difference in the number of IPNs detected between the primary and the thoracic radiologist's assessment. The thoracic radiologist classified fewer nodules as IPN and even reported with higher specificity and sensitivity for SPCM. More than 20% of IPNs (as classified by the thoracic radiologist) proved to be SPCM. Unfortunately, no radiological characteristics could be associated with a malignant outcome. In continuation of these findings we suggested a secondary review of scans with IPN be a group of dedicated thoracic radiologists. This approach might reduce the need for additional work-up for IPN and calls for clarification in future prospective studies. Identification of patients in particular risk of SPCM could be of value in the assessment of pulmonary nodules. Several biomarkers have been proposed for differential metastatic patterns in CRC. In study IV we investigated the significance of mismatch repair status (MMR) for the location of metastatic spread in a nationwide Danish cohort of patients with newly diagnosed CRC between 2010 and 2012. Deficient MMR was associated with a reduced risk of synchronous metastatic disease, however, the risk reduction only applied to hepatic metastases. MMR had no impact on SPCM and is therefore currently of no use in the assessment of IPN.
    MeSH term(s) Cohort Studies ; Colorectal Neoplasms/classification ; Colorectal Neoplasms/epidemiology ; Colorectal Neoplasms/pathology ; Colorectal Neoplasms/therapy ; Denmark/epidemiology ; Disease Management ; Early Detection of Cancer/methods ; Early Detection of Cancer/statistics & numerical data ; Female ; Humans ; Lung Neoplasms/diagnosis ; Lung Neoplasms/epidemiology ; Lung Neoplasms/secondary ; Lung Neoplasms/therapy ; Male ; Middle Aged ; Neoplasm Staging ; Prevalence ; Risk Factors
    Language English
    Publishing date 2016-01
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 2648771-8
    ISSN 2245-1919 ; 2245-1919
    ISSN (online) 2245-1919
    ISSN 2245-1919
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  8. Article ; Online: Fistula Laser Closure (FiLaC™) for fistula-in-ano-yet another technique with 50% healing rates?

    Nordholm-Carstensen, Andreas / Perregaard, Helene / Hagen, Kikke Bartholin / Krarup, Peter-Martin

    International journal of colorectal disease

    2021  Volume 36, Issue 9, Page(s) 1831–1837

    Abstract: Purpose: Treatment of ano-cutaneous fistulas remains a therapeutic challenge. Fistula Laser Closure (FiLaC™) is a relatively new technique for the treatment of ano-cutaneous fistulas. This study aimed to determine the success rate of fistula closure ... ...

    Abstract Purpose: Treatment of ano-cutaneous fistulas remains a therapeutic challenge. Fistula Laser Closure (FiLaC™) is a relatively new technique for the treatment of ano-cutaneous fistulas. This study aimed to determine the success rate of fistula closure using FiLaC™. Secondary endpoints included adverse events and patient characteristics associated with treatment success.
    Methods: This was a retrospective cohort study of consecutive patients subjected to FiLaC™ at Digestive Disease Center, Bispebjerg University Hospital, Copenhagen, between March 2017 and July 2019. All patients had a one-track fistula not suitable for fistulotomy. All were treated with a draining seton for at least 8 weeks prior to laser closure. Fistulas were ablated with a 360-degree emitting 12-watt 1470 nm laser probe. The inner fistula opening was closed with absorbable suture. All patients were followed with clinical examination including MRI or EAUS 1 year after the procedure.
    Results: In total, 66 patients with 68 fistulas were included. Two patients had a high intersphincteric, 20 had low transsphincteric, 41 high transsphincteric and 5 had suprasphincteric fistulas. Fistula aetiology was cryptoglandular in 83.8%, whereas the rest were due to Crohn's disease. Thirty-one (45.6%) were subjected to a second FiLaC™ procedure. Follow-up was median 19 months (12-26 months). Ultimately, 30 of 68 (44.1%) of the fistulas healed. No cases of incontinence following FiLaC™ were observed, but a single patient developed an abscess.
    Conclusion: Fistula closure with FiLaC™ had success rates comparable to that of other sphincter-sparing techniques. The technique seems safe with respect to adverse events and risk of incontinence.
    MeSH term(s) Anal Canal ; Humans ; Lasers ; Organ Sparing Treatments ; Rectal Fistula/etiology ; Rectal Fistula/surgery ; Retrospective Studies ; Treatment Outcome
    Language English
    Publishing date 2021-04-21
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 84975-3
    ISSN 1432-1262 ; 0179-1958
    ISSN (online) 1432-1262
    ISSN 0179-1958
    DOI 10.1007/s00384-021-03932-8
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  9. Article ; Online: Lateral internal sphincterotomy (LIS) using endoanal ultrasound - a video vignette.

    Perregaard, Helene / Hagen, Kikke B / Krarup, Peter-Martin / Nordholm-Carstensen, Andreas

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

    2021  Volume 23, Issue 11, Page(s) 3038–3039

    MeSH term(s) Anal Canal/diagnostic imaging ; Anal Canal/surgery ; Chronic Disease ; Fissure in Ano ; Humans ; Lateral Internal Sphincterotomy ; Treatment Outcome ; Ultrasonography
    Language English
    Publishing date 2021-09-14
    Publishing country England
    Document type Letter ; Video-Audio Media
    ZDB-ID 1440017-0
    ISSN 1463-1318 ; 1462-8910
    ISSN (online) 1463-1318
    ISSN 1462-8910
    DOI 10.1111/codi.15900
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  10. Article ; Online: [Treatment of perianal fistulas with mesenchymal stem cells].

    Dalby, Helene Rask / Perregaard, Helene / Dige, Anders / Hagen, Kikke Bartholin / Nordholm-Carstensen, Andreas / Lundby, Lilli

    Ugeskrift for laeger

    2022  Volume 184, Issue 14

    Abstract: Treatment of perianal fistulas are challenged by insufficient healing and a high rate of relapse. Existing sphincter-sparing procedures have healing rates of around 50%. Treatment with mesenchymal stem cells of both autologous and allogenic origin and ... ...

    Abstract Treatment of perianal fistulas are challenged by insufficient healing and a high rate of relapse. Existing sphincter-sparing procedures have healing rates of around 50%. Treatment with mesenchymal stem cells of both autologous and allogenic origin and freshly collected autologous adipose tissue show both promising healing rates and few complications and may be offered to patients with complicated fistulas not suited for other treatment modalities.
    MeSH term(s) Anal Canal ; Cutaneous Fistula ; Humans ; Mesenchymal Stem Cell Transplantation/adverse effects ; Mesenchymal Stem Cell Transplantation/methods ; Mesenchymal Stem Cells ; Organ Sparing Treatments/adverse effects ; Rectal Fistula/etiology ; Rectal Fistula/surgery ; Treatment Outcome
    Language Danish
    Publishing date 2022-04-12
    Publishing country Denmark
    Document type Journal Article
    ZDB-ID 124102-3
    ISSN 1603-6824 ; 0041-5782
    ISSN (online) 1603-6824
    ISSN 0041-5782
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