BACKGROUND Sacral neuromodulation (SNM) has emerged as a treatment option for faecal incontinence (FI). However, its objective effect on symptoms and anorectal function is inconsistently described. This study aimed to systematically review the impact of SNM on clinical symptoms and gastrointestinal physiology in patients with FI, including factors that may predict treatment outcome. METHODS A...

INTRODUCTION Transanal endoscopic microsurgery (TEM) is a method of choice for the local treatment of rectal adenomas. Though generally considered as a safe method, some authors have expressed skepticism about the anorectal function following TEM. AIM To review our experience in using TEM for removal of rectal adenomas. We focused on morbidity, local recurrence rates, and anorectal function f...

PURPOSE Clinical studies have demonstrated that stapled transanal rectal resection with Contour Transtar (Transtar procedure) is a safe and effective treatment for patients with obstructive defecation syndrome. The aim of this study was to determine functional outcome and quality of life after the procedure. METHODS Female patients with obstructive defecation syndrome were enrolled prospectiv...

We describe our experience with blowgun dart aspiration via an illustrative case series and review the resources available to teach children how to construct these objects. A 15-year-old boy presented with cough, wheeze, and eventually admitted to aspiration of a homemade blowgun dart. This instance heightened the awareness of our experience with blowgun dart aspiration as 3 cases presented wit...

PURPOSE Laparoscopic procedures for the treatment of patients with a rectal prolapse have gained increasing worldwide acceptance because they have lower recurrence and better functional outcome than perineal procedures. Nevertheless, ideal surgical methods are still not available. We propose a new surgical technique, laparoscopic vaginal suspension and rectopexy, for correcting a full-thickness...

CONTEXT Anismus is a prevalent functional cause of outlet delay. It is characterized by symptoms of obstructed defecation associated with paradoxical contraction of the pelvic floor muscles. OBJECTIVE To evaluate the ability of two dimensional anal ultrasonography to identify anismus patients with paradoxical contraction or normal relaxation, comparing findings with manometric measurements. ...

BACKGROUND Although interest in sphincter-sparing treatments for anal fistulas is increasing, few large prospective studies of these approaches have been conducted. OBJECTIVE The study assessed outcomes after implantation of a synthetic bioabsorbable anal fistula plug. DESIGN A prospective, multicenter investigation was performed. SETTING The study was conducted at 11 colon and rectal cen...

Purpose: Anal incontinence is a very stigmatizing condition, which affects biopsychosocially the patient. It is a neglected, but quite common complication of obstetric and anorectal surgery, however it has treatment options. None of the treatment options have exceptional efficacy rates and still associated with risk of recurrence. The surgery techniques known are: anterior and posterior shorten...

BACKGROUND With the increased usage of neoadjuvant chemoradiotherapy, improved surgical technique and stapling devices, sphincter-preserving resection has become more frequent for patients with rectal cancer. However, as for locally advanced ultra-low rectal cancer, sphincter-preservation is still facing an enormous challenge. OBJECTIVE To introduce an NLT strategy of sphincter-preservation-n...

Preoperative imaging for left atrial appendage closure (LAAC) is essential LAA sizing and thrombus assessment. Transesophageal echocardiography (TEE) cardiac computed tomography angiography (CCTA) have been utilized to date this purpose. During the recent global iodine contrast shortage, magnetic resonance (CMR) was as an alternative modality. The purpose of study assess CMR vs CCTA preoperativ...